Zeitschrift Fur Orthopadie Und Unfallchirurgie最新文献

{"title":"Minimalinvasive Implantation einer Duokopfprothese bei Schenkelhalsfraktur.","authors":"Marc Chmielnicki, Stefan Kessler, Axel Prokop","doi":"10.1055/a-1957-5837","DOIUrl":"https://doi.org/10.1055/a-1957-5837","url":null,"abstract":"Der Oberschenkelhalsbruch ist eine typische und häufige Verletzung des alten Menschen. Aufgrund der durch die Osteoporose verminderten Knochendichte und der zunehmenden Varisierung des Schenkelhalses ist es ein Prädilektionsort für Frakturen auch nach Minimaltraumen [1]. Mit zunehmendem Alter steigt die Inzidenz drastisch an. In Deutschland liegt die Häufigkeit über alle Einwohner gesehen bei 90/100000 Einwohnern [2, 3]. Bei den über 65-Jährigen beträgt die Inzidenz schon 966/100000 Einwohner, dabei schwanken die Zahlen in Abhängigkeit vom Wohnort. In Baden-Württemberg ist die Inzidenz mit 507 deutlich geringer als z. B. in Hamburg mit 1404/100000 Einwohner. Bis 2050 wird mit einer Verfünffachung der Inzidenz gerechnet [4]. Die Frakturen führen heute wie vor 20 Jahren zu einer signifikanten Verminderung der Lebenserwartung und haben für die betroffenen Patienten eine oft dramatische Verschlechterung der sozialen und gesundheitlichen Situation zur Folge [5, 6]. Viele Patienten verlieren ihre Selbstständigkeit und bedürfen zusätzlicher Hilfe oder werden sogar zum Pflegefall [7].","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"333-336"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9622580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupuytren-Kontraktur: Therapie mit Kollagenase Clostridium histolyticum vs. Fasziektomie","authors":"","doi":"10.1055/a-2019-3348","DOIUrl":"https://doi.org/10.1055/a-2019-3348","url":null,"abstract":"","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49657953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antero-inferiore Erstluxation: Vergleich von Schulterstabilisierung und Immobilisation","authors":"","doi":"10.1055/a-2019-3374","DOIUrl":"https://doi.org/10.1055/a-2019-3374","url":null,"abstract":"","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57822889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Note: Arthroscopic Resection of Snapping, Interponating Annular Ligament of the Elbow.","authors":"Kathi Thiele,&nbsp;Doruk Akgün,&nbsp;Faisal Al-Mutaresh,&nbsp;Ulrich Stöckle,&nbsp;Lucca Lacheta,&nbsp;Philipp Moroder","doi":"10.1055/a-1658-1038","DOIUrl":"https://doi.org/10.1055/a-1658-1038","url":null,"abstract":"<p><p>The indication for surgical treatment of lateral snapping elbow syndrome is recurrent joint blockage in combination with pain of the affected elbow joint. Different parts of the lateral synovial capsule sleeve complex, including the annular ligament itself, a hypertrophic synovial fold, or meniscus-like soft tissue interposition can lead to painful entrapment. Surgical treatment options can include an arthroscopic or open procedure. The aim of this technical note is to provide a step-by-step illustration of the authors' preferred arthroscopic approach with a comprehensive review of literature on clinical outcome.</p>","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"328-332"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Value of Registries in Shoulder Arthroplasty Using Reverse Arthroplasty as an Example.","authors":"Fabian Blanke,&nbsp;Charlotte Enghusen,&nbsp;Andreas Enz,&nbsp;Florian Haasters,&nbsp;Christoph Lutter,&nbsp;Wolfram Mittelmeier,&nbsp;Thomas Tischer","doi":"10.1055/a-1644-2032","DOIUrl":"https://doi.org/10.1055/a-1644-2032","url":null,"abstract":"<p><strong>Introduction: </strong>As a consequence of the Swedish model, endoprosthesis registers have become increasingly important worldwide. Due to the increasing number of joint replacements at the shoulder, these are being increasingly included in the register databases - in addition to interventions at the hip and knee joint. In this study, the value of endoprosthesis registers is investigated, using the example of shoulder endoprosthetics and including a comparison with clinical studies.</p><p><strong>Material and methods: </strong>The annual reports of 32 different endoprosthesis registers with data on hip, knee and/or shoulder arthroplasty were analysed. The number of operations and demographic patient data for all areas of endoprosthetics were examined. In addition, a more detailed consideration of variables such as the primary diagnosis, the cause of the revision, the revision rate depending on risk factors and patient-reported outcome measures (PROM scores) was carried out exclusively for the shoulder joint endoprostheses. Using the example of the inverse shoulder prosthesis, clinical studies were compared to registry data with special regard to the revision rate.