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[Skeletal dysplasias-Multidisciplinary orthopedics]. [骨骼发育不良-多学科骨科]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-11 DOI: 10.1007/s00132-025-04676-x
B Kraler, C Chiari, S Farr, A Kranzl, T Kainz, J Patsch, G Mindler
{"title":"[Skeletal dysplasias-Multidisciplinary orthopedics].","authors":"B Kraler, C Chiari, S Farr, A Kranzl, T Kainz, J Patsch, G Mindler","doi":"10.1007/s00132-025-04676-x","DOIUrl":"https://doi.org/10.1007/s00132-025-04676-x","url":null,"abstract":"<p><p>Skeletal dysplasias (SD) are a heterogeneous group of rare hereditary diseases with pronounced skeletal involvement and include over 750 phenotypes, which are associated with disease-triggering variants in more than 550 genes. In addition to orthopedic treatment, a network of various disciplines is necessary to ensure high-quality diagnostics and treatment for SD. This is ideally carried out at a center specialized in the treatment of rare bone diseases (European Reference Network on Rare Bone Diseases). The close networking of orthopedics with pediatrics and other disciplines is important to enable a state-of-the-art treatment and to monitor the influences of new forms of pharmacotherapy on the musculoskeletal apparatus.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621449","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}
引用次数: 0
[Implementing quality management successfully : Experiences from the Bundeswehr Medical Service]. [成功实施质量管理：德国联邦国防军卫勤处的经验]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-10 DOI: 10.1007/s00132-025-04672-1
Doerthe Lison, N D Ferreira Sa Marques, M Haunhorst, A Lison
{"title":"[Implementing quality management successfully : Experiences from the Bundeswehr Medical Service].","authors":"Doerthe Lison, N D Ferreira Sa Marques, M Haunhorst, A Lison","doi":"10.1007/s00132-025-04672-1","DOIUrl":"https://doi.org/10.1007/s00132-025-04672-1","url":null,"abstract":"<p><p>The Bundeswehr's medically and service-oriented rehabilitation for wounded and seriously injured soldiers serves the operational readiness of the armed forces even in peacetime. In addition to the employer's duty of care, it is based on legal requirements, the professional standards of civilian professional societies and cooperation with civilian rehabilitation facilities. In the case of national and collective defence, a QM system geared to military needs is an indispensable basis for sustainable rehabilitation measures under extreme conditions. The experience of a medical facility with a complex rehabilitative mission in the implementation of a QM system, under unfavourable conditions such as staff shortages, training deficits and limited material resources, can be helpful for civilian institutions with regard to public services in crisis and war.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602420","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}
引用次数: 0
["Bending" instead of explanting - Surgical treatment of thigh pain in diaphyseal anchored hip arthroplasty]. [“弯曲”代替外植-骨干固定髋关节置换术中大腿疼痛的手术治疗]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-09 DOI: 10.1007/s00132-025-04679-8
Birte Schoon, Stephan Brand, Max Ettinger
{"title":"[\"Bending\" instead of explanting - Surgical treatment of thigh pain in diaphyseal anchored hip arthroplasty].","authors":"Birte Schoon, Stephan Brand, Max Ettinger","doi":"10.1007/s00132-025-04679-8","DOIUrl":"https://doi.org/10.1007/s00132-025-04679-8","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593107","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}
引用次数: 0
[Sacroiliitides in the German armed forces : Axial spondyloarthritis as a differential diagnosis for chronic back pain among young soldiers]. [骶髂关节炎在德国武装部队：轴性脊柱炎作为年轻士兵慢性背痛的鉴别诊断]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-07 DOI: 10.1007/s00132-025-04673-0
Sebastian Klapa
{"title":"[Sacroiliitides in the German armed forces : Axial spondyloarthritis as a differential diagnosis for chronic back pain among young soldiers].","authors":"Sebastian Klapa","doi":"10.1007/s00132-025-04673-0","DOIUrl":"https://doi.org/10.1007/s00132-025-04673-0","url":null,"abstract":"<p><strong>Background: </strong>Axiale Spondyloarthritis (axSpA) is one of the most frequent rheumatic diseases among young adults.</p><p><strong>Objectives: </strong>Determination of the current recommendations for diagnosing and treating axSpA, discussion of the clinical relevance and situation of soldiers with axSpA in the German armed forces.</p><p><strong>Materials and methods: </strong>Evaluation of national and international guidelines and literature review.</p><p><strong>Results: </strong>AxSpA might be one of the most common underlying rheumatic diseases requiring treatment and is predicted to be an important differential diagnosis of chronic back pain in soldiers in the German armed forces. Early termination of deployment and possible premature termination of military service are associated with chronic back pain. Currently, axSpA is related to limited serviceability. New specific therapies can prevent impending service disability at an early stage.</p><p><strong>Conclusion: </strong>Early diagnosis and treatment are essential to counteract reduced serviceability.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585805","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}
