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[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 : 2025-07-01 Epub 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":"10.1007/s00113-025-01573-y","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"508-516"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","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
[The surgeon as a risk factor : German Congress for Orthopedics and Trauma Surgery (DKOU) Science Slam 2024]. [外科医生作为风险因素：德国骨科与创伤外科大会（DKOU）科学大满贯2024]。
Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-05-23 DOI: 10.1007/s00113-025-01579-6
Thomas Mittlmeier
{"title":"[The surgeon as a risk factor : German Congress for Orthopedics and Trauma Surgery (DKOU) Science Slam 2024].","authors":"Thomas Mittlmeier","doi":"10.1007/s00113-025-01579-6","DOIUrl":"10.1007/s00113-025-01579-6","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"552-559"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129703","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
[Supplements to MRI diagnostics in TFCC tears and operative treatment of Palmer class 1D injuries]. [补充TFCC撕裂的MRI诊断和Palmer 1D级损伤的手术治疗]。
Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-06-04 DOI: 10.1007/s00113-025-01590-x
Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther
{"title":"[Supplements to MRI diagnostics in TFCC tears and operative treatment of Palmer class 1D injuries].","authors":"Kristofer Wintges, Dirk Sommerfeldt, Hauke Rüther","doi":"10.1007/s00113-025-01590-x","DOIUrl":"10.1007/s00113-025-01590-x","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"567-568"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217783","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
[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
{"title":"[Fracture sequelae-when, how, what?]","authors":"Ole Somberg, Thomas Rosteius, Maria Bernstorff, Thomas A Schildhauer, Matthias Königshausen","doi":"10.1007/s00113-025-01584-9","DOIUrl":"10.1007/s00113-025-01584-9","url":null,"abstract":"<p><p>The treatment of fracture sequelae following proximal humeral fractures presents a significant challenge, as they range from necrosis and pseudarthrosis to malunions. Classifications such as Boileau's facilitate diagnosis and treatment planning. Type 1 sequelae, characterized by necrosis, can be treated with either anatomical or reverse prostheses depending on the condition of the rotator cuff. Type 2 sequelae involve locked dislocations and may require bony reconstructions. Type 3 pseudarthrosis is managed either with joint-preserving techniques or prosthetic replacement, depending on the degree of degenerative changes. Type 4 malunions often benefit from corrective osteotomies and/or prosthesis implantation. Studies have demonstrated significant functional improvements following surgical intervention, with individual factors such as deformities or rotator cuff condition influencing treatment strategies.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"517-524"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000513","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
[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
{"title":"[Proximal humerus fractures-a new era?]","authors":"Michael Raschke, Helmut Lill","doi":"10.1007/s00113-025-01589-4","DOIUrl":"https://doi.org/10.1007/s00113-025-01589-4","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"128 7","pages":"479-480"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546521","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
[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":"<p><p>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.</p>","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
[Bony and ligamentous injuries of the thumb ray]. [拇指骨和韧带损伤]。
Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub 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
{"title":"[Bony and ligamentous injuries of the thumb ray].","authors":"D T D Dinh-Biet, T Leschinger, L-P Müller, A Cavalcanti Kußmaul, F Unglaub, Christian Karl Spies","doi":"10.1007/s00113-025-01565-y","DOIUrl":"10.1007/s00113-025-01565-y","url":null,"abstract":"<p><p>Fractures and ligamentous lesions of the thumb ray are frequent due to the exposed position of the thumb. A thorough anatomical understanding with respect to the joints and stabilizing ligaments is essential for a targeted examination, the selection of appropriate imaging diagnostics and the decision for a surgical or conservative treatment approach. Misdiagnoses or untreated injuries can lead to impaired functionality, pain and instability, which can substantially impair the function of the hand, particularly thumb opposition.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"449-460"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047915","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
[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 : 2025-06-01 Epub Date: 2025-04-02 DOI: 10.1007/s00113-025-01555-0
Oliver Loose, F Fernandez, T Müller
{"title":"[Femoral head necrosis after femoral neck fracture-A lifelong burden].","authors":"Oliver Loose, F Fernandez, T Müller","doi":"10.1007/s00113-025-01555-0","DOIUrl":"10.1007/s00113-025-01555-0","url":null,"abstract":"<p><p>Posttraumatic femoral head necrosis after a femoral neck fracture in children and adolescents is a rare but severe complication. If this occurs in older patients a total hip arthroplasty (THA) is mostly indicated. In children and adolescents the primary goal of treatment is preservation of the hip joint. There is no standard treatment or generally applicable treatment recommendation. Various measures for treating this rare entity are discussed in the literature. In addition to conservative measures, retrograde drilling with or without cancellous bone grafting, joint distraction or grafting measures are available. As a final solution, however, a THA is also a suitable treatment option as soon as the anatomical conditions are appropriate.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"417-424"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766097","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 pediatric traumatology- updated]. [儿科创伤学并发症-更新]。
Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-05-27 DOI: 10.1007/s00113-025-01570-1
Dorien Schneidmüller
{"title":"[Complications in pediatric traumatology- updated].","authors":"Dorien Schneidmüller","doi":"10.1007/s00113-025-01570-1","DOIUrl":"https://doi.org/10.1007/s00113-025-01570-1","url":null,"abstract":"","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":"128 6","pages":"401-402"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152499","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
[Acute compartment syndrome in childhood]. [儿童急性筋膜室综合征]。
Unfallchirurgie (Heidelberg, Germany) Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1007/s00113-025-01553-2
Guido Fitze, Peter C Strohm
{"title":"[Acute compartment syndrome in childhood].","authors":"Guido Fitze, Peter C Strohm","doi":"10.1007/s00113-025-01553-2","DOIUrl":"10.1007/s00113-025-01553-2","url":null,"abstract":"<p><p>Traumatic acute compartment syndrome in childhood is a rare complication following an accident but it occurs more frequently than generally assumed. The accident mechanisms and anatomical localization are very well known so that this complication must always be considered if these risk factors are present. The diagnostic confirmation is based on clinical examination findings and implies the assessment of the three A's: increasing anxiety, agitation and analgesic requirement. The measurement of compartment pressure can only be used if this examination is not possible or appears unsafe; however, there are no recognized age-adapted normal values. In the presence of manifest acute compartment syndrome, a timely dermatofasciotomy is the only treatment measure that results in a very good functional outcome. Otherwise, Volkmann's ischemic contracture cannot be avoided.</p>","PeriodicalId":75280,"journal":{"name":"Unfallchirurgie (Heidelberg, Germany)","volume":" ","pages":"410-416"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722955","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
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