Unfallchirurgie (Heidelberg, Germany)最新文献

[Interprosthetic femoral fractures : Osteosynthesis, megaendoprosthesis, limb salvage?] 股骨假体间骨折：骨融合术、巨型假体、肢体保留？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-09 DOI: 10.1007/s00113-025-01641-3

Tilman Graulich, Matthias Hamphoff, Gabriela von Lewinski

{"title":"[Interprosthetic femoral fractures : Osteosynthesis, megaendoprosthesis, limb salvage?]","authors":"Tilman Graulich, Matthias Hamphoff, Gabriela von Lewinski","doi":"10.1007/s00113-025-01641-3","DOIUrl":"https://doi.org/10.1007/s00113-025-01641-3","url":null,"abstract":"Interprosthetic femoral fractures (IFF) involve fractures occurring between total hip and knee arthroplasty and represent an increasing challenge, with complication rates of up to 57% and a mortality rate of 31%. The treatment is complex and requires an individual, often multidisciplinary approach. Risk factors are related to the patient, implant and surgical technique. Classification systems, such as the one proposed by Pires enable a systematic categorization based on fracture location and morphological features of the fracture. The treatment options range from angular stable plate osteosynthesis, double plate fixation and nail-plate combinations to endoprosthetic solutions, such as stem revision, proximal or distal femur replacement or total femur replacement (TFR). As an alternative to TFR, sleeves can be used providing a bone-sparing solution. Endoprosthetic procedures are primarily indicated for loose prostheses and poor bone quality but carry a higher risk of complications. The choice of treatment depends on many factors, especially fracture type, prosthesis fixation and bone vitality. The goal is always an early functional, loadbearing reconstruction to prevent secondary complications. Preventively, attention should be paid to the biomechanically adapted and stable treatment of the primary arthroplasty. Ultimately, IFFs require detailed planning and expertise in both osteosynthetic and endoprosthetic treatment strategies.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254000","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

[Extra-articular fracture of the distal femur : Characteristics and treatment principles]. 【股骨远端关节外骨折：特点及治疗原则】。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-09 DOI: 10.1007/s00113-025-01637-z

Christian Walter Müller, José Fernando Sánchez Carbonel, Christian Alexander Kühne

引用次数: 0

[Periprosthetic fractures of the knee : Revision arthroplasty]. 膝关节假体周围骨折：关节置换术。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-07 DOI: 10.1007/s00113-025-01642-2

Marc-Pascal Meier, Wolfgang Lehmann, Thelonius Hawellek

{"title":"[Periprosthetic fractures of the knee : Revision arthroplasty].","authors":"Marc-Pascal Meier, Wolfgang Lehmann, Thelonius Hawellek","doi":"10.1007/s00113-025-01642-2","DOIUrl":"https://doi.org/10.1007/s00113-025-01642-2","url":null,"abstract":"Background: Periprosthetic fractures of the knee joint are among the major complications following joint replacement surgery. The surgical treatment is challenging and therefore requires careful preoperative planning in order to select the best possible treatment strategy.Material and methods: This review article was compiled based on a selective literature search of the PubMed database. Evidence-based treatment recommendations are provided using common classification systems and current research results.Results: Regardless of the location of a periprosthetic fracture in the knee, at first it has to be determined whether the knee joint endoprosthesis is stable or loose. If the implant is stable, the prosthesis can be retained with osteosynthetic treatment. In the case of a loose implant, prosthesis malfunctioning, malalignment or malpositioning, ligament instability, infection or deficient bone substance, the prosthesis has to be replaced. Knowledge of the exact classification of the fracture and the implant in place is therefore essential for determining the surgical strategy. This article focuses primarily on the different strategies for prosthesis replacement.Conclusion: Periprosthetic fractures of the knee are complex injuries that require extensive expertise in trauma and arthroplasty in order to provide the best possible surgical treatment.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240352","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

[Reduction techniques for acetabular fractures]. [髋臼骨折复位技术]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-07 DOI: 10.1007/s00113-025-01635-1

A Gänsslen, F Lampe, S Oberthür, J-D Clausen, S Sehmisch

引用次数: 0

[Long-term care of polytraumatized patients, requirements for rehabilitation management]. 【多发创伤患者的长期护理，康复管理要求】。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-06 DOI: 10.1007/s00113-025-01645-z

