Unfallchirurgie (Heidelberg, Germany)最新文献_第4页

[Radial neck fracture in children-"A benign fracture?"] [儿童桡骨颈骨折--"良性骨折？"]

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-13 DOI: 10.1007/s00113-024-01475-5

Sven-Oliver Dietz, Lotte Schierjott, Oliver Loose, Erol Gercek, Francisco Fernandez

{"title":"[Radial neck fracture in children-\"A benign fracture?\"]","authors":"Sven-Oliver Dietz, Lotte Schierjott, Oliver Loose, Erol Gercek, Francisco Fernandez","doi":"10.1007/s00113-024-01475-5","DOIUrl":"https://doi.org/10.1007/s00113-024-01475-5","url":null,"abstract":"Radial neck fractures in children are rare but clinically relevant injuries that are often accompanied by concomitant injuries. Girls between the ages of 8 and 12 years old are more frequently affected, whereby a cubitus valgus variant can be a predisposing factor. The main trauma mechanism is a fall onto the outstretched, supinated arm with additional valgus stress. Radial neck fractures can be associated with concomitant injuries of the elbow joint, including an olecranon fracture and elbow dislocation. The diagnosis is typically made by conventional X‑radiographs, although ultrasonography can be indicated in younger children.The treatment depends on the fracture dislocation. Conservative treatment is certainly possible at any age if the proximal fragment is angulated less than 20°, while a surgical intervention can be indicated for larger dislocations depending on age. Closed reduction with internal fixation using a elastic stable intramedullary nail (ESIN) according to Métaizeau has become established as the standard procedure. Complications such as premature epiphyseal joint closure, synostosis, avascular necrosis, pseudarthrosis and deformation of the radial head can occur and affect the functional outcome. The treatment of such complications often requires a comprehensive multidisciplinary approach and can include both conservative and surgical measures. Long-term studies show that most patients with radial neck fractures achieve good to very good outcomes, although certain predictive factors are associated with poorer outcomes.Knowledge of the potential complications and their treatment is crucial for the successful management of children with radial neck fractures and should be considered when making clinical decisions.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"127 10","pages":"697-704"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303033","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

[Recommendations for assessment of disability in private accident insurance-Interdisciplinary consensus-Status September 2024 : Recommended for use by the Specialist Society of Interdisciplinary Medical Expert Opinion (FGIMB) on 6 October 2023]. [私人意外保险中的残疾评估建议-跨学科共识-2024 年 9 月的状态：跨学科医学专家意见学会（FGIMB）于 2023 年 10 月 6 日推荐使用]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 DOI: 10.1007/s00113-024-01483-5

H T Klemm, E Ludolph, W Willauschus, M Wich, S Weber, R Fuhrmann, T Heintel

{"title":"[Recommendations for assessment of disability in private accident insurance-Interdisciplinary consensus-Status September 2024 : Recommended for use by the Specialist Society of Interdisciplinary Medical Expert Opinion (FGIMB) on 6 October 2023].","authors":"H T Klemm, E Ludolph, W Willauschus, M Wich, S Weber, R Fuhrmann, T Heintel","doi":"10.1007/s00113-024-01483-5","DOIUrl":"10.1007/s00113-024-01483-5","url":null,"abstract":"The centerpiece in private accident insurance is the compensation in cases of disability, which must be determined by a physician within a certain time limit. The insurer contract specifies the compensation rate for loss or inability to function. In cases of insurance the medical expert has to refer to generally accepted revised or updated assessment recommendations in order to be able to apply the given framework to the specific individual disability situation of the insured person. This article deals with the interdisciplinary consensus benchmarks for the assessment of disability, which form the principles of a uniform medical assessment of accident-related functional disorders in the private accident insurance.With the publication of these new assessment recommendations developed under the guidance of the Specialist Society of Interdisciplinary Medical Expert Opinion (FGIMB), the recommendations published by Schröter and Ludolph in 2009 [12] are withdrawn, so that these are now replaced as the authoritative version by the assessment recommendations of the FGIMB.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"127 10","pages":"748-766"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303034","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

[Modified Masquelet technique : Technique of the induced membrane in the course of time]. [改良马斯奎莱技术：时间过程中的诱导膜技术]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-08-07 DOI: 10.1007/s00113-024-01474-6

C Fischer, S Schipper, S Langwald, F Klauke, P Kobbe, T Mendel, M Hückstädt

引用次数: 0

[Incorrectly healed supracondylar humerus fracture : That will grow out later on?!] [肱骨髁上骨折愈合不当：以后会长出来的！]