引用次数: 0
[Basic principles of the diagnostics and treatment of malignant bone tumors in old age]. 【老年恶性骨肿瘤诊治的基本原则】。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-02 DOI: 10.1007/s00132-025-04667-y
M Weber, M Dietrich, A Hillmann
{"title":"[Basic principles of the diagnostics and treatment of malignant bone tumors in old age].","authors":"M Weber, M Dietrich, A Hillmann","doi":"10.1007/s00132-025-04667-y","DOIUrl":"https://doi.org/10.1007/s00132-025-04667-y","url":null,"abstract":"<p><p>Abnormal X‑ray images and magnetic resonance imaging (MRI) findings in older patients are common and require prompt evaluation to distinguish malignant diseases from harmless incidental findings. A thorough medical history, including pre-existing diseases and previous imaging, is essential. Conventional X‑ray images provide initial indications of lesion dignity using the Lodwick classification. The diagnostics are supplemented by contrast-enhanced MRI and, if necessary, additional CT scans. The most common malignant bone tumors in old age are metastases, followed by lymphomas, plasmacytomas and, less frequently, primary bone tumors. The fracture risk of the extremities can be assessed using the Mirels score and using the spinal instability neoplastic score (SINS) regarding the spine. In cases of unclear findings, a biopsy is necessary for further evaluation and should be performed at a specialized tumor center. The treatment depends on the tumor entity and staging and includes surgical procedures, radiotherapy and chemotherapy. The most important indicator of a pathological fracture is an inadequate trauma mechanism.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546491","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}
引用次数: 0
[A stem fracture rarely comes in pairs]. [茎部骨折很少成对发生]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-19 DOI: 10.1007/s00132-025-04660-5
Hanno Schenker, Julius Michael Wolfgart, Ulf Krister Hofmann
{"title":"[A stem fracture rarely comes in pairs].","authors":"Hanno Schenker, Julius Michael Wolfgart, Ulf Krister Hofmann","doi":"10.1007/s00132-025-04660-5","DOIUrl":"10.1007/s00132-025-04660-5","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"503"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096095","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}
引用次数: 0
[Short-stem THA-complications and therapy options]. [短茎tha并发症和治疗方案]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-05 DOI: 10.1007/s00132-025-04663-2
Karl Philipp Kutzner
{"title":"[Short-stem THA-complications and therapy options].","authors":"Karl Philipp Kutzner","doi":"10.1007/s00132-025-04663-2","DOIUrl":"10.1007/s00132-025-04663-2","url":null,"abstract":"<p><p>Short stems in total hip arthroplasty are increasingly being established and offer several advantages in terms of minimal invasiveness and bone preservation compared to standard implants. The rounded design and shorter stem length facilitate better adaptation to natural anatomy, at the same time also posing specific risks and complications. When transitioning to short stems, a learning curve must be considered. Careful patient selection and preoperative planning are crucial, and intraoperative imaging is recommended. The most common implant-specific complications include insufficient osseointegration, leading to subsidence and aseptic loosening, as well as periprosthetic fractures. The risk instability and dislocations as well as periprosthetic infections can potentially be reduced with short stems. This article discusses the frequency, causes, and treatment options for these types of complications and highlights current evidence-based treatment approaches.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"530-536"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236155","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}
引用次数: 0
[Medical malpractice in primary total hip arthroplasty : Why is there a medical malpractice clause?] 初级全髋关节置换术中的医疗事故：为什么会有医疗事故条款？］
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-05 DOI: 10.1007/s00132-025-04664-1
Moritz Innmann, Marcus Schiltenwolf
