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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 11-18 
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Beckenfraktur ; Epidemiologie ; Diagnostik ; Klassifikation ; Keywords ; Pelvic fracture ; Epidemiology ; Diagnosis ; Classification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Pelvic fractures, except for those of the acetabulum, account for 0.3–8% of all fractures and can be considered rare. They are generally either stable, and result from “low-energy” trauma, or unstable, mostly following “high-energy” trauma. The latter are associated with an increased morbidity, mortality and invalidity. Correct and complete ¶diagnosis including accompanying injuries may be difficult owing to the complex anatomical and biomechanical relations, ¶but is essential, particularly in the case of complex fractures and injury patterns, for immediate and adequate therapeutic management of fractures and of the frequently severe accompanying injuries. Classification of these fractures based on detailed X-ray evaluation not only allows for approximative estimation of injury severity and prognosis and is helpful in the selection of therapeutic procedures, but also facilitates comparative evaluations of different fracture types or treatment concepts. The conceptional aim of this paper is not a scientifically oriented presentation of details, but an overview relevant to clinical practice and to the work of experts commissioned to prepare official reports on the epidemiology, pathomechanisms, diagnosis and classification of pelvic fractures.
    Notes: Beckenfrakturen, ausgenommen Azetabulumfrakturen, sind mit einem Anteil am Gesamtkollektiv der Frakturen von 0,3–8% selten. Im Allgemeinen sind sie entweder stabil und Folge eines Low-energy-Traumas oder instabil, meist in Folge eines High-energy-Traumas. Letztere sind mit einer deutlich erhöhten Morbidität, Mortalität bzw. Invalidität vergesellschaftet. Die korrekte und vollständige Diagnose einschließlich Begleitverletzungen kann aufgrund der komplexen anatomischen und biomechanischen Zusammenhänge schwierig sein. Insbesondere bei komplexen Fraktur- und Verletzungsmustern ist sie jedoch die Voraussetzung für ein rasches und adäquates Therapiemanagement der Fraktur und der teils vitalen Begleitverletzungen. Die Frakturklassifikation auf der Basis einer exakten Röntgendiagnostik ermöglicht nicht nur eine approximative Schweregrad- und Prognoseabschätzung bzw. Hinweise für das therapeutische Verfahren, sondern letztlich auch eine vergleichende Evaluation verschiedener Frakturtypen bzw. Behandlungskonzepte. Konzeptionelles Ziel dieses Beitrags ist nicht die wissenschaftlich orientierte Darstellung von Detailfragen, sondern ein für die klinische Praxis und gutachterliche Tätigkeit relevanter Überblick zu Epidemiologie, Unfallmechanismus, Diagnostik und Klassifikation von Beckenfrakturen.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Trauma und Berufskrankheit 2 (2000), S. 19-27 
    ISSN: 1436-6274
    Keywords: Schlüsselwörter ; Azetabulumfrakturen ; Epidemiologie ; Diagnostik ; Klassifikation ; Keywords ; Acetabular fracture ; Epidemiology ; Diagnosis ; Classification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Acetabular fractures are typical lesions of polytraumatized patients. Therefore, treatment of these fractures has to be planned according to the overall trauma damage. ¶Adequate therapy is impossible without correct diagnosis and classification of the fracture. Conventional X-ray images including an anteroposterior view of the pelvis and obturator and iliac oblique views allow correct fracture classification according to the criteria of Letournel and the AO classification in most cases. To determine what therapeutic procedure will be adequate, it is important to evaluate the acetabular fracture by a synoptical analysis with comprehensive conventional X-ray diagnosis and a CT scan. Only ¶the CT scan allows reliable assessment of complex fractures, concomitant femoral head and pelvic fractures, intra-articular fragments and lesions preventing correct repositioning, and exact determination of the joint congruity. Three-dimensional CT ¶reconstruction should be reserved for planning the therapy in selected cases and for scientific examinations.
