Summary Background The aim of this prospective investigation was to determine factors that influence the verbal disease knowledge level of the patient after the informed consent (IC) talk and to assess whether it can be improved by additional education. Furthermore, the factors underlying quality of life (QoL) after treatment, among them knowledge, education, and ambulatory care, were investigated. Methods Consecutive patients who had undergone vascular surgical intervention for abdominal aortic aneurysm (AAA), thrombendarteriectomy (TEA) of the femoral bifurcation, or digital subtraction angiography (DSA) with or without endovascular intervention for arterial occlusive disease (AOD) were included over a defined study time period. They were divided randomly into (i) standard IC talk, (ii) extended IC talk with a PowerPoint lecture (PP; Microsoft Inc., Redmond, WA, USA), and (iii) extended IC talk with a walking diary (WD). The patients filled out questionnaires before and after treatment and a RAND36 Health Survey during follow-up. The disease knowledge level was quantified by six verbal items. Group comparisons were performed by matched-pair analysis (MPA) and factor analysis by multiple regression analysis and multivariate analysis of variance (MANOVA). Results From January 2015 until November 2016, n = 198 patients were enrolled. Remembrance and comprehension rates were in general low and did not improve significantly with additional PP or WD. Age was inversely associated with disease knowledge. Age was also inversely and WD/PP and knowledge level directly associated with mid-term QoL. However, other factors such as care provision and social status were important as well. Conclusion Communication with and education of vascular surgery patients is one of the mainstays of treatment and should be continued beyond the legal and formal requirements during treatment and after discharge from hospital in order to keep the QoL as high as possible.

Introduction Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group. Method Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed. Results A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.

Zusammenfassung Hintergrund Verletzungen der Peronealsehnen gelten als häufig unterdiagnostizierte Ursache lateraler Rückfußschmerzen. Prädisponierende Ursachen sind u. a. eine chronische laterale Instabilität sowie ein Rückfußvarus, da dies zu einer Überbelastung der Peronealsehnen führt. Klinisch äußern sich Peronealsehnenverletzungen meist unspezifisch mit lateralen Rückfußschmerzen. Material und Methoden In der Untersuchung zeigen sich Schmerzen bei Aktivierung der Sehnen gegen Widerstand. Die Sonographie zur Diagnostik bietet die Möglichkeit einer dynamischen Untersuchung, in der Magnetresonanztomographie (MRT) können gleichzeitig weitere Strukturen beurteilt werden. Zu unterscheiden sind eine Tendinopathie der Sehnen, eine Instabilität mit Luxation oder Subluxation verbunden mit Pathologien des superioren Peronealsehnenretinakulums sowie Längssplit und komplette Sehnenruptur. Bei Tendinopathien und Längsrissen erfolgt die Therapie primär konservativ. Ein kompletter Riss und eine Läsion über 50 % sollten operativ versorgt und, falls möglich, direkt genäht werden. Alternativ sind eine Tenodese oder ein Sehnenersatz mit einem Graft zu evaluieren. Ergebnisse Bei Patienten mit einer Peronealsehneninstabilität führen die Naht oder Rekonstruktion des superioren Peronealsehnenretinakulums zu guten Resultaten. Eine frühe Therapie zeigt eine bessere Heilungschance und kann somit zu einem besseren Outcome führen. Schlussfolgerung Zusammenfassend kann gesagt werden, dass bei chronischen lateralen Rückfußschmerzen an eine Peronealsehnenverletzung gedacht und bei Verdacht auf eine Läsion eine MRT oder eine Sonographie zur Bestätigung respektive Ausschluss der Diagnose durchgeführt werden sollte.