[Isolated fracture of the lesser trochanter-What age-related differences are important?].

Isolated fractures of the lesser trochanter are very rare injuries. This case report describes the age-related differences based on two cases. A 13-year-old girl suffered an avulsion fracture of the lesser trochanter while sprinting.

Cuboid nutcracker fracture in children: Management and results.

Introduction: Compression fractures of the cuboid bone in children and adolescents are rare. Fracture morphology, associated lesions, treatment options and long-term outcomes of this very rare injury are published in a few case reports. This study with review of the literature aims to support the understanding of fracture pattern and optimize pathways of decision making.

Avulsion fracture of the lesser trochanter in adolescents.

Introduction: Avulsion fractures of the lesser trochanter in adolescents are rare. They are a result of a sudden and forceful contraction of the iliopsoas muscle. Functional results in the medium term after non-operative treatment are unknown.

[Changes in the patient population with proximal femur fractures over the last decade : Incidence, age, comorbidities, and length of stay].

Background: Over the last decade, the percentage of people >65 years has increased from 16.6% to 20.7%.

Number of positive radiographic findings in pediatric trauma patients.

Purpose: Conventional radiography is frequently performed in pediatric patients in whom fractures and dislocations are suspected. However, until now, the rate of positive findings of the most commonly performed radiographic examinations in pediatric patients is unknown. The aim of this study was to evaluate the number of positive findings in the 20 most frequently requested standard radiographic examinations in pediatric patients in a level 1 trauma center systematically.

[X‑ray of the thoracic and lumbar spine in injured children and adolescents : Incidence, fracture rates and therapeutic consequences].

Introduction: Usually, conventional radiographs are appropriate for injuries in the region of the thoracic and lumbar spine (TLS) in children and adolescents. The aim of our study was to determine the incidence of trauma-associated radiographic findings in this anatomical region and to present the therapeutic consequences.

Material And Methods: In a retrospective cohort study (2007-2015) of a level 1 trauma center all children and adolescents (0-17 years) with a TLS-trauma, in which conventional radiographs were performed anteroposterior and lateral as the initial imaging modality, were included.

[Associated injuries with greater tuberosity fractures : Mechanism of injury, diagnostics, treatment].

Background: To date, little attention has been given to greater tuberosity fractures (GTFs) in the literature. Several mechanisms of injury are described, but few authors report that a GTF is accompanied by a high rate of often unrecognized associated injuries.

Objectives: The aim was to document the incidence of dislocation, to diagnose associated injuries and, based on these, these draw conclusions about the mechanism of injury concerning GTF.

Outcome after operative treatment of proximal humeral fractures in elderly patients.

Background: The proximal humeral fracture (PHF) (5 %) of the elderly is the third most common fracture after proximal femoral and distal radius fractures. Proximal femoral fractures often lead to a loss of autonomy.

Objectives: The aim of this study is to show how PHF changes the patient's autonomy and the coping with everyday life as well as which factors influence the outcome 1 year (y) after surgery.

Pediatric trauma care with computed tomography--criteria for CT scanning.

Trauma centers, trauma management concepts, as well as integration of whole-body computed tomography (CT) reduced mortality significantly. The accuracy of a trauma care algorithm with emergency CT in children was evaluated. Data of 71 children with emergency CT were recorded retrospectively.

[Injuries in children and adolescents in emergency services].

Background: A differentiated knowledge of trauma in children and adolescents is essential for the treatment of injured minors. The aim of this study was to present the focus of treatment in trauma emergency services.

Material And Methods: Over a period of 2 years all acutely injured children and adolescents (n = 4784) in the emergency service were analyzed prospectively.

[Length of hospital stay for patients with proximal femoral fractures : Influencing factors].

Background: In departments of orthopedic and trauma surgery patients with proximal femoral fractures constitute the largest proportion of trauma patients. The length of stay (LOS) has economic consequences and prolonged LOS leads to a shortage in bed capacity.

Objectives: In this study treatment and patient-related factors that influence the LOS of patients with proximal femoral fractures were investigated.

[The posterocentral approach to the posterior tibial plateau].

Objective: An anatomically preformed approach to the posterior tibial plateau is described. In avulsion fractures of the posterior cruciate ligament (PCL), the aim is to restore stability of the knee joint with functional treatment, while in posterior shearing tibial plateau fractures the aim is to restore anatomical dorsal alignment of the tibia.

Indications: Avulsion fracture the PCL, posterior shearing tibial plateau fracture.

[Factors influencing course of hospitalization in patients with hip fractures: Complications, length of stay and hospital mortality].

