Zeitschrift fur Orthopadie und Unfallchirurgie最新文献

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Vielen Dank! 多谢!
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-12-01 Epub Date: 2023-12-04 DOI: 10.1055/a-2191-4471
{"title":"Vielen Dank!","authors":"","doi":"10.1055/a-2191-4471","DOIUrl":"10.1055/a-2191-4471","url":null,"abstract":"","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483667","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
[Clavicle Fractures: Diagnosis and Choice of the Appropriate Therapeutic Procedure]. [锁骨骨折:诊断和适当治疗方法的选择]。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-12-01 Epub Date: 2023-12-04 DOI: 10.1055/a-1958-7147
Sarah Langenbrunner, Christof A Müller
{"title":"[Clavicle Fractures: Diagnosis and Choice of the Appropriate Therapeutic Procedure].","authors":"Sarah Langenbrunner, Christof A Müller","doi":"10.1055/a-1958-7147","DOIUrl":"10.1055/a-1958-7147","url":null,"abstract":"<p><p>Clavicle fractures are one of the most common injuries of the shoulder girdle. In addition to the targeted clinical examination, the appropriate imaging must be initiated to formulate the correct diagnosis and subsequently apply an appropriate therapeutic method. Indirect force impact in recreational and sports accidents, such as falling on the outstretched or adducted arm, is the most common accident mechanism. The prevalence shows a bipartite clustering. On the one hand, there are young male patients and, on the other hand, female patients from the age of 65. Thus, a heterogeneous patient population with different complication profiles and different functional demands presents itself.The demand for a stable and, as far as possible, anatomical restoration after clavicle fracture results from its function as the sole connection between the shoulder joint and the sternum. Conservative therapy was the standard procedure for a long time, but due to further development of surgical therapy is now frequently used. Pediatric clavicle fracture remains the domain of conservative therapy. Early functional exercise of the shoulder girdle is essential for outcome in both surgical and conservative therapy.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483660","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
Surgical Treatment of Patients with Sacroiliac Joint Syndrome: Comparative Study of Two Implants. 骶髂关节综合征的手术治疗:两种植入物的比较研究。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-11-22 DOI: 10.1055/a-2188-3398
Theresa Splitt, Robert Pflugmacher, Osama Soliman, Hany Mohamed Abd Allah, Rudolf Hering, Adnan Kasapovic, Philip Rössler, Ernst M W Koch, Rahel Bornemann
{"title":"Surgical Treatment of Patients with Sacroiliac Joint Syndrome: Comparative Study of Two Implants.","authors":"Theresa Splitt, Robert Pflugmacher, Osama Soliman, Hany Mohamed Abd Allah, Rudolf Hering, Adnan Kasapovic, Philip Rössler, Ernst M W Koch, Rahel Bornemann","doi":"10.1055/a-2188-3398","DOIUrl":"https://doi.org/10.1055/a-2188-3398","url":null,"abstract":"<p><p>The treatment of patients with ISJ dysfunction is difficult due to the multifactorial causes of pain and various problems in clarification. Treatment includes physical therapy, corticosteroids, prolotherapy, radiofrequency denervation and sacroiliac joint fusion. A new option for the surgical treatment of ISG dysfunction is the Torpedo implant system. For a safe fusion, only 2 implants are needed, which are available in lengths of 30-50 mm. The new implant system has been tested in pilot studies for efficacy and biocompatibility with good results. For further documentation for the Torpedo implant system, a comparative study against the iFuse system was carried out.Two different implants were used: Group 1: Deltacor Torpedo, Group 2: iFuse implants (Si-Bone). The data generated during admission and subsequent check-ups (VAS, ODI, opioid use) were entered into an evaluation file set up for this purpose. Follow-up appointments were set at 1 month, 3, 6 and 12 months postoperatively.The data of 65 patients were evaluated comparatively. In all comparisons, only very small effect sizes were found with regard to the differences in the decrease in pain intensities, so that equivalent effectiveness of the two methods could initially be postulated from a clinical point of view. Most patients in both groups reported taking opioids to treat pain before surgery. According to the decrease in pain intensity, opioid treatment could be discontinued in some patients after the operation. After 12 months, the number of patients treated with opioids decreases to 23% in group 1 and to 17% in group 2. The success of the fusions with the two methods can also be proven by image documentation, from which the position of the implants can also be clearly recognised. In no case was there any loosening.Overall, the evaluation of this study allows the conclusion that both implant systems can be successfully used for the treatment of patients with ISJ syndrome. The present results should be confirmed in further comparative studies with the proposed evaluation methods.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296888","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