{"title":"[Medical malpractice in primary total hip arthroplasty : Why is there a medical malpractice clause?]","authors":"Moritz Innmann, Marcus Schiltenwolf","doi":"10.1007/s00132-025-04664-1","DOIUrl":"10.1007/s00132-025-04664-1","url":null,"abstract":"<p><p>The provision of a hip endoprosthesis for coxarthrosis is one of the most common medical procedures associated with treatment errors. These errors are most frequently identified in the surgical execution. The most crucial prerequisite for preventing treatment errors is correct and guideline-compliant indication. Additionally, proper execution and documentation of both risk disclosure and precautionary disclosure are essential. Patient-specific factors, such as comorbidities or anatomical peculiarities, must be taken into account, as they are identified during mandatory preoperative planning. For postoperative radiological measurement parameters (e.g., implant positioning and leg length), clear and universally valid target values with acceptable deviations have not been definitively established. However, recommended values help assess whether an implantation error is present. Furthermore, a causal relationship between damage (e.g., dislocation, muscle weakness) and implantation errors must be established.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"537-542"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236154","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}
引用次数: 0
[Why does a total hip replacement dislocate? : Diagnosis and management]. 为什么全髋关节置换术会脱臼？【诊断与管理】。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-31 DOI: 10.1007/s00132-025-04662-3
Raphael Trefzer, Franz Reichel, Mustafa Hariri, Timo Nees, Tobias Reiner, David Spranz, Tilman Walker
{"title":"[Why does a total hip replacement dislocate? : Diagnosis and management].","authors":"Raphael Trefzer, Franz Reichel, Mustafa Hariri, Timo Nees, Tobias Reiner, David Spranz, Tilman Walker","doi":"10.1007/s00132-025-04662-3","DOIUrl":"10.1007/s00132-025-04662-3","url":null,"abstract":"<p><strong>Background: </strong>Dislocations represent one of the leading complications and the most common cause of early surgical revision in primary total hip arthroplasty (THA). Patient-, implant- and procedure-related factors can contribute causally by impairing soft tissue tension and/or impingement-free mobility.</p><p><strong>Influencing factors: </strong>Patient-specific factors, such as underlying neurological disorders or reduced spinopelvic mobility, should be carefully considered by the surgeon when selecting implants and devising a treatment strategy. Furthermore, the range of market-approved implants offers a broad spectrum of preventive measures for dislocation in both primary and revision settings.</p><p><strong>Therapy: </strong>Central to prevention is the precise and appropriate positioning of the implant, tailored to the patient's individual joint biomechanics. While tripolar acetabular systems are utilized in specific patient groups during primary surgery and revision procedures, constrained liners, should be reserved as a fallback strategy in exceptional cases. The occurrence of a THA dislocation constitutes a medical emergency, necessitating immediate radiographic evaluation and early reduction. In cases of a first-time dislocation, additional imaging may be warranted during follow-up, whereas recurrent dislocations mandate tomographic imaging to exclude malpositioning or loosening of the implant. This review summarizes the underlying causes and preventive strategies for THA instability, as well as the diagnostic and therapeutic algorithms for managing THA dislocations.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"506-512"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192584","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}
引用次数: 0
[Influence of macromastia on cervical spine and thoracic spine]. [大乳突对颈椎和胸椎的影响]。
Orthopadie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-04-24 DOI: 10.1007/s00132-025-04646-3
Alexander Schuh, Maria Dietrich, Liudmilla Bragina, Philipp Koehl
{"title":"[Influence of macromastia on cervical spine and thoracic spine].","authors":"Alexander Schuh, Maria Dietrich, Liudmilla Bragina, Philipp Koehl","doi":"10.1007/s00132-025-04646-3","DOIUrl":"10.1007/s00132-025-04646-3","url":null,"abstract":"<p><p>Macromastia refers to an excessively large breast volume, which can occur on one or both sides and is disproportionate to the patient's body proportions. Patients with macromastia often suffer from chronic pain of the breasts, shoulders, back and neck, degenerative changes of the spine, increased kyphosis of the thoracic spine, increased lordosis of the cervical and lumbar spine, headache, neurological problems such as dysesthesia of the ulnar nerve and carpal tunnel syndrome. Reduction mammoplasty is the gold standard in the treatment of symptomatic macromastia. A resection weight of more than 500 g per side is considered a medically indicated breast reduction by most health insurance companies if weight loss and comprehensive conservative treatment have not led to the desired success. Reduction mammoplasty results in a significant reduction of pain, improved posture and gait with a low complication rate.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"573-582"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009131","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}
引用次数: 0
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