Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study Clinical Trial Controlled Clinical Trial[Complications after harvesting of autologous bone from the ventral and dorsal iliac crest - a prospective, controlled study].
In a prospective, controlled study, donor site morbidity after bone graft harvesting from the anterior and posterior iliac crest was documented. ⋯ Bone graft harvesting from the posterior iliac crest should be preferred over harvesting from the anterior iliac crest beeause of the substantially reduced donor site morbidity. Harvesting from the ventral iliac crest should have a clear indication, synthetic bone substitutes should be taken into consideration.
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study[Evidence-based medicine in orthopaedics - a sensible or unnecessary addition to clinical routine? Part 2: the therapy tool].
In the second part of our project to implement evidence-based medicine into day-to-day clinical practice the module therapy is presented. ⋯ In conclusion we can show, that EBM can help to solve day-to-day clinical problems, because the structured analysis concerning valid answers to concrete clinical problems is possible.
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study[Evidence-based medicine in orthopedics - a sensible or unnecessary addition to clinical routine? Part 1: the diagnostics tool].
The methods of evidence based medicine (EBM) are recommended to solve problems in day-to-day routine. Aim of this article is to demonstrate the practicability of this procedure for the diagnostic module. ⋯ In conclusion we show that EBM can help to solve day-to-day clinical problems, because the structured analysis of concrete questions can lead to a validation of the literature.
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Z Orthop Ihre Grenzgeb · May 2003
Comparative Study[DRG based development of revenues in orthopaedic surgery. A comparison on the development of cost weights and average lengths of hospital stay in Germany (G-DRG V1.0) and in Australian teaching hospitals (AR-DRG 4.1)].
In September 2002 the Federal Ministry of Health (BMG) has passed a decree in respect to the diagnosis related group system (G-DRG) for German hospitals (KFPV). From 2003 on the basis of this decree German hospitals were offered for the first time to use the G-DRG system optionally according to the " Section 17b Abs.4 of the Hospital Financing Law (Krankenhausfinanzierungsgesetz-KHG)". In addition the preliminary calculation data for the German DRG-System were published. The goal of this study was to compare the development of the cost weights and the average lengths of hospital stay in Australian teaching hospitals between 1998 and 2001 with the cost weights and average lengths of hospital stay in German hospitals according to the data published in the first German calculation (G-DRG V1.0). ⋯ A high quality of right-coding of ICD and ICPM Codes is a prerequisite to reach the correct revenue-relevant DRG. In Germany the average length of hospital stay is significantly longer than in Australia. In general the MDC-8-DRG's have demonstrated a smaller range when compared with the first calculated German DRG's in respect to the complexity of the procedures. Future management of the expected reductions in hospital stay will be based on a continuous co-operative efforts to improve the structural-, process- and (clinical guidelines and clinical pathways) and outcome quality of our medical procedures. The central objective of this effort is the well-being of our patients.
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Z Orthop Ihre Grenzgeb · May 2003
[Treatment of periprosthetic femoral fractures associated with total hip arthroplasty].
Periprosthetic femoral fractures represent a heterogeneous type of injury with a variety of treatment options. By retrospectively analysing our data, the results of different therapeutic procedures are compared and, reviewing previously published cases, suggestions for the management have also been developed. ⋯ Due to their different clinical presentations periprosthetic fractures need to be managed individually and in most cases operatively. Internal fixation with a plate proved to give the best functional results for stable stem implants. Loosening stems have to be replaced by revision implants with long stems for intramedullary fixation. Alternative osteosynthetic techniques and additive minimal osteosynthesis can be favoured in special cases. Modular prostheses for bone replacement are reserved for fractures with extensive bone loss.