Unfallchirurgie (Heidelberg, Germany)最新文献

[Centers for geriatric trauma DGU® : Distribution and development in Germany]. [老年创伤中心DGU®：在德国的分布和发展]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-06 DOI: 10.1007/s00113-025-01568-9

Josef Stolberg-Stolberg, Charlotte Ramadan, Jeanette Köppe, Janette Iking, Karen Fischhuber, Markus Blätzinger, Michael J Raschke, J Christoph Katthagen

{"title":"[Centers for geriatric trauma DGU® : Distribution and development in Germany].","authors":"Josef Stolberg-Stolberg, Charlotte Ramadan, Jeanette Köppe, Janette Iking, Karen Fischhuber, Markus Blätzinger, Michael J Raschke, J Christoph Katthagen","doi":"10.1007/s00113-025-01568-9","DOIUrl":"10.1007/s00113-025-01568-9","url":null,"abstract":"Background: Due to the demographic changes, including the need for more orthogeriatric co-management, addressing the healthcare of geriatric patients is an important issue.Objective: The aim of this study was to create an overview of the fundamental characteristics of centers for geriatric trauma ATZ-DGU including the distribution of departments and cooperations as well as the level of trauma care. The distribution of sites across Germany was compared to hospital and population data.Methods: Certified German ATZ-DGU were assigned to Trauma Center DGU® (TC) certification data (levels III-I) via institutional numbers. They were evaluated descriptively and correlations with several parameters at the federal states level were added.Results: Due to cooperations 188 institutions formed 147 ATZ-DGU and 152 provided orthogeriatric co-management in domo. Of the facilities with trauma surgery departments 86% (n = 168) were certified as TCs (level II = 33% > III = 30% > I = 22%). The number of ATZ-DGU per German state was correlated with the number of hospitals (rs = 0.88), inhabitants (rs = 0.92) and cases in total (rs = 0.92, p < 0.001 each) but not with the proportion of people older than 65 years (p > 0.05). With only 14 facilities, the new federal states of Germany seemed to be disadvantaged and also showed great disparities compared to each other.Conclusion: The levels of trauma care revealed a distribution referring to the different focus of the two certificates: treatment of the severely injured vs. geriatric co-treatment. On average, the population in the new German states was older, while there were less ATZ-DGU; however, there seemed to be a slight tendency towards improvement.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"525-532"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058892","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

[Osteosynthesis for proximal humeral fractures : Plating, double plating and more]. [肱骨近端骨折的植骨术：钢板，双钢板及更多]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-04-24 DOI: 10.1007/s00113-025-01574-x

Karl J Sander, Julia Sußiek, Mats Jonas Wiethölter, Michael J Raschke, J Christoph Katthagen

{"title":"[Osteosynthesis for proximal humeral fractures : Plating, double plating and more].","authors":"Karl J Sander, Julia Sußiek, Mats Jonas Wiethölter, Michael J Raschke, J Christoph Katthagen","doi":"10.1007/s00113-025-01574-x","DOIUrl":"10.1007/s00113-025-01574-x","url":null,"abstract":"Due to demographic changes, proximal humeral fractures (PHF) are becoming increasingly more frequent in routine clinical practice. At the same time, surgical treatment is more frequently indicated and more demanding due to increasingly more complex fracture morphology and declining bone quality. Osteosynthesis using locking plate fixation remains the mainstay of surgical treatment alongside reverse fracture arthroplasty. The treatment concept is individually dependent on the characteristics of the fracture morphology, the patient-specific risk profile and the expertise of the surgeon. In younger patients fracture fixation is preferable, when feasible. In recent years, combinations of different surgical techniques have been increasingly used to achieve humeral head preservation and sufficient stability. The risk of complications, such as secondary dislocation and screw cut-out has significantly decreased in recent years due to improved evaluation of the indications and surgical techniques. As one of these combined procedures, double plate fixation offers promising options for complex fractures due to an additional plate applied ventrally. This technique is increasingly becoming established in routine clinical practice. Cement augmentation of screws and different bone grafts are additional options to supplement locking plate osteosynthesis so that a good reconstruction result can also be achieved in osteoporotic bone.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"501-507"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045548","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

[Wrist arthroscopy remains the reference standard for the diagnostics of lesions of the triangular fibrocartilage complex]. [腕关节镜仍然是三角纤维软骨复合体病变诊断的参考标准]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-26 DOI: 10.1007/s00113-025-01586-7

Christian Karl Spies

引用次数: 0

[Robotically assisted placement of a pubic ramus screw and an SI-S1 screw]. [机器人辅助放置耻骨支螺钉和SI-S1螺钉]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-06 DOI: 10.1007/s00113-025-01580-z

