Pubic rami fractures are frequently associated with concomitant posterior pelvic ring injuries, making these injuries more unstable than generally assumed. Based on this fact and the long duration of hospital stay, more aggressive management of these injuries may be considered. The principle aims in this patient population are satisfying pain management, early mobilisation, conservation of independence and return to previous place of residence.

In Germany, patients with acute myocardial infarction are less likely to undergo cardiac catheterization compared to patients in other Western countries (e.g. , the United States). Despite recommended guidelines, invasive strategies are more frequent in low risk groups (younger patients, male gender) than in postinfarction patients at high risk (severely impaired left ventricular function, clinical signs of congestive heart failure, the elderly).

There is no "one fits all" concept for the organization of clinical emergency units. Instead, a number of well characterized organizational concepts are available enabling a rational choice based on a hospital's mission and demand.

As the population ages, the number of fragility fractures is expected to increase dramatically. These injuries are frequently associated with less than satisfactory outcomes. Many of the patients experience adverse events or death, and few regain their pre-injury functional status. Many also lose their independence as a result of their fracture. This manuscript will explore problems and some potential solutions to evaluate the outcomes of geriatric fracture care. Specific, system-wide, and societal concerns will be discussed. Limited suggestions will be made for future steps to improve outcomes assessments.

ZusammenfassungAtypische Femurfrakturen machen 0,6–1,2 % aller Femurfrakturen aus (4, 5). Die American Society of Bone and Mineral Research (ASBMR) hat 2010 Major- und Minor-Kriterien vorgeschlagen (2) und diese 2014 präzisiert (3), anhand derer Femurfrakturen identifiziert werden. Wir möchten diskutieren, ob bei strikter Anwendung der ASBMR-Kriterien alle atypischen Femurfrakturen erkannt werden und stellen zwei Fälle vor, die suggestiv für das Vorliegen einer atypischen Femurfraktur sind, aber trotzdem nicht als solche gewertet werden. Mit einem weiteren Fall stellen wir das Basler M&M-Konzept zur Behandlung atypischer Femurfrakturen vor, womit biomechanisch-chirurgische (1. M = Mechanik) und medikamentöse (2. M = Medikamente) Behandlungskompetenz zusammengeführt werden.