Unfallchirurgie (Heidelberg, Germany)最新文献_第3页

[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 : 2025-04-28 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","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

[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 : 2025-04-24 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045548","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

[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 : 2025-04-22 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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","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

[Bony and ligamentous injuries of the thumb ray]. [拇指骨和韧带损伤]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-16 DOI: 10.1007/s00113-025-01565-y

D T D Dinh-Biet, T Leschinger, L-P Müller, A Cavalcanti Kußmaul, F Unglaub, Christian Karl Spies

引用次数: 0

[Traumatic TFCC lesions in childhood and adolescence-A previously neglected injury?] 儿童和青少年创伤性TFCC病变-以前被忽视的伤害？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-11 DOI: 10.1007/s00113-025-01563-0

Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther

{"title":"[Traumatic TFCC lesions in childhood and adolescence-A previously neglected injury?]","authors":"Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther","doi":"10.1007/s00113-025-01563-0","DOIUrl":"https://doi.org/10.1007/s00113-025-01563-0","url":null,"abstract":"Although injuries to the triangular fibrocartilage complex (TFCC) are less common in children and adolescents than in adults, can lead to chronic pain and instability in the distal radioulnar joint (DRUJ), ultimately predisposing individuals to long-term osteoarthritis. A dislocated distal radius fracture with avulsion of the styloid process of the ulna following high-energy trauma is a risk factor for a TFCC injury. The diagnostics include a thorough clinical examination and imaging procedures, such as X‑ray and magnetic resonance imaging (MRI). If there is no instability of the DRUJ, conservative treatment can be successful in most cases. However, if there is instability of the DRUJ or if there is no improvement after 3 months of conservative treatment, diagnostic arthroscopy of the wrist is indicated for further diagnostics and concurrent treatment. Depending on the age and extent of the injury, various surgical techniques can be used, such as transcapsular or transosseous refixation. Early diagnosis and treatment are essential to achieve freedom from pain, a stable DRUJ and enable a return to sports activities. In our own patient collective 12 children and adolescents showed very good results with no major complications.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045733","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

[Intraspinal subdural hematoma after polytrauma]. [多发创伤后椎管内硬膜下血肿]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-04 DOI: 10.1007/s00113-025-01569-8

Andreas Termer, Markus Klebingat, Philip Gierer

引用次数: 0

[Artificial intelligence in advanced surgical training : An overview]. [人工智能在高级外科训练中的应用综述]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-03 DOI: 10.1007/s00113-025-01558-x

Adrian Deichsel, Felix C Öttl, Johannes Pawelczyk, Lea Usov, Henryk Haffer

引用次数: 0

[Femoral head necrosis after femoral neck fracture-A lifelong burden]. [股骨颈骨折后股骨头坏死-终身负担]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-02 DOI: 10.1007/s00113-025-01555-0

Oliver Loose, F Fernandez, T Müller

引用次数: 0

Partial tear of the medial gastrocnemius head : A case report of meniscal symptoms in a 32-year-old recreational athlete. 腓肠肌内侧头部分撕裂：一例32岁休闲运动员半月板症状报告。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-02-06 DOI: 10.1007/s00113-025-01534-5

Daniel P Berthold, Fabian Traub, Fabian Gilbert, Wolfgang Böcker, Boris Holzapfel, Markus Bormann

{"title":"Partial tear of the medial gastrocnemius head : A case report of meniscal symptoms in a 32-year-old recreational athlete.","authors":"Daniel P Berthold, Fabian Traub, Fabian Gilbert, Wolfgang Böcker, Boris Holzapfel, Markus Bormann","doi":"10.1007/s00113-025-01534-5","DOIUrl":"10.1007/s00113-025-01534-5","url":null,"abstract":"This case report presents the clinical findings and management of a 32-year-old male recreational athlete who presented with ongoing knee pain for 4 months, without a history of trauma. The patient experienced intermittent pain during walking, particularly after prolonged periods of sitting, and exhibited positive findings on meniscus tests. However, he was able to participate in sports activities without pain. Magnetic resonance imaging (MRI) revealed a partial tear of the medial gastrocnemius head, confirming the diagnosis. Conservative treatment, including rest, physical therapy, and a gradual return to sports activities, led to significant symptom improvement. This case highlights the importance of considering rare injuries, such as isolated tears of the medial gastrocnemius head, in patients with persistent knee pain and meniscal symptoms, even in the absence of traumatic events. Previous reports on this specific injury are sparse, indicating its rarity and underscoring the need for further understanding and documentation.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"319-323"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257493","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

[Innovative e-learning tool for amputees in Ukraine and Germany : Digital assistance for self-help in interdisciplinary rehabilitative care]. [乌克兰和德国截肢者的创新电子学习工具：跨学科康复护理自助的数字援助]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI: 10.1007/s00113-025-01543-4

C Egen, C Gutenbrunner, J Ernst, C Sturm, J Schiller

{"title":"[Innovative e-learning tool for amputees in Ukraine and Germany : Digital assistance for self-help in interdisciplinary rehabilitative care].","authors":"C Egen, C Gutenbrunner, J Ernst, C Sturm, J Schiller","doi":"10.1007/s00113-025-01543-4","DOIUrl":"10.1007/s00113-025-01543-4","url":null,"abstract":"Background: Following the Russian war of aggression the number of people in Ukraine with amputated arms and legs rose sharply, overwhelming a fledgling rehabilitation system.Aim: This article describes the development and implementation of an e‑learning tool aimed at medical professionals, amputees and their relatives, which contains a wide range of information on rehabilitation after limb amputation and is easily accessible. It is designed to provide practical support for the rehabilitation process of affected individuals and is available free of charge in the Ukrainian and German languages.Material and methods: An interdisciplinary team of doctors, therapists, orthopedic technicians and a scientist developed the structure and outline of the learning module in a consensus process. The content was developed in small teams and, after an internal content review by two team members, linguistically synchronized and implemented on the open-source learning platform Integrated Learning, Information and Work Cooperation System (Integriertes Lern‑, Informations- und Arbeitskooperations-System, ILIAS).Results and discussion: The e‑learning tool was fully developed and implemented within 10 months. It is available free of charge in two languages at https://digitale-lehre-mhh.de . It distinguishes between rehabilitation after arm or leg amputation, after which three consecutive rehabilitation phases (postacute, intermediate and maintenance phases) can be selected. The next level gives access to the specific content, which consists of a pathway, explanatory texts, images, video sequences and audio files on treatment, self-exercises and practical tips.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"283-288"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574784","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