Orthopadie (Heidelberg, Germany)最新文献

{"title":"Erratum zu: Osteochondrale Frakturen im Kindes- und Jugendalter.","authors":"Kristofer Wintges, Merle Körner, Danny Henkies, Hauke Rüther","doi":"10.1007/s00132-024-04551-1","DOIUrl":"10.1007/s00132-024-04551-1","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"667"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977412","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":"[Osteochondral fractures in childhood and adolescence].","authors":"Kristofer Wintges, Merle Körner, Danny Henkies, Hauke Rüther","doi":"10.1007/s00132-024-04527-1","DOIUrl":"10.1007/s00132-024-04527-1","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral fractures (OCF) are traumatic shearing injuries to portions of cartilage and bone. The most common cause is patellar dislocation, with the main localisation being the medial patellar facet and the lateral femoral condyle. They can occur in all age groups.</p><p><strong>Diagnosis: </strong>Clinically, there is a painful knee joint effusion (haemarthrosis) with a \"dancing patella\". This is usually accompanied by restricted movement and/or a locking phenomenon. In addition to the standard X‑ray of the knee in three planes (lateral, anterior-posterior and tangential patella), an MRI should be performed promptly in the case of haemarthrosis and suspicious symptoms, as concomitant injuries are present in up to 70% of cases.</p><p><strong>Treatment: </strong>The aim of treatment is to restore joint congruence in order to prevent the risk of secondary osteoarthritis. Small chondral and stable osteochondral fractures can be treated conservatively. Surgery is indicated for all other OCFs. In addition to refixation with various materials (bioresorbable screws, bone plugs, suture material and Kirschner wires), cartilage regeneration procedures (AMIC, MACI, OAT, etc.) are available for late diagnosed or non-refixable fragments. However, the number of cases is small.</p><p><strong>Conclusion: </strong>Osteochondral fractures are rare injuries in children and adolescents. Prompt MRI is recommended for diagnosis in cases of suspected OCF. Refixation is the preferred treatment method, with bioresorbable implants showing promising results in reducing the need for additional surgery. The risk of secondary osteoarthritis can be reduced with regular treatment.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"646-650"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731689","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":"[Angular and torsional malalignments of the paediatric knee joint].","authors":"Adrien Frommer, Andrea Maria Laufer, Gregor Toporowski, Henning Tretow, Robert Rödl, Björn Vogt","doi":"10.1007/s00132-024-04546-y","DOIUrl":"10.1007/s00132-024-04546-y","url":null,"abstract":"<p><strong>Background: </strong>Abnormal angular and torsional alignment of the lower extremities during growth are a common reason for consultation of a paediatrician or orthopaedist. There is often uncertainty about the pathological value of these abnormalities and the need for treatment, even among specialists. In the course of physiological growth and development processes, the axial and torsional alignment of the legs sometimes change considerably and in characteristic patterns.</p><p><strong>Diagnostics: </strong>The ability to assess whether abnormal angular or torsional alignments of the lower limb in the course of growth should still be regarded as normal or already as pathological, depending on age and gender, is essential for the treating physician and requires precise knowledge of the physiological development processes and the tolerable limits in all three spatial dimensions.</p><p><strong>Treatment: </strong>After careful explanation to the frequently concerned parents, a restrictive approach with observation of the spontaneous course of correction on the basis of regular clinical check-ups makes sense in the majority of cases. Pathological deviations from the physiological conditions are rare overall, can be idiopathic or of secondary origin and should be further clarified diagnostically using imaging procedures. As conservative measures are ineffective, pronounced angular and/or torsional deformities of the legs requiring treatment can only be corrected by surgical intervention, even in children and adolescents. The surgical treatment modalities available are varied and differ in terms of their invasiveness and complication profile, depending on the localization, type and severity of the deformity, as well as the age and possible concomitant diseases of the affected child or adolescent.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"631-645"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019795","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 effect of electromagnetic fields on tendinopathies : Study on the effect analysis of a singular application of high-energy pulsed electromagnetic fields].","authors":"Patrick Wilms, Jan Schröder, Lorenz Scheit, Rüdiger Reer","doi":"10.1007/s00132-024-04541-3","DOIUrl":"10.1007/s00132-024-04541-3","url":null,"abstract":"<p><strong>Objective: </strong>Tendinopathies are diseases that often entail long-term treatment consisting of analgesics, physiotherapy, orthotics, and sparing. The aim of this study was to investigate the effect of a single application of a high-energy PEMF (pulsed electromagnetic field) on pain perception and blood born inflammation parameters.</p><p><strong>Methods: </strong>34 patients were randomly assigned to a verum group (10 min PEMF, 0,78 T) or a placebo group (10 min sham condition). Prior to and up to one week after the patient blinded treatment (t1-t5), local pain state was assessed by means of algometry as pain pressure threshold (PPT). Accordingly, heat-shock protein 70 (HSP70) levels were analysed. Statistical analyses included 2‑way ANOVA (2 × 5). The clinical trial was registered (DRKS00031321).</p><p><strong>Results: </strong>After randomization and drop-out (verum n = 17, placebo n = 13) baseline-analyses did not reveal significant between-group differences for PPT (p = 0,096), for HSP70 (p = 0,524), or any other sample characteristics (p > 0,05). Pain reduction during one week of observation showed to be significantly higher (p = 0,045, η² = 0,013) for the PEMF group (PPT: +83 bis +139%) compared to the placebo group (PPT: +10 bis +36%). There were no HSP70 associated effects.</p><p><strong>Conclusions: </strong>A single bout of high energy PEMF led to an immediate pain relief in tendinopathy patients lasting at least for one week, but the hypothesized underlying HSP70 associated inflammatory pathway could not be confirmed.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"668-676"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019741","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":"[How does trauma secondary to unexpected extreme weather affect orthopaedic surgery departments? : An epidemiological study on the Filomena snowstorm].","authors":"Irene Zarcos-Paredes, Irene Matellanes-Mielgo, Alejandro Ordas-Bayon","doi":"10.1007/s00132-024-04529-z","DOIUrl":"10.1007/s00132-024-04529-z","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, was one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients caused Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events.