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Die Gesamtversorgung des polytraumatisierten Patienten

  • H. Tscherne
  • G. Regel

Zusammenfassung

Die Versorgung des polytraumatisierten Patienten ist ein vorrangiges Problem in unserer Gesellschaft und ihre adäquate Behandlung muß in Zukunft eine zentrale Rolle im Gesundheitssystem der Bundesrepublik Deutschland darstellen. Ziel der Versorgung muß eine weitere Verringerung der Letalität und eine Verbesserung der körperlichen und sozialen Rehabilitation von Unfallverletzten sein.

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Literatur

  1. 1.
    Aebi M, Mohler J, Zach GA, Morscher E (1986) Indication, surgical technique, and results of 100 surgically-treated fractures and fracture-dislocations of the cervical spine. Clin Orthop 244–257.Google Scholar
  2. 2.
    American College of Surgeons (1986) Hospital and prehospital resources for optimal care of the injured patient. (abstract).Google Scholar
  3. 3.
    AOK (1990) Krankheitsartenstatistik des AOK-Bundesverbandes 1990. (abstract).Google Scholar
  4. 4.
    Baum H (1989) Wirtschaftliche Erfolgsmessung der Luftrettung. Tagungsbericht der 10. RTH-Fachtagung, Garmisch-Partenkirchen, 11–13 Oktober 1989. (abstract).Google Scholar
  5. 5.
    Bishop MH, Jorgens J, Shoemaker WC et al. (1991) The relationship between ARDS, pulmonary infiltration, fluid balance, and hemodynamics in critically ill surgical patients. Am Surg 57:785–792.PubMedGoogle Scholar
  6. 6.
    Blauth M, Tscherne H, Haas N (1987) Therapeutic concept and results of operative treatment in acute trauma of the thoracic and lumbar spine: the Hannover experience. J Orthop Trauma 1:240–252.PubMedCrossRefGoogle Scholar
  7. 7.
    Bone L, Bucholz R (1986) The management of fractures in the patient with multiple trauma. J Bone Joint Surg (Am) 68:945–949.Google Scholar
  8. 8.
    Bosch U, Pohlemann T, Haas N, Tscherne H (1992) [Classification and management of complex pelvic trauma] Klassifikation und Management des komplexen Beckentraumas. Unfallchirurg 95:189–196.PubMedGoogle Scholar
  9. 9.
    Bundesanstalt für Strassenwesen (1995) Amtliche Mitteilungen der Bundesanstalt für Straßen-wesen. (abstract).Google Scholar
  10. 10.
    Driscoll PA, Vincent CA (1992) Variation in trauma resuscitation and its effect on patient outcome. Injury 23:111–115.PubMedCrossRefGoogle Scholar
  11. 11.
    Driscoll PA, Vincent CA (1992) Organizing an efficient trauma team. Injury 23:107–110.PubMedCrossRefGoogle Scholar
  12. 12.
    Ertel W, Trentz O (1996) Das stumpfe und penetrierende Abdominaltrauma. Unfallchirurg 99:288–303.PubMedGoogle Scholar
  13. 13.
    Ganz R, Krushell RJ, Jakob RP, Kuffer J (1991) The antishock pelvic clamp. Clin Orthop 71–78.Google Scholar
  14. 14.
    Garrett JW, Braunstein PW (1962) The seat belt syndrome. J Trauma 2:220.Google Scholar
  15. 15.
    Glinz W, Affentranger T (1975) The fate of patients with severe multiple injuries, 5 years after intensive care. Bull Soc Int Chir 34:545–548.PubMedGoogle Scholar
  16. 16.
    Hansen ST (1987) The type IIIC open tibial fracture. Salvage or amputation. J Bone Joint Surg (Am) 69:799–800.Google Scholar
  17. 17.
    Helfet DL, Howey T, Sanders R, Johansen K (1990) Limb salvage versus amputation. Preliminary results of the Mangled Extremity Severity Score. Clin Orthop 80–86.Google Scholar
  18. 18.
    Hoffmann R, Nerlich M, Muggia Sullam M, Pohlemann T, Wippermann B, Regel G, Tscherne H (1992) Blunt abdominal trauma in cases of multiple trauma evaluated by ultrasonography: a prospective analysis of 291 patients. J Trauma 32:452–458.PubMedCrossRefGoogle Scholar
  19. 19.
    Hüfner T, Schmidt U, Regel G, Zeichen J, Tscherne H (1995) Das traumatische Hochdrucködem der Lunge. Rettungsdienst 18:6–11.Google Scholar
  20. 20.
    Jeffrey RB Jr, Federle MP, Crass RA (1983) Computed tomography of pancreatic trauma. Radiology 147:491–494.PubMedGoogle Scholar
  21. 21.
    Kivioja AH, Myllynen PJ, Rokkanen PU (1990) Is the treatment of the most severe multiply injured patients worth the effort? A follow-up examination 5 to 20 years after severe multiple injury. J Trauma 30:480–483.PubMedGoogle Scholar
  22. 22.
    Krettek C, Schandelmaier P, Guy P, Tscherne H (1996) Transartikuläre Rekonstruktion, perkutane Plattenosteosynthese und retrograde Nagelung. Unfallchirurg 99:2–10.PubMedGoogle Scholar
  23. 23.
    Krettek C, Schandelmaier P, Rudolf J, Tscherne H (1994) Unreamed nailing of the tibial shaft fractures: update of techniques and results based on the analysis of 75 reviewed cases. Unfallchirurg 11:575–599.Google Scholar
  24. 24.
    Krettek C, Schandelmaier P, Tscherne H (1995) Nonreamed interlocking nailing of closed tibial fractures with severe soft tissue injury. Clin Orthop 34–47.Google Scholar
  25. 25.
