Operative Orthopadie Und Traumatologie最新文献

{"title":"[Proximalization of the tibial tuberosity as a salvage operation of the symptomatic patella baja].","authors":"Yannick J Ehmann, Michael Götz, Andreas B Imhoff, Sebastian Siebenlist, Julian Mehl","doi":"10.1007/s00064-025-00911-y","DOIUrl":"https://doi.org/10.1007/s00064-025-00911-y","url":null,"abstract":"<p><strong>Objective: </strong>Improvement of flexion and thereby restoration of function of the knee joint as well as pain reduction by proximalization of the tibial tuberosity in combination with arthrolysis and release of the patellar retinaculum.</p><p><strong>Indications: </strong>Salvage surgery if conservative or arthroscopic treatment for a patella baja (Canton-Deschamps index < 0.6) has failed, especially in the case of mechanical and pain-related limitation of mobility. The timing for the surgery is crucial; surgery should only be performed after the end of the inflammatory phase and fibrosis of the patella ligament is complete.</p><p><strong>Contraindications: </strong>Possible conservative and arthroscopic therapy attempts, local infection, pseudarthrosis, bone defects of the patella, fracture in the area of the tuberosity, active inflammatory process.</p><p><strong>Surgical technique: </strong>Median longitudinal incision. Combined medial and lateral arthrotomy alongside the patellar tendon. Wedge-shaped tuberosity osteotomy over approximately 7 cm. The patella is thereafter reflected proximally to expose the entire knee joint. Extensive open arthrolysis especially of the superior recess and release of the retinaculum. Proximalized refixation of the tuberosity with at least two screws, depending on the preoperative planning and intraoperative movement control. If necessary, lengthening of the medial and lateral retinaculum to completely close the joint.</p><p><strong>Postoperative management: </strong>Postoperative (post-OP) week 1-6: partial weight bearing 20 kg, knee brace, continuous passive motion (CPM) training, limitation of the range of motion (ROM) to flexion/extension: 90°/0°/0°. Post-OP week 7: additional load of 20 kg per week, free ROM.</p><p><strong>Results: </strong>The authors followed a series of 7 patients with proximalization of the tibial tuberosity in symptomatic patella baja. The authors recorded pre- and postoperative patient-reported outcome measures with an average follow-up of 3.0 ± 2.6 years (range 0.6-7.6 years). The patients were 43 ± 11 years old (6 women, 1 men). There was a significant improvement in the 2000 International Knee Documentation Committee (IKDC)-subjective score (pre-OP: 40 ± 17 vs. post-OP: 72 ± 10; p = 0.011) and in the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscore for activities of daily living (pre-OP: 20 ± 23 vs. post-OP: 60 ± 20; p = 0.014). The authors were also able to identify a trend towards improvement, particularly in the Kujala score and the KOOS subscores for pain and physical activity; however no significant improvements were observed. These results make it clear that the proximalization of the patellar tuberosity can improve the subjective outcome in symptomatic patella baja.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709951","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":"[Arthroscopic matrix-associated bone marrow stimulation of ankle joint lesions].","authors":"Sebastian Frischholz, Annette Eidmann, Markus Walther, Maximilian Rudert, Ioannis Stratos","doi":"10.1007/s00064-025-00910-z","DOIUrl":"https://doi.org/10.1007/s00064-025-00910-z","url":null,"abstract":"<p><strong>Objective: </strong>Arthroscopic matrix-associated bone marrow stimulation enables treatment of symptomatic osteochondral lesions of the ankle joint to alleviate pain and improve function.</p><p><strong>Indications: </strong>Symptomatic osteochondral lesions caused by trauma, osteochondritis dissecans, or isolated degenerative cartilage damage. Unstable lesions with nonrefixable fragments.</p><p><strong>Contraindications: </strong>Acute infections, ubiquitous advanced osteoarthritis.</p><p><strong>Surgical technique: </strong>Treatment of intra-articular pathologies and resection of hypertrophic synovia. Unstable cartilage tissue is debrided, and stable margins are created. The subchondral bone is microfractured to promote bleeding and cell migration. For deeper defects, a spongiosa graft can be performed. A tailored collagen matrix is introduced through a mini-arthrotomy and fixed with fibrin glue.