Zeitschrift fur Orthopadie und Unfallchirurgie最新文献

{"title":"Total Hip Arthroplasty in Patients with Left Ventricular Assist Devices: Perioperative Management and Clinical Outcome.","authors":"Xiaojun Hu, Stavros Goumenos, Jobst Leopold Hansberg, Ulrich Stöckle, Carsten Perka, Markus Mueller, Philipp Pickerodt, Sebastian Meller","doi":"10.1055/a-2963-8832","DOIUrl":"https://doi.org/10.1055/a-2963-8832","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Left ventricular assist devices (LVADs) are commonly utilized in severe left-sided heart disease as a bridge to transplantation or long-term treatment. Total hip arthroplasty (THA) improves mobility in these patients but entails numerous perioperative risks. Our study focused on perioperative management and clinical outcomes for LVAD patients undergoing THA, aiming to provide insights into this complex setting.</p><p><strong>Abstract: </strong>METHODS: We retrospectively analyzed patients with LVADs who underwent THA at our institution from May 2019 to November 2023. The outcomes of interest were perioperative anticoagulation management, thrombotic or bleeding events, transfusion needs, mortality, surgical site complications, and reoperations. The functional outcome was evaluated using the modified Harris Hip Score (mHHS) and the EQ-5D quality of life score at their last follow-up.</p><p><strong>Abstract: </strong>RESULTS: The cohort consisted of 11 male patients, mean age 68.1 years. Patient survival was recorded over a 22.8-month mean follow-up (range, 1-53). Seven patients (63.6%) required postoperative transfusions and 5/11 patients (45.5%) experienced thromboembolic events. The mean hospital stay after THA was 13.5 days. The overall mortality related-to-disease rate in our series of LVAD patients undergoing primary THA was 27%. Three patients (27.3%) developed surgical site hematomas, which required one additional reoperation, and one of those was infected. Hip functionality improved markedly, with the mean mHHS rising from 27.5 to 72.3.</p><p><strong>Abstract: </strong>CONCLUSIONS: THA in LVAD patients is challenging yet feasible, offering significant functional improvements despite the increased perioperative morbidity. Mortality was associated with their underlying disease, but not the surgery.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241156","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}

{"title":"[Volume-Outcome Effects in Primary and Revision Hip Arthroplasty: Evidence for Minimum Volume Thresholds in German Hospital Service Groups].","authors":"Franz Ehm, Bernd Kladny, Klaus-Peter Günther, Karl-Dieter Heller, Lukas Kwietniewski, Johannes Wolff, Manfred Gogol, Monika Nothacker, Jochen Schmitt","doi":"10.1055/a-2959-8285","DOIUrl":"https://doi.org/10.1055/a-2959-8285","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;BACKGROUND: In Germany, hospital services will generally only be reimbursed within designated service groups (SGs) in the future. The assignment of SG is tied to various requirements ensuring quality of care, including provision of minimum volume thresholds. Although evidence on the relationship between case volume and outcome quality exists for many indications and procedures, this evidence is lacking at the SG level. Using hip arthroplasty as an example, this study is the first to examine, at the SG level, the effect of minimum case-volume thresholds on outcome quality and population accessibility, thereby providing indications for potential minimum volume thresholds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;METHODS: Outcome quality was measured using the MTL30 and MTL21 indicators, which describe the composite outcome of in-hospital mortality and external transfer within 30 or 21 days, and length of stay beyond the expected duration. Based on nationwide hospital service data for the year 2024, the risk of MTL30 and MTL21 was estimated as a function of hospital case volume and relevant patient-level risk factors using Poisson regression. For various case-volume thresholds, accessibility analyses were conducted using travel-time data at the market-cell level. The findings serve as a basis for recommendations by the relevant scientific medical societies regarding future minimum capacity thresholds in SG 23 (primary hip arthroplasty) and SG 25 (revision hip arthroplasty).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;RESULTS: The analysis of 221,698 cases performed in 2024 across a total of 1,062 hospital sites in SG 23 and SG 25 nationwide showed a clear positive association between case volume and outcome quality. Patients undergoing elective primary hip arthroplasty in SG 23 had a 44% lower risk of MTL21 at institutions with at least 100 cases per year compared with sites with fewer than 100 cases per year (RR = 0.56 [95% CI: 0.53, 0.59]). For elective revision procedures in SG 25, the risk of MTL30 decreased by 24% (RR = 0.76 [95% CI: 0.68, 0.83]) when the institution performed at least 15 cases per year. At these case-volume thresholds, the average travel time to the nearest hospital site was less than 20 minutes in both SGs. Further quality gains in SG 23 and SG 25 were observed at minimum case volumes of 150 and 25 cases, respectively, while average travel time remained below 25 min.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;CONCLUSION: This study demonstrates substantial potential for quality improvement in SG 23 (primary hip arthroplasty) and SG 25 (revision hip arthroplasty) under moderate concentration of care. The authors recommend minimum case-volume thresholds of at least 100 cases, preferably 150, for primary hip arthroplasty, and at least 15 cases, preferably 25, for revision hip arthroplasty, given accessibility within an average travel time of less than 20 and 25 min, respectively. These findings are associated with clear improve","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198103","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}

