Die Behandlung der Condylus-radialis-humeri-Fraktur im Kindesalter

Zusammenfassung: Operationsziel: Operative Reposition und Retention des Condylus radialis humeri zur Vermeidung von bleibenden Fehlstellungen, Pseudarthrosen und Gelenkinstabilitäten. Indikationen: Absolut: Primär vollständig dislozierte Frakturen oder Frakturen, die nach 4 Tagen im gipsverbandfreien Kontrollröntgen eine Sekundärdislokation von > 2 mm aufweisen. Relativ: Komplette Frakturen des Condylus radialis humeri, die im Verlauf eine Sekundärdislokation von ≤ 2 mm aufweisen. Kontraindikationen: Inkomplette, sog. hängende Frakturen des Condylus radialis humeri ohne erkennbare Sekundärdislokation im Verlauf. Operationstechnik: Offene Reposition des Condylus radialis humeri über einen lateralen Zugang am Ellenbogengelenk. Bei jüngeren Kindern (< 5 Jahre) Kirschner-Draht-Fixierung. Bei älteren Kindern (≥ 5 Jahre) oder bei unzureichender Kompression Durchführung einer radialen Zugschraubenosteosynthese. Zusätzliche Periostnaht. Weiterbehandlung: Anlage einer Oberarmgipslonguette bis zum Abschluss der Wundheilung; im Anschluss Oberarmgipsverband für insgesamt 3-4 Wochen nach der Operation. Materialentfernung bei Konsolidierung (Röntgen) nach ca. 2-3 Monaten. Keine routinemäßige postoperative Physiotherapie. Ergebnisse: Im Zeitraum vom 01.01.1999 bis 31.12.2006 wurden insgesamt 85 Kinder mit einem Altersmedian von 6,1 Jahren wegen einer Condylus-radialis-humeri-Fraktur behandelt. 47 Patienten wurden operativ versorgt, davon 31 Kinder mit einer Kombination aus Schraube und Kirschner-Drähten, 13 Kinder mit einer Schraube allein und drei Kinder nur mit Kirschner-Drähten. Die Implantate wurden im Median 8,6 Wochen (5,0-17,1 Wochen) postoperativ entfernt. Insgesamt betrug die mediane Nachbeobachtungszeit 6 Monate (2-50 Monate). Bei keinem Patienten in dieser Serie traten Spätkomplikationen im Sinne einer nicht stattgefundenen Konsolidierung und/oder einer Pseudarthrosenbildung auf. In fünf Fällen mit Hypästhesien im Bereich der Haut über dem proximalen Radius kam es binnen 6 Monaten nach der Operation zu einer vollständigen Normalisierung. Im Rahmen eines Telefoninterviews im September 2007 konnten 87% der Patienten (n = 74) nachverfolgt werden. Drei Kinder gaben eine geringe Minderung der groben Kraft des verletzten Arms im Seitenvergleich an, wobei eines dieser Kinder zusätzlich ein geringes Ellenbogenflexionsdefizit berichtete, welches im Vergleich zur letzten klinischen Untersuchung nicht progredient war. In keinem der telefonisch kontaktierten Fälle war es nötig, den Patienten aufgrund persistierender Beschwerden und/oder eines subjektiv nicht akzeptablen Behandlungsergebnisses akut erneut einzubestelle

VISION - Vienna survey in Orion. III. Young stellar objects in Orion A

38 pages, 25 figures, Accepted for publication by A&A. Reproduced with permission from Astronomy & Astrophysics. © 2018 ESOWe extend and refine the existing young stellar object (YSO) catalogs for the Orion A molecular cloud, the closest massive star-forming region to Earth. This updated catalog is driven by the large spatial coverage (18.3 deg^2, ~950 pc^2), seeing limited resolution (~0.7''), and sensitivity (Ks<19 mag) of the ESO-VISTA near-infrared survey of the Orion A cloud (VISION). Combined with archival mid- to far-infrared data, the VISTA data allow for a refined and more robust source selection. We estimate that among previously known protostars and pre-main-sequence stars with disks, source contamination levels (false positives) are at least ∼7% and ∼2.5%, respectively, mostly due to background galaxies and nebulosities. We identify 274 new YSO candidates using VISTA/Spitzer based selections within previously analyzed regions, and VISTA/WISE based selections to add sources in the surroundings, beyond previously analyzed regions. The WISE selection method recovers about 59% of the known YSOs in Orion A's low-mass star-forming part L1641, which shows what can be achieved by the all-sky WISE survey in combination with deep near-infrared data in regions without the influence of massive stars. The new catalog contains 2978 YSOs, which were classified based on the de-reddened mid-infrared spectral index into 188 protostars, 184 flat-spectrum sources, and 2606 pre-main-sequence stars with circumstellar disks. We find a statistically significant difference in the spatial distribution of the three evolutionary classes with respect to regions of high dust column-density, confirming that flat-spectrum sources are at a younger evolutionary phase compared to Class IIs, and are not a sub-sample seen at particular viewing angles.Peer reviewedFinal Accepted Versio