</p><p><strong>Postoperative management: </strong>Partial weightbearing of 10-20 kg, depending on the procedure performed. From week 7, load-bearing is gradually increased; full weight-bearing is possible after 12 weeks. Sports activities can be resumed after 6 months.</p><p><strong>Results: </strong>In a retrospective analysis of 10.611 inpatient procedures in Germany from 2006-2022, the numbers for arthroscopies and arthrotomies initially increased, whereby the number of arthrotomies peaked in 2020, followed by a decline. Arthroscopic procedures increased steadily, especially from 2014 onward, indicating a preference for the minimally invasive technique.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683612","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":"Arthroscopic techniques in ankle surgery.","authors":"Anna Altemeier, Sarah Ettinger","doi":"10.1007/s00064-025-00909-6","DOIUrl":"https://doi.org/10.1007/s00064-025-00909-6","url":null,"abstract":"<p><strong>Surgical objective: </strong>Arthroscopy of the ankle joint is one of the standard procedures for treating many pathologies of the ankle joint. Ventral and posterior arthroscopy can be performed. The aim is to gain an overview of the joint using minimal incisions. There are many indications to perform ankle arthroscopy.</p><p><strong>Indications: </strong>Arthroscopy can be used diagnostically to check the cartilage status or the ligamentous apparatus. In traumatology, arthroscopy can be used to check for intra-articular damage or step formation following osteosynthesis. Arthroscopy can also be performed for cartilage therapy, ligament reconstruction or to support arthrodesis of the ankle joint.</p><p><strong>Contraindications: </strong>Absolute contraindications are rare. The most important contraindication is noncompliance. Relative contraindications include acute infection, severe vascular disorders, complex regional pain syndrome (CRPS), osteopenia or coagulation disorders. Nicotine consumption and obesity should be discussed critically with the patient.</p><p><strong>Postoperative management: </strong>Postoperative treatment depends on the addressed concomitant pathology. Suture material can be removed 14 days postoperatively. If an isolated arthroscopy is performed (e.g., diagnostic, arthrolysis, exclusion of infection), the authors recommend pain-adapted full weight-bearing, possibly in a lower leg orthosis until the wound has healed properly.</p><p><strong>Results: </strong>The results of arthroscopy depend on the pathology addressed. The primary advantage is a significantly reduced risk of wound healing disorders due to small incisions.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638722","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":"[Arthroscopic Haglund deformity exostosis resection].","authors":"Klaus Edgar Roth, Kajetan Klos, Robert Ossendorff, Philipp Drees, Hazibullah Waizy","doi":"10.1007/s00064-025-00908-7","DOIUrl":"https://doi.org/10.1007/s00064-025-00908-7","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of symptomatic Achilles tendinopathy.</p><p><strong>Indications: </strong>Impingement between the calcaneus and the Achilles tendon.</p><p><strong>Contraindications: </strong>General contraindications. Active soft tissue infection.</p><p><strong>Surgical technique: </strong>Incision medial and lateral to the distal portion of the Achilles tendon at the level of the lower ankle joint, if necessary under X‑ray control. Blunt preparation of the two portals (laterally, taking into account the course of the sural nerve) towards the posterior process of the calcaneus with a curved clamp. Insertion of the arthroscope into the lateral portal and the shaver into the medial portal. Resection of the bursa and visualization of the insertion area of the tendon. Insertion of the bone acromionizer or a burr to resect the offending bone; changing the portal and removing bone portions on the medial side of the calcaneus. If necessary, additional transachillary incision to remove the bone near the insertion. Wound closure.</p><p><strong>Postoperative management: </strong>Immobilization of the foot in equinus position for 3-5 days in a dorsal splint. Retention in a walker for a further 2 weeks after the swelling has subsided. Weight bearing after 3 weeks.</p><p><strong>Results: </strong>A total of 26 patients were retrospectively evaluated with a mean follow-up time of 25 ± 6 months. The Foot Function Index (FFI) improved from 62 preoperatively to 7 points at the last follow-up examination. The final visual analog scale foot and ankle (VAS-FA) score was recorded as 89. Residual symptoms were present in 15% of patients.