Orthopadie (Heidelberg, Germany)最新文献

{"title":"[Cervical stenosis-Diagnostics and treatment of symptomatic spinal canal stenosis and neuroforaminal stenosis].","authors":"Daniel Begrich, Marcus Jäger","doi":"10.1007/s00132-024-04526-2","DOIUrl":"10.1007/s00132-024-04526-2","url":null,"abstract":"<p><p>Cervical stenosis is a clinical picture that is regularly encountered by both hospital physicians and orthopedic surgeons in the daily clinical practice. While advanced cervical spinal canal stenosis may lead to myelopathic symptoms in cases of sufficient manifestation and spinal cord injury, neuroforaminal stenosis leads to radicular symptoms due to compression of the nerve roots. The clinical examination can provide initial clues as to the suspected cause of the patient's symptoms; however, reliable diagnostics are based only on sectional imaging of the cervical spine. Depending on the extent of the symptoms, the treatment options vary between nonsurgical treatment for moderate symptoms without neurological deficits and surgical decompression of the spinal cord or nerve roots. The surgical treatment can be performed from anterior or posterior depending on the findings. Surgery can lead to an improvement of the neurological symptoms; however, the primary aim of surgical treatment is to avoid deterioration of the neurological deficits.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"617-628"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Aus der Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie in Zusammenarbeit mit der Deutschen Gesellschaft für Neurowissenschaftliche Begutachtung (DGNB) : Bemessungsempfehlungen für muskuloskelettale Verletzungsfolgen in der Privaten Unfallversicherung.","authors":"Marcus Schiltenwolf, Klaus Dresing, Johannes Eckert, Torsten Eyfferth, Peter Wolfgang Gaidzik, Martin Grotz, Sven Lundin, Klaus-Dieter Thomann, Bernhard Widder, Johannes Zeichen","doi":"10.1007/s00132-024-04540-4","DOIUrl":"10.1007/s00132-024-04540-4","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"585-586"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patellofemoral instability in children and adolescents].","authors":"Sebastian Farr, Matthias Pallamar","doi":"10.1007/s00132-024-04530-6","DOIUrl":"10.1007/s00132-024-04530-6","url":null,"abstract":"<p><p>Patellofemoral instability is a common and clinically relevant disorder of multifactorial causes. Several concomitant problems such as genua valga, hyperlaxity, injuries or sports-related overuse may contribute to the development of instability and recurrent patellar dislocations. A thorough diagnosis is of paramount importance to delineate every contributing factor. This includes radiographic modalities and advanced imaging such as magnetic resonance imaging or torsional analyses. The authors recommend non-operative management (including physiotherapy, gait and proprioceptive training, orthoses) and, whenever non-operative measures fail, surgical patellar stabilization using, e.g. MPFL reconstruction.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"567-574"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ligamentous and meniscal injuries of the pediatric knee joint].","authors":"Oliver Loose, Oliver Eberhardt, Thomas Wirth, Francisco Fernandez","doi":"10.1007/s00132-024-04539-x","DOIUrl":"10.1007/s00132-024-04539-x","url":null,"abstract":"<p><p>Intraligamentous injuries to the anterior cruciate ligament (ACL) and meniscus injuries are rare in children and adolescents and often occur as a result of sports injuries. Clinically, they usually present as a hemarthrosis. The diagnosis of choice is the MRI examination. Surgical treatment of intraligamentary ACL injuries using the transphyseal technique is now also the gold standard treatment for children and adolescents, leg axis and length checks are necessary after surgery until growth is complete. Meniscus injuries are also addressed surgically. Postoperative follow-up treatment and rehabilitation are particularly important in order to prevent reinjury. The disc meniscus is a special entity and is also treated surgically if it is symptomatic. Isolated collateral ligament and posterior cruciate ligament ruptures are rarities.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"557-566"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fractures around the knee in children : Epiphysiolysis and physeal fractures of the distal femur and proximal tibia].","authors":"Benjamin Schoof, Dirk W Sommerfeldt","doi":"10.1007/s00132-024-04528-0","DOIUrl":"10.1007/s00132-024-04528-0","url":null,"abstract":"<p><p>Epiphysiolysis and epiphyseal fractures of the distal femur and proximal tibia are an extremely rare entity, but due to their far-reaching consequences with associated functional restrictions of the knee joint, they must be recognized and treated thoroughly. Complete and correct diagnosis is essential and, diagnostically speaking and in addition to standard x‑rays in two planes, the threshold for cross-sectional imaging examination techniques should be low. A conservative treatment attempt is possible for undisplaced fractures, but surgical retention and stabilization using wires and screws is usually indicated. Growth disorders often and inevitably occur after such injuries. Clinical monitoring of complications only ends once growth is complete.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"580-584"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Injuries of the knee extensor complex in children].","authors":"Nicholas A Beuscher, Peter C Strohm, Dorien Schneidmüller","doi":"10.1007/s00132-024-04534-2","DOIUrl":"10.1007/s00132-024-04534-2","url":null,"abstract":"<p><strong>Background: </strong>Fractures of the knee extensor complex are relatively rare injuries in children. We distinguish between a pure tendon rupture and ruptures with bony avulsions. A mid-substance tear in children is a relatively rare injury, whereas bony avulsions due to skeletal immaturity are seen more often. Sole bony fractures of the patella also only account for a low number of paediatric related fractures. Sleeve fractures are characterized by an avulsion of cartilage and, usually, bone pulled off from the distal patella pole. Avulsion fractures of the tibia tubercle are found in the group of sportive adolescents.