Which Factors Are Associated With Rerupture After Superior Capsular Reconstruction of the Shoulder With Autologous Long Biceps Tendon? - A Systematic Review. 哪些因素与自体长二头肌肌腱肩部上囊重建术后再破裂有关?-系统检讨。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-11-15 DOI: 10.1055/a-2195-0790
Marius von Knoch, Daniel B Hoffmann, Mike H Baums
{"title":"Which Factors Are Associated With Rerupture After Superior Capsular Reconstruction of the Shoulder With Autologous Long Biceps Tendon? - A Systematic Review.","authors":"Marius von Knoch, Daniel B Hoffmann, Mike H Baums","doi":"10.1055/a-2195-0790","DOIUrl":"https://doi.org/10.1055/a-2195-0790","url":null,"abstract":"<p><p>Based on a systematic review, the present work analyses factors associated with the rerupture rate or non-healing after superior capsular reconstruction with autologous long biceps tendon in the reconstruction of the rotator cuff of the shoulder.A systematic review of the U.S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was conducted in September 2021 using the PRISMA checklist. Articles were identified and analysed that contained data on the rerupture rate after superior capsular reconstruction with autologous long biceps tendon in reconstruction of the rotator cuff of the shoulder. The aim was to identify factors associated with rerupture or non-healing. The risk of bias was determined using the Newcastle-Ottawa scale.Primarily 86 hits could be generated. Seven articles from 2020 and 2021 met the inclusion criteria and were further analysed in terms of content. The evidence level was III to IV. Follow-up was between 12 (minimum) and 24 to 48 months. The risk of bias was not low. Factors that may be associated with rerupture or non-healing are diabetes mellitus and high-grade fatty degeneration of the subscapularis, infraspinatus, or teres minor as preoperative factors. Age, percent footprint coverage, tear size, symptom duration, number of bundles, acromioplasty performed, and tear configuration were not significant factors. Gender, degree of fatty degeneration of the supraspinatus and lesions of the subscapularis tendon were rated differently.According to the literature, but still currently with short-term observation periods, superior capsular reconstruction with an autologous long biceps tendon is another treatment option in the case of massive tears and elderly patients, if there is no high-grade fatty degeneration of the subscapularis, infraspinatus or teres minor. Diabetes mellitus has an unfavorable prognosis. Additional acromioplasty has so far not been associated with better outcomes.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650813","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
Efficacy of Mirror Therapy in Patients with Phantom Pain after Amputation of a Lower Limb: A Systematic Literature Review. 镜像疗法治疗下肢截肢后幻肢痛的疗效:系统文献综述。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-11-15 DOI: 10.1055/a-2188-3565
Lorena Scholl, Annette Schmidt, Martin Alfuth
{"title":"Efficacy of Mirror Therapy in Patients with Phantom Pain after Amputation of a Lower Limb: A Systematic Literature Review.","authors":"Lorena Scholl, Annette Schmidt, Martin Alfuth","doi":"10.1055/a-2188-3565","DOIUrl":"https://doi.org/10.1055/a-2188-3565","url":null,"abstract":"<p><p>Up to 80% of patients after amputation are affected by phantom limb pain. This may be due to various mechanisms of cortical reorganisation. Non-surgical treatment of the neuropathic phantom limb pain involves mirror therapy. Thereby, the use of a mirror should induce the illusion that the extremity has been preserved. This illusion should initiate processes to restore the original organisation of the somatosensory and motor cortex and thus to reduce pain. Evidence of mirror therapy to treat lower extremity phantom limb pain is rare. Therefore, the aim of this systematic review is to qualitatively analyse the efficacy of mirror therapy for treatment of phantom limb pain in adult patients after unilateral amputations of the lower extremity.The databases Medline (PubMed), Physiotherapy Evidence Database (PEDro), Cochrane Library (Central), and OPENGREY were systematically searched until 26th November 2020, followed by continued searches in these databases to provide a review of updated literature. Study selection, data extraction, and risk of bias evaluation (Risk of Bias Tool [RoB]) of included studies were conducted by two reviewers independently. The primary outcome was pain intensity, and secondary outcomes were pain frequency, pain duration, activities of daily life (ADL), and quality of life. The methodology of this review follows the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and the Cochrane Handbook for Systematic Reviews of Interventions.The search revealed 234 articles. Four articles were included in the analysis. A reduction in pain intensity due to mirror therapy was