Unfallchirurgie (Heidelberg, Germany)最新文献

{"title":"[Online resources for ankle sprains : A German language web analysis].","authors":"Sophie Maria Tengler, Mark Lenz, Gunther O Hofmann, Marianne Rosenthal, Klaus E Roth, Lena Mohr, Hazibullah Waizy, Kajetan Klos","doi":"10.1007/s00113-024-01526-x","DOIUrl":"10.1007/s00113-024-01526-x","url":null,"abstract":"<p><strong>Background: </strong>With the Internet as the main source of information for health content, the quality of websites with medical information is of high importance.</p><p><strong>Objective: </strong>This study analysed 250 websites on acute ankle sprain (ASD), one of the most common musculoskeletal disorders, for their quality and readability. Based on the results, a guide for patients was created.</p><p><strong>Method: </strong>The quality of the websites was assessed using a 25-item content score and the EQIP36 score for medical information material. The reading level could be determined using the Flesch-Kincaid index and the calculated readability. The best three websites were evaluated in a user survey.</p><p><strong>Results: </strong>Of the 250 websites recorded 77 were included in the study. The quality of these varied significantly, with none achieving the maximum score. Sources in the healthcare system showed higher quality, while commercially influenced sites were below average in terms of completeness of content. Only 14% of the websites reached the recommended reading level. A significant negative correlation was found between completeness of content and readability. The user survey showed a mixed level of satisfaction and participants with previous medical knowledge were more critical than laypersons.</p><p><strong>Conclusion: </strong>Online resources about ASD are suboptimal and differ considerably. Deficiencies in content, readability and structure were identified, which limit the effective use by patients. Health information publishers should work harder to improve the comprehensibility and quality of the information provided.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"201-208"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017321","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":"[Diagnostics and classification of fractures of the thoracic and lumbar spine in adults : Approach depending on the bone structure].","authors":"Bernhard U Hoehl, Tom Niklas Folkerts, Matthias Pumberger, Friederike Schömig","doi":"10.1007/s00113-024-01500-7","DOIUrl":"10.1007/s00113-024-01500-7","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology, treatment and prognosis of thoracolumbar vertebral fractures are fundamentally influenced by the bone quality of the patient. In individuals with healthy bone structure, a high-energy trauma is typically required to cause a fracture. In contrast, osteoporosis can cause fractures and also be present as a comorbid pathology in traumatic fractures. Comprehensive diagnostics and a precise classification are essential for appropriate treatment.</p><p><strong>Material and method: </strong>This narrative review outlines the diagnostic approach and classification of thoracolumbar vertebral fractures depending on the bone quality as the basis of treatment.</p><p><strong>Results: </strong>In addition to a physical examination, conventional radiographs with the patient in a standing position and computed tomography (CT) scans of the affected region serve as the foundation for fracture classification. Supplementary magnetic resonance imaging (MRI) primarily assesses discoligamentous and neurological structures of the spine as well as the age of the fracture. In suspected cases of osteoporotic fractures, a short-tau inversion recovery (STIR) sequence of the entire thoracic and lumbar spine is recommended for reliable detection of bone marrow edema. For patients with healthy bone structure, the AO Spine classification is used, whereas the osteoporotic fracture (OF) classification and the OF score are applied in cases of osteoporosis.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"147-155"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640291","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":"[Isolated osseous tuberculosis : Differential diagnosis of treatment refractory osteomyelitis?]","authors":"Hendrik Schöllmann, M Glombitza, V Heck, M Dudda, E Steinhausen","doi":"10.1007/s00113-024-01527-w","DOIUrl":"10.1007/s00113-024-01527-w","url":null,"abstract":"<p><p>We report the case of a 66-year-old female patient with a treatment refractory disorder of wound healing of the knee, who had already been treated several times surgically and with antibiotics for several months. The examination revealed a skin defect with a fistula in the region of the knee joint. The X‑ray imaging showed an extensive bony defect of unclear etiology. After specific diagnostics for acid-resistant rod-shaped bacteria, it was possible to identify Mycobacterium tuberculosis as the causative pathogen. After antitubercular drug treatment complete healing of the lesions was observed. The bony defect could be filled with bone substitute. There was neither a history of primary foci nor of a potentially infectious environment.