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Introduction Scaphoid nonunion after failed primary treatment remains challenging particularly when entailed by bone loss, avascular necrosis or deformity. We describe a scaphoid augmentation and fixation technique for cases of recalcitrant nonunion after screw placement by autologous press fit corticocancellous dowel. This study aims to provide reliable data on clinical and radiological outcomes and to contextualize in the face of other treatment options. Material and methods The study included 16 patients with recalcitrant nonunion of the scaphoid. All patients received screw removal and scaphoid reconstruction by a dowel shaped non-vascularized corticocancellous bone graft from the iliac crest facilitating packing of the screw channel. Bone union, the scapholunate, radiolunate and intrascaphoidal angles were evaluated on X-ray and CT images, range of motion noted. Additionally grip strength, DASH and Green O’Brien scores were obtained from eight patients. Results A union rate of 73% was noted after mean follow-up of 54 months. After revisional reconstruction of the scaphoid an extension–flexion rate of 84% of the healthy side was noted while pronation-supination reached 101%. DASH score averaged at 2.9, rest pain on a numeric rating scale was 0.43 with 99% peak grip force of the healthy side. Conclusion In complex cases of revisional scaphoid nonunion after screw placement, the corticocancellous iliac crest pressfit dowel is an option for augmentation and stabilization of the scaphoid by preserving the articular surface. Level of evidence IV, retrospective case series.

Zusammenfassung Ziel Diese retrospektive Studie vergleicht die klinischen Ergebnisse der frühfunktionellen Nachbehandlung mit den Ergebnissen mittels 6-wöchiger Schienenruhigstellung nachbehandelter Fingergrundgliedfrakturen nach perkutaner, antegrader K-Draht-Osteosynthese. Patienten und Methoden Von insgesamt 90 Patienten, die zwischen 2010 und 2017 aufgrund einer isolierten Fingergrundgliedfraktur nach geschlossener Reposition mittels perkutaner, antegrader K-Draht-Osteosynthese operativ versorgt wurden, konnten 46 (17 Frauen und 29 Männer mit einem mittleren Alter von 42,8 Jahren) im Mittel nach 18,5 Monaten nachuntersucht werden. Bei 28 Patienten war eine frühfunktionelle, bei 18 eine statische Nachbehandlung erfolgt. Beide Gruppen unterschieden sich nicht statistisch signifikant bzgl. des Alters, der Geschlechtsverteilung, der Frakturlokalisation und -morphologie, des Unfallmechanismus und der Dauer der Operation. Bei der Nachuntersuchung wurde die aktive und passive Beweglichkeit des operierten Fingers (total active motion [TAM] und total passive motion [TPM], Fingerkuppen-Hohlhand-Abstand [FKHA], Nagelrand-verlängerter-Handrückenebenen-Abstand [NHREA]) und des korrespondierenden, unverletzten Fingers der Gegenseite gemessen und in Relation zueinander gesetzt (TAMrel, TPMrel). Des Weiteren wurde die Kraft bei verschiedenen Griffformen bestimmt und in Relation zur Kraft der unverletzten Gegenseite gesetzt. Intra- und postoperative Komplikationen, der DASH-Score und die Zeit bis zur Wiederaufnahme der Arbeitstätigkeit wurden erfasst. Ergebnisse Keine signifikanten Unterschiede zwischen den beiden Gruppen konnten bzgl. der Häufigkeit von Komplikationen und notwendiger Revisionen, der Fingerbeweglichkeit und Kraft festgestellt werden. Patienten mit aktiver Nachbehandlung kehrten im Vergleich zu Patienten mit statischer Nachbehandlung jedoch signifikant früher an ihre Arbeitsplätze zurück (2,5 vs. 9,0 Wochen nach operativer Versorgung, p = 0,035). Der DASH-Score in der Gruppe mit aktiver Nachbehandlung war mit 1,7 Punkten etwas niedriger als in der Gruppe mit statischer Nachbehandlung mit 2,5 Punkten (p = 0,269). Schlussfolgerung Patienten mit frühfunktioneller Nachbehandlung waren signifikant kürzer arbeitsunfähig. Zum Nachuntersuchungszeitpunkt fand sich kein Unterschied in der globalen Fingerbeweglichkeit beider Gruppen. Bei gegebener Compliance kann auf eine postoperative Ruhigstellung verzichtet werden.

Teachers’ time is a critical resource for education systems and a key input for student learning. Like any type of resource, teachers’ time can be used more or less effectively to promote a range of outcomes such as student learning, equity and well-being. Whether teachers are given an additional hour in the classroom, an hour to prepare their lessons or an hour to engage in professional learning can affect both the cost and the quality of education. Based on OECD survey data and indicators, this paper provides a systematic overview of how teachers across the OECD report using their time and how their time use is regulated in national policy frameworks. Building on the findings from the OECD School Resources Review series, the paper then explores human resource policies that can support education stakeholders in rethinking priorities, roles and responsibilities in school education and promote an effective use of teachers’ time.