reported in all studies, however, in only 2 studies there were significant differences between mirror therapy and the comparison after 4 weeks of treatment (p < 0.001; p < 0.05). This significant difference was maintained after 3 and 6 months follow-up in one of those studies (p < 0.001). The outcomes pain frequency, pain duration, and ADL were decreased after 4 and 10 weeks of mirror therapy compared to comparison, but with no statistical significance (p > 0.05). After 6 months, there was a significant improvement in the duration of pain and in ADL after mirror therapy compared with the control group (p < 0.05). Differences in the results quality of life between the intervention group and comparison were observed in 2 studies.Mirror therapy of high frequency and duration is an effective intervention to reduce phantom limb pain in patients after unilateral lower extremity amputation. The superiority of mirror therapy to other interventions cannot be concluded, as the evidence was of low quality.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650812","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
A Novel Radiological Classification System of the Proximal Humerus. 一种新的肱骨近端放射学分类系统。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-11-08 DOI: 10.1055/a-2195-0914
Rudy Sangaletti, Salahulddin Abuljadail, Mustafa Akkaya, Luigi Zanna, Thorsten Gehrke, Mustafa Citak
{"title":"A Novel Radiological Classification System of the Proximal Humerus.","authors":"Rudy Sangaletti, Salahulddin Abuljadail, Mustafa Akkaya, Luigi Zanna, Thorsten Gehrke, Mustafa Citak","doi":"10.1055/a-2195-0914","DOIUrl":"https://doi.org/10.1055/a-2195-0914","url":null,"abstract":"<p><p>Different anatomical variants have been reported for the proximal and distal femur. Given this context, the goal of our study was to answer the following question: Can we also identify different anatomical variants of the proximal humerus?Two hundred anteroposterior (AP) radiographs of the proximal humerus with an equal gender distribution and equal laterality per gender were reviewed. The metaphyseal diameter of the proximal humerus at the level of the anatomical neck (X) and the intramedullary diameter at 10 cm from the apex of the greater tuberosity (Y) were measured. A new ratio was established, based on both measurements (Y/X). Radiographs showed different anatomical variants: type A: Y/X < 0.3, type B: Y/X = 0.3-0.4, type C: Y/X > 0.4. Two observers reviewed the AP radiographs independently and blindly in 2 different sessions.Three different anatomical groups (A, B and C) were identified based on the 25th and 75th percentiles. A higher percentage of type C was observed among females and a higher percentage of type A among males. A high inter-observer reliability was noted, with a Cronbach's alpha of 0.97 (ICC 0.96-0.98). The intra-observer reliability for observer 1 had a Cronbach's alpha of 0.98.A novel radiological classification of the proximal humerus has been established based on 3 different anatomical types (A, B and C). Further studies are needed to establish whether the novel classification system can be used as an indicator for aseptic loosening of cemented or cementless total shoulder arthroplasty.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71524000","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 Megaendoprosthesis in Revision Arthroplasty - a Cost-revenue Analysis in the aG-DRG System. 翻修关节成形术中的巨大内假体——aG DRG系统中的成本收益分析。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-10-23 DOI: 10.1055/a-2174-1439
Katharina Awwad, Carsten Gebert, Marcel Dudda, Jendrik Hardes, Arne Streitbürger, Yannik Hanusrichter, Martin Wessling
{"title":"The Megaendoprosthesis in Revision Arthroplasty - a Cost-revenue Analysis in the aG-DRG System.","authors":"Katharina Awwad,&nbsp;Carsten Gebert,&nbsp;Marcel Dudda,&nbsp;Jendrik Hardes,&nbsp;Arne Streitbürger,&nbsp;Yannik Hanusrichter,&nbsp;Martin Wessling","doi":"10.1055/a-2174-1439","DOIUrl":"https://doi.org/10.1055/a-2174-1439","url":null,"abstract":"<p><p>Megaendoprosthesis offer a viable treatment in complex revision arthroplasty cases with good functional outcome. In the context of a neoplastic indication, the diagnosis-related group (DRG) I95A is usually assigned with a relative weight of 4.906 (2021). In contrast, in revision arthroplasty, the appropriate DRG is assigned, depending on the joint replacement. The additional costs compared to the invoiced DRG are to be compensated by agreeing on hospital-specific individual fees. These complex revision arthroplasties set high technical and operative demands and are mainly performed in specialised departments. We conducted a cost-benefit analysis of the use of the megaendoprosthesis in revision cases in a specialised orthopaedic clinic, as a single centre study. The question we sought to answer was: Is cost recovery possible in the modified German DRG system (aG-DRG)?A retrospective single centre analysis of treatment costs was performed. From 2018 to 2020, 113 patients treated with a