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"231-236"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960197","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":"[Indications for surgical treatment of traumatic fractures of the thoracic spine and lumbar spine].","authors":"Philipp Pieroh, Christoph-E Heyde","doi":"10.1007/s00113-024-01518-x","DOIUrl":"10.1007/s00113-024-01518-x","url":null,"abstract":"<p><p>Fractures of the thoracic (Th) and lumbar (L) vertebrae are among the most frequent fracture entities in Germany and particularly affect the thoracolumbar junction (TLJ; Th11-L2). Based on expert recommendations and consensus meetings, the thoracolumbar AOSpine injury score was established for patients with healthy bone and the osteoporotic fracture (OF) score for geriatric patients with the respective classifications for treatment decisions. In both cohorts, the treatment decision is based on the fracture morphology, neurological status and patient-specific contextual factors. In terms of fracture morphology, surgical treatment is generally indicated for distraction and rotation/translation injuries. The treatment decision for compression fractures is more complex as additional factors must be taken into consideration. The decision in patients with healthy bone is primarily influenced by imaging morphological criteria (deformity and destruction) whereas in osteoporotic patients the decision is influenced by individual criteria, such as the general condition, the possibility of low pain mobilization and concomitant diseases. Overall, the treatment decision for fractures of the TLJ is not dogmatic as individual factors must be considered and high-quality studies are lacking.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"156-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048952","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":"[Surgical techniques for above- and below-knee amputation].","authors":"Patrick Schröter, Marc Hückstädt, Steffen Langwald, Bianca Schröter, Philipp Kobbe","doi":"10.1007/s00113-024-01531-0","DOIUrl":"10.1007/s00113-024-01531-0","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"222-230"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069499","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":"[Traumatic fractures of the thoracolumbar spine].","authors":"Ulrich Spiegl","doi":"10.1007/s00113-025-01533-6","DOIUrl":"https://doi.org/10.1007/s00113-025-01533-6","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"128 3","pages":"145-146"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484998","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":"[Current surgical treatment concepts for traumatic thoracic and lumbar vertebral fractures in adults with good bone quality].","authors":"Ulrich Spiegl, Robert Pätzold, J Krause, Mario Perl","doi":"10.1007/s00113-024-01505-2","DOIUrl":"10.1007/s00113-024-01505-2","url":null,"abstract":"<p><p>The surgical treatment of traumatic vertebral body fractures in patients with good bone quality is controversially discussed. The data situation is unclear and only of limited help due to mainly insufficient evidence. The surgical measures include an axially aligned reduction and an osteosynthesis which is stable under load so that immediate mobilization of the patient is possible. This requires anatomical restoration of the alignment and the biomechanical challenge of fracture healing or fusion in the correct position without relevant loss of reduction must be taken into account. The aim should be the lowest possible loss of function. In the case of existing or impending neurological deficits it is crucial to prevent deterioration of the neurological situation and to achieve the prerequisites for recovery. Posterior stabilization primarily plays the decisive role in the operative treatment. If possible, this should be a minimally invasive procedure and over short distances. For bisegmental treatment monoaxial screws and the use of index screws improve construct stability. In addition, stable cobalt rods should be used as 5mm longitudinal support. Special minimally invasive reduction instruments are helpful in restoring the sagittal and coronal relationships. The indications for an additional ventral column depend on the rigidity of the posterior stabilization, the extent of the injury of the anterior column and the intervertebral disc. Anterior fusion can often be delayed or avoided altogether, depending on the course with corresponding clinical signs.