</p><p><strong>Results: </strong>A total of 20 endoprosthesis registers could be included, 9 of these collected data on shoulder arthroplasty. The main primary diagnoses were osteoarthritis (40.6%), rotator cuff defect arthropathy (30.2%) and fractures (17.6%). The most commonly used shoulder joint endoprosthesis was the inverse prosthesis (47.3%). The proportion of revision surgeries in total shoulder arthroplasty operations was less than 10% in all registers. In addition to the revision rate, the PROM scores were sometimes used in the registers to evaluate the success of the prosthesis. Compared to registry data, clinical studies showed more heterogeneous data with a significantly higher revision rate of over 10% in long-term follow-up - using the example of the inverse shoulder prosthesis.</p><p><strong>Conclusion: </strong>Register data are a valuable source of information in shoulder arthroplasty and can make a significant contribution to the quality assurance of endoprosthetic treatments. Compared to clinical studies, they primarily provide data on durability of different endoprosthesis and give lower revision rates. Clinical studies use PROM scores and clinical and radiological examinations to focus only on individual implants and surgical centres on the one hand and much more on the functional results on the other.</p>","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"280-289"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9622026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of Death in the Seriously Injured -Why do Severely Injured Patients Die Today?","authors":"Arne Wilharm,&nbsp;Alexander Pflug,&nbsp;Franz Loos,&nbsp;Oliver Sommerfeld,&nbsp;Gunther O Hofmann,&nbsp;Stefanie Sauer","doi":"10.1055/a-1651-0996","DOIUrl":"https://doi.org/10.1055/a-1651-0996","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Hintergrund: &lt;/strong&gt;Trauma ist die häufigste Todesursache bei unter 45-Jährigen und trotzdem gibt es nur wenig Daten zu den genauen Todesursachen Schwerverletzter nach Klinikeinlieferung in Deutschland aus den letzten 10 Jahren. Ziel der Arbeit ist 1. eine Auswertung der Daten der verstorbenen Schwerverletzten eines überregionalen TraumaZentrums aus den letzten 10 Jahren. Erforscht werden sollen Verlässlichkeit der Daten, Häufigkeit der Todesursachen und Zusammenhänge mit dem Unfallmechanismus und 2. die Nachvollziehbarkeit der Daten im TraumaRegister DGU.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patienten und methoden: &lt;/strong&gt;Es erfolgte die Auswertung der Daten von 203 verstorbenen schwerverletzten Patienten aus dem Universitätsklinikum Jena, die von 2007 bis 2017 verunfallt sind.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Ergebnisse: &lt;/strong&gt;Eine eindeutige Festlegung der Todesursache ist anhand von Klinikdaten in ca. 85% der Fälle möglich. Häufigste Todesursache von Schwerverletzten nach Klinikeinlieferung ist mit 59,6% das Schädel-Hirn-Trauma, gefolgt von 17% Organversagen, 14% Hämorrhagie und 9,4% sonstigen Todesursachen. Die Verifizierung anhand von Daten aus dem TraumaRegister DGU ist möglich. Es besteht ein klarer Zusammenhang zwischen Unfallmechanismus und Todesursache.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Schlussfolgerungen: &lt;/strong&gt;Welche Todesursache angegeben wird, unterliegt immer auch einer subjektiven Einschätzung. Insbesondere bestehen Schwierigkeiten bei Patienten, die vor weiterer Diagnostik im Schockraum versterben. Häufigste Todesursache ist heute das Schädel-Hirn-Trauma. Es ist sinnvoll, die Todesursache im TraumaRegister DGU extra zu erfassen, da diese anhand von anderen Registerdaten nur teilweise abgeleitet werden kann. Die Zusammenhänge zwischen Unfallmechanismus und Todesursache könnten ggf. für Präventionsmaßnahmen genutzt werden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The leading cause of death among people under 45 years of age is trauma. However, there is little information from the last 10 years on the exact causes of death of seriously injured people after hospital admission in Germany. The aim of the study is to evaluate the data of a level I trauma centre from the last 10 years. The reliability of the data, frequency of the causes of death and correlations with the mechanism of injury as well as the confirmability of the data in the TraumaRegister DGU are to be investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The University Hospital Jena data were analysed for 203 deceased trauma patients from accidental death between 2007 and 2017.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A clear determination of the cause of death is possible in about 85% of cases on the basis of hospital data. The most frequent cause of death of severely injured patients after admission to the hospital is traumatic brain injury (59.6%), followed by organ failure (17%), haemorrhage (14%) and other causes of death (9.4%). Verification using data from the TraumaRegister DGU is possible. There is a clear cor","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"297-303"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locking Compression Plate as an External Fixator for the Treatment of Tibia Infected Bone Defects.","authors":"Hong Xiao,&nbsp;Shulin Wang,&nbsp;Feibo Wang,&nbsp;Sun Dong,&nbsp;Jie Shen,&nbsp;Zhao Xie","doi":"10.1055/a-1545-5363","DOIUrl":"https://doi.org/10.1055/a-1545-5363","url":null,"abstract":"<p><strong>Purpose: </strong>This study was designed to observe the medium-term efficacy of an induced membrane technique combined with a locking compression plate as an external fixator for the treatment of tibia infected bone defects.