Unfallchirurgie (Heidelberg, Germany)最新文献

{"title":"[As a surgeon in Tanzania : Experiences from working in a Lutheran Hospital in South Tanzania].","authors":"Werner Kronenberg","doi":"10.1007/s00113-025-01648-w","DOIUrl":"10.1007/s00113-025-01648-w","url":null,"abstract":"<p><p>An overseas assignment in a rural hospital in Tanzania provides surgeons with extraordinary insights into clinical practice under completely different conditions. The injury patterns are largely determined by motorcycle accidents: open fractures, traumatic brain injuries and polytrauma dominate the spectrum. Limited resources make simple and robust techniques, such as external fixation, lag screw osteosynthesis and plaster cast treatment central to patient care. Diagnostic options and intensive care are restricted, requiring a renewed focus on clinical examination, prioritization and pragmatic solutions. In addition to clinical work, the training of young colleagues plays a key role in sustainably strengthening local structures. Such an assignment broadens professional horizons, sharpens clinical judgment and fosters a deep appreciation of the possibilities offered by modern surgery in Europe.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"299-302"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403248","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 stabilization of fragility fractures of the pelvis shows a good age-appropriate result regardless of the surgical procedure].","authors":"Anne Sofie Vogelsang, Mikolaj Bartosik, Eckart Mayr, Ulf Culemann","doi":"10.1007/s00113-026-01678-y","DOIUrl":"10.1007/s00113-026-01678-y","url":null,"abstract":"<p><strong>Background: </strong>The treatment of fragility fractures of the pelvis (FFP) is becoming increasingly more important due to the demographic changes. Older age and the associated multimorbidity pose a challenge for the optimal treatment of pelvic fractures.</p><p><strong>Method: </strong>A total of 36 patients were included. They were categorized according to the FFP classification with the following distribution: 44.4% FFP II, 16.7% FFP III and 38.9% FFP IV. Transiliosacral screws used unilaterally/bilaterally (cannulated 7.3 mm titanium screws with 32 mm thread, MedTech J&J, Umkirch, Germany) were compared to a continuous transiliosacral sacral rod (cannulated 7.5 mm rod, Marquardt, Spachingen, Germany) for stabilization of the posterior pelvic ring (screw vs. rod) and in combination with or without a ventral supra-acetabular external fixator (steel Schanz screws with cross-connectors classified as ⌀Fix vs. Fix). The parameters measured were the duration of surgery, complication and revision rates and functional outcomes. The quality of life on the visual analogue scale (EQ-VAS), EQ-5D-5L index and Elderly Mobility Scale (EMS) were compared 1 day, 6 weeks and 6 months postoperatively.</p><p><strong>Results: </strong>The mean age of the overall cohort was 81.5 ± 7.7 years and the overall mortality rate was 5.6%. The higher complication (29.4% vs. 17.6%, p = 0.419) and revision rates (5.9% vs. 0.0%, p = 0.310) of the screw group were not statistically significant. The EQ-VAS, EQ-5D-5L and EMS showed no significant differences between screw vs. rod. The fix group had a longer operation time (47.2 ± 9.2 min vs. 35.2 ± 20.2 min, p = 0.005) but a lower complication rate (11.1% vs. 28.0%, p = 0.306); however, their mobility was significantly reduced postoperatively and after 6 weeks (EMS day 1: 6 ± 4 vs. 11 ± 4, p = 0.003; week 6: 12 ± 2 vs. 16 ± 3, p = 0.010).</p><p><strong>Discussion: </strong>Osteoporosis treatment had not been performed prior to the injury in 64.7% of the injured patients, 29.4% received a basic treatment for osteoporosis and 5.9% received specific treatment for osteoporosis. Surgical treatment of FFP II-IV showed a good clinical outcome with age-appropriate values after 6 months. The clinical outcome was the same after 6 months regardless of the surgical procedure.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"310-319"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042296","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":"(Karriere‑)Wege in der Unfallchirurgie : Vom Mut, eigene Wege zu gehen.","authors":"Marit Herbolzheimer, Stephan Sehmisch","doi":"10.1007/s00113-026-01697-9","DOIUrl":"10.1007/s00113-026-01697-9","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"289-290"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438306","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":"Retrograde posterior column acetabular screw: robotically assisted and CT-guided minimally invasive procedure.","authors":"Dominik M Haida, Friedemann Meiswinkel, Georgi Prosenikov, Stefan Huber-Wagner","doi":"10.1007/s00113-026-01704-z","DOIUrl":"10.1007/s00113-026-01704-z","url":null,"abstract":"<p><strong>Objective of the surgery: </strong>The aim of this operation is to stabilise a T-type acetabular fracture against secondary dislocation and to restore the patient's preoperative functionality.