Surgical Drill Guide for Insertion of an Infra-Acetabular Screw Based on an Anatomically Precontoured Plate System: A Cadaveric Study.

Purpose: Due to the anatomic structure of the pelvis, free-hand placement of screws in the acetabular fracture management can be difficult. Infra-acetabular screw fixation increases acetabular stability by distal fixation of the cup. Aim of this cadaveric study is to investigate if a plate-referenced drill guide can provide save placement of an infra-acetabular screw over a precontoured suprapectineal quadrilateral buttress plate (SQBP).

Injury Analysis in Professional Soccer by Means of Media Reports - Only Severe Injury Types Show High Validity.

Purpose: Injury data of professional soccer players obtained from media reports are frequently used in scientific research, but the accuracy of such data is still unclear.

Patients And Methods: Injuries of professional soccer players of the German first and second league were documented by continuously screening media reports over one season (2015-2016). After the season, the validity of media-reported injuries was anonymously analyzed by the team physicians of 8 different soccer clubs.

Novel implant-free loop Tenodesis vs. simple Tenotomy of the long biceps tendon - a biomechanical investigation.

Background: Simple tenotomy and anchor tenodesis are commonly used in treatment of long biceps tendon (LHB) pathologies. The tenotomy can result in biceps distalization or cosmetic deformities. A novel loop Tenodesis Technique (LTD) could prevent a distalization of the biceps muscle without the risk of implant associated complications.

Minimal invasive plating of distal radius fractures. A safe procedure?

Background: Minimal invasive plate osteosynthesis (MIPO) with preservation of the pronator quadratus (PQ) muscle represents a new technique for stabilization of distal radius fractures. However, the complex anatomy of the distal radius metaphysis requires implants with features that address all morphologic specifics of this area to avoid complications, which are still reported with this technique. It was the aim of our anatomic investigation to evaluate the feasibility of plate insertion via a minimal transverse approach as well as the risk of soft- tissues compromise with the use of an implant, which is only partially adapted to the characteristics of distal radius metaphysis.

Normal values of distal radioulnar translation assessed by three-dimensional C-arm scans: a cadaveric study.

We investigated whether mobile C-arm cone beam computer tomography (CBCT) could be used to measure radioulnar translation. The study was conducted on 31 Thiel-fixed intact cadaver arms. Three-dimensional scans of each wrist were carried out in pronation and supination.

Total Hip Arthroplasty for Hip Fractures: Time to Surgery With Respect to Surgical Revision, Failure, and Mortality.

Introduction: There are increasing demands to perform surgery of hip fractures without delay. However, few studies have assessed the time to surgery in relation to outcome measurements.

Methods: A total of 643 consecutive patients with a minimum age of 60 years underwent total hip arthroplasty (THA) for an intracapsular hip fracture.

Risk of extrapelvine vascular injuries in osteosynthesis with gliding hip screws.

Background: Dynamic hip screw (DHS) osteosynthesis represents one of the most frequently performed fixation methods in orthopedic practice. The purpose of this study was to determine the potential risk of vascular damage by DHS side-plate screws (PS) and plunging instruments for individual femoral vessels and screw positions.

Methods: In ten hemipelvic/leg specimens mounted with a large femur distractor, a DHS system with a four-hole side-plate was inserted.

Bone block augmentation from the iliac crest for treatment of deep osteochondral defects of the knee resembles biomechanical properties of the subchondral bone.

Purpose: Bone block augmentation from the iliac crest can be used for reconstruction of the osteochondral unit to restore the underlying subchondral bone upon restoration of the cartilaginous layer via matrix-induced chondrocyte transplantation. To critically understand the successful restoration of the defect, biomechanical and histological analysis of the implanted bone blocks is required. The aim of the study was to analyse the ability of the bone block technique to restore huge bone defects by mimicking the physiological subchondral zone.

Biomechanical evaluation of a new gliding screw concept for the fixation of proximal humeral fractures.

Aims: Plating displaced proximal humeral fractures is associated with a high rate of screw perforation. Dynamization of the proximal screws might prevent these complications. The aim of this study was to develop and evaluate a new gliding screw concept for plating proximal humeral fractures biomechanically.

Clinical application of a minimally invasive cement-augmentable Schanz screw rod system to treat pelvic ring fractures.

Purpose: The purpose of this study is to analyze the results using the USS fracture MIS system (DePuy Synthes) to treat instable pelvic ring fractures. As its outstanding feature, it is the only Schanz screw and rod system at present that combines angular stability, perforation/fenestration of the screws for cement-augmentation, a variable screw length, and a large screw diameter.

Materials And Methods: Retrospective investigation of 134 pelvic ring fractures treated in 2012-2013.

Determination of Elbow Laxity in a Sequential Soft-Tissue Injury Model: A Cadaveric Study.

Background: The objective of our study was to analyze, under fluoroscopy, joint angulation of uninjured elbows and elbows with distinct induced collateral ligament injury.

Methods: Twelve elbow specimens were tested for varus and valgus joint angulation using 4 different examination methods (application of both varus and valgus stress by each of 2 examiners [Examiner 1 and Examiner 2] and application of 1 and 2 Nm of torque using a calibrated electric force scale) in 4 elbow positions (in full extension with 90° of supination and 90° of pronation, and in 30° of flexion with 90° of supination and 90° of pronation). Six elbow specimens were examined under varus stress at each of 5 sequential stages: (1) intact, (2) transection of the lateral ulnar collateral ligament (LUCL), (3) complete transection of the lateral collateral ligament complex (LCLC), (4) transection of the anterior aspect of the capsule (AC), and (5) transection of the medial collateral ligament (MCL).