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477906","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":"Surgical technique of low-profile dual plating for midshaft clavicle fractures.","authors":"Bryan J M van de Wall, Nadine Diwersi, Lukas Scheuble, Yannic Lecoultre, Björn Christian Link, Reto Babst, Frank J P Beeres","doi":"10.1007/s00064-025-00903-y","DOIUrl":"https://doi.org/10.1007/s00064-025-00903-y","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this surgical technique is fracture healing with anatomical alignment and less implant irritation due to smaller, low-profile plates. Equal to superior stability is provided compared to single superior- or anterior-based plates.</p><p><strong>Indications: </strong>The same general indications for surgical stabilization of clavicle fractures apply for low-profile double plating and include fracture displacement of one or more shaft width, shortening of more than 1 cm in length, and patients with high physical activity levels. Double plating is especially suitable for fractures in the midportion of the clavicle.</p><p><strong>Contraindications: </strong>Fractures in the far lateral portion of the clavicle due to physiological thinning of the clavicle potentially causing problems with screw purchase of screws fitted in the anterior plate.</p><p><strong>Surgical technique: </strong>A 2.0 mm low-profile mini plate is used on the superior and a 2.4 or 2.7 mm on the anterior surface of the clavicle. The plates are fixated with a minimum of two cortical or locking screws on each side of the fracture in each plate. A lag screw can be used if absolute stability can be obtained in simple fractures.</p><p><strong>Postoperative management: </strong>A standard functional postoperative regime can be followed after plate fixation with free mobilization up to 90° without weight bearing for 6 weeks. Afterwards free range of motion and weight bearing are allowed.</p><p><strong>Results: </strong>A biomechanical study, meta-analysis, and retrospective analysis have shown that low profile double plating offers equal to superior stability, lower rates of implant irritation and subsequent removal compared to conventional single plating with equal healing potential.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295335","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":"[Arthroscopy in the treatment of acute and chronic syndesmotic injuries of the ankle joint].","authors":"Judith Schrempf, Boris M Holzapfel, Hans Polzer, Sebastian F Baumbach","doi":"10.1007/s00064-025-00907-8","DOIUrl":"https://doi.org/10.1007/s00064-025-00907-8","url":null,"abstract":"<p><strong>Objective: </strong>Identification and treatment of concomitant intra-articular pathologies, verification of syndesmotic instability, debridement of syndesmotic structures in chronic injuries, reduction, and retention of the fibula in the distal tibiofibular joint.</p><p><strong>Indications: </strong>Acute and chronic two- or three-ligamentous syndesmotic ruptures in active patients.</p><p><strong>Contraindications: </strong>Soft tissue injuries, general risk factors, e.g., circulatory disorders, diabetic foot syndrome, complex regional pain syndrome.</p><p><strong>Surgical technique: </strong>Diagnostic arthroscopy of the ankle joint using anterolateral and -medial portals; identify and treat concomitant intra-articular pathologies; verify syndesmotic instability by inserting an instrument > 4 mm into the incisura fibularis; in case of chronic syndesmotic injuries, debridement of syndesmotic structures, and if necessary debridement of the deltoid ligament complex; reduction of the fibula in the incisura fibularis; retention of the fibula using a screw or flexible implant.</p><p><strong>Postoperative management: </strong>Partial weight-bearing with 20 kg for 6 weeks, no immobilization, exercise for the mobility of the ankle joint, X‑ray after 6 weeks, then increase of weight-bearing.</p><p><strong>Results: </strong>Acute syndesmotic injuries: 19 patients (37 ± 13 years) were examined 38 ± 17 months after arthroscopically assisted treatment of an acute syndesmotic injury. 53% suffered a two-ligament injury, 16% a three-ligament injury, and in 32% a bony syndesmotic injury. Grade II cartilage damage was observed in 35%, grade IV damage in 20%, and loose bodies were removed in 16%. 