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

[Stress fractures of the growth plates in the fingers of adolescent rock climbers]. [青少年攀岩者手指生长板应力性骨折]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1007/s00113-024-01482-6

Volker Schöffl, Othmar Moser, Thomas Küpper

{"title":"[Stress fractures of the growth plates in the fingers of adolescent rock climbers].","authors":"Volker Schöffl, Othmar Moser, Thomas Küpper","doi":"10.1007/s00113-024-01482-6","DOIUrl":"10.1007/s00113-024-01482-6","url":null,"abstract":"Background: Primary periphyseal stress injuries (PPSI) of the hand and fingers are a rare condition overall but are most commonly seen in adolescent rock climbers and is the most common sport-specific injury in young climbers. Early diagnosis and treatment are crucial for a good treatment outcome and to avoid chronic sport-related injury.Objective: The aim of the study is to introduce the injury to a wider audience. Based on an analysis of the current literature, the pathophysiology is demonstrated and the diagnostic and treatment standards are analyzed. Prophylactic measures are also reported.Material and methods: Based on a systematic multiple database analysis, the current literature on PPSI of the hand and fingers in climbers were collected and further analyzed in a narrative review. The pathophysiology, diagnostic and treatment concepts are presented.Results: Most cases of PPSI to the hand and fingers are in young rock climbers; however, a few cases have been reported in gymnasts, baseball players and piano players. Overall, there are over 200 documented cases in the literature. Most are Salter-Harris III/Aitken II fractures but grade I, II and IV fractures have also been reported. Patients are mostly 13-15 years of age and within the main pubertal growth spurt. After diagnosis, usually by magnetic resonance imaging (MRI), treatment is often conservative, with an increasing number of cases requiring surgical revision. Surgery usually involves spot drilling of the growth plate to induce fusion.Discussion: Early diagnosis and treatment are critical for a good outcome. This includes specific education and information for athletes, coaches, parents and treating physicians. Also, the frequent use of the crimp position has also been shown to increase the risk of PPSI. Preventive aspects should target this as well as overall load management.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"824-831"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303030","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

[Treatment concepts for the medial clavicle and the sternoclavicular joint]. [锁骨内侧和胸锁关节的治疗理念]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-08-06 DOI: 10.1007/s00113-024-01461-x

J Gleich, T Helfen, C Lampert

{"title":"[Treatment concepts for the medial clavicle and the sternoclavicular joint].","authors":"J Gleich, T Helfen, C Lampert","doi":"10.1007/s00113-024-01461-x","DOIUrl":"10.1007/s00113-024-01461-x","url":null,"abstract":"Medial clavicle fractures and injuries to the sternoclavicular joint are rare injuries but can have life-threatening consequences. There are no standardized treatment algorithms or guidelines for the diagnostics and treatment. This article provides an overview of the individual topographies as well as the conservative and surgical treatment strategies.Conservative treatment is preferred for medial clavicle fractures. The indications for surgical treatment are variable but this is frequently carried out if there is a fracture displacement > 1 cm or 1 shaft width and high functional demands. In the case of accompanying injuries to neurovascular structures, an open fracture or the threat of perforation of the skin, surgical treatment is mandatory. Open reduction and internal fixation using (locking) plates is currently the preferred form of treatment.In the case of posterior dislocation of the sternoclavicular joint, an immediate closed reduction must be attempted with the patient under analgosedation and with emergency treatment on standby. This temporal urgency does not exist for anterior and superior dislocations. Surgical treatment is indicated in cases of unsuccessful reduction, persistent symptomatic instability or injuries of the neurovascular bundle. From a multitude of treatment options, arthrodesis with suture cerclage has shown good results. Tendon grafts as well as special hook plates are increasingly being used due to better biomechanical qualities. The surgical treatment of combined injuries is determined by the individual injury pattern.Despite the variety of treatment strategies, the long-term outcome has consistently been positively described.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"783-787"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899087","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

[Surgical access route and choice of implant in the region of the clavicle shaft]. [锁骨轴区域的手术入路和植入物选择]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-08-27 DOI: 10.1007/s00113-024-01470-w

