Search

In order to get a better data management of complications in orthopedic surgery and in order to get comparable statistics a standardisation of nomenclature and classification of complications is demanded since 1.1.1997. The Orthopedic University Clinic of Heidelberg started with a register of all early complications of all inpatients. According to a standardized nomenclature all occured complications the doctors put in the data of complications in a database. These data were controlled, complemented and classified by members of the quality menagement group. This guideline consists of five parts: catalogue of diagnoses, general and special definitions, classification and an allocation table of diagnoses to grades of severity.

Virtual Reality is a new form of human-machine interface. Virtual Reality integrates the human into the virtual world of the computer. Concerning existing Virtual Reality programs and 3D-graphics in medicine this article shows possibilities and perspectives for orthopedic surgery. Using Virtual Reality the orthopedic specialist is able to improve the diagnosis, the planning and supporting of operations just as new ways of teaching and training. Virtual Reality (VR) assists disabled individuals in improving the quality of life an working with computers. Principles will be discussed in respect to the four categories Immersive VR, Desktop VR, Pseudo VR and Inverse VR.

An historical overview is given about the medical photography especially in orthopaedic surgery from the beginning until modern times. Orthopaedic surgeons early found out the advantage of this method for documentation of clinical cases. More and more photography was used from the end of the 19. century until now because of its remarkable advantages. In the last years three dimensional photographic measurement has established and is acknowledged to be useful in diagnosis and follow up of deformities, especially of scoliosis. Cinematographic methods for analysis of human movement are helpful tools for diagnosis and therapy of pathologic movement.

Questions By which criteria can a homepage be evaluated? How is the quality of homepages provided by universities in the field of orthopaedics/traumatology? Methods Based on 37 ranking instruments, an optimized list of criteria has been developed. Homepages of orthopaedic and traumatology departments of medical schools in the G7 Nations have been found with help of university homepages and search engines and afterwards were analysed according to previously defined criteria. Results A list of criteria containing 18 subject areas with 49 questions was developed. 136 homepages were evaluated from October 1998 to April 1999. 15 outstanding homepages were found. The best homepages are from medical schools in the USA and Germany. The most frequent subjects were structure of the department (contained in 85% of the homepages) and education/training (68%). 42 homepages provided medical information, 67% of those homepages provided references (attribution), and 26% provided information about authority and authorship. 46% of all hompages were not updated sufficiently. Out of 125 homepages with an e-mail address 36% responded to an inquiry. Multimedia features such as video, sound or animation were used by 6% of the homepages. Conclusion Apart from few exceptions, homepages of orthopaedic-traumatologic departments of medical schools are still insufficient with regard to quality and quantity, especially regarding medical information for patients and professionals. The developed last of criteria should be helpful in installing a basic standard for homepage quality. The time and effort involved in setting up and servicing a homepage should not be underestimated.

For the judgment of the quality of medical services and for the progress of clinical medicine the comparison of data and informations of the diagnostic and therapeutic process is demanded. Therefore a systematic and concrete system of documentation should be implemented in every clinic, which consists of standard nomenclature, classification, instruments of outcome measure and documentation standards. There are a group of problems and barriers which stand in the way of this goal. It is useful to build a minimum basis data set which includes core criterias of clinical dokumentation in orthopedic surgery and include this in an information system so that all of these parts are considered and that a central and comparable data pool is offered for patient care, quality management and research.

An overview of the 30 years history and developement of documentation and information systems in the Orthopedic University Hospital Heidelberg is presented. Since the foundation in 1967 four developmental phases can be described: first initiatives of medical doctors, establishment of a basic documentation system for scientific purposes, strategic information system planning and realisation of information systems with the possibility of controlling in medical areas and thereby steering of the services. Planning and realisation were accomplished within the framework of the masterplans and concepts of the university clinics of the state of Baden-Württemberg.

A solitary osteochondroma of the metatarsale II of an adolescent is presented which led to a painful Metatarsus primus varus. After resection of the tumor the patient was free of symptoms, the postoperative resulting form of the foot was normal. One should be aware of a tumor as a possible cause of foot deformities.