Development and validation of a simplified thoracolumbar spine fracture classification system.

Study Design: Development and validation of fracture classification system.

Objective: To develop and validate a Simplified Classification System (SCS) for Thoraco-Lumbar (TL) fractures (SCS - TL fractures).

Setting: Tertiary Spinal Injuries Centre, New Delhi, India METHODS: Based on the International Spinal Cord Society Spine Trauma Study Group (ISCoS STSG, n = 23) experts' clinical consensus conducted by the senior author and on his own experience, the Denis classification for TL fractures was modified to develop a SCS-TL fractures that could guide the management.

Radiological protocol in spinal trauma: literature review and Spinal Cord Society position statement.

Purpose: The Spinal Cord Society constituted a panel tasked with reviewing the literature on the radiological evaluation of spinal trauma with or without spinal cord injury and recommend a protocol. This position statement provides recommendations for the use of each modality, i.e.

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters.

Purpose: The intention of the current work was to assess the association between clinical parameters and seven different quality of life (QoL) instruments after surgical treatment of thoracolumbar spinal fractures after an average follow-up of 4.2 years.

Methods: The following human-related quality of life and PRO measures of 66 patients were correlated to clinical parameters such as fingertip-to-floor distance (FFD), Schober measurement, pressure and percussion pain in the lumbopelvine area (PPP), and paravertebral muscle tension: reALOS, SF-36, VAS, VAS spine score, BDI, the GBB-24, and the IES-R.

[An optimised assessment of "severely injured patients" for the documentation of road traffic accident black spots].

Introduction: The success of traffic safety improvement strategies is based on documentation. Analysis and remedy of accident black spots in addition to improvements in automobile production involve the work of traffic engineers, politicians, traffic regulations, police, and medical care. To create priorities, the traffic statistics differentiate accidents in a 3-class system in relation to severe accidents: slightly injured, severely injured and fatally injured (death).

Early short-term inpatient psychotherapeutic treatment versus continued outpatient psychotherapy on psychosocial outcome: a randomized controlled trial in trauma patients.

Background: Inpatient psychotherapeutic support has been shown to reduce mental health problems in severely injured patients. However, this effect mostly disappears after discharge. The aim of this study was to compare short-term inpatient versus continued long-term outpatient psychotherapeutic support.

The removal of Al2O3 particles from grit-blasted titanium implant surfaces: effects on biocompatibility, osseointegration and interface strength in vivo.

For the improvement of surface roughness and mechanical interlocking with bone, titanium prostheses are grit-blasted with Al(2)O(3) particles during manufacturing. Dislocated Al(2)O(3) particles are a leading cause of third-body abrasive wear in the articulation of endoprosthetic implants, resulting in inflammation, pain and ultimately aseptic loosening and implant failure. In the present study, a new treatment for the removal of residual Al(2)O(3) particles from grit-blasted, cementless titanium endoprosthetic devices was investigated in a rabbit model.

[Unstable pertrochanteric femur fractures. Failure rate, lag screw sliding and outcome with extra- and intramedullary devices (PCCP, DHS and PFN)].

Aim Of The Study: The dynamic hip screw (DHS) often shows a high incidence of therapeutic failure and an impared outcome in the treatment of the unstable pertrochanteric femur fracture (31A2). Therefore often an intramedullary device is recommended. In a retrospective clinical study we examined whether the percutaneous compression plate (PCCP, Gotfried) provides advantages following unstable fractures in comparison to DHS and PFN.

The neurofunctional mechanisms of traumatic and non-traumatic memory in patients with acute PTSD following accident trauma.

Neurofunctional alterations in acute posttraumatic stress disorder (PTSD) and changes thereof during the course of the disease are not well investigated. We used functional magnetic resonance imaging to assess the functional neuroanatomy of emotional memory in surgical patients with acute PTSD. Traumatic (relative to non-traumatic) memories increased neural activity in the amygdala, hippocampus, lateral temporal, retrosplenial, and anterior cingulate cortices.

Trust, social support and patient type--associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients.

Objective: Trust is an important aspect of physician-patient-interaction, both in terms of compliance and patient- and physician-reported outcomes. Trust-building communication is especially important in terms of severely injured patients because of severity of their injuries and frequently associated physical and psychological consequences. Patients preferences concerning medical treatment (patient type) is also regarded to be important in terms of trust.

Biomimetic modification of the TiO(2)/glass composite Ecopore with heparinized collagen and the osteoinductive factor BMP-2.

The porous TiO(2)/glass composite Ecopore has potential applications in hard tissue replacement. We describe the modification of Ecopore with the growth factor bone morphogenetic protein-2 (BMP-2) to add osteoinductive properties. Ecopore covalently coated with BMP-2 caused a weak induction of alkaline phosphatase in murine embryonal fibroblasts.

[Surgical outcome in pertrochanteric femur fracture: the impact of osteoporosis. Comparison between DHS and percutaneous compression plate].

Aim: The dynamic hip screw (DHS) often shows an impared outcome and a high incidence of therapeutic failure in patients with osteoporotic pertrochanteric femur fractures. This is caused predominantly by a fracture collapse and appears often in unstable fractures (31A2, 31A3). In a prospectively documented clinical study, we examined whether or not the percutaneous compression plate (PCCP, Gotfried) offers advantages following osteoporotic fractures.

[Treatment of the combined pelvic and thoracic trauma in the emergency room].

Priorities in the diagnosis and treatment of a multiple trauma with injuries to the thorax and pelvis are usually determined by the pattern and the severity of the injury sustained. In this case a haemodynamically unstable patient with severest pelvic trauma and a moderate thoracic trauma developed progressive haemodynamic instability during an intervention to the pelvis, resulting in a lethal outcome for the patient. The cause only became obvious when computed tomography of the thorax (CTT) was performed which was able to demonstrate venous pulmonary bleeding compressing the left atrium.

