Unfallchirurgie
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The occupational radiation exposure of trauma surgeons has increased over the last few years as a result of biologic orthopaedic procedures like intramedullary nailing as closed reduction and insertion of distal interlocking screws need fluoroscopic control. In order to assess the surface doses of the primary surgeon with and without lead shield of the thyroid we performed in vitro measurements during operative procedures of the lower extremities simulating different intraoperative situations under fluoroscopic control. ⋯ In a previous study we found average fluoroscopy times during intramedullary nailing of tibia and femur of 4.6 min per procedure. Extrapolation of this value leads to the result, that even when 1000 intramedullary nailings were carried out without wearing lead protection, 13% of the dose limit recommended by the International Commission on Radiological Protection for the thyroid of 300 mSv per year would not be exceeded, whereas by wearing the lead protection only 0.2% of the recommended dose would be reached.
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Case Reports
[Rare, in plain roentgen unidentifiable severe combination injury of the tarsometatarsal joint].
We report a rare case of a 35-year-old man who sustained a severe injury of the tarso-metatarsal joint. An isolated fracture of the medial cuneiform was seen on initial radiographs; final diagnosis was made by CT-scan.
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With shortage of research funds and increasing competition for medical posts, performance indicators and control instruments are being looked for in order to be able to allot research funds and make professorial appointments in relation to scientific performance. Incomprehensibly for many, the impact factor has become the decisive scientometric indicator at German universities despite of substantial systematic limitations. The impact factor is derived from the journal citation reports. ⋯ The faculties should reach agreement on relevant (also on German language) organs of publication. The impact factor is not suitable as an indicator of the research activity and the quality of a researcher or an institution. Besides careful human judgement and other classical methods of decision making, the Science Citation Index can contribute to the individual evaluation.
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After severe head injury intracranial pressure (ICP) must be measured continuously for management to assess and maintain the cerebral perfusion. Therefore in our hospital epidural transducers are used. To prove the efficiency of this method in a 12-month period the clinical courses of 23 patients with intracranial pressure transducers were analysed retrospectively. ⋯ In 17 patients the measurements were considered as reliable, 6 measurements were not reliable, which included 1 of the 5 patients who died. One transduce was displaced, another one showed a hemorrhage at the drill hole. There was no infection.