    MacKenzie EJ, Morris JA Jr, Smith GS, Fahey M (1990) Acute hospital costs of trauma in the United States: implications for regionalized systems of care. J Trauma 30:1096–1101.PubMedCrossRefGoogle Scholar
  26. 26.
    MacKenzie EJ, Siegel JH, Shapiro S, Moody M, Smith RT (1988) Functional recovery and medical costs of trauma: an analysis by type and severity of injury. J Trauma 28:281–297.PubMedCrossRefGoogle Scholar
  27. 27.
    McNamara MG, Heckman JD, Corley FG (1994) Severe open fractures of the lower extremity: a retrospective evaluation of the Mangled Extremity Severity Score (MESS). J Orthop Trauma 8:81–87.PubMedCrossRefGoogle Scholar
  28. 28.
    Moore FA, Haenel JB, Moore EE, Whitehill TA (1992) Incommensurate oxygen consumption in response to maximal oxygen availability predicts postinjury multiple organ failure [see comments]. J Trauma 33:58–65.PubMedCrossRefGoogle Scholar
  29. 29.
    Pape HC, Regel G, Dwenger A, Sturm JA, Tscherne H (1993) Influence of thoracic trauma and primary femoral intramedullary nailing on the incidence of ARDS in multiple trauma patients. Injury 24 (Suppl 3): S82–103.PubMedCrossRefGoogle Scholar
  30. 30.
    Pohlemann T, Bosch U, Gansslen A, Tscherne H (1994) The Hannover experience in management of pelvic fractures. Clin Orthop 69–80.Google Scholar
  31. 31.
    Regel G, Lobenhoffer P, Lehmann U, Pape HC, Pohlemann T, Tscherne H (1993) [Results of treatment of polytraumatized patients. A comparative analysis of 3 406 cases between 1972 and 1991] Ergebnisse in der Behandlung Polytraumatisierten Eine vergleichende Analyse von 3406 Fällen zwischen 1972 und 1991. Unfallchirurg 96:350–362.PubMedGoogle Scholar
  32. 32.
    Regel G, Seekamp A, Takacs J, Bauch S, Sturm JA, Tscherne H (1993) [Rehabilitation and reintegration of polytraumatized patients] Rehabilitation und Reintegration polytraumatisierter Patienten. Unfallchirurg 96:341–349.PubMedGoogle Scholar
  33. 33.
    Schmidt U, Frame SB, Nerlich ML, Rowe DW, Enderson BL, Maull KI, Tscherne H (1992) On-scene helicopter transport of patients with multiple injuries-comparison of a German and an American system [see comments]. J Trauma 33:548–553.PubMedCrossRefGoogle Scholar
  34. 34.
    Schwartz RJ, Jacobs LM, Yaezel D (1989) Impact of pre-trauma center care on length of stay and hospital charges [see comments]. J Trauma 29:1611–1615.PubMedCrossRefGoogle Scholar
  35. 35.
    Trentz O (1993) [Management of patients with multiple injuries] Management des Mehrfachverletzten. Ther Umsch 50:491–499.PubMedGoogle Scholar
  36. 36.
    Trunkey D (1991) Initial treatment of patients with extensive trauma. N Engl J Med 324:1259–1263.PubMedCrossRefGoogle Scholar
  37. 37.
    Trunkey DD (1982) Society of University Surgeons. Presidential address: On the nature of things that go bang in the night. Surgery 92:123–132.Google Scholar
  38. 38.
    Tscherne H, Illgner A (1991) Die ventrale interkorporelle Spondylodese der Halswirbelsäule. Operat Orthop Traumatol 3:147–157.CrossRefGoogle Scholar
  39. 39.
    Tscherne H, Nerlich ML, Sturm JA (1988) Der schwerverletzte Patient—Prioritäten und Management. Hefte Unfallheilkd 394–410.Google Scholar
  40. 40.
    Tscherne H, Regel G, Sturm JA, Friedl HP (1987) [Degree of severity and priorities in multiple injuries] Schweregrad und Prioritäten bei Mehrfachverletzungen. Chirurg 58:631–640.PubMedGoogle Scholar
  41. 41.
    UVB (1991) Der Bundesminister für Verkehr (ed). Unfallverhütungsbericht Straßenverkehr 1991.Google Scholar
  42. 42.
    VDR (1991) Verband Deutscher Rentenversicherungsträger. VDR Statistik: 99.Google Scholar
  43. 43.
    VFB (1988) Verletzungsfolgekosten nach Straßenverkehrsunfällen. Schriftenreihe der gewerblichen Berufsgenossenschaften e.V. (abstract).Google Scholar
  44. 44.
    Waydhas C, Nast Kolb D, Trupka A, Zettl R, Kick M, Wiesholler J, Schweiberer L, Jochum M (1996) Posttraumatic inflammatory response, secondary operations, and late multiple organ failure. J Trauma: Injury, Infection, and Critical Care 40:624–631.CrossRefGoogle Scholar
  45. 45.
    Whitesides TE, Heckman MM (1996) Acute Compartment Syndrome: Update on Diagnosis and Treatment. J Amer Acta Orthop Surg 4:209–218.Google Scholar
  46. 46.
    Zangger P (1989) [Rehabilitation of polytraumatized brain-injured patients] Die Rehabilitation von polytraumatisierten hirnverletzten Patienten. Ther Umsch 46:455–459.PubMedGoogle Scholar
  47. 47.
    Zink PM, Samii M (1991) [Diagnosis and surgical treatment of craniocerebral trauma within the scope of polytrauma management] Die Diagnostik und operative Behandlung des Schädel-Hirn-Traumas im Rahmen der Polytraumaversorgung. Unfallchirurg 94:122–128.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • H. Tscherne
  • G. Regel

There are no affiliations available

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