{"title":"Saving the Limb-Tissue Collectors, Growth Factors, and Antibiotics in a War Injury.","authors":"Eleftherios Papaeleftheriou, Andrea Sowislok, Alexander Wegner, Marcel Haversath, Marcus Jäger","doi":"10.1055/a-2972-3247","DOIUrl":"https://doi.org/10.1055/a-2972-3247","url":null,"abstract":"<p><strong>Abstract: </strong>As a life-saving procedure, limb amputation is frequently indicated in severe war injuries, especially in suboptimal medical supply. We report of a 56-year-old Ukrainian male who was wounded on the battlefield by an air attack during Russian early invasion in Zaporizhzhia. The blast injury caused a critical soft-tissue defect of the lower leg combined with comminuted fractures of the tibia and fibula. Although indicated, the patient refused the amputation of the lower leg. Initially closed reduction and stabilization by an external fixator, local debridement as well as soft-tissue coverage by a porcine skin were performed at a local field hospital. Due to destroyed infrastructure and missing escape corridors, further evacuation was difficult. Thus, it took 15 days to transfer the patient by ground transportation to our institution. Based on the massive tissue loss, superinfection necrosis and questionable blood supply, the indication for amputation was confirmed, but the patient insisted on limb preservation. To save the lower leg, a brought spectrum of regenerative strategies was applied, accompanied by standard trauma treatment regimens (debridement, vacuum sealing, antibiotics, intramedullary nailing, suralis flap).</p><p><strong>Abstract: </strong>These included the local application of growth factors, the use of innovative tissue collectors, the implementation of biomaterial/tissue combinations and the application of a vasodilator. Six months after treatment, the patient was free of pain and infection. However, further follow-up was complicated by delayed bone healing and required revision surgery. Although the limb was saved, it ultimately took 1 year until full rehabilitation was achieved. This case illustrates the special demands in war lower leg injuries but also demonstrates that a combination of standardized and innovative treatment protocols can save a limb, even when amputation might be indicated as a first-line therapy.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168588","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}

{"title":"PCA Calculation Based on Multiplane Two-Dimensional Computed Tomography Sliding Measurement in Preoperative Total Knee Arthroplasty Planning.","authors":"Yuandong Liu, Yinong Chang, Kun Liu, Zhibo Zhang, Jidong Xie, Donglin Fu, Zongqing Fan","doi":"10.1055/a-2811-2115","DOIUrl":"10.1055/a-2811-2115","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Various osteotomy measurement techniques to assess the posterior condylar angle (PCA) are utilized in total knee arthroplasty (TKA). However, the most accurate method remains unclear. This study made use of preoperative two-dimensional (2D) computed tomography (CT) images to measure the PCA and integrated three-dimensional (3D) printing technology for in vitro verification and to improve preoperative planning of osteotomy measurement techniques in TKA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;A retrospective study was conducted involving a limited cohort of 10 patients diagnosed with knee osteoarthritis. These patients underwent three-dimensional CT reconstruction of the knee joint using a medical 3D model. This study employed three distinct methodologies to measure the PCA. The first method involved single-plane 2D CT measurement, which provides a clear assessment of the posterior femoral condyle axis line (PCAL) and the surgical epicondylar axis (sTEA) of the femur. The second method utilized multiplane 2D CT with continuous plane sliding positioning to identify both the PCAL and sTEA when measuring PCA. The third method incorporated a 3D printing model whereby a solid model of the patient's distal femur was fabricated using 3D printing technology. In this approach, the PCAL and sTEA were marked using in vitro Kirschner wires, followed by CT scans of the marked femur. The PCA was subsequently measured based on the positioning of the Kirschner wires, with the PCA obtained from the 3D printed model considered the reference standard. The accuracy and consistency of PCA measurements obtained from different CT planes were evaluated using paired sample t-tests and intraclass correlation coefficients (ICC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the single-plane 2D CT measurement group, the PCA value was 1.33 ± 0.50° (0.83-2.1°, 95% CI: 0.97-1.69°) with a measurement error of -0.84 ± 1.12° (-3.24-0.87°, 95% CI: -1.64--0.04°) and an outlier rate of 10%. In the multiplane 2D CT sliding measurement group, the PCA value was 1.61 ± 0.38° (1.13-2.32°, 95% CI: 1.34-1.88°) with a measurement error of -0.56 ± 1.09° (-2-1.6°, 95% CI: -1.34-0.22°) and no abnormal values were detected. The PCA measurement value for the 3D printed model group was 2.17 ± 1.16° (0.23-4.01°, 95% CI: 1.34-3.00°). The PCA measurement values in the single-plane 2D CT group were significantly lower than those in both the multiplane 2D CT sliding measurement group and the 3D printed model group, with no significant difference observed between the latter two groups. Moreover, the measurement error and outlier rates in the multiplane 2D CT sliding measurement group were significantly lower than those in the single-plane 2D CT group. The PCA measurements in the single-plane 2D CT group exhibited moderate repeatability (ICC: 0.507-0.641) while those in the multiplane 2D CT sliding group demonstrated high consistency (ICC: 0.840-0.940).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":"424-434"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583503","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}