Interpretation of surface EMGs in children with cerebral palsy: An initial study using a fuzzy expert system.

Surface EMG detected simultaneously at different muscles has become an important tool for analysing the gait of children with cerebral palsy (CP), as it offers essential information about muscular coordination. However, the interpretation of surface EMG is a difficult task that assumes extensive knowledge and experience. As such, this noninvasive procedure is not frequently used in the general clinical routine.

The effect of surface modification of a porous TiO2/perlite composite on the ingrowth of bone tissue in vivo.

The porous TiO2/perlite composite Ecopore is a synthetic biomaterial with possible clinical application in bone substitution. In our previous work, we demonstrated that surface modification of Ecopore with fibronectin (FN) enhanced spreading and growth of human osteoblasts in vitro. In the present study, we implanted untreated, alkaline-etched and FN-coated Ecopore cylinders into critical size defects of rabbit femora and applied pulsed polychrome sequence staining.

Structural, mechanical and in vitro characterization of individually structured Ti-6Al-4V produced by direct laser forming.

Direct laser forming (DLF) is a rapid prototyping technique which enables prompt modelling of metal parts with high bulk density on the base of individual three-dimensional data, including computer tomography models of anatomical structures. In our project, we tested DLF-produced material on the basis of the titanium alloy Ti-6Al-4V for its applicability as hard tissue biomaterial. To this end, we investigated mechanical and structural properties of DLF-Ti-6Al-4V.

In vitro behavior of a porous TiO2/perlite composite and its surface modification with fibronectin.

In this study, we introduce a porous composite material, termed "Ecopore", and describe in vitro investigation of the material and its modification with fibronectin. The material is a sintered compound of rutile TiO2 and the volcanic silicate perlite with a macrostructure of interconnecting pores. It is both inexpensive and easy to manufacture.

[Biomechanical tests of a new scaffold for the cultivation of chondrocytes].

Aim: Scaffolds for the cultivation of chondrocytes are of increasing importance. So far, only little is known about their biomechanical properties. The present preliminary study addresses the biomechanical characteristics of a new collagen type I scaffold for the cultivation of chondrocytes.

[Reconstruction of extensive soft tissue loss by transplantation of dermal and epidermal equivalents].

Aim: The opportunities of autologous dermal and epidermal grafting as starting point for non-invasive reconstruction of extensive soft tissue defects will be demonstrated and discussed.

Methods: Skin biopsies for cell cultivation were taken from patients with extensive acute soft tissue defects of different origin. Cultured autologous fibroblasts grown on three dimensional biocompatible scaffolds made up of benzyl ester of hyaluronan were transplanted as "neo-dermis" on debrided and conditioned wound sites.

Neural processing of traumatic events in subjects suffering PTSD - a case study of two surgical patients with severe accident trauma.

Neuroimaging research on the neurobiology of chronic PTSD (posttraumatic stress disorder) has revealed structural and functional alterations primarily affecting areas of the medial temporal lobe (hippocampus, amygdala, and parahippocampal gyrus) and the frontal cortex known to be associated with the disorder. Using functional magnetic resonance imaging (fMRI), the present study studied the functional neuroanatomy of traumatic and non-traumatic emotional memory in two surgical patients who had sustained severe accident trauma. While patient 1 had developed acute PTSD following the traumatic event, patient 2 (control) did not.

Surface pretreatments for medical application of adhesion.

Medical implants and prostheses (artificial hips, tendono- and ligament plasties) usually are multi-component systems that may be machined from one of three material classes: metals, plastics and ceramics. Typically, the body-sided bonding element is bone. The purpose of this contribution is to describe developments carried out to optimize the techniques, connecting prosthesis to bone, to be joined by an adhesive bone cement at their interface.

Surface modification of poly(vinylidenefluoride) to improve the osteoblast adhesion.

Cell adhesion to biomaterials is mediated primarily by the interaction between surface bound proteins and corresponding receptors on the membrane of the cells. The attachment of fibronectin onto poly(vinylidenefluoride) (PVDF) surface and the application of PVDF as biomaterial in bone contact was the subject of our study. PVDF is a biomaterial established for soft tissue applications.

Standardized qualitative evaluation of scar tissue properties in an animal wound healing model.

There is a great need to establish reproducible methods for evaluative studies of wound treatment and wound healing. Validation of the healing process through optical techniques, as well as histologic and immunohistochemical methodologies, have been improved and to some extent have become well-established assays. Data relating to biomechanical properties, e.

Bipolar hemiarthroplasty for treatment of femoral neck fractures in geriatric patients--surgical technique and outcome.

Fractures of the femoral neck are frequent in the elderly population. The reduced general health status and presence of concomitant diseases, in many cases, make the treatment of these patients demanding. Early mobilization is mandatory to avoid secondary infections, which were often lethal in the past.

[Heparin facilities proliferation of human osteoblasts in vitro].

It is a well-known fact that long-term application of heparin can lead to osteoporosis. To learn more about the mechanisms of heparin-induced osteoporosis, we exposed human osteoblasts in vitro to heparin in various concentrations. We found an increased proliferation rate, especially in concentrations used therapeutically in humans (0.

[Modification of human osteoblasts by various analgesics].

Analgesia plays a major role in the therapy of fractures. This raises the question whether frequently used analgetics as Tramadol and Diclofenac have negative effects on the healing of fractures. Human osteoblasts were isolated from human spongiosa and incubated with Diclofenac, Tramadol and without analgetic substance in an in vitro experiment.