J Schmidt, F Lehmann, N Ashouri, I Schmidt

{"title":"[Long-term care of polytraumatized patients, requirements for rehabilitation management].","authors":"J Schmidt, F Lehmann, N Ashouri, I Schmidt","doi":"10.1007/s00113-025-01645-z","DOIUrl":"https://doi.org/10.1007/s00113-025-01645-z","url":null,"abstract":"Background and question: The challenge in the rehabilitation of polytraumatized people is the lengthy path to the best possible recovery, which requires patience on the part of the person undergoing rehabilitation as well as continuous support. The aim of this analysis is to identify specific factors and times that are important in the rehabilitation process.Study design and investigation methods: A total of 50 documented courses of rehabilitation management with 214 course documentations were evaluated. Problems in the course and measures taken were clustered for statistical evaluation.Results: The patient population was similar to that of the Trauma Register of the German Society of Trauma Surgery (TR-DGU). The start of care was on average 200 days after the accident. In the initial period 4-5 months after the accident, medical and technical measures, especially obtaining second opinions, predominated in 78% of cases, further hospitalizations in 42% and further medical rehabilitation measures in 54%. Problems of occupational participation became relevant 11-12 months after the accident. Social rehabilitation management came to the fore after 15-16 months.Conclusion: In summary, rehabilitation after polytrauma requires a comprehensive, individually adapted concept that takes the physical, psychological and social aspects of recovery into account.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234171","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

[Periprosthetic acetabular fracture]. [假体周围髋臼骨折]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-02 DOI: 10.1007/s00113-025-01639-x

Jose A Roshardt, Silviya Ivanova, Hannes Kuttner, Christiane Leibold, Simon D Steppacher, Moritz Tannast, Johannes D Bastian

引用次数: 0

[Shaft fractures of the upper extremities and concomitant injuries : Epidemiology, classification, diagnostics and clinical relevance]. [上肢骨干骨折及伴发损伤：流行病学、分类、诊断及临床相关性]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-06-05 DOI: 10.1007/s00113-025-01593-8

Vincent Vieregge, Jan Friederichs, Fabian M Stuby, Alexander Trulson

{"title":"[Shaft fractures of the upper extremities and concomitant injuries : Epidemiology, classification, diagnostics and clinical relevance].","authors":"Vincent Vieregge, Jan Friederichs, Fabian M Stuby, Alexander Trulson","doi":"10.1007/s00113-025-01593-8","DOIUrl":"10.1007/s00113-025-01593-8","url":null,"abstract":"Shaft fractures of the upper extremities represent a significant challenge in trauma surgery due to their functional importance. The epidemiological analysis reveals characteristic distribution patterns: humeral shaft fractures (1.2-5% of all fractures) show a bimodal age distribution, with peaks at 20-30 years and above 60 years. Forearm shaft fractures (13.8/100,000 inhabitants [1]) occur particularly frequently in children and decrease with advancing age. The classification primarily follows the AO/OTA system, which was comprehensively revised in 2018, supplemented by specific classifications for special types, such as Monteggia and Galeazzi fractures. In the diagnostics, conventional radiography remains the initial standard, while computed tomography (CT), magnetic resonance imaging (MRI) and increasingly high-resolution sonography serve as complementary methods for assessing complex fracture morphologies and associated soft tissue injuries. Concomitant neurological injuries, especially radial nerve palsy in humeral shaft fractures (2-17%), which otherwise occur less frequently in routine trauma surgery, require differential diagnostics and individualized treatment concepts. While the majority of nerve lesions show spontaneous remission, microsurgical reconstruction techniques exist for persistent cases. Innovative approaches such as biological augmentation, virtual reality (VR)-based neurorehabilitation or functional electrical nerve stimulation could improve outcomes in the future. Interdisciplinary collaboration between orthopedic surgery, neurology and rehabilitation medicine is essential for optimal treatment results.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"732-739"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236199","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

[Tertiary survey for trauma patients : Practical recommendations of the Trauma Section of the DIVI]. [创伤患者的三级调查：DIVI创伤科的实用建议]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-09-01 DOI: 10.1007/s00113-025-01600-y

