D T D Dinh-Biet, T Leschinger, L-P Müller, A Cavalcanti Kußmaul, F Unglaub, Christian Karl Spies
{"title":"[Bony and ligamentous injuries of the thumb ray].","authors":"D T D Dinh-Biet, T Leschinger, L-P Müller, A Cavalcanti Kußmaul, F Unglaub, Christian Karl Spies","doi":"10.1007/s00113-025-01565-y","DOIUrl":"10.1007/s00113-025-01565-y","url":null,"abstract":"<p><p>Fractures and ligamentous lesions of the thumb ray are frequent due to the exposed position of the thumb. A thorough anatomical understanding with respect to the joints and stabilizing ligaments is essential for a targeted examination, the selection of appropriate imaging diagnostics and the decision for a surgical or conservative treatment approach. Misdiagnoses or untreated injuries can lead to impaired functionality, pain and instability, which can substantially impair the function of the hand, particularly thumb opposition.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"449-460"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Femoral head necrosis after femoral neck fracture-A lifelong burden].","authors":"Oliver Loose, F Fernandez, T Müller","doi":"10.1007/s00113-025-01555-0","DOIUrl":"10.1007/s00113-025-01555-0","url":null,"abstract":"<p><p>Posttraumatic femoral head necrosis after a femoral neck fracture in children and adolescents is a rare but severe complication. If this occurs in older patients a total hip arthroplasty (THA) is mostly indicated. In children and adolescents the primary goal of treatment is preservation of the hip joint. There is no standard treatment or generally applicable treatment recommendation. Various measures for treating this rare entity are discussed in the literature. In addition to conservative measures, retrograde drilling with or without cancellous bone grafting, joint distraction or grafting measures are available. As a final solution, however, a THA is also a suitable treatment option as soon as the anatomical conditions are appropriate.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"417-424"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Traumatic TFCC lesions in childhood and adolescence-A previously neglected injury?]","authors":"Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther","doi":"10.1007/s00113-025-01563-0","DOIUrl":"10.1007/s00113-025-01563-0","url":null,"abstract":"<p><p>Although injuries to the triangular fibrocartilage complex (TFCC) are less common in children and adolescents than in adults, can lead to chronic pain and instability in the distal radioulnar joint (DRUJ), ultimately predisposing individuals to long-term osteoarthritis. A dislocated distal radius fracture with avulsion of the styloid process of the ulna following high-energy trauma is a risk factor for a TFCC injury. The diagnostics include a thorough clinical examination and imaging procedures, such as X‑ray and magnetic resonance imaging (MRI). If there is no instability of the DRUJ, conservative treatment can be successful in most cases. However, if there is instability of the DRUJ or if there is no improvement after 3 months of conservative treatment, diagnostic arthroscopy of the wrist is indicated for further diagnostics and concurrent treatment. Depending on the age and extent of the injury, various surgical techniques can be used, such as transcapsular or transosseous refixation. Early diagnosis and treatment are essential to achieve freedom from pain, a stable DRUJ and enable a return to sports activities. In our own patient collective 12 children and adolescents showed very good results with no major complications.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"425-433"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Acute compartment syndrome in childhood].","authors":"Guido Fitze, Peter C Strohm","doi":"10.1007/s00113-025-01553-2","DOIUrl":"10.1007/s00113-025-01553-2","url":null,"abstract":"<p><p>Traumatic acute compartment syndrome in childhood is a rare complication following an accident but it occurs more frequently than generally assumed. The accident mechanisms and anatomical localization are very well known so that this complication must always be considered if these risk factors are present. The diagnostic confirmation is based on clinical examination findings and implies the assessment of the three A's: increasing anxiety, agitation and analgesic requirement. The measurement of compartment pressure can only be used if this examination is not possible or appears unsafe; however, there are no recognized age-adapted normal values. In the presence of manifest acute compartment syndrome, a timely dermatofasciotomy is the only treatment measure that results in a very good functional outcome. Otherwise, Volkmann's ischemic contracture cannot be avoided.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"410-416"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Tension band wiring arthrodesis of the metacarpophalangeal joint of the thumb in chronic multidirectional instability with secondary arthrosis].","authors":"Christian Karl Spies","doi":"10.1007/s00113-025-01564-z","DOIUrl":"10.1007/s00113-025-01564-z","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"461-466"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P Beck, S Imach, J C Wagner, S Künle, H Düsing, M M Paul
