Unfallchirurgie (Heidelberg, Germany)最新文献_第9页

[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

[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

[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

[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

[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