Yannic Lecoultre, Bryan J M van de Wall, Frank J P Beeres, Reto Babst

{"title":"[Surgical access route and choice of implant in the region of the clavicle shaft].","authors":"Yannic Lecoultre, Bryan J M van de Wall, Frank J P Beeres, Reto Babst","doi":"10.1007/s00113-024-01470-w","DOIUrl":"10.1007/s00113-024-01470-w","url":null,"abstract":"Background: Clavicle fractures are among the most frequent injuries of the shoulder girdle. Nondisplaced fractures are generally treated conservatively, whereas dislocated fractures require surgical reduction and stabilization. A variety of implants and surgical techniques with reliable results are available. While all techniques provide similar healing rates, they share a common disadvantage with the high incidence of implant irritation and correspondingly high rates of second interventions for material removal.Objective: The various surgical techniques for clavicle shaft fractures with their specific areas of application as well as advantages and disadvantages are presented. This review also provides an aid for deciding which surgical technique is most appropriate based on the fracture morphology. Furthermore, an overview of current research activities is presented, with a specific focus on new implants which could help to reduce implant irritation.Results and conclusion: Open superior and anteroinferior plate osteosyntheses each show similar reliable results. The minimally invasive plate osteosynthesis (MIPO) technique offers an alternative for multifragmented fractures as it has a lower complication rate compared to the open procedure. Double plate osteosynthesis using minifragment plates shows promising results with respect to the incidence of implant-related irritation. Larger prospective studies are still pending. Intramedullary nailing offers a good alternative, especially if material removal is planned anyway, e.g., in the pediatric setting.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"769-775"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074747","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

[Initial experiences with the audits of the German guidelines on treatment of proximal femoral fractures (QSFFx-RL) by the German medical service]. [德国医疗服务部门对德国股骨近端骨折治疗指南（QSFFx-RL）进行审核的初步经验]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI: 10.1007/s00113-024-01491-5

Carsten Schöneberg, Matthias Knobe

引用次数: 0

[Current treatment concepts of the lateral clavicle and the acromioclavicular joint]. [锁骨外侧和肩锁关节的当前治疗理念]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-08-14 DOI: 10.1007/s00113-024-01464-8

Sabine Roth, Spiros Tsamassiotis, Roman Karkosch, Hauke Horstmann, Tomas Smith, Gunnar Jensen

引用次数: 0

[Fatal course of a fulminant gas gangrene of the right hemithorax]. [右半胸暴发性气性坏疽的致命病程]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-10 DOI: 10.1007/s00113-024-01490-6

Christoph J Neumann, Matthias Unterberg, Daniel Mesbah, Mark Sandfort, Rüdiger Smektala

引用次数: 0

[Rotationally stable screw anchor (RoSA) vs. Gamma3 Nail (G3N) in pertrochanteric femoral fractures : A functional outcome analysis]. [旋转稳定螺钉锚（RoSA）与 Gamma3 钉（G3N）在股骨转子前骨折中的应用：功能结果分析]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-12 DOI: 10.1007/s00113-024-01479-1