While teachers’ initial education is key to ensuring that new teachers are prepared for their work, it is only one piece in the continuum of teachers’ professional growth. Continuing professional learning is vital for teachers to broaden and deepen their knowledge, keep up with new research, tools and practices and respond to their students’ changing needs. It also plays a key role in building collaborative school cultures and supporting the collective improvement of the teaching profession. While the importance of continuing teacher learning is widely recognised, building efficient, equitable and sustainable professional learning systems is far from trivial. The OECD Teachers’ Professional Learning (TPL) study seeks to support the development of effective TPL policies and practices in schools and school systems. This paper proposes a theoretical and analytical framework for the study, systematically maps available OECD indicators to this framework and identifies information gaps and areas for future comparative work.

Hand injuries are common and can result in a long time off work. To analyse and identify factors affecting time of work, a holistic view on patients is needed. World Health Organization's International Classification of Functioning, Disability and Health (ICF) with its bio-psycho-social perspective provides such a holistic view. The purpose of this study is to analyse time off work in patients with traumatic hand injuries and to identify factors affecting time off work from a bio-psycho-social perspective. We used factors derived from the ICF Core Set for Hand Conditions to predict time off work by applying Cox regression analyses and Kaplan-Meier method using data of a multicentre prospective study in nine German Level 1 hand trauma centres. In total, 231 study participants with a broad range of hand injuries were included. From these, 178 patients (77%) returned to work within 200 days. Impairments in mobility of joint functions and sensory functions related to temperature and other stimuli as well as higher hand strain at work led to extended time off work. Gender, fine hand use and employment status additionally influenced time off work in sub-models. Our results demonstrate that a bio-psycho-social perspective is recommended when investigating time off work.

Hintergrund Skaphoidfrakturen stellen die weitaus haufigsten Bruche der Handwurzelknochen dar und fuhren oft zu problematischen Heilungsverlaufen. Pseudarthrosen sind haufig und haben vielfaltige Ursachen. Unbehandelt fuhren sie zur Handgelenkarthrose und zum karpalen Kollaps. Ziel der Diagnostik und Behandlung von Skaphoidfrakturen ist deshalb die knocherne Ausheilung unter Erhaltung der normalen Knochenform und der langfristig normalen Funktion des Handgelenkes.

Hintergrund Voll- und Teilarthrodesen stellen heute differenzierte Behandlungsverfahren bei vielen fortgeschrittenen pathologischen Veranderungen des Handgelenks dar. Diese retrospektive Studie untersucht die subjektiven und objektiven Ergebnisse verschiedener handchirurgischer Versteifungsmethoden (Vollarthrodese, STT-Fusion [Fusion von Skaphoid, Trapezium und Trapezoideum] und mediokarpale Teilarthrodese).

The effective use of school resources is a policy priority across OECD countries. The OECD Reviews of School Resources explore how resources can be governed, distributed, utilised and managed to improve the quality, equity and efficiency of school education. The series considers four types of resources: financial resources, such as public funding of individual schools; human resources, such as teachers, school leaders and education administrators; physical resources, such as location, buildings and equipment; and other resources, such as learning time. This series offers timely policy advice to both governments and the education community. It includes both country reports and thematic studies.

Im vorliegenden Beitrag wird der rehabilitative Ablauf nach einer tiefen queren Schnittverletzung in der proximalen Hohlhand mit Durchtrennung aller 9 Beugesehnen, des N. medianus und des N. ulnaris am Beispiel einer 24-jahrigen Patientin dargestellt. Hierbei wird insbesondere auf die funktionelle Nachbehandlung nach Kleinert, Abhartungsmasnahmen, die Uberprufung der Reinnervierung und das Sensibilitatstraining eingegangen.

Background: Giant-cell tumors of the distal radius are rare. They have a high-risk of local recurrence and a risk of pulmonary metastasis. Curettage alone or combined with adjunctive agents is often associated with local recurrence. Methods: Three patients with giant-cell tumor of the distal radius are presented. All patients showed Campanacci grade 3 lesions. All patients underwent complete distal radius resection and reconstruction with a vascularized fibular graft distally fused with the scaphoid and the lunate, allowing midcarpal motion. Results: The follow-up period ranged from 6 to 60 months. For all three patients, emotional acceptance was excellent. The postoperative motion of the wrist was good, with a range of motion of 30-0-30°, 40-0-0°, and 30-0-10° (extension–flexion). There was neither tumor recurrence nor pulmonary metastasis. Conclusion: Fibulo-scapho-lunate fusion is an elegant method of distal radius reconstruction with good functional outcome and low risk of pulmonary metastasis. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.

