RESUMEN
Medical arbitration boards ("Schlichtungsstellen", expert panels for extrajudicial malpractice claim resolution) try to settle claims of suspected malpractice between patients and their physicians and to avoid court trials. Numerous studies found an increasing incidence of adverse events with rising age. Injuries that occur in the hospital are frequently beyond the specialty of the treating physician. Therefore, the physician has to broaden his diagnostic view beyond the borders of his own specialty to recognize injuries in his patients and to prevent malpractice claims.In this paper, we report on adverse events in elderly patients where the geriatrician/internist was accused of negligence for not having promptly recognized a fracture after a fall or having chosen an inadequate operative procedure. For example, the importance of weight bearing osteosynthesis, mandatory in hip fractures in the elderly population to prevent long-term immobilization, is discussed.Adverse events due to negligence are more frequent among the elderly; the reasons are discussed. They will never be entirely preventable. The data presented in this report may be helpful to recognize fractures in time and to ensure adequate treatment, in order to reduce the number of court claims.
Asunto(s)
Accidentes por Caídas , Errores Diagnósticos/legislación & jurisprudencia , Fracturas Óseas/diagnóstico , Geriatría/legislación & jurisprudencia , Mala Praxis/legislación & jurisprudencia , Traumatología/legislación & jurisprudencia , Anciano , Anciano de 80 o más Años , Femenino , Alemania , Consejo Directivo , Humanos , Masculino , Persona de Mediana Edad , NegociaciónRESUMEN
Primary or secondary grafting with autologous cancellous bone has become a routine procedure combined with osteosynthetic measures. At the Berufsgenossenschaftliche Unfallklinik Frankfurt 422 transplantations of autologous cancellous bone were performed during the last 6 years. The technique of obtaining the cancellous bone from the tibial head became highly standardized.
Asunto(s)
Trasplante Óseo , Callo Óseo , Fijación Interna de Fracturas/métodos , Humanos , Tibia/trasplante , Trasplante AutólogoRESUMEN
31 cases of infected pseudarthrosis of the femur were re-osteosynthesized with the interlocking nail. Bony consolidation was obtained in 26 patients, in all cases the chronic osteomyelitic infection subsided with removal of the nail. Pseudarthrosis persisted in 3 cases, after removal of the nail the patients could walk with a walking splint. In one of this group bony consolidation was obtained after repeated interlocking nailing. Persisting pseudarthrosis and infection was the indication for amputation in 2 cases.
Asunto(s)
Seudoartrosis/cirugía , Adolescente , Adulto , Amputación Quirúrgica , Clavos Ortopédicos , Enfermedad Crónica , Femenino , Fracturas del Fémur/complicaciones , Fracturas del Fémur/cirugía , Fijación Intramedular de Fracturas/métodos , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/etiología , Infección de la Herida QuirúrgicaRESUMEN
Experimental studies on an intramedullary device for lengthening the femur by continuous distraction are reported. The hydraulic distractor is placed in a modified interlocking nail. Lengthening up to 8 cm--under certain circumstances up to 16 cm--can be achieved with this method.