“The world of winter sports really is unique”

GenuTrain S following cruciate ligament injuries

From Bauerfeind Life Magazin

In short The Unfallsanatorium Dr. Rhomberg trauma surgery clinic in Lech am Arlberg carries out about 600 surgical procedures during the winter season. Around half are related to the knee, followed by the shoulder and upper extremities.

  • Using state-of-the-art imaging technology, the sanatorium can provide a diagnosis within about 30 minutes. Surgery usually takes place in the afternoon.
  • Cruciate ligament lesions are typical skiing injuries. After surgery, the GenuTrain S is used to stabilize the knee to safeguard the surgical outcome and for secondary prevention.
  • Rhomberg appreciates the GenuTrain S for its great fit and promotion of movement. The compression knit helps reduce swelling more quickly and it supports the healing process.

The ski season is near. It is not just the pistes that are very busy, but the operating theaters, too. If you suffer from a fracture, you are in good hands in Lech am Arlberg, where the Unfallsanatorium Dr. Rhomberg trauma surgery clinic is located at the foot of the mountains. “It’s a unique world,” says its director Dr. med. Nikolaus Rhomberg. With 600 surgical procedures during the winter months and more than half of them performed on knee, the GenuTrain S is a key treatment component following cruciate ligament reconstruction.  

life: Are you well equipped for the big rush?

Dr. Rhomberg: We’ve done our homework, the winter team is ready. We have well-equipped facilities including MRI and CT machines, operating theaters and lounge areas. During this year’s summer season, even though we still had as many as 200 procedures, we were able to expand our physiotherapy area. You just have to keep improving. In-depth training of new staff is very important – if you can find new people, that is. With all that’s going on during the winter, everybody needs to know exactly what to do. Patients need to be prepped and ready for the surgery when I come into the operating theater.

Dr. med. Nikolaus Rhomberg

What injuries do you see most often?

Dr. Rhomberg: Knee injuries. In almost half of all cases. Mainly tibial plateau fractures and torn cruciate ligaments. This is followed by shoulder injuries and proximal fractures of the upper arm. Those have increased significantly, probably because of the harder pistes and more frequent collisions. With all their kit, skiers need more space on the pistes than they used to, and their helmets restrict their sight and hearing more. Other typical severe injuries include fractures of the thigh and lower leg. With snowboarders, it’s mainly wrist, elbow and shoulder injuries. If they fall when jumping, calcaneus fractures can also occur. Winter hikers generally have ankle and wrist injuries. These are all injuries that require acute care.

What are the processes for this?

Dr. Rhomberg: Time plays an important part. Patients will have their clinical diagnosis within 30 minutes. We have all the imaging technology that is needed for this. After that, it’s usually obvious what has to be done. In the main group, knee injuries, I may treat a cruciate ligament conservatively, for example, but not a fractured knee joint. But because young people with cruciate ligament injuries will continue skiing or exercising in general, surgery makes sense, even just to prevent osteoarthritis. Even fit 80-year-olds can have cruciate ligament reconstruction if they want. In cases of ligament injuries, however, a lot of patients choose to try the conservative route because they prefer not to have surgery. The important aspect isn’t just what is medically possible, you also need to consider the individual patients and what they expect of themselves in the future. When it comes to complications, we are lucky to have patients who are mainly healthy and physically active. 80 to 85 percent of our clients are discharged the next day and return home or to their hotels. In theory, they could continue their vacation away from the piste. Severe cases, such as tibial plateau fractures, will stay with us while they need care. Many people say how much they like it here and that they want to stay. We even have regulars (laughs). The world of winter sports really is unique. 

Is it international as well?

Dr. Rhomberg: Yes, of course, there are those who need to get back home. If they are able to travel, they will receive crutches or a splint, if needed. We are also giving our patients discharge papers with the relevant information for their treating clinician in the US, South Africa or wherever they may be from. In Austria, Switzerland and Germany, the procedures are usually the same. In general, the physician following up on treatment doesn’t have any additional questions. That’s different in the Netherlands or the UK, where skiing is rare and serious injuries caused on the slopes are pretty exotic. Local colleagues are more familiar with other types of injuries.

“I prefer the GenuTrain S to all other stabilizing products because it fits really well and allows movement.”

Dr. med. Nikolaus Rhomberg

For which patients do you use orthotic products?

Dr. Rhomberg: For conservative cases and during post-operative follow-up care. Following cruciate ligament surgery, for example, it makes sense to support the joint with a splint to stabilize it against torsion and tensile forces. We use Bauerfeind’s GenuTrain S with hinges on the sides and straps around the thigh and lower leg. I prefer the GenuTrain S to all other stabilizing products because it fits really well and allows movement. Its compression knit also reduces swelling and supports healing. Psychologically, too, it’s really important for patients to feel the support. Some even use it for longer once they’ve recovered and they get back into skiing, as a preventive measure, if you will.

Increased stability to the knee: GenuTrain S stabilizes with lateral joint splints, non-elastic straps and with medically effective compression.

Do you ski, too?

Dr. Rhomberg: Unfortunately not. I would like to but I can’t afford to be missing during the season. I do have a colleague, but he only supports me during office hours on individual days. The responsibility for my staff and the patients, of course, is just too great. But skiing is an excellent activity.

Rapid help in the snow

The Unfallsanatorium Dr. Rhomberg trauma surgery clinic is a private hospital in the winter sports center in Lech am Arlberg. Around 40 employees provide acute care to winter sports enthusiasts who suffer accidents. The main season starts at the end of November and lasts until the beginning of April, keeping the team busy around the clock. 30 to 40 patients usually arrive in the morning, the afternoon is taken up by surgery. During the summer season, mainly elective procedures are performed. Local patients are also often treated then because they cannot miss work during the winter. Follow-up care takes place in the onsite physiotherapy practice. The hospital has been working with Bauerfeind Austria for many years.

Bilder: Bauerfeind, Unfallsanatorium Dr. Rhomberg

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