</p><p><strong>Indications: </strong>An 88-year-old patient with severe pain and immobility due to a T-type acetabular fracture (Letournel & Judet: associated fracture; AO: 62B2).</p><p><strong>Contraindications: </strong>General surgical contraindications.</p><p><strong>Surgical technique: </strong>This surgery was performed in a 3D-Navigation Hybrid Operating Room, the Robotic Suite (Brainlab, Munich, Germany). The setup includes a navigation unit (Curve Navigation System) a movable robotic 3D cone beam computed tomography unit (Loop-X), a robotic arm (Cirq Arm System), 3D mixed reality glasses (for planning), and a wall monitor (Buzz). A step-by-step video is available online.</p><p><strong>Follow-up: </strong>Immediate full weight-bearing, active and passive joint mobilisation through physiotherapy on the first postoperative day, pain medication as required.</p><p><strong>Evidence: </strong>Navigated surgeries of the pelvis (ring and acetabulum) have become standard practice, while robotic assistance is increasingly used, demonstrating very good outcomes and promising accuracy rates.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"342-346"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629407","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":"KI beim Publizieren: Was Ärzt*innen wissen und konkret beachten sollten.","authors":"Ines Wolff, Henning Schönenberger","doi":"10.1007/s00113-026-01710-1","DOIUrl":"10.1007/s00113-026-01710-1","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"339-341"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679352","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":"[Management of geriatric ankle fractures-Conservative treatment works well].","authors":"Verena Hecht, Thomas Lustenberger, Helen Anwander","doi":"10.1007/s00113-026-01706-x","DOIUrl":"https://doi.org/10.1007/s00113-026-01706-x","url":null,"abstract":"<p><strong>Background: </strong>Geriatric ankle fractures require treatment strategies aimed at early, safe mobilization with a risk of complications as low as possible. Surgical procedures are associated with an increased perioperative risk.</p><p><strong>Objective: </strong>To determine which fractures can be safely managed conservatively in older patients and which criteria are decisive.</p><p><strong>Material and methods: </strong>Narrative review of the literature on randomized trials and systematic reviews.</p><p><strong>Results: </strong>Stable fractures, including Weber A and stable Weber B fractures, isolated medial malleolar fractures (Herscovici types A-C), and non-displaced posterior malleolar fractures, can be treated conservatively with full weight-bearing as tolerated when ankle stability is confirmed. The assessment of ankle stability using radiographs of weight bearing is decisive, optionally supplemented by stress views or computed tomography (CT) during weight bearing. Even fractures with radiological signs of instability can be managed conservatively in selected cases of geriatric patients when the individual frailty and mobility are taken into consideration. Randomized trials demonstrate no functional advantage of surgery over conservative treatment with full-contact casts in patients older than 60 years.</p><p><strong>Conclusion: </strong>With appropriate patient selection, conservative treatment represents an evidence-based and functionally comparable treatment option with lower complication rates than surgery.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791769","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":"[Ligamentous knee injuries in children: Focus on cruciate ligaments].","authors":"Maiti Muenchgesang, Daniel Guenther","doi":"10.1007/s00113-026-01703-0","DOIUrl":"https://doi.org/10.1007/s00113-026-01703-0","url":null,"abstract":"<p><p>In cruciate ligament injuries in childhood and adolescence, bony avulsion injuries are common in addition to purely ligamentous ruptures. The injury patterns and mechanisms, continued longitudinal growth and psychosocial factors must be taken into account in the diagnostics and treatment. This article describes the most important techniques of surgical and nonoperative management, the associated rehabilitation protocols, as well as options for primary and secondary prevention.