megaendoprosthesis reconstruction in a referral centre due to extensive bone loss after aseptic or septic revision of a hip or knee prosthesis were included in the study. Relevant case-related cost drivers of the aG-DRG matrix (including staff and material costs of the operating theatre area and the ward) were taken into account. The actual costs were determined according to the specifications of the calculation manual published by the German institute for the remuneration system in hospitals (InEK). For each case, the contribution margin was calculated by relating the hospital's internal costs to the corresponding cost pool of the aG-DRG matrix.According to the DRG system 2021, 17 different DRGs were used for billing - in 70% based on a patient clinical complexity level (PCCL) ≥ 4. Compared with the InEK calculation, there is a deficit of -2,901 € per case in the examined parameters. The costs of physicians show a shortfall in both the operating theatre and on the ward. Implant costs, which were supposed to be compensated by hospital-specific additional charges, show a hospital-specific shortage of -2,181 €. When analysing the risk factors for cost recovery, only these showed a significant difference.Implantation of the megaendoprosthesis in revision arthroplasty is often the last option to preserve limb function. At present, despite a high degree of specialisation and process optimisation, this treatment cannot be provided cost-effectively even in tertiary care. The politically desired specialised department structure requires sufficient reimbursement for complex cases. The economic outcome of each treatment case is often unpredictable, however the surgeon is confronted with these cases and is expected to treat them. The high standard deviation indicates large differences in the cost/revenue situation of each individual case. Our results show for the first time a realistic cost analysis for megaprosthesis in revision arthroplasty and underline the importance ","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49695655","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
Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity. 负重对下肢手术后并发症的影响。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-10-01 Epub Date: 2022-03-02 DOI: 10.1055/a-1740-4445
Alexander Maximilian Eickhoff, Raffael Cintean, Carina Fiedler, Florian Gebhard, Konrad Schütze, Peter Richter
{"title":"Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity.","authors":"Alexander Maximilian Eickhoff,&nbsp;Raffael Cintean,&nbsp;Carina Fiedler,&nbsp;Florian Gebhard,&nbsp;Konrad Schütze,&nbsp;Peter Richter","doi":"10.1055/a-1740-4445","DOIUrl":"10.1055/a-1740-4445","url":null,"abstract":"<p><strong>Purpose: </strong>In order to prevent implant failure and secondary fracture dislocation, it is often recommended that patients perform partial weight-bearing after surgery of the lower extremity. Previous examinations showed that patients are often not able to follow these instructions. In this study, patients who had undergone surgery of the lower extremity were studied in order to analyze whether incorrect loading influenced the number and severity of complications.</p><p><strong>Methods: </strong>Fifty-one patients were equipped with electronic shoe insoles, which measure loading and other parameters. The measurement period was 24 to 102 hours. Median duration of follow-up was 490 days. The primary outcome parameter was postoperative complications leading to revision surgery. Statistical analysis was performed using the chi-square and Fisher exact tests with significance set at a p < 0.05.</p><p><strong>Results: </strong>Seven out of fifty-one patients had postoperative complications. Four wound complications, one implant failure, chronic instability after fracture of the tibia, and one implant loosening of a hip prosthesis were recorded. In total, 26 of 39 patients were not able to follow the postoperative instructions. Five of the twenty-six patients with difficulties in partial weight-bearing suffered a postoperative complication. In comparison, only 2 of the other 25 patients were affected. There was no statistically significant correlation between high weight-bearing and occurrence of complications (p = 0.29).</p><p><strong>Conclusion: </strong>Most of the patients were unable to follow the surgeon's instructions for partial weight-bearing. Excessive loading did not seem to influence the number and severity of postoperative complications, especially regarding implant failure. Therefore, we should continue with measurements and reevaluate the \"partial weight-bearing doctrine\".</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171875","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: 1
Bibliometric Analysis of Research Areas, Publication Hierarchy and Gender Authorship in German University Orthopaedic Surgery. 德国整形外科大学研究领域、出版层次和性别作者的文献计量分析。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-10-01 Epub Date: 2022-03-10 DOI: 10.1055/a-1735-4110
Jennifer Preut, Karl-Heinz Frosch, Eike Sebastian Debus, Reinhart T Grundmann
