[Treatment concept for a traumatic lesion of the prepatellar bursa]. / Behandlung der traumatisch eröffneten Bursa praepatellaris.

OBJECTIVE: Rapid recovery of the skin and soft tissue of the affected knee joint with surgical debridement of the wound and gentle, as well as risk-balanced partial resection of the traumatic lacerated prepatellar bursa. Functional aftercare with directed administration of antibiotics only. INDICATIONS: Acute, traumatic laceration of the prepatellar bursa. CONTRAINDICATIONS: Heavy contamination of the wound. Large, not closable skin defect or deep abrasion. Preexisting local infection. Additional fracture of the patella. Limited patient's cooperation, e. g., alcohol addiction or dementia. SURGICAL TECHNIQUE: Subdermal application of local anesthesia through the exposed wound margins. Exploration of the wound and excision of the wound margins. Dissection of the boundary layer between the bursa and the subcutaneous fat. Debridement of the wound and excision of the bruised and contaminated bursa tissue. Repetitive rinsing. Insertion of loop drainage. Single-layer wound closure. Crepe bandage. POSTOPERATIVE MANAGEMENT: Crepe bandage until the first wound inspection. Wound inspection on postoperative day 2 with removal of the loop. Pain-adapted functional treatment. Antithrombotic therapy until full weight-bearing. Removal of the stitches on postoperative day 14. Antibiotic prophylaxis (1st generation cephalosporin) for immunocompromised or polymorbid patients or heavily contaminated wounds. RESULTS: In 2013, we treated 50 traumatic lacerations of the prepatellar bursa. Four had to undergo further surgical treatment after primary care. In two other patients, one infected and one non-infected wound healing complication developed, which could be treated conservatively.

[Factors Associated with the Use of Protective Gear among Adults during Recreational Sledging]. / Einflussfaktoren auf das Tragen von Schutzausrüstung bei erwachsenen Rodlern.

BACKGROUND: Recreational sledging (tobogganing) is a very popular winter sport in the Alps. Therefore, injury prevention through the usage of protective gear seems important. Therefore, the aim of this study was to evaluate factors associated with the use of protective gear among adults during recreational sledging. METHODS: Adult recreational sledgers were interviewed during the winter seasons 2012/13 and 2013/14 at six sledging tracks in Austria on demographics, skill level, sledging frequency, risk taking behaviour, sitting alone or with another person on the sledge, previous sledging-related injuries, and use of protective gear, respectively. Interviews were conducted on all days of the week. RESULTS: A total of 1968 adult sledgers (49.4 % females) with a mean age of 37.1 ±â€Š14.4 years participated in this study. A (ski) helmet, sun or snow goggles, a back protector, and wrist guards were used by 42.3 %, 71.0 %, 5.9 %, 2.6 % of sledgers, respectively. Helmet use was significantly higher with increasing age and increasing skill level as well as when sitting alone compared to sitting together with another person. Females, Austrians, persons sitting alone on the sledge, a higher frequency of sledging and a higher skill level were significantly associated with an increasing use of goggles. A back protector was significantly more often worn by younger people, more risky sledgers, and persons with a previous sledging-related injury. Wrist guards were significantly more often used by persons with a previous sledging-related injury. CONCLUSION: During recreational sledging, the factors age, sex, nationality, skill level, sitting alone compared to sitting together with another person on the sledge, sledging frequency, and injury experience were associated with the frequencies of usage of different types of protective gear. These factors should be considered when implementing preventive measures for recreational sledging.