Unfallchirurgie (Heidelberg, Germany)最新文献_第2页

[Proximal humerus fractures-a new era?] 肱骨近端骨折——新时代？]

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 DOI: 10.1007/s00113-025-01589-4

Michael Raschke, Helmut Lill

引用次数: 0

[Fracture sequelae-when, how, what?] 骨折后遗症-何时，如何，什么？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-06 DOI: 10.1007/s00113-025-01584-9

Ole Somberg, Thomas Rosteius, Maria Bernstorff, Thomas A Schildhauer, Matthias Königshausen

引用次数: 0

[Proximal humerus fracture: old and new, established and doubtful, conservative and operative aspects]. [肱骨近端骨折：新老，已确诊和可疑，保守和手术方面]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-04-28 DOI: 10.1007/s00113-025-01571-0

Pierre Hepp, Ralf Henkelmann, Maria Elze, Jan Theopold

{"title":"[Proximal humerus fracture: old and new, established and doubtful, conservative and operative aspects].","authors":"Pierre Hepp, Ralf Henkelmann, Maria Elze, Jan Theopold","doi":"10.1007/s00113-025-01571-0","DOIUrl":"10.1007/s00113-025-01571-0","url":null,"abstract":"Proximal humeral fractures are not only frequent injuries but also serve as an important indicator for a possibly underlying osteoporosis. Therefore, in addition to fracture management, timely diagnostics and treatment of the osteoporosis should also be prioritized. The decision between a conservative and surgical treatment approach requires a differentiated consideration of the fracture morphology, individual patient characteristics and functional expectations. Conservative treatment can be an adequate alternative in specific cases, particularly in geriatric patients with low functional demands; however, the standardization of this treatment approach remains challenging. Surgical interventions have proven effective, especially for complex fractures, with reverse shoulder arthroplasty emerging as a reliable option. Various augmentation and fixation techniques, such as the combination of locking plates with fibular grafts or double plating osteosynthesis, demonstrate biomechanical advantages and can improve the primary stability. Innovative technologies, including 3D planning, intraoperative navigation and robotics, offer new possibilities for optimizing implant placement and can contribute to improvement of long-term clinical outcomes. Economic analyses suggest that reverse arthroplasty can provide not only clinical benefits in selected cases but can also be cost-effective; however, further evaluation of the long-term impact on the healthcare system is required.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"481-491"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044554","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

[Postinfectious dislocation of the tibialis posterior tendon in a prima ballerina : A 13-year case report]. [初级芭蕾舞演员感染后胫骨后肌腱脱位：13年病例报告]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-30 DOI: 10.1007/s00113-025-01597-4

Hans Zwipp

{"title":"[Postinfectious dislocation of the tibialis posterior tendon in a prima ballerina : A 13-year case report].","authors":"Hans Zwipp","doi":"10.1007/s00113-025-01597-4","DOIUrl":"https://doi.org/10.1007/s00113-025-01597-4","url":null,"abstract":"Background: The most frequent side effect of local corticosteroid injections in athletes is the rupture of collagenic tissues, such as fascia and tendons.Objective: 1. Warning against cortisone injections in the vicinity of tendons, fascia and retinacula. 2. Presentation of the anatomical restoration of the osteofibrous quiver of the tibialis posterior tendon. 3. Introduction of a pathogenetic classification of tibialis posterior tendon dislocation.Material and method: A 23-year-old female ballet dancer suffered from pain and significant loss of strength despite stiff taping while dancing en pointe 8 months after radical debridement for a putrid infection with Klebsiella pneumoniae of the left tibialis posterior tendon with a sonographically detectable dislocation. After debridement and reduction of the partially ruptured, scarred and split tendon, an anatomical restoration of the osteofibrous tendon quiver was performed with local tissue and transosseous sutures. The targeted perioperative administration of antibiotics, a postoperative lower leg cast for 6 weeks with thrombosis prophylaxis and subsequent intensive rehabilitation measures resulted in the complete ability to work after 8 weeks.Result: There were no recurrences over the 13-year period. With pain-free dancing en pointe without taping, the now 36-year-old soloist is still the lead female dancer at a renowned German opera house, is the mother of two children and believes that she dances better today than before.Discussion: Whether the initial local corticosteroid injection caused a pathological retinaculum rupture with dislocation of the tibialis posterior tendon or whether it was originally caused by the putrid infection after tendon revision surgery or whether a necrotic retinaculum was ultimately subjected to radical debridement, must remain an open question.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531532","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

[Peripheral fractures of the talus : An overview]. 【距骨外周骨折：综述】。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-26 DOI: 10.1007/s00113-025-01595-6

Sebastian F Baumbach, Wolfgang Böcker, Hans Polzer

引用次数: 0

[Robotically assisted and minimally invasive pedicle screw placement at the lumbar spine]. [机器人辅助微创腰椎椎弓根螺钉置入]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-26 DOI: 10.1007/s00113-025-01596-5

Dominik M Haida, Oybek Khakimov, Stefan Huber-Wagner

{"title":"[Robotically assisted and minimally invasive pedicle screw placement at the lumbar spine].","authors":"Dominik M Haida, Oybek Khakimov, Stefan Huber-Wagner","doi":"10.1007/s00113-025-01596-5","DOIUrl":"https://doi.org/10.1007/s00113-025-01596-5","url":null,"abstract":"Objectives of the surgery: The aim of this operation technique is to bridge the pathological fracture of a vertebral body by a dorsal spondylodesis, to stabilize the spine, reduce the pain and regain mobility.Indications: Due to the vertebral body fracture (OF 2) of the third lumbar vertebral body (L3) and the associated pain and immobility and due to the modified score of the AO Spine-DGOU osteoporotic fracture (OF) classification system.Contraindications: No specific contraindications.Surgical technique: Technical set-up: Robotic Suite (Brainlab, Munich, Germany) with navigation unit \"curve navigation system\", robotic 3D cone beam computed tomography (CBCT) \"Loop-X\", robotic arm \"Cirq Arm System\" and wall-mounted monitor \"BUZZ\". Operation steps are shown in the video (English): Planning of the screws based on preoperative CT imaging. Placement of the reference array. First imaging, image fusion and fusion control. Registration of instruments. Robotically assisted skin incision planning. Robotically assisted drilling. K-wire insertion. Second imaging and wire position check. Screw placement. Cement augmentation of the screws. Insertion of the connecting rods. Wound closure.Follow-up: Full weight bearing, pain medication if required. Physiotherapeutic treatment to learn strengthening exercises and restoration of mobility. Medication with vitamin D3 and calcium. Metal removal is not intended.Evidence: Operations on the lumbar spine are now routine clinical practice in orthopedics and trauma surgery. They can be performed without any problems and with very good accuracy in terms of precise screw placement.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499794","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

[Shaft fractures in children and adolescents: age-appropriate treatment strategies]. [儿童和青少年脊柱骨折：适合年龄的治疗策略]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-13 DOI: 10.1007/s00113-025-01594-7

Dorien Schneidmüller, Christoph Emanuel Gonser

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 : 2025-06-12 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287517","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

[Occupational risk: necrotizing fasciitis in an emergency physician after resuscitation of an infected female patient]. [职业风险：急诊医师抢救感染女性患者后出现坏死性筋膜炎]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-05 DOI: 10.1007/s00113-025-01591-w

Konstantin Wehrkamp, Alexander M Keppler, Wolfgang Böcker, Ludwig Ney, Uwe Kreimeier, Paul Reidler, Philipp Lohse, Fabian Gilbert, Rouven Neudeck

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 : 2025-06-05 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","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