{"title":"Bibliometric Analysis of Research Areas, Publication Hierarchy and Gender Authorship in German University Orthopaedic Surgery.","authors":"Jennifer Preut,&nbsp;Karl-Heinz Frosch,&nbsp;Eike Sebastian Debus,&nbsp;Reinhart T Grundmann","doi":"10.1055/a-1735-4110","DOIUrl":"https://doi.org/10.1055/a-1735-4110","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present bibliometric study was to record the focus of publications, type of study and publication activities depending on the hierarchy level and gender of the authors of German university departments for orthopaedic surgery.</p><p><strong>Material and methods: </strong>The publication performance of the staff surgeons, consisting of chief and senior physicians, section and division heads of 39 German university departments of orthopaedic surgery university hospitals, was recorded over a period of 10 years (January 1, 2010 to December 31, 2019). All publications were considered that were listed in PubMed and for which the staff surgeons were first or last authors. In addition, the impact factor (IF) and the h-index were determined.</p><p><strong>Results: </strong>1739 (39.2%) publications were compiled by 180 staff surgeons of university departments for trauma surgery and 2699 (60.8%) publications by 343 surgeons in departments of orthopaedics and trauma surgery. Most publications were related to injuries or impairments of the lower extremity including the hip (n = 1626; 38.1%), followed by the upper extremity (n = 737; 17.3%). These publications focussed on diagnostic testing (25.5%), surgical techniques (19.1%) or special osteosyntheses (16.9%). The highest average IF per publication was achieved by publications on plastics (IF 2.02), on outcome (IF 1.96) and on diagnostic testing (IF 1.93). Heads of departments were first authors in 18.8%, senior physicians with management functions in 40.7% and senior physicians without management functions in 69% of papers and last authors in 81.2%, 49.3% and 31.0% of articles, respectively. 64 of 523 staff surgeons (12.2%) were women. 306 authors (6.1%) were women, corresponding to 4.8 authorships per female surgeon - significantly for male surgeons (10.3 authorships per male surgeon).</p><p><strong>Conclusion: </strong>In the present study, among senior physicians with a management function, the share of publishing surgeons was 59.1% for women, but 85.5% for men. In contrast, in the group of senior physicians without management function female and male surgeons were almost equally represented (57.5% vs. 60.5%). It must therefore be asked whether the work life balance is more difficult to meet for women than for men with longer careers. Mentoring programs are required to support the publication activities of the increasing number of female applicants in the future.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172751","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: 1
Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: Long Term Results. 自体脂肪移植治疗拇指腕关节骨性关节炎:长期疗效。
Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2023-10-01 Epub Date: 2022-03-10 DOI: 10.1055/a-1737-4541
Christian Herold, Janina Lange, Hans Oliver Rennekampff, Sixtus Allert, Max Meyer Marcotty
{"title":"Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: Long Term Results.","authors":"Christian Herold,&nbsp;Janina Lange,&nbsp;Hans Oliver Rennekampff,&nbsp;Sixtus Allert,&nbsp;Max Meyer Marcotty","doi":"10.1055/a-1737-4541","DOIUrl":"https://doi.org/10.1055/a-1737-4541","url":null,"abstract":"<p><strong>Background: </strong>Initial results after autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis have been promising. But long-term results have not yet been available.</p><p><strong>Methods: </strong>In a prospective study, 42 patients with thumb carpometacarpal joint osteoarthritis were observed for a mean time of 5 years after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to numerous analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire score (DASH score) before and after treatment were analysed.</p><p><strong>Results: </strong>The average pain preoperatively was 8.0 ± 1.6 and 4.0 ± 3.0 after 5 years overall. Force and pinch force of the treated hand improved from 71% and 60% preoperative in comparison to the non-treated hand to 100% and 96%, respectively, 5 years after fat transplantation. There were similar improvements for the parameters strength and DASH score. All improvements were statistically significant. No serious adverse events were observed.</p><p><strong>Conclusions: </strong>Autologous fat transplantation is a real alternative to trapeziectomy even in the long term in basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in basal joint osteoarthritis of the thumb as it offers stable results and warrants a high patient satisfaction rate.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176587","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: 2
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