VISIONS:the VISTA Star Formation Atlas I. Survey overview

VISIONS is an ESO public survey of five nearby (d &lt; 500 pc) star-forming molecular cloud complexes that are canonically associated with the constellations of Chamaeleon, Corona Australis, Lupus, Ophiuchus, and Orion. The survey was carried out with the Visible and Infrared Survey Telescope for Astronomy (VISTA), using the VISTA Infrared Camera (VIRCAM), and collected data in the near-infrared passbands J (1.25 μm), H (1.65 μm), and KS (2.15 μm). With a total on-sky exposure time of 49.4h VISIONS covers an area of 650 deg2, it is designed to build an infrared legacy archive with a structure and content similar to the Two Micron All Sky Survey (2MASS) for the screened star-forming regions. Taking place between April 2017 and March 2022, the observations yielded approximately 1.15 million images, which comprise 19 TB of raw data. The observations undertaken within the survey are grouped into three different subsurveys. First, the wide subsurvey comprises shallow, large-scale observations and it has revisited the star-forming complexes six times over the course of its execution. Second, the deep subsurvey of dedicated high-sensitivity observations has collected data on areas with the largest amounts of dust extinction. Third, the control subsurvey includes observations of areas of low-to-negligible dust extinction. Using this strategy, the VISIONS observation program offers multi-epoch position measurements, with the ability to access deeply embedded objects, and it provides a baseline for statistical comparisons and sample completeness – all at the same time. In particular, VISIONS is designed to measure the proper motions of point sources, with a precision of 1 mas yr−1 or better, when complemented with data from the VISTA Hemisphere Survey (VHS). In this way, VISIONS can provide proper motions of complete ensembles of embedded and low-mass objects, including sources inaccessible to the optical ESA Gaia mission. VISIONS will enable the community to address a variety of research topics from a more informed perspective, including the 3D distribution and motion of embedded stars and the nearby interstellar medium, the identification and characterization of young stellar objects, the formation and evolution of embedded stellar clusters and their initial mass function, as well as the characteristics of interstellar dust and the reddening law

VISIONS:the VISTA Star Formation Atlas I. Survey overview

VISIONS is an ESO public survey of five nearby (d &lt; 500 pc) star-forming molecular cloud complexes that are canonically associated with the constellations of Chamaeleon, Corona Australis, Lupus, Ophiuchus, and Orion. The survey was carried out with the Visible and Infrared Survey Telescope for Astronomy (VISTA), using the VISTA Infrared Camera (VIRCAM), and collected data in the near-infrared passbands J (1.25 μm), H (1.65 μm), and KS (2.15 μm). With a total on-sky exposure time of 49.4h VISIONS covers an area of 650 deg2, it is designed to build an infrared legacy archive with a structure and content similar to the Two Micron All Sky Survey (2MASS) for the screened star-forming regions. Taking place between April 2017 and March 2022, the observations yielded approximately 1.15 million images, which comprise 19 TB of raw data. The observations undertaken within the survey are grouped into three different subsurveys. First, the wide subsurvey comprises shallow, large-scale observations and it has revisited the star-forming complexes six times over the course of its execution. Second, the deep subsurvey of dedicated high-sensitivity observations has collected data on areas with the largest amounts of dust extinction. Third, the control subsurvey includes observations of areas of low-to-negligible dust extinction. Using this strategy, the VISIONS observation program offers multi-epoch position measurements, with the ability to access deeply embedded objects, and it provides a baseline for statistical comparisons and sample completeness – all at the same time. In particular, VISIONS is designed to measure the proper motions of point sources, with a precision of 1 mas yr−1 or better, when complemented with data from the VISTA Hemisphere Survey (VHS). In this way, VISIONS can provide proper motions of complete ensembles of embedded and low-mass objects, including sources inaccessible to the optical ESA Gaia mission. VISIONS will enable the community to address a variety of research topics from a more informed perspective, including the 3D distribution and motion of embedded stars and the nearby interstellar medium, the identification and characterization of young stellar objects, the formation and evolution of embedded stellar clusters and their initial mass function, as well as the characteristics of interstellar dust and the reddening law

