Treadmill training of rats after sciatic nerve graft does not alter accuracy of muscle reinnervation.

Background And Purpose: After peripheral nerve lesions, surgical reconstruction facilitates axonal regeneration and motor reinnervation. However, functional recovery is impaired by aberrant reinnervation.

Materials And Methods: We tested whether training therapy by treadmill exercise (9 × 250 m/week) before (run-idle), after (idle-run), or both before and after (run-run) sciatic nerve graft improves the accuracy of reinnervation in rats.

[Conventional X-Rays of Ankle Joint Fractures in Older Patients are Not Always Predictive].

Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays.

Suture button reconstruction of the central band of the interosseous membrane in Essex-Lopresti lesions: a comparative biomechanical investigation.

Unlabelled: Surgical reconstruction of the interosseous membrane may restore longitudinal forearm stability in Essex-Lopresti lesions. This study aimed to compare the longitudinal stability of the intact forearm with a single-bundle and a double-bundle reconstruction of the central band of the interosseous membrane using digital image correlation with a three-dimensional camera system. Single and cyclic axial loading of eight fresh-frozen forearm specimens was carried out in the intact state, after creation of an Essex-Lopresti lesion, after a single-bundle and after a double-bundle reconstruction of the central band using a TightRope (Arthrex GmbH, Munich, Germany) construct.

[Shortening deformities of the clavicle after diaphyseal clavicular fractures : Influence on patient-oriented assessment of shoulder function].

Objective: The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities.

Material And Methods: The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment.

The AO Foundation and Orthopaedic Trauma Association (AO/OTA) scapula fracture classification system: focus on body involvement.

Background: A comprehensive system has been developed by the AO Classification Advisory Group to allow in-depth classification of scapular fractures for clinical research and surgical decision making. This paper evaluates a detailed classification system of scapular body fractures to better address the need for clinical relevance.

Methods: Seven experienced shoulder and orthopaedic trauma specialist surgeons participated in a follow-up series of agreement studies to specify and to evaluate the involvement of the body in scapula fractures.

Focussed classification of scapula fractures: failure of the lateral scapula suspension system.

Introduction: Following an increase in the incidence of scapular fractures and interest in the outcome of their treatment, a basic classification system was developed for ease of use in the emergency setting. It has been expanded to a comprehensive system to allow for more in-depth classification of scapular fractures for clinical research and surgical decision making. It focusses on three specific regions of the scapula: the scapular body, the glenoid fossa and the lateral scapular suspension system (LSSS).

The AO Foundation and Orthopaedic Trauma Association (AO/OTA) scapula fracture classification system: focus on glenoid fossa involvement.

Background: Fractures of the glenoid frequently require surgical treatment. A comprehensive and reliable scapula classification system involving the glenoid fracture patterns is needed to describe the underlying pathology. The AO Scapula Classification Group introduces an appropriate novel system that is presented along with its inter-rater reliability and accuracy.

Compartments of the foot: topographic anatomy.

Recent publications have renewed the debate regarding the number of foot compartments. There is also no consensus regarding allocation of individual muscles and communication between compartments. The current study examines the anatomic topography of the foot compartments anew using 32 injections of epoxy-resin and subsequent sheet plastination in 12 cadaveric foot specimens.

[A simple clavicle score. An effective and reliable classification for outcome assessments of midclavicular fractures].

Background: To compile an evaluation system (score) for post-treatment outcomes of midclavicular fractures, 172 patients were studied on average 15 months post-injury. As a control group 45 healthy volunteers were examined. The most relevant elements were filtered out for use in a new classification system, the Clavicle Score (CS).

Midclavicular fracture: not just a trivial injury: current treatment options.

Background: Conservative treatment was long recommended for midclavicular fractures because of the excellent results that were reported in the 1960's and 70's. Recently, however, the rucksack bandage has received competition from surgical treatment. The spectrum of operations ranges from classic plate osteosynthesis to intramedullary techniques and angle-stable implants.

Transplantation of de novo scaffold-free cartilage implants into sheep knee chondral defects.

Background: New cell-based treatments for articular cartilage repair are needed. As the optimal scaffold for cartilage repair has yet to be developed, scaffold-free cartilage implants may remove the complications caused by suboptimal scaffolds.

Hypothesis: The implantation of a scaffold-free, autologous de novo cartilage implant into standardized full-thickness cartilage defects of femoral condyles in sheep leads to a qualitatively better regenerative tissue than does periosteal flap alone or no treatment.

Digital amorphous silicon flat-panel detector radiography at different exposure doses versus mammography film: possibility of radiation dose reduction in detecting rheumatologic bone defects.

Background: Radiographic examinations of the skeleton are the most commonly performed radiologic procedures, even outnumbering examinations of the chest. The imaging systems used in skeletal radiography must meet high standards in terms of contrast and spatial resolution to effectively visualize the high contrast between bone and soft tissue as well as fine bone structures.

Purpose: To determine the performance of amorphous silicon flat-panel detector radiography compared to mammography film in detecting rheumatologic bone defects at different exposure doses.

Chondral thickness and radii of curvature of the femoral condyles and talar trochlea.

To localize optimal donor regions for osteochondral graft transplantation, the chondral thickness and the radii of curvature of femoral condyles and the talar trochlea were determined. Optosil impressions of the articular surfaces of ten formalin fixed distal femora and talar domes were prepared. Therefrom, 5-mm thick frontal sections were made in order to measure the radii of curvature.