Dominik M Haida, Iris Wagenblast, Stefan Huber-Wagner

{"title":"[Robotically assisted placement of a pubic ramus screw and an SI-S1 screw].","authors":"Dominik M Haida, Iris Wagenblast, Stefan Huber-Wagner","doi":"10.1007/s00113-025-01580-z","DOIUrl":"10.1007/s00113-025-01580-z","url":null,"abstract":"Objective of surgery: The aim of this operation is to stabilize the anterior pelvic ring fractures on both sides and the sacral fracture on the right using robotically assisted screw osteosynthesis and to restore the mobility of the patient.Indications: The indications arise from the patient's very severe pain, resulting immobility under conservative treatment measures and a fragility fracture of the pelvis grade II (FFP II).Contraindications: Typical contraindications for this type of operation are the same as for conventional techniques (mainly infection and swelling).Surgical technique: Performed in the 3D navigation hybrid operating theatre Robotic Suite with the following components: navigation unit \"Curve Navigation System\", movable robotic 3D cone beam computed tomography (CBCT) \"Loop‑X\", robotic arm \"Cirq Arm System\" and wall monitor \"BUZZ\" (Brainlab, Munich, Germany). The individual surgical steps are explained in the video online (English).Follow-up treatment: Full weight bearing, pain medication according to the World Health Organization (WHO) stage scheme, physiotherapy after the first postoperative day.Evidence: Navigated and robotically assisted techniques are mainly used on the spine. These techniques are also increasingly being used on the pelvis, whereby very high levels of accuracy can also be achieved.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"560-564"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060711","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

[Prolonged immobilization with an external fixator for subtalar dislocation without fracture : A case report]. 外固定架长时间固定距下脱位无骨折1例。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-02 DOI: 10.1007/s00113-025-01583-w

Yasmin Youssef, Volker Schöffl, Gordian Weber, Steffen Röttel, Christian Willy, Falko Patzsch

{"title":"[Prolonged immobilization with an external fixator for subtalar dislocation without fracture : A case report].","authors":"Yasmin Youssef, Volker Schöffl, Gordian Weber, Steffen Röttel, Christian Willy, Falko Patzsch","doi":"10.1007/s00113-025-01583-w","DOIUrl":"10.1007/s00113-025-01583-w","url":null,"abstract":"Background: Subtalar dislocations (simultaneous dislocations of the talocalcaneal and talonavicular joints) without concomitant fracture are rare and account for 1-2% of all dislocations. The treatment has been described in several case reports and consists primarily of closed reduction with the patient under anesthesia followed by immobilization.Case: A 30-year-old male patient sustained a multidimensional nonfractured dislocation of the ankle joint with a predominantly subtalar component (luxatio subtalolateralis) while climbing. As it turned out later, a closed reduction was not possible due to interposition of the tendons of the posterior tibialis muscle and the flexor digitorum pedis longus muscle, so that an open reduction had to be performed. The full extent of the injury could only be assessed during the surgical exploration. The patient was treated in an external fixator for 12 weeks. Subsequently, physiotherapy was initiated. After only 6 months postoperatively the patient showed good mobility, functionality and resilience in the affected ankle joint. After 30 months the patient was free of symptoms. The prolonged immobilization after subtalar dislocation using an external fixator over a total period of 12 weeks, as performed in this case report, demonstrated good long-term functional outcomes.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"545-551"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201036","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

[Old and young-Differences in the treatment of proximal humeral fractures?] 老年和年轻肱骨近端骨折治疗的差异？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1007/s00113-025-01587-6

Jan N Riesselmann, Freya M Reeh, Helmut Lill, Alexander Ellwein

引用次数: 0

[Focus on the shoulder : Precise diagnostics for complex pathological alterations]. [关注肩部：复杂病理改变的精确诊断]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-26 DOI: 10.1007/s00113-025-01585-8

S Albers, M Zyskowski, P Zehnder, C Kirchhoff, P Biberthaler, Markus Schwarz

引用次数: 0

[The surgeon as a risk factor : German Congress for Orthopedics and Trauma Surgery (DKOU) Science Slam 2024]. [外科医生作为风险因素：德国骨科与创伤外科大会（DKOU）科学大满贯2024]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-23 DOI: 10.1007/s00113-025-01579-6

Thomas Mittlmeier

引用次数: 0

[Endoprosthesis in proximal humerus fractures -What is important?] 肱骨近端骨折内假体-什么是重要的？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-04-22 DOI: 10.1007/s00113-025-01573-y

M Kimmeyer, M Hackl, L J Lehmann

{"title":"[Endoprosthesis in proximal humerus fractures -What is important?]","authors":"M Kimmeyer, M Hackl, L J Lehmann","doi":"10.1007/s00113-025-01573-y","DOIUrl":"10.1007/s00113-025-01573-y","url":null,"abstract":"In cases of complex proximal humeral fractures a fracture prosthesis is an established treatment option. In the geriatric patient population, the use of reverse total shoulder arthroplasty is gaining in relevance. This article focuses on the specific requirements and challenges associated with the application of reverse total shoulder arthroplasty. Decisive for the success are a structured perioperative management, meticulous preoperative planning, thorough patient education and standardized protocols for infection and bleeding prophylaxis. Intraoperatively, emphasis is placed on precise implantation techniques and stable tuberosity fixation, of which the latter is essential for postoperative function. A humeral inclination of 135° has been shown to be associated with better tuberosity healing. Complications, such as scapular notching or instability can be minimized through an accurate surgical technique and optimized implant management. Postoperative care is tailored to the individual, employing either a shoulder abduction brace or an early functional rehabilitation approach. Overall, reverse shoulder arthroplasty provides an effective fracture treatment for geriatric patients, ensuring long-term functional and clinical benefits.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"508-516"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014060","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

[Supplements to MRI diagnostics in TFCC tears and operative treatment of Palmer class 1D injuries]. [补充TFCC撕裂的MRI诊断和Palmer 1D级损伤的手术治疗]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-04 DOI: 10.1007/s00113-025-01590-x

Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther

引用次数: 0