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Kindliche Verletzungen im Bereich der Halswirbelsäule sind selten. Wesentlich sind eine frühzeitige Diagnosestellung und die rasche, konsequente Therapie. Dies ist die wahrscheinlich beste Ausgangssituation, um Spätfolgen zu vermeiden, denn diese würden das Kind ein Leben lang behindern. Entsprechend behandelt dieser Beitrag die Akutversorgung und Spätfolgen bei kindlichen Verletzungen der Halswirbelsäule. [ABSTRACT FROM AUTHOR]

Injuries of the cruciate ligaments are frequent in sport and are one of the most frequent causes of sport invalidity. Conservative and surgical treatment options are possible for ruptures of the anterior cruciate ligament. What are the current treatment recommendations? This article examines exactly this question and presents the surgical and conservative therapy options. The anamnesis is given priority in the diagnostics. The following are established tests to investigate the integrity of the anterior cruciate ligament: the Lachman test, the pivot shift test and the anterior drawer test. Whereas accompanying bony injuries can be detected by native X-ray imaging, magnetic resonance imaging (MRI) is suitable for the diagnostics of cruciate ligament injuries. Although conservative therapy of anterior cruciate ligament lesions can be successful, it has been shown that surgical reconstruction is more often necessary, particularly for highly demanding sporting activities; however, the original knee function can never be restored in an identical fashion by reconstruction of the anterior cruciate ligament. This explains why not all athletes can return to the same performance level achieved before the cruciate ligament lesion and only 55 % can maintain sport at a competition level. [ABSTRACT FROM AUTHOR]

Fractures of the distal radius represent the most common fracture in adults. All degrees of severity can occur depending on the fracture morphology, ranging from complete recovery up to extremely severe courses. In addition, the outcome is strongly influenced by possible accompanying carpal injuries. The patient population is divided into young patients under 40 years old with approximately equal proportions of female and male patients presenting with relevant traumatic events and into predominantly female patients over 60 years old with poor bone quality due to osteoporosis and minor traumatic events. Up to approximately 35 years ago treatment was almost exclusively conservative. Surgical procedures, such as Kirschner bore-wire fixation were performed in cases of severe dislocation and external fixation in cases of severe soft tissue problems. The development of modern locking compression plates has led to a paradigm shift in treatment. Conservative treatment is now predominantly limited to stable fractures. The identification of typical errors in the positioning of implants and the development of new X-ray imaging techniques increase the safety of the surgical treatment with volar locking compression plates and establish its position as the standard treatment. At the same time, a more differentiated perception of geriatric trauma patients is evolving, which initiated a change in treatment strategies within this patient population. [ABSTRACT FROM AUTHOR]

For most but not all state medical associations X-ray diagnostics are no longer included in the regulations for further education to specialist for orthopedics and casualty surgery. In most cases it is only necessary to provide evidence that intraoperative radiological control of findings has been included in the training and moreover the supplementary further education topic'X-ray diagnostics of the skeleton' has been introduced in the further education regulations. Overall the current further education situation in X-ray diagnostics for casualty surgeons and orthopedists is unsatisfactory because the often necessary referral to a radiologist hinders the rapid treatment of patients. In order to find a solution to this problem orthopedists and casualty surgeons should also try to ensure that when amendments are being made to the further education and X-ray regulations, ways should be found which do not unnecessarily limit access to X-ray examination. [ABSTRACT FROM AUTHOR]