Modified triangular posterior osteosynthesis of unstable sacrum fracture.

We report preliminary results for unstable sacral fractures treated with a modified posterior triangular osteosynthesis. Seven patients were admitted to our trauma center with an unstable sacral fracture. The average age was 31 years (22-41). There were four vertical shear lesions of the pelvis and three transverse fracture of the upper sacrum. The vertical shear injuries were initially treated with an anterior external fixator inserted at the time of admission. Definitive surgery was performed at a mean time of 9 days after trauma. The operation consisted in a posterior fixation combining a vertebropelvic distraction osteosynthesis with pedicle screws and a rod system, whereby the transverse fixation was obtained using a 6 mm rod as a cross-link between the two main rods. Late displacement of the posterior pelvis or fracture was measured on X-ray films according to the criteria of Henderson. The patients were followed-up for a minimum time of 12 months. Four patients who presented with a pre-operative perineal neurological impairment made a complete recovery. No iatrogenic nerve injury was reported. One case of deep infection was managed successfully with surgical debridement and local antibiotics. All patients complained of symptoms related to the prominence of the iliac screws. The metalwork was removed in all cases after healing of the fracture, at a mean time of 4.3 months after surgery. No loss of reduction of fracture was seen at final radiological follow-up. The preliminary results are promising. The fixation is sufficiently stable to allow an immediate progressive weight-bearing, and safe nursing care in polytrauma cases. The only problem seems to be related to prominent heads of the distal screws

Crackling Noise

Crackling noise arises when a system responds to changing external conditions through discrete, impulsive events spanning a broad range of sizes. A wide variety of physical systems exhibiting crackling noise have been studied, from earthquakes on faults to paper crumpling. Because these systems exhibit regular behavior over many decades of sizes, their behavior is likely independent of microscopic and macroscopic details, and progress can be made by the use of very simple models. The fact that simple models and real systems can share the same behavior on a wide range of scales is called universality. We illustrate these ideas using results for our model of crackling noise in magnets, explaining the use of the renormalization group and scaling collapses. This field is still developing: we describe a number of continuing challenges

Chancen und Risiken der digitalen Transformation für die Rechnungslegung

Die heutige Gestalt des Rechnungswesens geht auf konzeptionelle Überlegungen früherer Dekaden zurück. Auch jüngere Entwicklungen in Finanzberichterstattung und Controlling sind davon nicht ausgenommen. Durch die digitale Transformation haben sich die realwirtschaftlichen Geschäftsmodelle mittlerweile – im Vergleich zu jenen dieser Entstehungszeit – aber fundamental geändert. Altbekannte Verfahren und Instrumente müssen entsprechend angepasst werden. Durch neue Technologien sind hierfür mannigfaltige Möglichkeiten gegeben, welche allerdings auch mit Herausforderungen einhergehen. Vor allem der Mensch, welcher nach wie vor primärer Entscheidungsträger und Nutzer von Informationen des Rechnungswesens ist, sollte in diesem Kontext nicht außer Acht gelassen werden, um Entscheidungs‐ und Steuerungsfehler zu vermeiden