Proximal Femoral Fractures and Anticoagulation Therapy - When Is Surgery Safe?

Patients presenting with proximal femur fractures are at high risk of developing DVT and pulmonary embolism. Many of these patients suffer from additional anticoagulant treatment. Patients on anticoagulation treatment are complex to manage, especially regarding timing of surgery due to implemented quality control recommendations.

Wire Placement in the Sustentaculum Tali Using a 2D Projection-Based Software Application for Mobile C-Arms: Cadaveric Study.

Background: Indirect screw fixation of the sustentaculum tali in the lateral-medial direction can be challenging due to the complex calcaneal anatomy. A novel 2-dimensional (2D) projection-based software application detects Kirschner wires (K-wires) and visualizes their intended direction as a colored trajectory. The aim of this prospectively randomized cadaver study was to investigate whether the software would facilitate the indirect K-wire placement in the sustentaculum tali.

The nerve supply of zygomaticus major: Variability and distinguishing zygomatic from buccal facial nerve branches.

The zygomaticus major (ZM) is important for the human smile. There are conflicting data about whether the zygomatic or buccal branches of the facial nerve are responsible for its motor innervation. The literature provides no precise distinction of the transition zone between these two branch systems.

Anatomical and radiological evaluation of less invasive stabilisation system (LISS) in correlation with knee lateral collateral ligament insertion.

Introduction: The Less Invasive Stabilisation System (LISS) is an angle-stable plate that enables treatment of distal femoral comminuted and periprosthetic fracture. As it is placed through a minimally-invasive lateral approach, lateral knee pain is a commonly described symptom after its application. This study investigates knee lateral collateral ligament (LCL) iatrogenic injury during LISS plate fixation.

Scaphoid screw placement under minimal radiation exposure.

Background: Percutaneous scaphoid fixation through either a volar or dorsal approach has the advantage of minor soft tissue damage compared with ORIF, and faster fracture union compared with conservative treatment. However, this technique demands highly intraoperative reliance on X-ray control, including increased radiation exposure and all associated side effects.

Purpose: To test the possibility and efficacy of volar percutaneous scaphoid screw placement under minimalradiation exposure.

Comparison of volar and dorsal plate osteosynthesis for radial shaft fractures: an anatomical pilot study.

Background: No publication has yet described the interface between the radius and the plate in various positions. Neither clinical examination nor assessment of fracture radiographs provides information about the anatomy of the radius before injury.

Purpose: We investigated radius anatomy to analyse dorsal and volar plate-to-bone fit for radial shaft fracture management.

Avoiding radial nerve palsy in proximal radius shaft plating - a cadaver study.

Background: Opinions vary concerning the position of forearm rotation during detachment of the supinator in radial nerve palsy Henry's and Thompson's approaches.

Purpose: To define the optimal forearm position for a safe detachment of the supinator during these approaches and to clarify their close relationship to the posterior interosseous nerve (PIN).

Methods: The study sample comprised 90 upper extremities of 45 human adult cadavers, embalmed using Thiel's method.

Humeral shaft cerclage wiring: a safe technique to prevent radial nerve injury.

Humeral periprosthetic fractures are a challenging problem and their occurrence has increased, particularly over the last decade. The role of cerclage wires or cables in these fractures includes revisions with longer stems, and augmentation of a plate osteosynthesis in which the stem does not allow additional screw placement or structural bone grafts as supplementary fixation. These procedures are demanding because of the proximity of the radial nerve within the operating field.

Biomechanical investigation of four different fixation techniques in sacrum Denis type II fracture with low bone mineral density.

With increasing life expectancy, fragility fractures of the pelvic ring are seen more frequently. Although their osteosynthesis can be very challenging, specific biomechanical studies for investigation of the fixation stability are still lacking. The aim of this study was to biomechanically evaluate four different fixation methods for sacrum Denis type II fractures in osteoporotic bone.

Primary stability in total hip replacement: A biomechanical investigation.

Background: In total hip replacement (THR), it is essential to achieve a primary stability to guarantee good long-term results. A novel locking screw hip (LSH)-stem, anchored to the medial cortex of the proximal femur by 5 monocortical locking screws, was developed to overcome the shortcomings of uncemented press-fit and cemented straight stems while simultaneously achieving primary stability. The aim of this study was to investigate the biomechanical competence of the LSH-stem in comparison to an uncemented press-fit stem.

Clinical and Radiological Regeneration of Large and Deep Osteochondral Defects of the Knee by Bone Augmentation Combined With Matrix-Guided Autologous Chondrocyte Transplantation.

Background: Large osteochondral defects of the knee are a challenge for regenerative treatment. While matrix-guided autologous chondrocyte transplantation (MACT) represents a successful treatment for chondral defects, the treatment potential in combination with bone grafting by cancellous bone or bone block augmentation for large and deep osteochondral defects has not been evaluated.

Purpose: To evaluate 1- to 3-year clinical outcomes and radiological results on magnetic resonance imaging (MRI) after the treatment of large osteochondral defects of the knee with bone augmentation and MACT.

Standard Approaches to the Acetabulum Part 3: Intrapelvic Approach.

Introduction The intrapelvic approach was originally described by Hirvensalo et al. from Finland in the early 90ies (8) and a further comparable description was published shortly thereafter by Cole et al. (5).

Are two retrograde 3.5 mm screws superior to one 7.3 mm screw for anterior pelvic ring fixation in bones with low bone mineral density?

Objectives: Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible.The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws.

Standard Approaches to the Acetabulum Part 2: Ilioinguinal Approach.

The ilioinguinal approach is one of the standard approaches in the treatment of displaced acetabular fractures used during the last decades (9). The meta-analysis of Giannoudis et al. showed that 21.