Korngrosenanalysen werden haufig fur die hochauflosende Charakterisierung der raumlichen Variabilitat von kf-Werten genutzt und sind somit Grundlage vieler hydrogeologischer Modellierungen. In Anbetracht der Vielzahl von Formeln zur Berechnung von kf-Werten auf Grundlage von Korngrosenanalysen existiert ein breites Spektrum an Literatur zur Evaluierung dieser Formeln, allerdings wurden bislang weder der Grad der Reproduzierbarkeit, noch die Auswirkungen der in der Praxis unvermeidbaren Messunsicherheit bei der Korngrosenanalyse auf die errechneten kf-Werte kritisch betrachtet.

INTRODUCTION: The necessity of spongiosaplasty in the treatment of solitary enchondroma in the hand has been a subject of controversial discussions for several years. Over a period of 10 years the authors performed single curettage without spongiosaplasty. The aim of this study was to investigate our results and to compare these findings with those of other studies. PATIENTS AND METHOD: Over the last 10 years we have treated 106 patients with solitary enchondroma of the hand by single curettage without bone grafting. All patients underwent postoperative radiological examination. The mean follow-up was 34 months. The results of the X-ray investigation were examined retrospectively concerning the recurrence rates and the Hasselgren score. RESULTS: Two patients (1.9%) have experienced radiological changes according to Hasselgren score IV. One patient (0.8%) demonstrated radiological III° changes according to score of Hasselgren. Including the patient with the radiological changes according to Hasselgren score III, the overall recurrence rate was 2.8%. DISCUSSION: After comparing our results with those of other studies, we conclude that additional bone-grafting does not improve the recurrence rate of solitary enchondromas of the hand.

The effective use of school resources is a policy priority across OECD countries. The OECD Reviews of School Resources explore how resources can be governed, distributed, utilised and managed to improve the quality, equity and efficiency of school education. The series considers four types of resources: financial resources, such as public funding of individual schools; human resources, such as teachers, school leaders and education administrators; physical resources, such as location, buildings and equipment; and other resources such as learning time. This series offers timely policy advice to both governments and the education community. It includes both country reports and thematic studies.

Nach Sehnenverletzungen an der Hand entscheidet die Qualitat der Diagnostik, Operation und Nachbehandlung uber die wieder zu erwartende Funktion.

Die Indikation zur Anwendung des Fixateur externe am Handskelett hat sich im Lauf der letzten 25 Jahre uber die Versorgung von hohergradigen Frakturen ausgedehnt und mittlerweile einen festen Stellenwert im Repertoire des versierten Handchirurgen erhalten. Durch die 3 Hauptwirkungen der externen Fixation wie Distraktion,Kompression und Immobilisation kann das handchirurgische Einsatzspektrum auch auf Infektsituationen, Fehlbildungen,Kallusdistraktionen u. a.ausgedehnt werden.Ein universelles Fixateursystem hat sich nicht herausgebildet. Aufgrund der Vielseitigkeit sind die Anforderungen an den Chirurgen gewachsen.

How can student assessment, teacher appraisal, school evaluation and system evaluation bring about real gains in performance across a country’s school system? This review report for the Netherlands provides, from an international perspective, an independent analysis of major issues facing the Dutch evaluation and assessment framework in education, current policy initiatives and possible future approaches. This series forms part of the OECD Review on Evaluation and Assessment Frameworks for Improving School Outcomes.

This book finds that, in many ways, Northern Ireland stands out internationally with its thoughtfully designed evaluation and assessment framework. The major components are well developed, in particular policies for student assessment, school evaluation and school system evaluation. It has been developed using the majority of key design principles recommended by the OECD. The approach to evaluation and assessment combines: central control over policy development and standard setting; transparency over procedures and reporting of results; an increasing responsibility for the implementation of evaluation and assessment among teachers and schools; and central mechanisms to monitor the effectiveness of implementation. For example, while schools and their Boards of Governors are accountable for their educational quality and are accountable to their communities, school development planning processes are also monitored as part of external school evaluation by a central inspectorate. Teachers play a central role in student assessment and their assessment of pupil progress against central standards is moderated by a central agency which engages working teachers in the process. Teachers in primary schools are offered central diagnostic tests to support their assessment of pupil progress. Only teacher appraisal remains entirely school based, but there is a set of common competence standards for teachers.

This book provides, from an international perspective, an independent analysis of major issues facing teacher evaluation, current policy initiatives, and possible future approaches in Chile.

This book provides, from an international perspective, an independent analysis of major issues facing the educational evaluation and assessment framework, current policy initiatives, and possible future approaches in Mexico.

This book provides, from an international perspective, an independent analysis of major issues facing the educational evaluation and assessment framework, current policy initiatives, and possible future approaches in Portugal.