</p><p><strong>Material and methods: </strong>A retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group) was made. The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay of surgical treatment.</p><p><strong>Results: </strong>A total of 1237 patients were included, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), which was five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In the Filomena group, surgically treated fractures increased by 168%, being more severe, as C‑type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78 days during the snowstorm.</p><p><strong>Conclusion: </strong>Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures, is to be expected, which will imply elective surgery cancellation, hurting patients and increasing costs.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"677-681"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749926","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":"[Myofascial pain syndrome-a neurovegetative complaints pattern].","authors":"Gerhard Opitz","doi":"10.1007/s00132-024-04547-x","DOIUrl":"10.1007/s00132-024-04547-x","url":null,"abstract":"<p><p>The diagnosis of myofascial pain syndrome is usually made after structural-morphological explanations have been ruled out. The lack of positive findings to guide treatment inevitably leaves room for interpretation despite the extensive use of all imaging, neurophysiological or serological diagnostics. Under these circumstances, a careful differential diagnosis must be made between functional and structural aspects, both of which in many cases must be assessed in their different relevance. Particular attention must be paid to indications of vegetative-sympathetic adjustment disorders.The great importance of a clinical, experience-based approach to this symptom pattern becomes clear here, especially if the technical diagnostic data is of no help. The dominance of imaging findings naturally promotes a structure-based, mechanistic understanding of the illness. In contrast, the emotional, vegetative mood of the patient should be given greater consideration as a diagnostic and therapeutic focus. Treatment measures should have a high success rate, as persistent reductions in stimulus thresholds may lead to prognostically unfavorable chronification.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"682-687"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908544","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":"[Non-traumatic osteochondral lesions of the knee joint during growth : Juvenile osteochondritis dissecans (JOCD) of the knee].","authors":"Konstantinos Tsaknakis, Faik K Afifi, Heiko M Lorenz, Anna K Hell","doi":"10.1007/s00132-024-04552-0","DOIUrl":"10.1007/s00132-024-04552-0","url":null,"abstract":"<p><strong>Background: </strong>Juvenile osteochondritis dissecans of the knee joint is the most common osteochondral lesion during growth, usually occurring between the 10th and 14th year of age.</p><p><strong>Pathogenesis: </strong>Repetitive microtraumata lead to a subchondral osseus lesion, which is commonly located at the medial aspect of the femoral condyle. Sport activities are considered to be the main cause, although genetic and hereditary factors as well as vitamin D₃ deficiency also play a role. Current classification systems distinguish between stable and unstable osteochondral lesions, which is decisive for further treatment.</p><p><strong>Treatment: </strong>Stable lesions may heal through conservative treatment by avoiding weight bearing and sport. Unstable lesions, on the other hand, can lead to a complete defect of the joint surface with the formation of a free joint body. In such cases, various surgical techniques aim at reconstructing the surface of the joint, in order to reduce the risk of secondary arthritis.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"651-658"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082869","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":"Tibialis spastic varus foot without tarsal coalition: a case report.","authors":"Mustafa Alper İncesoy, Gokcer Uzer","doi":"10.1007/s00132-024-04536-0","DOIUrl":"10.1007/s00132-024-04536-0","url":null,"abstract":"<p><p>Tibialis spastic varus foot (TSVF) is an uncommon clinical entity primarily associated with tarsal coalition. This case report presents a rare instance of TSVF without tarsal coalition in an 8‑year-old male patient. Successful treatment was achieved through a conservative approach involving botulinum toxin injections and a plaster cast, highlighting the potential of nonsurgical interventions for this rare condition.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"698-702"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006065","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":"[Multidisciplinary approach to treatment of positional cranial asymmetry in infants].","authors":"U Scheibl, J A Mitterer","doi":"10.1007/s00132-024-04533-3","DOIUrl":"10.1007/s00132-024-04533-3","url":null,"abstract":"<p><p>The prevalence of positional cranial asymmetry has significantly increased since the introduction of the \"Back to Sleep\" campaign. Some deformities require therapeutic measures, such as growth-guiding head prostheses. The diagnosis is based on the clinical features, a thorough clinical examination and measurement of the infant's head. Prevention includes early education of parents about alternative positioning methods. Early interventions such as positioning therapy and physiotherapy can be effective in mild cases. In severe cases, the use of growth-guiding orthoses is necessary. The treatment and timing are crucial as head growth is highest in the first year of life. Helmet treatment should be started early to achieve optimal results in order to achieve an improvement in the head shape and ear position. Multidisciplinary approaches including physiotherapy and osteopathy are essential.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"709-718"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001521","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 painful knee in children].","authors":"Kiril Mladenov, Martin Rupprecht","doi":"10.1007/s00132-024-04535-1","DOIUrl":"10.1007/s00132-024-04535-1","url":null,"abstract":"<p><p>Knee pain is one of the most common reasons for medical consultation for musculoskeletal problems in the paediatric population. The aetiology is of very variable origin and necessitates a precise assessment. In addition to a thorough anamnesis, clinical and imaging examination methods, as well as laboratory diagnostics are of utmost importance to establish a proper diagnosis and an adequate treatment regimen. This chapter summarises the current diagnostic algorithm for dealing with knee pain in children and adolescents.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"553-556"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749927","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}