[Case-based learning can improve the teaching quality in trauma surgery education : A survey analysis among medical students]. / Fallbasiertes Lernen kann die Lehrqualität im unfallchirurgischen Unterricht verbessern : Eine Umfrageanalyse unter Medizinstudierenden.

BACKGROUND: Medical education has always been challenging for students and teachers. Of growing importance is the promotion of knowledge of correlations and knowledge transfer from theoretical aspects into clinical practice. In order to achieve this aim, student-centered teaching concepts are increasingly being employed in the literature. OBJECTIVE: Can a trauma surgery practical seminar be improved by a case-based teaching concept? MATERIAL AND METHODS: For this purpose, standardized case studies and corresponding teaching materials, such as classification aids and treatment strategies, were made available to the students and lecturers. Using a two-staged evaluation the effects of the modified teaching design could be recorded and statistically analyzed. RESULTS: The seminar was considered to be relevant for the examinations. The teaching by the lecturers was found to be more competent and appeared more motivated. Overall, the seminar was rated better by the students. CONCLUSION: A case-based teaching concept can significantly improve the education in trauma surgery, when correctly and specifically implemented.

A novel internal fixation method for open book injuries of the pubic symphysis- A biomechanical analysis.

BACKGROUND: Pelvic fractures in adults are common injuries and account for up to 3.64% of all fractures. Usually, the treatment of open book injuries (Types B1.1 and B1.2 AO-Classification) is open reduction and plate stabilization using dynamic compression plates, with or without interlocking screws. These implants seem to enhance the outcome of such injuries, but also variety of complications occurs. To reduce complications and achieve appropriate reduction and stabilization, this study compared established stabilization techniques to a novel minimally invasive internal fixation method using an internal fixator system that is already being utilized for spinal fractures. METHODS: This study was performed on 32 composite pelvises in a bilateral stance biomechanical model. The pelvises were variously stabilized with an internal fixator, a 4.5 mm dynamic compression plate and a 3.5 mm symphyseal locking dynamic compression plate. The contact area and loading forces were assessed by a sensor film inside the symphyseal gap. FINDINGS: This study showed significantly greater reduction and loading capabilities of the internal fixator compared to the other implants (p < 0.05). There was also significantly greater contact area with the use of an internal fixator compared to the other implants (p < 0.05). The 3.5 mm interlocking plate showed significantly greater contact area compared to the 4.5 mm plate (p < 0.05). INTERPRETATION: The internal fixator that is already proven in spinal surgery is biomechanically superior to conventional implants used in pelvic surgery. The contact area analysis furthermore showed a more physiological loading pattern, which can improve ligamentous healing in a clinical context.

Stabilization of a Type B1.1 Injury in a Morbidly Obese Patient Using an Internal Fixator in a Minimally Invasive Technique: A Case Report.

CASE: In this case report, we present a novel stabilization technique of the pubic symphysis using an internal spinal fixator in a 78-year-old morbidly obese woman having a pelvic disruption type B1.1 (AO classification). We treated the disruption using an internal fixator to reduce the extent of the incision and soft-tissue damage. CONCLUSIONS: The use of an internal fixator, known from percutaneous spinal fixation, for the stabilization of the pubic symphysis in cases of disruption ("open book" injuries) may be an alternative to the standard plate fixation as a novel minimally invasive stabilization technique.

Massa adiposa ligamenti falciformis or anterior abdominal fat pad - Its dimension and relation to body weight.

The anterior abdominal fat pad is associated with the falciform ligament in the upper middle/right abdomen and is frequently seen there in diagnostic imaging. It varies greatly in size and has often been described as an incidental finding in adults and has hitherto rarely been regarded as being illness-relevant. The aim of this study has been to assess whether the dimension of the corpus adiposum may be associated with body mass index. Ultrasound findings of 26 patients from birth until adolescence were analyzed for this purpose. In addition, an example from a recent dissection course has been included. The structure is constantly found with its smallest dimension in newborns, with a slight increase in infancy. The average dimensions were 7.6 by 3.5 by 0.7cm. The cubic volume correlated with age, weight and body mass index, whereas the latter association was strongest. Our data suggest that routinely determined dimension of falciform fat may be a surrogate parameter of relative body weight in childhood.