Background: Time of surgery, age, sex, and co-morbidities influence the complication and mortality rate in patients with hip fractures. Patients with relevant co-morbidities, who were hospitalized at the weekend have a higher mortality rate. Complications prolong length of stay (LOS), which results in higher costs and shortage of bed capacity.

[The DRG responsible physician in trauma and orthopedic surgery. Surgeon, encoder, and link to medical controlling].

Background: Precise coding is an essential requirement in order to generate a valid DRG. The aim of our study was to evaluate the quality of the initial coding of surgical procedures, as well as to introduce our "hybrid model" of a surgical specialist supervising medical coding and a nonphysician for case auditing.

Materials And Methods: The department's DRG responsible physician as a surgical specialist has profound knowledge both in surgery and in DRG coding.

[Treatment duration of trauma and orthopedic patients in an emergency department].

Introduction: The majority of emergency patients are admitted to hospital via the emergency department. Overcrowding in emergency departments results in dissatisfied patients, increased complication rates, and negative medicoeconomic consequences. To overcome these problems, sufficient personnel strength should be available depending on treatment duration and the patients' characteristics.

Mortality after proximal femur fracture with a delay of surgery of more than 48 h.

Purpose: For hip fractures, guidelines require surgery as soon as possible, but not later than 48 h. Some authors observed a positive and some a negative effect of early operation on mortality rate. The aim was to evaluate the mortality rate of patients with a delay of surgery >48 h after admission, as well as influencing factors and reasons for delay.

[Emergency radiographs in injured children and adolescents].

Background: Adequate interpretation of radiographs of injured children and adolescents is key for appropriate treatment. For the purposes of structuring in-hospital education and training, conventional radiographs obtained in the emergency department (ED) should be analyzed.

Material And Methods: A total of 10,232 radiographs of children and adolescents (0-17 years old) were analyzed retrospectively.

[Early complication rate of fractures close to the hip joint. Dependence on treatment in on-call services and comorbidities].

Background: Guidelines advocate early surgery for proximal femoral fractures so that operations are frequently performed in on-call duty times. Multimorbid patients also suffer more frequently from postoperative complications. Does on-call duty or night shift services correlate with higher postoperative complication rates and what influence do comorbidities have?

Patients And Methods: In 300 patients (> 65 years) postoperative surgical and non-surgical complications were documented and correlated with comorbidities, on-call duty and night shift service times.

[Proximal femoral fractures in the German external quality assurance module 17/1: reasons for delay in surgery].

Background: For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given.

Materials And Methods: Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission.

Results: A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission.

[ProFI reduction of pediatric pulled elbow].

Background: Pulled elbow is a common injury in children under the age of 5 years which is usually treated by manual reduction. Supination of the forearm is recommended as opposed to pronation or other maneuvers. The author has developed a manipulative intervention for reduction of pulled elbow in young children on the basis of the pronation technique and called ProFI reduction.

[Posterocentral approach to the posterior tibial plateau. Reconstruction of tibial plateau fractures and avulsions of the posterior cruciate ligament].

Background: For surgical treatment of posterior shearing tibial plateau fractures and avulsion fractures of the posterior cruciate ligament (PCL) a posterocentral approach without dissection or separation of the heads of the gastrocnemius muscle is used. The aim of this study was an evaluation of this approach.

Patients And Methods: From 2001-2012 a total of 33 patients were surgically treated using a posterocentral approach to the dorsal knee joint.

Mortality and quality of life after proximal femur fracture-effect of time until surgery and reasons for delay.

Introduction: Studies yield conflicting results from the effect of early surgery on mortality. Some observed a positive, others a negative and some did not find any effect of early operation. In this study, mortality and quality of life in relation to time until surgery as well as reasons for delay were observed prospectively.

Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment.

Background: Serial rib fractures and flail chest injury can be treated by positive-pressure ventilation. Operative techniques reduce intensive care unit (ICU) stay, overall costs, mortality and morbidity, as well as pain. The aim of this study was to evaluate the benefit of surgical rib stabilisation in comparison to non-operative treatment in patients with severe trauma of the chest wall.

[Assessment of prehospital injury severity in children: challenge for emergency physicians].

Background: The prognosis of polytraumatized patients is dependent on the quality of emergency room (ER) management and a smooth transition from prehospital to ER therapy is essential. The accurate assessment of prehospital injury severity by emergency physicians influences prehospital therapy and level of care of the destination hospital. It also helps to ensure that medical resources are immediately available.

[Pediatric calcaneal fracture after supination trauma: conservative therapy with an orthosis].

We report the case of a 12-year-old boy with a calcaneal fracture due to a simple supination trauma. As magnetic resonance imaging (MRI) showed a non-displaced extra-articular fracture no surgical treatment was necessary. A conservative therapy using calcaneal fracture orthosis with full weight bearing was carried out.