    Notes: Azetabulumfrakturen treten typischerweise bei mehrfachverletzten und polytraumatisierten Patienten auf, sodass die Versorgung der Fraktur unter Berücksichtigung der Gesamtverletzung geplant werden muss. Die Basis für eine suffiziente Therapie stellen die korrekte Diagnostik und Klassifikation der vorliegenden Fraktur dar. Die Basisdiagnostik zum Nachweis einer Azetabulumfraktur bildet die konventionelle Röntgendiagnostik, welche die Beckenübersicht-, Ala- und Obturatoraufnahme umfassen muss. Dadurch lassen sich zwar die meisten Frakturen anhand der derzeit etablierten Klassifikationssysteme von Letournel u. Judet und der AO beurteilen. Zur Therapieplanung und Entscheidungsfindung hinsichtlich eines operativen oder konservativen Vorgehens hat sich allerdings die synoptische Betrachtung des Frakturverlaufs in der kompletten konventionellen Röntgendiagnostik sowie in der Computertomographie bewährt. Erst die computertomographische Diagnostik ermöglicht in den meisten Fällen die sichere Erfassung komplexer Frakturformen, Begleitverletzungen des Hüftkopfs und Beckenrings, intraartikulärer Fragmente und Repositionshindernisse sowie die exakte Beurteilung der Gelenkkongruenz. Die 3D-Rekonstruktion sollte ausgesuchten Frakturen zur Operationsplanung sowie wissenschaftlichen Untersuchungen vorbehalten bleiben.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1619-7089
    Keywords: Key words: Osteomyelitis – Spondylitis – Fluorine-18 fluorodeoxyglucose – Positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to evaluate the clinical use of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in acute and chronic osteomyelitis and inflammatory spondylitis. The study population comprised 21 patients suspected of having acute or chronic osteomyelitis or inflammatory spondylitis. Fifteen of these patients subsequently underwent surgery. FDG-PET results were correlated with histopathological findings. The remaining six patients, who underwent conservative therapy, were excluded from any further evaluation due to the lack of histopathological data. The histopathological findings revealed osteomyelitis or inflammatory spondylitis in all 15 patients: seven patients had acute osteomyelitis and eight patients had chronic osteomyelitis or inflammatory spondylitis. FDG-PET yielded 15 true-positive results. The tracer uptake correlated with the histopathological findings in each case. Bone scintigraphy performed in 11 patients yielded ten true-positive results and one false-negative result. Follow-up carried out on two patients revealed normal or clearly reduced tracer uptake, which correlated with a normalisation of clinical data. In early postoperative follow-up it was impossible to differentiate between postsurgical reactive changes and further infection using FDG-PET. It is concluded that acute and chronic osteomyelitis of the peripheral as well as the central skeleton can be detected using FDG-PET. Osteomyelitis can be differentiated from soft tissue infection surrounding the bone. Unlike computed tomography and magnetic resonance imaging, FDG-PET is not affected by metal implants used for fixing fractures. FDG-PET demonstrated promising initial results with respect to treatment monitoring. Nevertheless, in the early postoperative phase FDG-PET seems to be of limited value owing to unspecific tracer uptake.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1619-7089
    Keywords: Key words: Thyroid cancer ; Fluorine-18 fluorodeoxyglucose ; Positron emission tomography ; Sestamibi ; Radioiodine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n =222) and the group with negative radioiodine scan (n=166), respectively. Specificity was 90% in the whole patient group. Sensitivity and specificity of WBS were 50% and 99%, respectively. When the results of FDG-PET and WBS were considered in combination, tumour tissue was missed in only 7%. Sensitivity and specificity of MIBI/Tl were 53% and 92%, respectively (n=117). We conclude that FDG-PET is a sensitive method in the follow-up of thyroid cancer which should be considered in all patients suffering from differentiated thyroid cancer with suspected recurrence and/or metastases, and particularly in those with elevated thyroglobulin values and negative WBS.
    Type of Medium: Electronic Resource
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