</p><p><strong>Treatment: </strong>Especially dislocated fractures should be conveyed to surgical therapy to avoid excessive bone callus. Timely diagnostics and an efficient and consistent treatment are recommended. Deformities and dislocated avulsions will regularly not remodel spontaneously during further growth. Therefore, it is mandatory to reconstruct the articular surface and the knee extensor complex to avoid future complications such as osteoarthritis or elongation of the knee extensors.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"575-579"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The growing knee (Part 1)].","authors":"Adrien Frommer, Björn Vogt","doi":"10.1007/s00132-024-04532-4","DOIUrl":"10.1007/s00132-024-04532-4","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":"53 8","pages":"551-552"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Electric scooter-associated orthopedic injuries cause long absence from work, regret and are emerging as a major cause of hip fractures in young individuals: a comprehensive study from a regional trauma center in a densely populated urban setting].","authors":"Mahmut Enes Kayaalp, Nazim Canberk Kilic, Ibrahim Kandemir, Mazlum Bayhan, Engin Eceviz, Mahmut Enes Kayaalp","doi":"10.1007/s00132-024-04523-5","DOIUrl":"10.1007/s00132-024-04523-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to give a full spectrum of orthopedic injuries associated with electric scooter (e-scooter) use and analyze related factors, report on follow-up data from the patient's perspective and make a comparative etiological analysis of young adult hip fractures.</p><p><strong>Methods: </strong>A total of 851 consecutive patients were admitted to the Emergency Department following e‑scooter injuries between January 2021 and July 2022, of whom 188 had 214 orthopedic injuries. The demographics, injury, and incident characteristics of these patients were collected. All fractures were classified as per the AO/OTA classification. Two groups were created as operatively or conservatively treated patients and data were comparatively analyzed. Follow-up examination incorporated a survey using binary questions on patients' perspectives. An etiological comparative analysis of hip fractures in young adults admitted to the same center between 2016 and 2022 was conducted.</p><p><strong>Results: </strong>The median patient age was 25. Inexperienced drivers constituted 32% of the injured. The protective gear use rate was at 3%. Higher speed (p = 0.014) and age (p = 0.011) were significantly associated with operative treatment. A total of 39% of the operated patients could not return to preinjury physical function, while 74% regretted using an e‑scooter. The most common etiological factor for traumatic young hip fractures was fall from a height between 2016 and 2020, whereas it became e‑scooter accidents in 2021-2022.</p><p><strong>Conclusion: </strong>The rate of e‑scooter-related operative treatment is high and leaves the patient in regret (84%) and a physically limited condition (39%). A speed limit of ≤ 15 km/h could decrease the rate of operative injuries. The e‑scooter was identified as the top etiological factor in the last 2 years for traumatic young hip fractures.</p><p><strong>Level of evidence: </strong>II, Diagnostic cohort study.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"587-596"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Update of the S3-guideline on diagnostics, prophylaxis and treatment of osteoporosis].","authors":"Michael Drey, Sven Otto, Friederike Thomasius, Ralf Schmidmaier","doi":"10.1007/s00132-024-04522-6","DOIUrl":"10.1007/s00132-024-04522-6","url":null,"abstract":"<p><p>With the aid of a new fracture risk model, the great treatment gap for osteoporosis should be closed. All patients older than 70 years should undergo a diagnostic procedure for osteoporosis. An additional risk threshold (≥ 10% per 3 years for femoral and vertebral fractures) should enable patients with a high risk of fracture to be treated with osteoanabolic agents. The use of osteoanabolic agents makes it necessary to administer antiresorptive drugs afterwards. Due to the low event rate of osteonecrosis of the jaw, the initiation of a specific osteoporosis treatment should not be delayed by prophylactic dental treatment. The adherence to the drug treatment should be improved by an individualized approach on the basis of a cooperation between patients, caregivers, and physicians. A regular assessment of falls, including the timed up and go test should be carried out in patients older than 70 years.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"541-549"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Numerical simulation in musculoskeletal biomechanics : Application perspectives and possibilities].","authors":"Maeruan Kebbach, Lucie Hucke, Daniel Kluess, Jörg Miehling, David Scherb, Sandro Wartzack, Iris Wechsler, Andreas Wittek, Matthias Woiczinski, Michael Schwarze","doi":"10.1007/s00132-024-04515-5","DOIUrl":"10.1007/s00132-024-04515-5","url":null,"abstract":"<p><strong>Background: </strong>Computational research methods, such as finite element analysis (FEA) and musculoskeletal multi-body simulation (MBS), are important in musculoskeletal biomechanics because they enable a better understanding of the mechanics of the musculoskeletal system, as well as the development and evaluation of orthopaedic implants. These methods are used to analyze clinically relevant issues in various anatomical regions, such as the hip, knee, shoulder joints and spine. Preoperative simulation can improve surgical planning in orthopaedics and predict individual results.</p><p><strong>Examples from practice: </strong>In this article, the methods of FE analysis and MBS are explained using two practical examples, and the activities of the \"Numerical Simulation\" cluster of the \"Musculoskeletal Biomechanics Research Network (MSB-NET)\" are presented in more detail. An outlook classifies numerical simulation in the age of artificial intelligence and draws attention to the relevance of simulation in the (re)approval of implants.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"487-493"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}