Unfallchirurgie (Heidelberg, Germany)最新文献_第5页

[Vascular complication in pelvic ring stabilization : Case report of an iatrogenic injury to the superior gluteal artery]. [骨盆环稳定中的血管并发症：臀上动脉医源性损伤1例]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-06-30 DOI: 10.1007/s00113-026-01725-8

Anna L Schiltenwolf, Christof K Audretsch, Tina Histing, Steven C Herath, Markus A Küper

引用次数: 0

[Treatment of tibial plateau fractures between the priorities of reconstruction and arthroplasty]. 胫骨平台骨折的治疗优先重建与关节置换术。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-07-08 DOI: 10.1007/s00113-026-01728-5

Julian Kylies, Karl-Heinz Frosch, Christian Ries, Matthias Krause

{"title":"[Treatment of tibial plateau fractures between the priorities of reconstruction and arthroplasty].","authors":"Julian Kylies, Karl-Heinz Frosch, Christian Ries, Matthias Krause","doi":"10.1007/s00113-026-01728-5","DOIUrl":"10.1007/s00113-026-01728-5","url":null,"abstract":"Tibial plateau fractures are complex intra-articular injuries associated with a considerable risk of post-traumatic osteoarthritis and potential future total knee arthroplasty (TKA). Traditionally, treatment strategies focus on anatomical reconstruction based on fracture morphology; however, demographic changes and the increasing incidence of fragility fractures require a more patient-specific treatment approach. In younger patients, anatomical reconstruction aiming to restore joint congruity, tibial plateau width and mechanical alignment remains the primary goal. In contrast, older patients with osteoporotic bone, complex fracture patterns and limited compliance with postoperative weight-bearing restrictions may benefit from alternative strategies, including primary arthroplasty in selected cases. In addition to fracture morphology and patient factors, the choice of surgical approach plays a crucial role. Surgical approaches influence soft tissue conditions, scar formation and implant positioning, which may affect the feasibility and complexity of future TKA. Bone quality and augmentation techniques must also be considered as they influence fracture healing, implant stability and potential future arthroplasty. This article discusses current concepts in the management of tibial plateau fractures with particular focus on patient-specific treatment strategies and implications for future knee arthroplasty.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"609-615"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407337","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

[Hand lacerations in initial clinical treatment : Small cut-Major injury]. 【手部撕裂伤初期临床治疗：小切口-大损伤】。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-06-15 DOI: 10.1007/s00113-026-01724-9

Martynas Tamulevicius, Florian Bucher, Nils Neubert, Peter M Vogt

引用次数: 0

[Primary total knee arthroplasty in geriatric patients with tibial plateau fractures]. [原发性全膝关节置换术治疗老年胫骨平台骨折]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-06-02 DOI: 10.1007/s00113-026-01721-y

Christian Ries, Holger Bäthis, Vera Jaecker, Claudio Glowalla, Tim Rolvien, Frank Timo Beil

{"title":"[Primary total knee arthroplasty in geriatric patients with tibial plateau fractures].","authors":"Christian Ries, Holger Bäthis, Vera Jaecker, Claudio Glowalla, Tim Rolvien, Frank Timo Beil","doi":"10.1007/s00113-026-01721-y","DOIUrl":"10.1007/s00113-026-01721-y","url":null,"abstract":"Fractures around the knee joint are per se challenging to treat, often regardless of the patient's age. Osteosynthesis remains the gold standard for fracture management; however, geriatric patients are often unable to comply with postoperative weight-bearing restrictions on the osteosynthetically treated limb. This can result in a prolonged hospital stay and particularly in aged patients to an increased risk of internal complications. Secondary total knee arthroplasty (TKA) is associated with both higher complication and revision rates compared to primary TKA for acute fractures. The advantage of primary TKA for acute tibial plateau fractures is the possibility for early mobilization with full weight-bearing, even in patients with poor compliance. The aim of primary TKA in treating geriatric tibial plateau fractures is to perform only a single surgery on the injured knee joint (one-shot surgery). Individual patient assessment and an interdisciplinary treatment approach appear to be essential for this specific patient cohort and highlight the importance of primary fracture TKA.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"597-608"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145831","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

[Visibility on social media but how? : A guide]. [如何在社交媒体上获得曝光度？[指南]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 DOI: 10.1007/s00113-026-01739-2

Anna Sittig, Tina Suhai, Michal Meyer Zu Tittingdorf, Julie Kind

引用次数: 0

Behandlung der Tibiakopffraktur beim geriatrischen Patienten – zwischen Rekonstruktion und Endoprothetik. 老年患者胫骨颅骨置换的治疗-重建与修复之间。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-08-24 DOI: 10.1007/s00113-026-01736-5

Karl-Heinz Frosch

引用次数: 0

[Return to sports after cruciate ligament surgery : Retrospective evaluation of the results of return to sports (RTS) testing after anterior cruciate ligament (ACL) reconstruction in an acute care hospital]. [交叉韧带手术后恢复运动：回顾性评价急性护理医院前交叉韧带（ACL）重建后恢复运动（RTS）测试结果]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-09-01 Epub Date: 2026-05-08 DOI: 10.1007/s00113-026-01714-x