94% of patients achieved a treatment outcome in line with the healthy reference population for the Olerud and Molander Ankle Score (OMAS; primary outcome parameter) and Foot and Ankle Ability Measure (FAAM). Type of syndesmotic injury and severity of cartilage damage had no significant influence on treatment outcomes. Chronic syndesmotic injuries: a systematic literature search identified 17 studies with 196 patients following surgically treated chronic syndesmotic injuries, 16 of which were retrospective case series and one prospective case series. Arthroscopically assisted surgery was performed in 13 studies. Regardless of the surgical technique, surgery resulted in an improvement in the American Orthopaedic Foot and Ankle Society (AOFAS) score in 10 studies. Overall, the study quality was low and the information on complications, secondary diastasis, treatment results, etc. was very limited.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235970","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":"[Radial tunnel syndrome/supinator lodge syndrome-neurolysis facilitating the anterolateral approach].","authors":"Florian Flock, F Unglaub, L P Müller, T Leschinger, Christian K Spies","doi":"10.1007/s00064-025-00906-9","DOIUrl":"https://doi.org/10.1007/s00064-025-00906-9","url":null,"abstract":"<p><strong>Objective: </strong>Treatment of pain and hypaesthesia caused by radial tunnel syndrome and functional deficits caused by supinator lodge syndrome. The objective for chronic nerve compression is containment to prevent further damage.</p><p><strong>Indications: </strong>Radial tunnel syndrome, supinator lodge syndrome, tumour compressing the nerve, unsuccessful conservative therapy for at least 6 weeks and up to 4-6 months.</p><p><strong>Contraindications: </strong>Infection or skin disease at the surgical area, severe scarring from previous surgery, systemic diseases that prevent anaesthesia, and nerve entrapment outside the radial tunnel and supinator tunnel.</p><p><strong>Surgical technique: </strong>Decompression of the radial nerve both by addressing the entrapments within the radial tunnel and incising the supinator tunnel facilitating the anterolateral approach via the internerval plane between the brachioradialis and brachialis muscles.</p><p><strong>Postoperative management: </strong>Compressive dressing around the complete arm for 3 weeks.</p><p><strong>Results: </strong>Radial tunnel syndrome (RTS) and supinator lodge syndrome are nerve compression syndromes of the radial nerve. Proximal compression may cause mixed symptoms with pain, sensory, and motor deficits, while distal compression may cause either sensory or motor deficits. If symptoms persist for 4-6 months, surgical decompression is recommended, whereby the anterolateral approach is preferred due to better healing results and extensibility. The success rate after surgical decompression averages between 67 and 92%.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210256","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":"[Techniques of lower limb immobilization in children and adolescents].","authors":"Peter P Schmittenbecher, Theddy F Slongo","doi":"10.1007/s00064-025-00889-7","DOIUrl":"10.1007/s00064-025-00889-7","url":null,"abstract":"<p><strong>Objective: </strong>Conservative treatment for femur shaft fractures in small infants and for distal femur and lower leg fractures with sufficient stability in every age, if axial deformities, including rotational failures, are reliably avoided and normal limb function without pain is ensured.</p><p><strong>Indications: </strong>Femur shaft fractures in infants up to 3 years of age. Undisplaced, stable fractures and/or fractures within the range of age-dependent spontaneous correction as well as stable reducible fractures of distal femur and of the whole lower leg, especially buckle, greenstick and isolated tibia fractures, mainly in children less than 10 years of age.</p><p><strong>Contraindications: </strong>Femur shaft fractures in children > 3 years of age or > 15 kg body weight. Instable and displaced fractures at distal femur and whole lower leg beyond the range of age-dependent spontaneous correction, especially if the fibula is involved.</p><p><strong>Surgical technique: </strong>1. Spica cast in children in the first and second year of life for femur shaft fractures. 2. Closed split long leg cast for distal femur fractures and for fractures of the proximal tibia and lower leg shaft fractures as well as in all small infants who easily slip out of shorter casts. 3. Closed split lower leg cast or wide lower leg splint for distal lower leg fractures including ankle fractures and distorsions as well as fractures of the foot, except for small infants who easily lose lower leg casts and need long leg casts even in distal lower leg fractures. 