</p><p><strong>Methods: </strong>Patients with a tibial infection were admitted to our department between January 2013 and November 2014. All patients were treated with the induced membrane technique. In the first stage, polymethyl methacrylate (PMMA) cement was implanted in the defects after debridement and then fixed with a locking compression plate (LCP) as an external fixator. In the second stage, bone grafts were implanted to rebuild the defects. The external plates were replaced with nails in 57 patients (internal group), and the remaining 30 patients were not exchanged with fixation (external group). The infection control rate, bone union rate, and complications of the two groups were compared.</p><p><strong>Results: </strong>Eighty-seven patients were enrolled in this study, and all patients had a minimum follow-up of 5 years (average 62.8 months) after grafting. Eighty-three patients (95.4%) achieved bone union, and the average union time was 6.77 months. Five patients (5.7%) experienced recurrence of infection. Complications included pin tract infection, fixation loosening, deformity connection, and limitation of joint range of motion (ROM). No significant differences in the infection control rate or bone defect union rate were noted between the two groups. The overall rate of complications in the external group was 50%, which was greater than that noted in the internal group (21.1%).</p><p><strong>Conclusions: </strong>Locking compression plates are external fixators with smaller sizes that are easier to operate than conventional annular fixators or assembled external fixators. The use of locking compression plates in combination with the induced membrane technique in the treatment of tibia infected bone defects can achieve good clinical efficacy after medium-term follow-up.</p>","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"311-317"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9995110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onboarding in O und U – strukturierte Einarbeitung für mehr Qualität in der Patientenversorgung.","authors":"Marit Herbolzheimer,&nbsp;Rolf Schipp,&nbsp;David A Ullmann,&nbsp;Golnessa Rommelfanger,&nbsp;Kristina Götz","doi":"10.1055/a-2019-3335","DOIUrl":"https://doi.org/10.1055/a-2019-3335","url":null,"abstract":"","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"255-258"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Complex Regional Pain Syndrome (CRPS) - State of the Art in Diagnostics and Therapy].","authors":"Mike Christian Papenhoff,&nbsp;Kathrin Habig,&nbsp;Christian Schmitz,&nbsp;Sven Lundin,&nbsp;Detlef Schreier,&nbsp;Julia Tineghe,&nbsp;Marcel Dudda","doi":"10.1055/a-1898-2454","DOIUrl":"https://doi.org/10.1055/a-1898-2454","url":null,"abstract":"<p><p>The complex regional pain syndrome (CRPS) usually occurs within a few weeks in 2-5% of all patients after trauma or surgery or subsequent measures of the distal extremities. There are certain risk factors for its occurrence but no \"CRPS personality\", instead there are factors that negatively influence the course. The prognosis is generally good (\"rule of thirds\"), but remaining limitations are common. The diagnosis is clinically possible according to the \"Budapest criteria\". Additional examinations are possible in case of doubt but are neither conclusive nor exclusive. Corticoids and bisphosphonates are used alongside drugs that have an effect on neuropathic pain. Invasive therapies do not have good evidence and have therefore lost their importance. The rehabilitative therapy is carried out actively and with a lot of self-exercises at an early stage. Invasive anesthetic, passive therapies are obsolete. Special forms of treatment are \"graded exposure\" (GEXP) in the case of dominant anxiety and, e.g., \"graded motor imagery\" (GMI) in case of neglect-like symptoms. In addition to educational and behavioral therapy elements, psychotherapy for CRPS also includes participation as part of graded exposure.</p>","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":"161 3","pages":"337-352"},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meniskusverletzungen bei Kindern: Einfluss von Geschlecht, Alter und BMI","authors":"","doi":"10.1055/a-2019-3361","DOIUrl":"https://doi.org/10.1055/a-2019-3361","url":null,"abstract":"","PeriodicalId":51219,"journal":{"name":"Zeitschrift Fur Orthopadie Und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48771094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}