Unfallchirurgie (Heidelberg, Germany)最新文献_第6页

[What are typical presentations of acute retrobulbar hematoma?] [急性球后血肿有哪些典型表现？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-06-13 DOI: 10.1007/s00113-024-01447-9

Poramate Pitak-Arnnop, Julius Hirsch, Dirk Stengel, Christian Stoll

引用次数: 0

[Acute and post-acute soft tissue reconstruction]. [急性和急性后软组织重建]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI: 10.1007/s00113-024-01448-8

Rami Al Meklef, Susanne Rein, Thomas Kremer

{"title":"[Acute and post-acute soft tissue reconstruction].","authors":"Rami Al Meklef, Susanne Rein, Thomas Kremer","doi":"10.1007/s00113-024-01448-8","DOIUrl":"10.1007/s00113-024-01448-8","url":null,"abstract":"Background: The precise analysis of the injured structures requiring reconstruction in complex wound defects is a prerequisite for successful restoration.Objective: The fundamental reconstructive strategies for soft tissue defects of the extremities including injuries to vessels, nerves and burn wounds in the context of the acute and post-acute trauma phases are presented.Material and methods: The different phases of soft tissue reconstruction are described. Recommendations for action with respect to the reconstruction of the functional structures are described. Two clinical case examples illustrate the approach.Results: The acute reconstruction phase is defined as the period 0-72 h after the traumatic event and includes surgical debridement, primary reconstruction of nerves and vessels using interpositional grafts if necessary and temporary soft tissue reconstruction. Combined thermomechanical trauma requires early debridement combined with internal fixation of open fractures. In the post-acute reconstruction phase, which is generally defined as a period of up to 6 weeks after the traumatic event, definitive soft tissue reconstruction is performed. In the case of long reinnervation distances, nerve transfer or motor replacement plastic surgery is performed in the post-acute phase.Conclusion: The reconstruction of soft tissue after trauma necessitates a stage-dependent approach. In the acute phase procedures aim at the immediate preservation of the limb. In the post-acute phase, definitive soft tissue reconstruction is performed to enable maximum functional preservation. Combined thermomechanical injuries require early surgical treatment in order to prevent infections.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"560-566"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422185","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}

引用次数: 0

[Secondary defect coverage and functional reconstruction]. [二次缺陷覆盖和功能重建]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-07-09 DOI: 10.1007/s00113-024-01451-z

Stephan Thunich, Nicco Krezdorn

引用次数: 0

[Plastic surgery for defect coverage of soft tissue defects]. [软组织缺损的整形覆盖]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-07-29 DOI: 10.1007/s00113-024-01453-x

Peter M Vogt

引用次数: 0

[Traumatic hemipelvectomy : An uncommon case in trauma surgery]. [外伤性半十二指肠切除术：外伤手术中的罕见病例]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-08-01 Epub Date: 2024-07-11 DOI: 10.1007/s00113-024-01455-9

F Pfalzgraf, M Ecker, Y Goßlau, E Mayr

{"title":"[Traumatic hemipelvectomy : An uncommon case in trauma surgery].","authors":"F Pfalzgraf, M Ecker, Y Goßlau, E Mayr","doi":"10.1007/s00113-024-01455-9","DOIUrl":"10.1007/s00113-024-01455-9","url":null,"abstract":"The challenge in treating traumatic hemipelvectomy is the dynamics of the complex and life-threatening consequences of the injury. These include skin and soft tissue defects, osseous, neural and vascular injuries as well as the subsequent hemostatic derangement and organ dysfunction as part of the shock process. The treatment requires rapid and targeted decisions to save the patient's life. In this particular case a 34-year-old farmer was trapped between a wheeled loader and a stationary trailer. Upon arrival at the hospital the patient was in a state of hemorrhagic shock with accompanying acute traumatic coagulopathy and a grade III open pelvic trauma with complete ischemia of the left leg and a bladder injury. After performing emergency surgery and a two-stage approach for pelvic stabilization the patient's condition deteriorated up to multiorgan failure, necessitating left-sided hemipelvectomy as an immediate life-saving salvage procedure. In the further course multiple revision surgeries and plastic reconstructions due to wound infections and the presence of skin and soft tissue damage were required. Due to the rare confrontation with this type of injury in everyday practice and the absence of a universal treatment algorithm, the following case report is intended to contribute to a better understanding of the treatment and to illustrate the coherent interactions of the individual organ systems affected.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"607-612"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581792","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}

引用次数: 0

[Chance of conditions in trauma surgery : A current and realistic scenario?] [创伤手术中的条件机会：当前的现实情况？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-07-02 DOI: 10.1007/s00113-024-01450-0

B Friemert, D Bieler, A Franke, G Achatz

引用次数: 0

[Trauma surgical relevance of bite injuries by animals and humans]. [人兽咬伤的创伤外科相关性]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-06-17 DOI: 10.1007/s00113-024-01441-1