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719114","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":"[Calcaneal fractures-Current status and treatment approaches].","authors":"Sebastian Schilde, Christian Fischer, Phillipp Kobbe, Thomas Mendel","doi":"10.1007/s00113-026-01699-7","DOIUrl":"https://doi.org/10.1007/s00113-026-01699-7","url":null,"abstract":"<p><p>Calcaneal fractures primarily affect patients aged 40-59 years, with an incidence rate of 17.5 per 100,000 inhabitants. They are typically caused by axial forces resulting from falls from a height or traffic accidents. In 75% of cases the posterior facet of the subtalar joint is affected, which can result in substantial functional limitations. The aim of treatment is to anatomically reconstruct the joint surfaces and the shape of the foot and to prevent long-term damage, such as osteoarthritis. Surgical treatment typically involves open reduction and internal fixation (ORIF), although minimally invasive procedures are increasingly being adopted to minimize soft tissue complications. The long-term results vary, with the initial severity of the fracture and the quality of the reduction being decisive factors. Complications, such as wound healing disorders, infections and posttraumatic osteoarthritis are common, particularly in complex fractures. Advances in minimally invasive surgery offer promising approaches to improve outcomes. Overall, treating calcaneal fractures remains challenging and requires a tailored strategy for each type of fracture to achieve optimal functional results.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629487","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":"Influence of coracoclavicular heterotopic ossifications in treatment of clavicular fractures : Case report.","authors":"Malik Jessen, Philipp Zehnder, Peter Biberthaler, Chlodwig Kirchhoff, Markus Schwarz","doi":"10.1007/s00113-026-01686-y","DOIUrl":"10.1007/s00113-026-01686-y","url":null,"abstract":"<p><strong>Background: </strong>Heterotopic ossification (HO) arising from inflammatory processes often results in bony transformation of soft tissue. While the occurrence of HO is well-documented, its biomechanical influence on clavicular fractures remains less explored. We present a case report of a patient with a clavicular fracture following a bicycle accident, accompanied by incidental findings of HO around the coracoclavicular (CC) ligaments.</p><p><strong>Case presentation: </strong>A 59-year-old man presented with a displaced right-sided clavicular fracture and a cervical vertebral body fracture following a bicycle fall. Incidental findings revealed pronounced HO around the CC ligaments. The patient underwent surgical stabilization for the cervical vertebral body fracture and clavicular fracture using open reduction and internal fixation. The presence of ossified CC ligaments may influence the biomechanical considerations for clavicular fractures.</p><p><strong>Conclusion: </strong>The present case report suggests that ossified CC ligaments may impact clavicular biomechanics, potentially offering increased stability at the CC attachment and acting as a protective shield during trauma. This observation may indicate a possible predisposition to fractures in the clavicular region medial to the CC ligaments. While we cannot determine causality based on this single case, pronounced ossification of the CC ligaments could increase local stiffness and alter load distribution.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"276-280"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168436","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":"[Rare tendon injuries of the foot and ankle : Tibialis posterior-Tibialis anterior-Peroneus longus and brevis].","authors":"Patrick Gahr, Ingmar Rinas, Thomas Mittlmeier","doi":"10.1007/s00113-025-01669-5","DOIUrl":"10.1007/s00113-025-01669-5","url":null,"abstract":"<p><p>Compared to ruptures of the Achilles tendon, injuries to the tibialis anterior and tibialis posterior tendons or the peroneal tendons are relatively rare, so that the literature on this subject largely consists of individual case reports and small case series. There are major differences between the individual entities in terms of the pathogenesis, possible sequelae and treatment recommendations. This article is intended to provide an overview and instruction manual for the clinical management.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"265-275"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032009","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}