{"title":"Surgical Management of Tibial Plateau Fractures: Current Concepts and Strategies.","authors":"Christian Arras, Matthias Krause, Karl-Heinz Frosch","doi":"10.1055/a-2832-3761","DOIUrl":"10.1055/a-2832-3761","url":null,"abstract":"<p><strong>Abstract: </strong>Tibial plateau fractures are considered severe injuries of the lower extremity and require a differentiated treatment approach. The goal of surgical therapy is the anatomical reconstruction of the articular surface, while simultaneously restoring axial, length, and rotational alignment, in order to prevent long-term functional impairment and the development of post-traumatic gonarthrosis. A successful treatment is based on comprehensive diagnostics, including radiography, computed tomography, CT angiography in cases with suspected dislocation, and, if necessary, additional magnetic resonance imaging to assess associated ligamentous and meniscal injuries. The ten-segment classification and the three-column model have proven to be effective tools for preoperative planning and for selecting the optimal surgical approach. The concept of stepwise extension of the surgical approach as needed allows complete and generally soft-tissue sparing exposure of the affected joint surfaces. Intraoperative three-dimensional imaging significantly improves reduction control and is associated with greater anatomical accuracy and lower revision rates. Concomitant ligamentous and meniscal lesions should be addressed, either simultaneously or in a staged manner, depending on their relevance for joint stability. While partial meniscal tears may be left untreated in stable situations, displaced or unstable ruptures require (possibly arthroscopically assisted) repair and only rarely (partial) resection. Bony avulsion injuries of ligaments should be included in the fracture fixation, whereas intraligamentous ruptures or high-grade instabilities can be successfully treated with direct suture, augmentation, or secondary reconstruction. In summary, a stepwise extendable surgical approach, in combination with complete articular surface exposure, intraoperative 3D imaging control, and function-oriented management of concomitant injuries, has proven to be an evidence-based strategy to achieve stable, anatomical restoration and optimal long-term functional outcomes.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":"458-468"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793849","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}

{"title":"Osteoporotic Fractures of the Pelvic Ring.","authors":"Steven C Herath, Markus Alexander Küper, Benedikt Johannes Braun, Maximilian M Menger, Christof K Audretsch, Tina Histing, Mika F R Rollmann","doi":"10.1055/a-2813-2426","DOIUrl":"10.1055/a-2813-2426","url":null,"abstract":"<p><strong>Abstract: </strong>In the past, pelvic ring fractures were rare injuries that were classically caused by high-energy trauma. However, due to demographic change, most pelvic ring fractures today arise on the basis of osteoporosis, usually due to low-energy accidents or without an accident at all. The incidence of pelvic ring fractures has increased significantly in recent decades. Today, predominantly elderly patients are affected. Osteoporosis-related pelvic ring fractures represent a separate entity amongst fractures of the pelvis. Their treatment differs significantly from high-energy pelvic fractures, especially regarding the indication for surgical intervention and the necessary medical infrastructure. The present work provides an overview of the specifics of diagnostics, classification and treatment of osteoporosis-related pelvic ring fractures.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":"451-457"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641160","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}