Sven Löhnert, Klaus-Jürgen Maier, Peter Behrendt, Michael Hoffmann

{"title":"[Rotationally stable screw anchor (RoSA) vs. Gamma3 Nail (G3N) in pertrochanteric femoral fractures : A functional outcome analysis].","authors":"Sven Löhnert, Klaus-Jürgen Maier, Peter Behrendt, Michael Hoffmann","doi":"10.1007/s00113-024-01479-1","DOIUrl":"https://doi.org/10.1007/s00113-024-01479-1","url":null,"abstract":"Background: The pertrochanteric femoral fracture (PFF) represents one of the most common fracture types throughout Germany. To enable early mobilization of patients, the primary surgical goal is load-stable osteosynthesis. Implant failure still represents the largest group of implant-related complications (>80%).Objective: The aim of the study was to document and analyze the influence of the implant on the functional outcome and an evaluation of the rotationally stable screw anchor (RoSA) vs. Gamma3 nail.Material and methods: In a retrospective study 43 patients with PFF (AO 31A1-A3) were included in the study. The influence of the implant on the functional outcome was assessed by 2 standardized questionnaires (SF-36, NMS (New Mobility Score)) and analyzed in a retrospective evaluation.Results: In the study no significant differences in functional outcome scores ≥ 1 year after osteosynthesis of the PFF could be shown depending on the implant used. There is an overall tendency for a better outcome in the G3N group.Discussion/conclusion: In the literature the superiority of intramedullary nailing over extramedullary implants is continually discussed. Implant failure is still the most frequent complication. In intramedullary implants, such as the G3N, the primary cause is failure of the head-neck component. For conventional extramedullary implants the biomechanical properties on the femoral shaft also pose a challenge in the case of unstable PFF. The further development of the RoSA to an intramedullary implant could combine the advantages of intramedullary load carriers with the advantages of the blade-screw combination in the head-neck fragment and lead to a reduction in implant-associated complications.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"127 10","pages":"722-728"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303035","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

[Direct anterior bone block grafting for treatment of bone defects and dysplasia of the coronoid process]. [直接前方骨块移植治疗骨缺损和冠状突发育不良]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-08-07 DOI: 10.1007/s00113-024-01457-7

Amine Mellal, Jaad Mahlouly, Célia Guttmann, Charlotte Fröning, Stefan Bauer

{"title":"[Direct anterior bone block grafting for treatment of bone defects and dysplasia of the coronoid process].","authors":"Amine Mellal, Jaad Mahlouly, Célia Guttmann, Charlotte Fröning, Stefan Bauer","doi":"10.1007/s00113-024-01457-7","DOIUrl":"10.1007/s00113-024-01457-7","url":null,"abstract":"Objective: The aim of the surgery was to treat an elbow instability caused by critical coronoid bone loss (CCBL), lateral ulnar collateral ligament (LUCL) insufficiency,and general hyperlaxity by performing a direct anterior coronoid bone graft (CBG) and LUCL reconstruction in the same setting.Indications: In cases with CCBL isolated ligament reconstruction harbors a high failure rate, necessitating supplementary bony procedures. The diagnosis of CCBL is confirmed through lateral radiographs and further quantified through computed tomography (CT) imaging. Objective assessment of instability is conducted with standardized arthroscopic tests. Performing an anterior approach for CBG offers distinct advantages, notably in terms of achieving precise positioning of plates and screws and providing access to the proximal radioulnar joint.Contraindications: Usual contraindications to surgery, coronoid bone loss less than 40%.Surgical technique: The surgical procedure is thoroughly illustrated with a video of the operation that can be accessed online: reconstruction of the LUCL with a semitendinosus allograft, harvesting of the graft from the iliac crest, exposure of the coronoid process with a direct anterior approach, freshening up of the graft bed. Temporary fixation of the graft with a Kirschner wire. Assessment of joint congruency, stability and range of motion (ROM) prior to definitive fixation with a 2.4 mm buttress plate and screws.Follow-up: Nonsteroidal anti-inflammatory drugs (NSAID) to prevent heterotopic ossification. Elbow mobilization in pronation from day 1 with an overhead motion protocol. Removable splint for 4 weeks, free mobilization at 6 weeks, return to sport at 3 months.Results: Durable elbow stability was achieved along with free ROM and high patient satisfaction.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"743-747"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899150","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

[Complications in paediatric traumatology : "It will grow out"]. [儿科创伤并发症："会长出来的"]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-23 DOI: 10.1007/s00113-024-01478-2

Dorien Schneidmueller

引用次数: 0

[Modified Masquelet technique for reconstruction of critical bone defects]. [用于重建严重骨缺损的改良 Masquelet 技术]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1007/s00113-024-01473-7

Marc Hückstädt, Christian Fischer, Michael Mitin, Friederike Klauke, Steffen Langwald, Thomas Mendel, Philipp Kobbe, Sandra Schipper

引用次数: 0