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Copyright of Chirurgie (2731-6971) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Tibial plateau fractures represent 1-2 % of all human fractures. Complex fractures affecting the tibial joint surface and accompanying injuries of the soft tissue covering can be a special challenge for surgeons. This paper provides the current state of treatment options. Classification: In German-speaking countries the classification of the Working Group for Osteosynthesis ( Arbeitsgemeinschaft für Osteosynthesefragen, AO) is accepted as the gold standard but in English-speaking countries the classification by Schatzker is preferred. Diagnostics: The severity of the soft tissue injury is the main factor for determining the time of operation and for perioperative decision making. The gold standards in imaging diagnostics are conventional x-ray photographs in two planes and computed tomography plus 3D reconstruction. Magnetic resonance imaging plays the most important role in evaluating concomitant injuries of ligaments and menisci. Therapy: One of the main goals is to avoid posttraumatic arthritis of the knee joint. Time and fracture management depend on the so-called personality of the fracture. Screws and locking plates are most commonly used as implants. The importance of arthroscopically assisted surgery is increasing. For filling bone defects artificial bone graft substitutes are inserted more frequently. Conclusion: The long-term outcome of surgically treated younger patients with low energy trauma seems to be good. Poorer results can be expected in cases with high energy trauma and higher degrees of destruction of the tibial joint surface. The ongoing research on operation techniques, implants and bone graft substitutes aims at improving the results in the future. [ABSTRACT FROM AUTHOR]

Concept and design of an independent scientific evaluation of different pathways of care for schizophrenia patients in Germany with respect to effectiveness and efficiency are presented. In this prospective, observational study, schizophrenia patients receiving an integrated care treatment, the intervention group (IG), are compared with patients under routine care conditions treated by the same physician (first control group, CG 1). A second control group (CG 2) of patients treated by office-based psychiatrists not participating in the integrated care program will be recruited and their data compared with the two other groups. The total amount of psychiatric hospital days after 12 months is defined as primary outcome parameter. Secondary outcome parameters comprise the frequency of psychiatric inpatient readmissions, severity of schizophrenia symptoms, remission rates and quality of life. Patients undergo assessments at baseline, month 6 and 12 using standardized and experimental questionnaires. Routine data of a regional German social health insurance fund complement information on included patients. Additionally, a cost-effectiveness and cost-utility analysis will be performed. Until now, 137 psychiatrists included 980 patients in the integrated care project in Lower Saxony, Germany, and 47 psychiatrists (IG and both CGs) are willing to participate in the independent evaluation. For the first time, a prospective observational controlled evaluation study of a countrywide integrated care project planning to recruit 500 schizophrenia patients has started using comprehensive assessments as well as routine data of a social health insurance fund. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)