{"title":"Performance-based Functional Outcomes After Primary vs Predominantly Septic First-time Revision TKA.","authors":"Kevser Sevik Kacmaz, Tuba Unver, Bayram Unver, Vasfi Karatosun","doi":"10.1055/a-2833-5977","DOIUrl":"10.1055/a-2833-5977","url":null,"abstract":"<p><strong>Background: </strong>Total knee arthroplasty (TKA) outcomes are mainly assessed using radiographic and clinical survival analysis. Recently, several studies have been published on patient-reported outcome measures. However, data on functional performance differences between primary and revision TKA (rTKA) are limited. The study aims to compare the functional performance of primary and revision TKA.</p><p><strong>Patients/methods: </strong>Twenty-nine patients with primary TKA and rTKA were included in this study. Patients completed the performance-based tests of the 3-meter Backwards Walk Test (3MBWT), the modified Four Square Step Test (mFSST), and the Figure-of-Eight Walk Test (F8WT). Their pain levels and the Hospital for Special Surgery (HSS) knee scores were determined.</p><p><strong>Results: </strong>Age, gender, body mass index, time after surgery, pain level, and HSS scores were similar across groups. Surgery in the rTKA group was predominantly indicated for sepsis (26/29). The 3MBWT, mFSST, and F8WT scores of the rTKA patients were lower than those of patients who had primary TKA (p < 0.05).</p><p><strong>Discussion: </strong>The functional performances related to fall risk, dynamic balance, stepping, and various walking skills after predominantly septic first-time rTKA were poorer than after primary TKA, with medium effect sizes. These results offer patients realistic expectations after TKA and rTKA, predominantly septic first-time rTKA. Clinicians and patients should make additional efforts to improve the durability of the primary operation and reduce the need for future revision surgery. Additionally, rTKA patients may require more intensive, comprehensive rehabilitation programs.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":"415-423"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793833","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}

{"title":"Resilienz der Gesundheitsversorgung – Vorsorge für einen Ernstfall.","authors":"Matthias Manych","doi":"10.1055/a-2916-1817","DOIUrl":"https://doi.org/10.1055/a-2916-1817","url":null,"abstract":"","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":"164 5","pages":"403-404"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077262","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}

{"title":"Diagnosis and Management of the Stiff Total Knee Arthroplasty.","authors":"Lisa Wiederhold, Philip Anderson, Jan Oberfeld, Maximilian Rudert","doi":"10.1055/a-2811-4624","DOIUrl":"10.1055/a-2811-4624","url":null,"abstract":"<p><strong>Abstract: </strong>The stiff total knee arthroplasty (TKA) remains a major driver of dissatisfaction after primary implantation. Persisting myofibroblasts and a transforming growth factor-beta (TGF-β)-driven scar matrix underlies painful limitations in flexion/extension, either independent of or in addition to mechanical problems. A pragmatic diagnostic pathway includes structured history and examination, conventional radiographs, mandatory exclusion of periprosthetic joint infection, and targeted three-dimensional computed tomography (3D-CT) and single-photon emission computed tomography (SPECT-CT) for malposition/overstuffing; metal artifact reduction sequence MRI (MARS-MRI) supports soft-tissue-predominant pathology. Management is time-critical: early multimodal, opioid-sparing analgesia, strict oedema control, and pain-adapted physiotherapy; if flexion remains < 90-95° by week 6-8, manipulation under anaesthesia (MUA) (ideally ≤ 12 weeks) with immediate remobilization is indicated. Persistent adhesions are treated arthroscopically or openly; mechanical causes or failure warrant revision, including rotating-hinge strategies in selected cases. Early risk stratification, a stepwise algorithm, and tightly controlled rehabilitation stabilize range-of-motion gains and reduce reinterventions, although patient-reported outcomes may remain limited.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":" ","pages":"435-443"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476139","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}

{"title":"[Periprosthetic Fractures - A Growing Challenge in Orthopedics and Trauma Surgery].","authors":"Christina Pempe, Dmitry Notov, Andreas Roth","doi":"10.1055/a-2809-1363","DOIUrl":"10.1055/a-2809-1363","url":null,"abstract":"<p><strong>Abstract: </strong>Periprosthetic fractures are a central topic in orthopedic and trauma surgery. With increasing numbers of joint replacements and an aging, active population, a continuous rise in these injuries is expected. A key factor is the assessment of implant stability, which determines whether conservative treatment, osteosynthesis, or complex revision arthroplasty is indicated. The article addresses total knee and total hip arthroplasties.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":"164 5","pages":"476-491"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077283","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}