{"title":"[The NIPPLE trial-On the secure placement of chest drains or why men and women may sometimes be really equal : German Congress for Orthopedics and Trauma Surgery (DKOU) Science Slam 2024].","authors":"P Beck, S Imach, J C Wagner, S Künle, H Düsing, M M Paul","doi":"10.1007/s00113-025-01578-7","DOIUrl":"10.1007/s00113-025-01578-7","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"470-475"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C Kammerlander, K Sahrarudi, V Smekal, A Hartmann, G Mattiassich, L Negrin
{"title":"[Austrian Society for Trauma Surgery Diploma-Austrian Trauma Days].","authors":"C Kammerlander, K Sahrarudi, V Smekal, A Hartmann, G Mattiassich, L Negrin","doi":"10.1007/s00113-025-01577-8","DOIUrl":"10.1007/s00113-025-01577-8","url":null,"abstract":"<p><p>The increasing overlap between trauma surgery and orthopedics presents new challenges for medical training. However, specialized and structured training is essential, particularly in acute traumatology. With the Austrian Society for Trauma Surgery (ÖGU) diploma \"Advanced Trauma Surgery | Traumatology\", ÖGU offers a 3‑year training program that combines theoretical content with practice-oriented modules. The aim of the program is to optimally prepare specialists and residents for modern trauma care. The first round of the program will start in October 2025 as part of the Austrian Trauma Days.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"476-477"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cora R Schindler, Florian Pavlu, Philipp Faul, Philipp Störmann, Dan Bieler, Uwe Schweigkofler
{"title":"[Trauma room workload in German trauma centers : Reality of trauma care underrepresented in reform].","authors":"Cora R Schindler, Florian Pavlu, Philipp Faul, Philipp Störmann, Dan Bieler, Uwe Schweigkofler","doi":"10.1007/s00113-025-01538-1","DOIUrl":"10.1007/s00113-025-01538-1","url":null,"abstract":"<p><strong>Introduction: </strong>The Federal Joint Committee (G-BA) published a regulation on a staged system for emergency structures in hospitals (according to Social Security Code V) in April 2018 and therefore established the foundations for emergency care in the inpatient sector. The structural requirements for the care of potentially severely injured patients is primarily defined by the specialist society and means a high provision of personnel with a simultaneous annual increase in the burden due to increasing numbers of patients. Critics fear that the reforms do not take sufficient account of trauma care both professionally and financially. The aim of the study was to record the actual workload of the emergency trauma rooms in certified German trauma centers.</p><p><strong>Method: </strong>A nationwide online survey was performed in Germany among 619 trauma centers certified by the German Society for Trauma Surgery (DGU®) to quantify the frequency of trauma room callouts. The results were retrospectively compared with the data from the annual reports of the TraumaRegister (TR) DGU® from 2021 and 2022.</p><p><strong>Results: </strong>The 167 participating hospitals reported 22,479 trauma room callouts in 2021 and 24,366 in 2022 (response rate of the online survey 24.1%). Of these callouts 70% concerned level 1 supraregional trauma centers. The comparative analysis showed that the actual number of callouts is 3-5 times higher than the data documented in the TR-DGU® . Of the trauma rooms 80% were not included in the register due to low injury severity. The study confirms the discrepancy between the documented and actual workload of the trauma rooms in German trauma centers and emphasizes the necessity to adjust the financial and personnel consideration of the trauma centers to the actual utilization in order to ensure a continuing high quality of care.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"434-440"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Intraspinal subdural hematoma after polytrauma].","authors":"Andreas Termer, Markus Klebingat, Philip Gierer","doi":"10.1007/s00113-025-01569-8","DOIUrl":"10.1007/s00113-025-01569-8","url":null,"abstract":"<p><p>A severely injured patient was intubated at the accident site. The polytrauma computed tomography (CT) revealed complex injuries to the trunk and open fractures of the extremities. Stable fractures of the C2 and L4 vertebrae were identified in the spine. During the course of treatment a sensorimotor deficit in the lower extremities persisted on extubation. Magnetic resonance imaging (MRI) revealed an intraspinal subdural hemorrhage with absolute stenosis of the spinal canal. Immediate decompression did not result in any improvement of symptoms. A spinal subdural hematoma is a rare condition with severe consequences for the patient.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"467-469"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}