Christoph Andreas Oratsch, Vinzenz Smekal

{"title":"[Return to sports after cruciate ligament surgery : Retrospective evaluation of the results of return to sports (RTS) testing after anterior cruciate ligament (ACL) reconstruction in an acute care hospital].","authors":"Christoph Andreas Oratsch, Vinzenz Smekal","doi":"10.1007/s00113-026-01714-x","DOIUrl":"10.1007/s00113-026-01714-x","url":null,"abstract":"Background: This retrospective study investigates functional fitness and return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction at an acute care hospital. ACL injury often leads to functional knee impairment. Modern rehabilitation focuses on individualized, functional criteria rather than fixed time intervals to ensure a safe RTS.Objective: What is the functional and psychological status of patients approximately 1 year postsurgery based on the Knee Injury and Osteoarthritis Outcome Score (KOOS), ACL-RSI (RSI: Return to Sport after Injury scale), and RTS tests? Which factors influence the return to sport?Materials and methods: A total of 149 patients (aged 18-60) with isolated ACL reconstruction were retrospectively analyzed using KOOS, ACL-RSI, and a standardized test battery (including strength, jumping ability, and balance). The Limb Symmetry Index (LSI) with a 90% cut-off was used for functional assessment.Results: Significant and clinically relevant improvements in pain, function, and psychological readiness were observed across all age groups, especially in sports participation and quality of life. Limited single-leg jumping performance, especially in middle adulthood, and functional deficits under fatigue proved to be key limiting factors for athletic performance. Return to sport was significantly influenced by subjective sports function and psychological readiness, which were strongly correlated (KOOS Sport-ACL-RSI: ρ = 0.56; p < 0.001), while objective functional parameters such as single-leg jump performance were moderately or weakly associated.Conclusion: The combination of objective tests and psychological evaluation is essential for a safe RTS. Rehabilitation should specifically address functional deficits in middle-aged individuals.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"623-633"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847445","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

[Primary arthrodesis-Does it have advantages?] 原发性关节融合术-有优势吗？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-05-06 DOI: 10.1007/s00113-026-01709-8

Ann-Sophie Clara Weigel, A Milstrey, S Gartung, K Horst, S Ochman

{"title":"[Primary arthrodesis-Does it have advantages?]","authors":"Ann-Sophie Clara Weigel, A Milstrey, S Gartung, K Horst, S Ochman","doi":"10.1007/s00113-026-01709-8","DOIUrl":"10.1007/s00113-026-01709-8","url":null,"abstract":"Ankle fractures are the third most common fractures in old age with an incidence of up to 150/100,000 inhabitants per year. While anatomical joint reconstruction of the ankle using open reduction and internal fixation (ORIF) achieves good results in younger patients, geriatric patients are particularly prone to complications after surgery due to osteoporosis, multimorbidity and limited ability to maintain partial weight-bearing. Primary arthrodesis, usually performed as retrograde tibiotalocalcaneal (TTC) nailing, does not follow the anatomical reconstruction of the joint but pursues a different goal of a load-stable fixation that enables immediate full weight-bearing and thus avoids complications associated with immobilization. Studies have shown union rates of 85-100%, moderate functional results and a tendency towards fewer soft tissue complications compared to anatomical joint reconstruction. The indications are strictly selective and include nonreconstructable fractures, critical soft tissue situations, inability to bear partial weight and frail low-demand patients; however, the level of evidence is not high enough to derive recommendations. The currently available studies only have a retrospective study design, so that prospective randomized studies are required.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"547-556"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847405","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

[Evaluation and risk assessment of geriatric ankle fractures? : What must be considered?] 老年人踝关节骨折的评估和风险评估？必须考虑什么？］

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-05-11 DOI: 10.1007/s00113-026-01712-z

Christine Marx, Stefan Rammelt, Florian Guggenbichler, Konrad Kamin, Anne Elisabeth Postler

{"title":"[Evaluation and risk assessment of geriatric ankle fractures? : What must be considered?]","authors":"Christine Marx, Stefan Rammelt, Florian Guggenbichler, Konrad Kamin, Anne Elisabeth Postler","doi":"10.1007/s00113-026-01712-z","DOIUrl":"10.1007/s00113-026-01712-z","url":null,"abstract":"The frequency of fractures in old age is steadily increasing including geriatric ankle fractures. These injuries are associated with increased morbidity and prolonged hospitalization. The consequences of courses prone to complications represent a relevant socioeconomic factor and the goal of treatment is to preserve the patient's mobility and quality of life. To ensure optimal perioperative care, the identification of geriatric patients, evaluation of the functional status and existing risk factors with subsequent interdisciplinary treatment are required. Various surgical procedures are available that enable early full weight-bearing. Risk factors such as malnutrition, osteoporosis, diabetes mellitus, angiopathy and postoperative delirium should be preoperatively screened and optimized. Open fractures pose a particularly high risk with respect to morbidity and mortality and require a special thorough individualized management. With an adapted interdisciplinary treatment strategy complications can be reduced and good functional outcomes can be achieved even after ankle fractures in very old people.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"509-515"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870947","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

[Management of geriatric ankle fractures-Conservative treatment works well]. 老年性踝关节骨折的治疗——保守治疗效果良好。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2026-08-01 Epub Date: 2026-04-24 DOI: 10.1007/s00113-026-01706-x

Verena Hecht, Thomas Lustenberger, Helen Anwander

{"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":"10.1007/s00113-026-01706-x","url":null,"abstract":"Background: 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.Objective: To determine which fractures can be safely managed conservatively in older patients and which criteria are decisive.Material and methods: Narrative review of the literature on randomized trials and systematic reviews.Results: 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.Conclusion: With appropriate patient selection, conservative treatment represents an evidence-based and functionally comparable treatment option with lower complication rates than surgery.","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"516-523"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791769","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