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.1007/s00113-024-01462-w

Ralf Kraus, Dorien Schneidmueller

{"title":"[Incorrectly healed supracondylar humerus fracture : That will grow out later on?!]","authors":"Ralf Kraus, Dorien Schneidmueller","doi":"10.1007/s00113-024-01462-w","DOIUrl":"10.1007/s00113-024-01462-w","url":null,"abstract":"The supracondylar humerus fracture is the most frequent fracture of the elbow region during the growth period. The peak age is around 5 years. Extension fractures predominate. The clinical diagnostics are supplemented by X‑ray images in two projections. Growth-associated spontaneous corrections of posttraumatic deformities rarely occur. The goal of treatment is therefore the active transformation of every displaced fracture into a nondisplaced stably fixed fracture.If this is not successful, the consequences of healing in a malalignment can be, e.g., restriction of elbow flexion due to remaining antecurvation or cubitus varus. Combinations are often present. The causes include technical problems with reduction and retention but also misjudgement of the X‑ray findings, ignorance of the growth prognosis or inadequate verification of whether the treatment goal has been achieved.Unsatisfactory treatment results should be corrected as early as possible. This can be done primarily before bony healing is completed or secondarily as a corrective osteotomy at any later point in time. The earlier the correction of the malalignment is performed, the greater the chances of a complete restoration to the original condition. Depending on the type and extent of the deformity various techniques for corrective osteotomy are suggested in the literature.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"689-696"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636069","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

[Posttraumatic growth disturbances of the distal radius in childhood]. [儿童桡骨远端创伤后生长障碍]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-08-12 DOI: 10.1007/s00113-024-01463-9

Peter P Schmittenbecher, Peter Laier

{"title":"[Posttraumatic growth disturbances of the distal radius in childhood].","authors":"Peter P Schmittenbecher, Peter Laier","doi":"10.1007/s00113-024-01463-9","DOIUrl":"10.1007/s00113-024-01463-9","url":null,"abstract":"Background: Fractures of the distal radius in childhood are frequent but rarely lead to relevant growth disturbances.Objective: The experiences of a pediatric trauma center over 15 years are exemplarily presented and discussed.Material and methods: Osteotomies of the distal radius were selected and the clinical and radiological findings were recorded and analyzed.Results: Posttraumatic growth disturbances were corrected in 10 cases with a median age of 13 ½ years. In six cases an iatrogenic cause was also possible. In two cases callus distraction with secondary palmar plate osteosynthesis was used for consolidation. In eight cases primary ad hoc corrections were carried out using palmar plate osteosynthesis (six with iliac crest and two with allogeneic grafts). In five cases the distal ulnar growth plate was also addressed. During follow-up breakage of one plate was registered. After an average of 31 months postoperatively, 9 children had full range of motion (ROM) and in 1 case there was an extension deficit of 10o.Conclusion: It is important to evaluate the cause of the mostly partially inhibiting growth disturbances to draw preventive conclusions. From a clinical perspective the visible deformity is given priority and the pain and functional limitations are less relevant. The indications for corrective surgery must include the age of the patient, remaining growth potential, size and localization of the growth plate bridge, the deformity and the individual wishes of patients and parents. In most cases a full correction is possible with palmar plate osteosynthesis and an iliac crest graft. External fixation and callus distraction is an alternative in cases where the correction is more extensive. The distal ulnar growth plate should be controlled concerning further growth potential before hardware removal.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"705-712"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918300","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

[Greenstick fractures of the forearm shaft-Is it obligatory or facultative to break the cortex?] [前臂轴的绿色棍状骨折--打破皮质是强制性的还是可变性的？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI: 10.1007/s00113-024-01477-3

Thomas Petnehazy, Martin Münnich, Ferdinand Füsi, Saskia Hankel, Anna Erker, Elena Friehs, Hesham Elsayed, Holger Till, Georg Singer

{"title":"[Greenstick fractures of the forearm shaft-Is it obligatory or facultative to break the cortex?]","authors":"Thomas Petnehazy, Martin Münnich, Ferdinand Füsi, Saskia Hankel, Anna Erker, Elena Friehs, Hesham Elsayed, Holger Till, Georg Singer","doi":"10.1007/s00113-024-01477-3","DOIUrl":"10.1007/s00113-024-01477-3","url":null,"abstract":"Background: To break or not to break-That is the question that has been asked in pediatric traumatology for many years regarding the treatment of greenstick fractures of the diaphyseal forearm shaft.Objective: The frequency of greenstick fractures of the forearm shaft in children and adolescents; the influence of breaking the fracture on the refracture rate.Methods: Analysis and discussion of relevant articles, analysis of the refracture rate of pediatric greenstick fractures of the forearm shaft in our own patient population.Results: Greenstick fractures frequently occur in the area of the forearm shaft and incomplete consolidation leads to an increased refracture rate. In the patient collective of the authors of 420 children with greenstick fractures of the diaphyseal forearm, there was a refracture rate of 9.5%; however, the rate for non-completed fractures was significantly higher compared to the group with completed fractures (15.2% vs. 3%). While in the subgroup of conservatively treated fractures (n = 234), breaking the intact cortex significantly reduced the refracture rate, breaking the intact cortical bone during surgical treatment with elastic stable intramedullary nailing (ESIN) did not change the refracture rate.Conclusion: As part of the conservative treatment of greenstick fractures of the diaphyseal forearm, completing the fracture can be recommended in order to lower the refracture rate. Completing the fracture does not appear to be necessary during surgical treatment using ESIN.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"127 10","pages":"713-721"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303032","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