Paula Beck, Aileen Spieckermann, Jörg Bayer, Oliver Cruciger, Hanns-Christoph Held, Katharina Hinrichs, Axel Rand, Uwe Hamsen

{"title":"[Tertiary survey for trauma patients : Practical recommendations of the Trauma Section of the DIVI].","authors":"Paula Beck, Aileen Spieckermann, Jörg Bayer, Oliver Cruciger, Hanns-Christoph Held, Katharina Hinrichs, Axel Rand, Uwe Hamsen","doi":"10.1007/s00113-025-01600-y","DOIUrl":"10.1007/s00113-025-01600-y","url":null,"abstract":"The tertiary survey serves to identify injuries and their consequences in the hours and days following polytrauma. A structured process has been proven to result in a high rate of previously missed additional diagnoses, leading to subsequent changes in patient management; however, to date there are no concrete practical recommendations or widespread implementation of the tertiary survey in German trauma centers. We recommend performing the tertiary survey for the first time as early as possible in the intensive care unit, followed by repeated assessments as needed when the patient´s clinical condition changes. Furthermore, we recommend utilizing the tertiary survey as a structured re-evaluation of the patient beyond physical examination. This should include the assessment of psychological stress, a thorough review of imaging and consultative findings and the collection of additional information regarding the accident and the patient´s medical history. After compiling all information further treatment plans should be evaluated and defined. The Trauma Section of the German Interdisciplinary Association for Intensive and Emergency Medicine (DIVI) is developing a freely available tertiary survey form, which will undergo continuous optimization supported by scientific evaluation. In the long term, the goal is to provide a standardized tool for integration into local standard operating procedures of trauma centers, quality management systems and digital emergency care pathways.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"801-805"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981948","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

[High commitment despite high task load: work-related evaluation in the implementation of a virtual multidisciplinary limb board]. [高任务负荷下的高承诺：虚拟多学科肢体板实施中的工作相关评估]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-06-12 DOI: 10.1007/s00113-025-01588-5

Joachim Hasebrook, Sibyll Rodde, Marion Laumann, Tobias Hirsch, John Grosser, Steffen B Roßlenbroich

{"title":"[High commitment despite high task load: work-related evaluation in the implementation of a virtual multidisciplinary limb board].","authors":"Joachim Hasebrook, Sibyll Rodde, Marion Laumann, Tobias Hirsch, John Grosser, Steffen B Roßlenbroich","doi":"10.1007/s00113-025-01588-5","DOIUrl":"10.1007/s00113-025-01588-5","url":null,"abstract":"Background: As part of the evaluation of a virtual multidisciplinary expert board to improve the treatment of trauma to the lower extremities (project EXPERT), work-related aspects are examined in addition to medical and economic outcomes. Initial results of a survey of employees involved in EXPERT are presented here.Material and methods: Clinical staff worked on an online questionnaire on the topics of workload, work commitment, work-related resources and technical readiness. Work-related resources are physical, social and organizational aspects for overcoming work demands, such as peer support, feedback, opportunities to learn and meaningfulness of work. Factors that have a significant effect on work commitment and willingness to work were recorded.Results: At the beginning of the project, the work commitment was very high, although the individual workload was also high. When individual stress was high, the willingness to use technology increased if sufficient work-related resources were available. Nonmedical staff showed a high willingness to use technology, especially with limited resources. With high team-related stress, e.g. due to conflicts and only a few resources, the willingness to use technology was particularly low.Discussion: Diverse work-related resources not only strengthen work commitment but also the acceptance of digital innovations. In the case of high individual stress, employees, especially members of the nonmedical professions, perceived the use of technology as helpful. The prerequisite for this is that the cooperation in the team works.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"775-782"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287517","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

[Shaft fractures of the upper extremities: precision in diagnostics and treatment : Current concepts and interdisciplinary challenges]. [上肢轴骨折：诊断和治疗的精确性：当前概念和跨学科挑战]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-10-01 Epub Date: 2025-09-22 DOI: 10.1007/s00113-025-01627-1

Fabian Stuby

引用次数: 0