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"167-180"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792966","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":"[Current surgical treatment concepts for traumatic fractures of the thoracic and lumbar spine with osteoporotic bone substance].","authors":"Max J Scheyerer, Klaus Schnake, Bernhard Ullrich, Ulrich Spiegl","doi":"10.1007/s00113-024-01525-y","DOIUrl":"10.1007/s00113-024-01525-y","url":null,"abstract":"<p><p>Osteoporosis-related vertebral fractures are among the most frequent fracture entities in geriatric patients. They are associated with far-reaching individual and socioeconomic consequences. Adequate diagnostics and treatment are therefore essential. The osteoporotic fracture (OF) score is a central element in determining the right treatment. Although the majority of fractures can be healed with conservative treatment, a change of treatment should be considered in good time in cases of failure. Isolated cement augmentation procedures are particularly suitable for reducing pain in primarily stable osteoporotic vertebral fractures with a preserved framework structure (OF types 1-3) and a largely intact posterior edge. Dorsal cement-augmented stabilization with cementing of the fractured vertebral body leads to good results in unstable OF types 3 and 4 fractures. Dorsoventral procedures with cement-augmented internal fixator from the dorsal side and vertebral body replacement from the ventral side play a more subordinate role. Purely ventral procedures should be avoided in this patient group.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"181-191"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030445","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":"[Major amputations of the lower extremity].","authors":"Patrick Schröter, Marc Hückstädt, Steffen Langwald, Bianca Schröter, Philipp Kobbe","doi":"10.1007/s00113-024-01530-1","DOIUrl":"10.1007/s00113-024-01530-1","url":null,"abstract":"<p><p>In Germany there are approximately 18,500 major amputations of the lower extremity each year, primarily transtibial or transfemoral. For successful rehabilitation, knowledge about the desired optimal stump condition and specific amputation techniques are essential. Biomechanical considerations regarding the amputation stump play a crucial role in the selection of the surgical technique as do the reasons for the amputation. Techniques such as myodesis, myoplasty or Gottschalk plastic surgery help to maintain muscle tension and optimize prosthesis control.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"209-221"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191578","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 to the thoracic and lumbar spine in children under 16 years of age-Reality of care in German-speaking countries: a registry study].","authors":"Hauke Rüther, Saleh Alayesh, Christoph-E Heyde, Dina Wiersbicki, Yasmin Youssef, Julia Bolte, Pia Brecht, Alexander Carl Disch, Jan-Sven Jarvers","doi":"10.1007/s00113-024-01504-3","DOIUrl":"10.1007/s00113-024-01504-3","url":null,"abstract":"<p><strong>Background: </strong>Spinal injuries in childhood are rare. There are few meaningful data for German-speaking countries.</p><p><strong>Questions/aim of the study: </strong>Evaluation of the registry data of the German Spine Society (DWG) with respect to the reality of care for thoracolumbar injuries in childhood.</p><p><strong>Material and methods: </strong>This retrospective study was initiated by the Spinal Trauma in Childhood Working Group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery (DGOU). All patients under the age of 16 years who underwent surgery between 1 January 2017 and 31 June 2023 were included. An anonymized evaluation of the demographic data was carried out with respect to age, gender, level of injury, neurological impairment, classification and treatment performed with intraoperative and postoperative complications. The specified documentation in the spine register served as the information basis. Regarding age classification 3 groups were used: I: 0-6 years, II: 7-9 years, III: 10-16 years.</p><p><strong>Results: </strong>Data from 83 children with 150 injuries in the thoracic and lumbar spine areas with a mean age of 11.4 (± 3.45) years were analyzed. A total of 78 (52%) thoracic and 72 (48%) lumbar injuries were found. Type A injuries were most common (n = 89; 59.2%). Type B injuries were found in 32.2% (n = 48) and occurred mainly in group III. According to the AO neurological injury classification 18 (21%) patients had incomplete and 4 (4.8%) patients had complete paraplegia. Various methods were used for surgical treatment, the most common being dorsal stabilization (n = 73; 87.9%). The majority of operations were uncomplicated (n = 75; 90.4%).</p><p><strong>Discussion: </strong>According to the registry data 83 children were treated surgically with an acceptable complication rate. Older children and adolescents (group III) had a significantly higher injury severity compared to younger children. As with most registry studies, only limited conclusions can be drawn about surgical strategies, indications and techniques.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"192-200"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792968","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}