[Medicine for people with disabilities : Special features of trauma surgical care of extremity injuries in people with severe mental and physical disabilities].

The v. Bodelschwingh Foundation Bethel can look back on a tradition of more than 150 years in the treatment of people with disabilities. The trauma patient collective is regularly characterized by the most severe mental and physical developmental disorders and (multiple) disabilities, with and without behavioral disorders and concomitant internal diseases. This special combination requires treatment and indication assessment both medically and in nursing, which must be specifically weighed up and adapted in all treatment steps. Treatment guidelines or recommendations for this patient group do not exist in the literature. Furthermore, the treatment of fractures in people with disabilities cannot always follow established concepts. Due to a high postoperative complication rate, conservative treatment plays a crucial role. The decision for surgical treatment must be made on an interdisciplinary and individual basis, taking all factors into account. Special attention must be paid to the procedure to be chosen (stability, functional needs).