Katharina Estel, Catharina Scheuermann-Poley, Ole Goertz, Jennifer Urban, Kristina Landscheidt, Werner Wenzel, Christian Willy

引用次数: 0

[National challenges for trauma surgery in Germany due to violence and war]. [德国因暴力和战争而面临的创伤外科国家挑战]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-06-11 DOI: 10.1007/s00113-024-01442-0

Axel Franke, Dan Bieler, Wolfgang Lehmann, Tim Pohlemann, Benedikt Friemert, Gerhard Achatz

{"title":"[National challenges for trauma surgery in Germany due to violence and war].","authors":"Axel Franke, Dan Bieler, Wolfgang Lehmann, Tim Pohlemann, Benedikt Friemert, Gerhard Achatz","doi":"10.1007/s00113-024-01442-0","DOIUrl":"10.1007/s00113-024-01442-0","url":null,"abstract":"Due to the war in Ukraine and the treatment of patients with war wounds in the hospitals of the TraumaNetworks of the German Society for Trauma Surgery (TraumaNetzwerke DGU®), injuries from life-threatening mission situations (LebEL), terrorism, violence and war have become a matter of daily professional life. Furthermore, the societal and global feeling of security has fundamentally changed. The much-cited term \"turning point in history\", the reorientation of the Armed Forces and the investigation of the resilience of the healthcare system with respect to the \"fitness for war\", approximate to the description of the current challenges for trauma surgery (UCH) in Germany. Based on the developments following the terrorist attacks in Paris in 2015 and in Brussels in 2016, a clarification is given as to which adaptations have already been successful and how quickly an improvement could successfully be achieved. In this context, the concept of tactical care and the course on Terror and Disaster Surgical Care (TDSC), for example, have been game changing. The main challenge currently lies in overcoming the structural alterations in the German healthcare system and professionally in the treatment of war wounded personnel from Ukraine. The knowledge gained from these two national tasks must be analyzed for the future development and adaptation of established treatment structures, e.g., of the TraumaNetzwerke DGU®, under the requirements of the increased resilience against war, terrorism and violence. The aim is to name that which has already been achieved with respect to the national challenges for UCH and at the same time to outline or discuss further necessities for improvements and elimination of possible gaps in capabilities.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"492-499"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302210","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}

引用次数: 0

[Traumatic posterior atlantoaxial dislocation without fracture of the upper cervical spine in a female geriatric patient : Case report and literature search]. [一名女性老年患者的创伤性寰枢椎后脱位，但无上颈椎骨折：病例报告和文献检索]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-05-30 DOI: 10.1007/s00113-024-01445-x

Johannes Wunder, Christoph Schirdewahn, Christian von Rüden

引用次数: 0

[Challenge of limb care after violence and war with a special focus on imaging procedures]. [暴力和战争后肢体护理的挑战，特别关注成像程序]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-06-11 DOI: 10.1007/s00113-024-01449-7

Gerhard Achatz, Axel Franke, Benedikt Friemert, Vinzent Forstmeier, Torsten Andres, Meike Wendlandt, Michael Grunert, Falk von Lübken, Dan Bieler

{"title":"[Challenge of limb care after violence and war with a special focus on imaging procedures].","authors":"Gerhard Achatz, Axel Franke, Benedikt Friemert, Vinzent Forstmeier, Torsten Andres, Meike Wendlandt, Michael Grunert, Falk von Lübken, Dan Bieler","doi":"10.1007/s00113-024-01449-7","DOIUrl":"10.1007/s00113-024-01449-7","url":null,"abstract":"Background: Injury patterns in the area of the extremities following violence and war harbor many special features and require special attention. Destructive and complex defect injuries are often present, which necessitate elaborate and special reconstruction approaches, predominantly as part of a staged and multistaged procedure.Research question: In this context, special attention must be paid to the diagnostic options as an essential aspect, as a clear diagnosis means that targeted treatment steps can be planned and implemented.Material and method: The authors' experience in this field from military operations in Afghanistan, Iraq, the Republic of Mali, Kosovo and Georgia, as well as the core content of the Terror and Disaster Surgical Care (TDSC®) course on this topic, have been contextualized and incorporated. In addition, aspects of interdisciplinary cooperation with radiological and, in particular, nuclear medicine disciplines are taken into account in the daily routine.Results and discussion: Extremity injuries in the context of violence and war are accompanied by complex bone and surrounding soft tissue defects due to the high energy impact. The principles of reconstruction familiar from everyday life can only be transferred one-to-one to a limited extent. The treatment pathways are often very long and complex and the questions of infection and tissue vitality must be answered again and again in stages. Interdisciplinary collaboration with the disciplines specialized in imaging procedures, particularly in the field of nuclear medicine, is one of the key building blocks for a successful treatment pathway.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"515-521"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302199","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}

引用次数: 0