The venous pump of the first metatarsophalangeal joint: clinical implications.

Background: Although the anatomy and physiology of the venous circulation of the ankle and midfoot are well documented, the physiologic importance of forefoot mobility has not been reported in the literature. The question of this study was whether the first metatarsophalangeal (MTP) joint may operate, like the ankle, as a "pump" to encourage venous return.

Methods: Forty-nine cadaver foot specimens were examined using dissection, plastination, vessel infiltration, and maceration, and radiographic (including venography, MRI, and magnetic resonance angiography) techniques.

[Percutaneous plate osteosynthesis for clavicular fractures. Initial description].

Insertion of titanium nails for type A and B clavicular fractures can fail intraoperatively due to the small diameter or irregular nature of the medullary canal. At present, such failures lead to open reduction and fixation (ORIF) with plates. In type C fractures (comminuted fractures), a telescoping effect is observed so that ORIF is the only suitable alternative besides nonoperative therapy.

Perilunate fracture-dislocations of the wrist: comparison of temporary screw versus K-wire fixation.

Purpose: Temporary intercarpal screw fixation has been suggested as an alternative to temporary K-wire fixation in the treatment of perilunate wrist dislocations. We compared the 2 treatment methods in 2 retrospective cohorts with a null hypothesis that there would be no difference in final wrist motion.

Methods: Eighteen patients with surgically treated perilunate wrist dislocations (9 treated with intercarpal screws, 9 with intercarpal K-wires) were evaluated an average of 44 months after injury.

Complete talar dislocation without late osteonecrosis: clinical case and anatomic study.

Avascular necrosis is a well-known, severe complication postfracture or subluxation of the talus. Type and localization of injury often permit conclusions regarding the probability of bone necrosis. In the following case, talar neovascularization was demonstrated after severe trauma, resulting in an open pilon fracture of the right tibia and complete talar dislocation with consequent destruction of the most relevant blood supply.

[Cleavage lines and incisions in foot surgery].

Background: In the constantly evolving, increasingly important field of foot surgery, the question arises as to whether the incision types currently in use are adequate. Whether Langer's lines should be considered during the operative approach to the foot is examined here. The goal of the current study was to investigate the pattern of skin cleavage lines of cadaveric feet and to establish the optimal incision type for surgical approaches to the foot.

[Implantation of matrix-free cartilage transplants in standardized defects in sheep knee joints].

The goal of the current investigation was to make a comparative analysis of regenerative tissue after autologous de novo cartilage transplantation on the femoral condyles of sheep after a chondral defect. One chondral defect measuring 4 mm in diameter was placed in the center of one medial femoral condyle of each of 48 Suffolk sheep. Twelve defects were left to heal spontaneously, 16 defects were covered with periosteal flaps, and 20 defects were filled with autologous de novo cartilage graft.

Malunion of the clavicle causes significant glenoid malposition: a quantitative anatomic investigation.

Objective: An experimental cadaver model was used to assess the effects of a malunited fracture of the middle third of the clavicle on the functional anatomy of the shoulder joint.

Method: Anatomic samples were prepared with simulated shortening and axial malposition of the clavicle. From these, alterations in glenoid fossa position were measured and depicted graphically.

The volar extension of the lunate facet of the distal radius: a quantitative anatomic study.

Purpose: To describe quantitatively the protrusion of the volar part of the lunate facet of the distal radius articular surface anterior to the volar metaphyseal cortex, which is susceptible to fracture and can be difficult to control with plates and screws alone.

Methods: Quantitative anatomic measurements of 48 3-dimensional computed tomography scans of the distal radius were analyzed to quantify the anatomy of the volar part of the lunate facet of the distal radius. The measurements were scaled to account for overall bone size.

Reduced collagen degradation in polytraumas with traumatic brain injury causes enhanced osteogenesis.

Patients with traumatic brain injury (TBI) and skeletal injuries have increased rates of excessive bone healing (EH = hypertrophic callus formation and/or heterotopic ossification). Polytrauma patients are often attributed higher rates of delayed fracture union. This study compares 182 total fractures in 29 isolated polytrauma patients (POLY) and 48 patients after TBI and polytrauma (TBI+POLY), examining the clinical parameters of EH versus delay.

Anatomy of the clavicle and the intramedullary nailing of midclavicular fractures.

Intramedullary fixation is used increasingly to treat clavicular fractures. Anatomical variations in the clavicle of relevance to this procedure are analyzed. The length, diameters and curvature of the clavicle were measured in 196 specimens from the dissecting room.

Augmentation of intraarticular calcaneal fractures with injectable calcium phosphate cement: densitometry, histology, and functional outcome of 18 patients.

Eighteen patients with intraarticular calcaneal fractures treated with open reduction and internal fixation and augmentation with an injectable carbonated apatite cement. Functional follow-up studies using the Zwipp Foot Score and densitometry were performed at 6-month intervals postoperatively. Histological samples of biopsies obtained at the time of hardware removal (6 months postoperatively) were also analyzed.

Outcomes and complications of elastic stable intramedullary nailing for forearm fractures in children.

This prospective study investigated medium-term outcomes for 51 children treated from 1997 to 2001 for displaced diaphyseal forearm fractures with elastic stable intramedullary nailing. Forty-three patients included achieved excellent/good functional results at an average follow-up of 38 months. Four patients required open fracture-manipulation at surgery.