[Inpatient vs. outpatient costs analysis of septumplasty in Germany]. / Potenzialanalyse und Kostenbewertung bei der ambulanten Durchführung der Septumkorrektur.

The septumplasty is realized inpatient and outpatient in different countries. Caused by the pressure of reduction of expenses there is the question of the economic benefit if done outpatient in Germany. A comparison of the inpatient and outpatient gratification will be done. There is a yearly potential of cost reduction of 180 million euro, if the operation would be done as an outpatient procedure. From the hospital view actual there is no economical recommendation doing an outpatient septumplasty caused by the poor outpatient remuneration. That's why an adjustment of the outpatient remuneration should be done. Actual there is no medical or economical recommendation doing the septumplasty as an outpatient procedere.

[Rare mechanisms of blowout fractures. Discussion of two case reports]. / Seltene Mechanismen von Orbitabodenfrakturen. Diskussion von 2 Fallberichten.

In the emergency room different forms of traumata with resulting insulating orbital blowout fracture are observed. The cause of accident is almost always impact to the central face with a solid object or on a hard surface. The hydraulic pressure theory and buckling force theory in terms of the pathomechanism are valid and accepted explanation models. We report two clinical cases of unusual injury mechanisms, which we discuss with reference to the available literature.

[Partial nucleotomy of the ovine disc as an in vivo model for disc degeneration]. / Die partielle Nukleotomie der ovinen Bandscheibe als In-vivo-Modell für die Bandscheibendegeneration.

AIM: The aim of this study was to develop a suitable animal model for the clinical situation of progressive disc degeneration after microsurgical nucleotomy. METHODS: Twenty sheep underwent standardised partial anterolateral nucleotomy at lumbar segment 3/4. After randomisation, 10 animals were sacrificed after 12 weeks (group 1). The remainder was sacrificed after 48 weeks (group 2). For radiological examination X-rays, MRI and post-mortem CT scans were performed. Lumbar discs L 3/4 with adjacent subchondral trabecular bone were harvested and analysed macroscopically and histologically. An image-analysing computer program was used to measure histomorphometric indices of bone structure. RESULTS: 17 segments could be evaluated. After 12 weeks (group 1) histological and radiological degenerative disc changes were noted. After 48 weeks (group 2), radiological signs in MRI reached statistical significance. Furthermore, group 2 showed significantly more osteophyte formations in CT scans. Histomorphometric changes of the disc and the adjacent vertebral bone structure suggest a significant progressive degenerative remodelling. The facet joints did not show any osteoarthrosis after 48 weeks. CONCLUSIONS: Partial nucleotomy of the ovine lumbar disc leads to radiological and histological signs of disc degeneration similar to those seen in humans after microsurgical nucleotomy. The presented in vivo model may be useful to evaluate new orthopaedic treatment strategies.