VISIONS: The VISTA Star Formation Atlas -- I. Survey overview

© The Authors 2023. Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0).VISIONS is an ESO public survey of five nearby (d < 500 pc) star-forming molecular cloud complexes that are canonically associated with the constellations of Chamaeleon, Corona Australis, Lupus, Ophiuchus, and Orion. The survey was carried out with VISTA, using VIRCAM, and collected data in the near-infrared passbands J, H, and Ks. With a total on-sky exposure time of 49.4 h VISIONS covers an area of 650 deg$^2$, and it was designed to build an infrared legacy archive similar to that of 2MASS. Taking place between April 2017 and March 2022, the observations yielded approximately 1.15 million images, which comprise 19 TB of raw data. The observations are grouped into three different subsurveys: The wide subsurvey comprises shallow, large-scale observations and has visited the star-forming complexes six times over the course of its execution. The deep subsurvey of dedicated high-sensitivity observations has collected data on the areas with the largest amounts of dust extinction. The control subsurvey includes observations of areas of low-to-negligible dust extinction. Using this strategy, the VISIONS survey offers multi-epoch position measurements, is able to access deeply embedded objects, and provides a baseline for statistical comparisons and sample completeness. In particular, VISIONS is designed to measure the proper motions of point sources with a precision of 1 mas/yr or better, when complemented with data from VHS. Hence, VISIONS can provide proper motions for sources inaccessible to Gaia. VISIONS will enable addressing a range of topics, including the 3D distribution and motion of embedded stars and the nearby interstellar medium, the identification and characterization of young stellar objects, the formation and evolution of embedded stellar clusters and their initial mass function, as well as the characteristics of interstellar dust and the reddening law.Peer reviewe

Laparoscopy-assisted single-port appendectomy in children

In childhood, laparoscopy-assisted single-port appendectomy (SPA), including the advantages of open and laparoscopic surgery, is not widely used. However, there is debate whether the retrieval of the infected appendix via the umbilicus results in a higher infection rate compared with other laparoscopic or open techniques. The aim of the study was to determine the postoperative infection rate and possible risk factors for infection after SPA in children

Surgical decision criteria : Bednar tumour of the foot in a child

An 8-year-old boy was admitted for excision of a putative 'blue nevus' on the left foot. Histological examination and immunohistochemistry revealed a Bednar tumour, the pigmented variant of dermatofibrosarcoma protuberans. Surgical options considered by a multidisciplinary team included wide local excision, Mohs micrographic surgery or a staged excision with examination of several histological sections. The third alternative procedure was chosen after consideration of tumour and patient factors to achieve the best possible clinical, cosmetic and functional outcome. After the final surgical procedure with resection of the third metatarsal bone, all peripheral margins were free of tumour, and the interdigital space was reconstructed with a pedicled pulpa flap. Three years after surgery, there was no tumour recurrence, and further long-term follow-up for this patient will be provided

A simple scoring system to train surgeons in basic laparoscopic skills

AIM To develop and validate a scoring system for a training assessment tool using a box trainer which can objectively demonstrate progression in laparoscopic skills. METHOD 170 assessments were performed over a 5-year period by doctors working in a busy paediatric surgical department. Each participant was scored based on experience and then undertook six laparoscopic tasks in a box trainer in a dry skills lab. The quicker and more accurate the performance, the lower the score. Validity and reliability tests were applied. RESULTS Pearson correlation coefficient demonstrated that more experienced surgeons performed better than novices with an r of -0.63 (p 40) p < 0.001]. Improvement in score was seen at all experience levels with greatest improvement seen in the less experienced (2315, 1820, 1571 p < 0.001). Cronbach's alpha was 0.70 and the intraclass correlation coefficient for test-retest reliability was 0.81. CONCLUSION Construct validity with adequate reliability has been demonstrated for this simple training tool and scoring system. All experience levels demonstrated improvement in their laparoscopic skills by simulation training in a laparoscopic box trainer