Epicondylopathia humeri radialis. / Epicondylopathia humeri radialis (Epicondylitis radialis) ­ Diagnostik und Therapie unter Berücksichtigung der aktuellen S2k-Leitlinie.

BACKGROUND: Lateral epicondylitis is a common orthopaedic condition often massively restricting the quality of life of the affected patients. There are a wide variety of treatment options - with varying levels of evidence. METHOD: The following statements and recommendations are based on the current German S2k guideline Epicondylopathia radialis humeri (AWMF registry number: 033 - 2019). All major German specialist societies participated in this guideline, which is based on a systematic review of the literature and a structured consensus-building process. OUTCOMES: Lateral epicondylitis should be diagnosed clinically and can be confirmed by imaging modalities. The Guidelines Commission issues recommendations on clinical and radiological diagnostic workup. The clinical condition results from the accumulated effect of mechanical overload, neurologic irritation and metabolic changes. Differentiating between acute and chronic disorder is helpful. Prognosis of non-surgical regimens is favourable in most cases. Most cases spontaneously resolve within 12 months. In case of unsuccessful attempted non-surgical management for at least six months, surgery may be considered as an alternative, if there is a corresponding structural morphology and clinical manifestation. At present, it is not possible to recommend a specific surgical procedure. CONCLUSION: This paper provides a summary of the guideline with extracts of the recommendations and statements of its authors regarding the pathogenesis, prevention, diagnostic workup as well as non-surgical and surgical management.

The acceptance of CIRS among orthopedic and trauma surgeons in Germany-Significant gap between positive perception and actual implementation in daily routine.

PURPOSE: Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. METHODS: Between April 10, 2015 and May 22, 2015, a web-based questionnaire, which was designed by an expert team consisting of orthopedic and trauma surgeons, aeronautic human factors specialists, and psychologists (Lufthansa Aviation Training), was sent to all members of the German Society for Orthopedic and Trauma Surgery. The survey consisted of three questions regarding CIRS and its use in German hospitals. RESULTS: A total of 669 orthopedic and trauma surgeons working in German hospitals completed the questionnaire. All participants rated CIRS as useful, although 71.3% of participants did not report a critical incident in the last 12 months. In that time period, only 13.4% of participating residents reported at least one incident, but 44.7% of chief physicians reported one incident within the same period. CONCLUSION: The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.

[Safety Culture in Orthopaedic Surgery and Trauma Surgery - Where Are We Today?] / Sicherheitskultur in Orthopädie und Unfallchirurgie ­ wo stehen wir heute?

INTRODUCTION: The development of a new safety culture in orthopaedics and trauma surgery needs to be based on the knowledge of the status quo. The objective of this research was therefore to perform a survey of orthopaedic and trauma surgeons to achieve a subjective assessment of the frequency and causes of "insecurities" or errors in daily practice. METHODS: Based on current literature, an online questionnaire was created by a team of experts (26 questions total) and was sent via e-mail to all active members of a medical society (DGOU) in April 2015. This was followed by two reminder e-mails. The survey was completed in May 2015. The results were transmitted electronically, anonymously and voluntarily into a database and evaluated by univariate analyses. RESULTS: 799 active members took part in the survey. 65% of the interviewed people stated that they noticed mistakes in their own clinical work environment at least once a week. The main reasons for these mistakes were "time pressure", "lack of communication", "lack of staff" and "stress". Technical mistakes or lack of knowledge were not of primary importance. CONCLUSIONS: The survey indicated that errors in orthopaedics and trauma surgery are observed regularly. "Human factors" were regarded as a major cause. In order to develop a new safety culture in orthopaedics and trauma surgery, new approaches must focus on the human factor.