[Innovations in amputation medicine : New treatment dimension by the use of innovative technologies, microsurgery and interprofessionality]. [截肢医学的创新：利用创新技术、显微外科和跨专业的新治疗方法]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1007/s00113-024-01471-9

Jennifer Ernst

引用次数: 0

[A retrospective identification of severely injured patients using ICD 10 diagnoses codes : Part of the project "Quality of life and ability to work after severe trauma" (LeAf Trauma)]. [使用 ICD 10 诊断代码对重伤患者进行回顾性鉴定：严重创伤后的生活质量和工作能力 "项目（LeAf Trauma）的一部分]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1007/s00113-024-01446-w

Anne Neubert, Sebastian Hempe, Veronika Gontscharuk, Carina Jaekel, Joachim Windolf, Erwin Kollig, Catharina Gäth, Dan Bieler

{"title":"[A retrospective identification of severely injured patients using ICD 10 diagnoses codes : Part of the project \"Quality of life and ability to work after severe trauma\" (LeAf Trauma)].","authors":"Anne Neubert, Sebastian Hempe, Veronika Gontscharuk, Carina Jaekel, Joachim Windolf, Erwin Kollig, Catharina Gäth, Dan Bieler","doi":"10.1007/s00113-024-01446-w","DOIUrl":"10.1007/s00113-024-01446-w","url":null,"abstract":"Background: Due to continuous improvements in treatment, more and more severely and seriously injured patients are surviving. The complexity of the injury patterns of these patients means that they are difficult to map in routine data.Aim of the work: The aim of the data exploration was to identify ICD 10 diagnoses that show an association with an injury severity score (ISS) ≥ 16 and could therefore be used to operationalize severely injured patients in routine data.Material and methods: The coded four-digit ICD 10 S diagnoses and the calculated ISS of trauma patients from the Armed Forces Central Hospital Koblenz (BwZKrhs) and the University Hospital Düsseldorf (UKD) were analyzed using statistical association measures (phi and Cramer's V), linear regressions and machine learning methods (e.g., random forest).Results: The S diagnoses of facial, head, thoracic and pelvic injuries, associated with an ISS ≥ 16 were identified. Some S diagnoses showed an association with an ISS ≥ 16 in only 1 of the 2 datasets. Likewise, facial, head, thoracic and pelvic injuries were found in the subgroup of 18-55-year-old patients.Discussion: The current evaluations show that it is possible to identify ICD 10 S diagnoses that have a significant association with an ISS ≥ 16. According to the annual report of the trauma register of the German Society for Trauma Surgery (TR-DGU®), injuries with an abbreviated injury scale (AIS) ≥ 3 are particularly common in the head and thoracic regions.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"660-664"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263607","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

["Calcaneogenesis" with secondary Achilles tendon-bone allograft for repair of the loss of hindfoot function : A 12-year case report]. [利用 "钙生成 "与二次跟腱骨异体移植修复后足功能丧失：12 年病例报告]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-09-01 Epub Date: 2024-07-24 DOI: 10.1007/s00113-024-01458-6

Hans Zwipp, René Grass, Michael Amlang, Stefan Rammelt

{"title":"[\"Calcaneogenesis\" with secondary Achilles tendon-bone allograft for repair of the loss of hindfoot function : A 12-year case report].","authors":"Hans Zwipp, René Grass, Michael Amlang, Stefan Rammelt","doi":"10.1007/s00113-024-01458-6","DOIUrl":"10.1007/s00113-024-01458-6","url":null,"abstract":"Background: Calcanectomy and Achilles tendon resection are very hard to repair.Objective: Ilizarov's \"calcaneogenesis\" is possible with ankle joint preservation. Even after 3.5 years of functio laesa of the triceps surae muscle it can be rebuilt.Material and methods: A 25-year-old motorcyclist suffered a 3rd degree open calcaneal dislocation fracture (type 5). Osteitis and necrosis required calcanectomy, resection of the Achilles tendon and a latissimus dorsi muscle transfer. A talus corpus osteotomy with Ilizarov distraction created in the 1st step a \"neo-calcaneus\". In a delayed 2nd step a fresh-frozen Achilles tendon-bone block allograft was transplanted to regain active plantar flexion.Results: The initial AOFAS score of 35 points was significantly improved to 70 points 12 years after step 1. After both operations the patient could walk without an orthosis and regained 88% of normal plantar flexion strength. Quantitative measure of health outcome according to EQ-5D-5L was marked by the patient with 80 out of 100 points.Discussion: \"Calcaneogenesis\" with preservation of the ankle joint is possible and innovative. Despite 3.5 years of disconnection of the triceps surae muscle, an Achilles tendon-bone block allograft could restore 88% of the push-off force even attached to a neo-calcaneus that is 1/3 smaller than normal, which is also new.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"677-684"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763169","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

[Lisfranc injuries]. [Lisfranc损伤]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-09-01 Epub Date: 2024-07-30 DOI: 10.1007/s00113-024-01467-5

Johannes Wunder, Christoph Schirdewahn, David Griger, Matthias Schnabl, Christian von Rüden

引用次数: 0