4. Sarmiento cast for special situations or for functional treatment.</p><p><strong>Postoperative management: </strong>Stable fractures: Cast removal after 3-4 weeks, clinical control of consolidation and start of mobilization. Fractures displaced or reduced within the range of spontaneous correction: x‑ray control of alignment after 1 week to exclude secondary displacement, closing the cast if necessary, x‑ray control of consolidation without cast 4 weeks later, further immobilization if necessary depending on age and extent of callus formation.</p><p><strong>Results: </strong>With consequent and professional postoperative management, results of conservative treatment for femur shaft fractures in small children, in distal femur and lower leg fractures are good. Skin complications especially at the heel occur in about 2% of cases and these must be prevented with adequate padding.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"213-227"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442709","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":"[Fasciocutaneous flap according to Becker and Gilbert].","authors":"Bernhard Lukas, Christian Kindler","doi":"10.1007/s00064-025-00890-0","DOIUrl":"10.1007/s00064-025-00890-0","url":null,"abstract":"<p><strong>Objective: </strong>The fasciocutaneous flap according to Becker and Gilbert is used to cover soft tissue defects of the hand and wrist.</p><p><strong>Indications: </strong>Soft tissue reconstruction of palmar and dorsal defects of the hand and wrist. Coverage of the median nerve after neurolysis.</p><p><strong>Contraindications: </strong>Stenosis of the ulnar artery, scars at the ulnar distal forearm.</p><p><strong>Surgical technique: </strong>Drawing the flap design with the pivot point 2-4 cm proximal to the pisiform. Maximal length: 20 cm, maximal width: between palmaris longus muscle and finger extensor tendons. The flap is cut from radial palmar to ulnar dorsal and from proximal to distal together with the underlying fascia. The ulnar artery, the ulnar nerve and the dorsal branch of the ulnar artery are prepared distally. After cutting the distal skin bridge the flap is transposed to the defect. The donor side is closed directly or by a skin graft. As a modification, the flap is prepared as a fascious flap with overlying fat to cover the median nerve after neurolysis.</p><p><strong>Postoperative management: </strong>Immobilization of the wrist , in a soft palmar cast for 10 days; regular examination of the circulation of a fasciocutaneous flap.</p><p><strong>Results: </strong>The Becker flap was used in 10 persons: 4 times as fasciocutaneous flap, 6 times as fascious flap. For closing the donor side, a skin graft was necessary in 2 cases; no flap was lost.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"242-253"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484602","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":"[Pediatric traumatology: closed or minimally invasive reduction technique for upper and lower limb fractures].","authors":"Kai Ziebarth, Theddy Slongo","doi":"10.1007/s00064-025-00892-y","DOIUrl":"10.1007/s00064-025-00892-y","url":null,"abstract":"<p><strong>Objective: </strong>Stable reduction of pediatric fractures to the accepted position. Prevention of recurrent dislocation or loss of reduction to avoid invasive surgery.</p><p><strong>Indications: </strong>Pediatric fractures of the upper and lower extremities.</p><p><strong>Contraindications: </strong>Joint fractures, comminuted fractures, open fractures.</p><p><strong>Technique: </strong>A comfortable environment for the child as well as sufficient pain management is of highest importance for successful treatment. Depending on the location of fracture or fracture pattern, indirect reduction (e.g. by cuff and collar), or direct manual reduction is applied with or without fixation of the fragments (screws, Kirschner wire, external fixator).</p><p><strong>Postoperative management: </strong>Follow-up radiograph 5-7 days after closed reduction. In case of retention with hardware, a consolidation control with radiograph 3-6 weeks postintervention (depending on the age of the patient) is appropriate.</p><p><strong>Results: </strong>Introduction of closed reduction techniques makes pediatric fracture treatment feasible without open interventions or need of osteosynthesis.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":"184-194"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}