Evaluation of Pelvic Circular Compression Devices in Severely Injured Trauma Patients with Pelvic Fractures.

The role of pelvic circumferential compression devices (PCCD) is to temporarily stabilize the pelvic ring, reduce its volume and to tamponade bleeding. The purpose of this study was to evaluate the effect of PCCDs on mortality and bleeding in severely injured trauma patients, using a large registry database. We performed a retrospective analysis of all patients registered in the Trauma Register DGU® between 2015 and 2016.

Third day laboratory follow-up: mandatory for surgical site infections of tibial plateau fractures.

Introduction: Tibial plateau fractures are common fractures in adults and can be extremely challenging for surgeons. State-of-the-art therapy is open reduction and internal fixation (ORIF), although major complications of ORIF are surgical site infections (SSIs). This is especially critical on the proximal tibia, which is only sparsely covered by soft tissue and has a close relation to the knee joint.

Biomechanical analysis of anterior pelvic ring fractures with intact peripelvic soft tissues: a cadaveric study.

Purpose: Biomechanical studies of the pelvis are usually performed using dissected pelvic specimens or synthetic bones. Thereby the stabilising effect of the surrounding soft tissues is analysed insufficiently. Biomechanical data for isolated anterior pelvic ring fractures are currently missing.

Accuracy of navigated and conventional iliosacral screw placement in B- and C-type pelvic ring fractures.

Introduction: The objective of this study is to report the institutions experiences with standardized 2D computer-navigated percutaneous iliosacral screw placement (CNS), as well as the conventional fluoroscopically assisted screw placement method (CF) over a period of 10 years.

Patients And Methods: A total of 604 patients with sacral fractures (OTA B and C) were treated at the institution. Cases with both, a preoperative and postoperative CT scan were included for further analysis.

ß-TCP bone substitutes in tibial plateau depression fractures.

Background: The use of beta-tricalciumphospate (ß-TCP, Cerasorb®) ceramics as an alternative for autologous bone-grafting has been outlined previously, however with no study focusing on both clinical and histological outcomes of ß-TCP application in patients with multi-fragment tibial plateau fractures. The aim of this study was to analyze the long-term results of ß-TCP in patients with tibial plateau fractures.

Methods: 52 patients were included in this study.

Posterior Only Vertebral Column Resection for the Treatment of Severe Spinal Deformities in Pediatric Patients: A Retrospective Case Series.

Objective: The treatment of severe spinal deformities in pediatric patients is very challenging. Posterior only vertebral column resection (PVCR) allows for correcting of severe deformities of the vertebral column via a posterior only procedure. We analyzed radiologic outcome of PVCR performed on a series of pediatric patients with severe congenital and acquired spinal deformities.

Five-Year Outcome Analysis of Intertrochanteric Femur Fractures: A Prospective Randomized Trial Comparing a 2-Screw and a Single-Screw Cephalomedullary Nail.

Objectives: To compare the radiological and functional outcome after fixation of intertrochanteric fractures (IF) using either an integrated 2-screw cephalomedullary nail [InterTan (IT); Smith & Nephew] or a single-screw device [Gamma3 (G3); Stryker] with a 5-year follow-up.

Design: Prospective, randomized.

Settings: A single-center study.

Isolated syndesmotic injuries in acute ankle sprains: diagnostic significance of clinical examination and MRI.

Purpose: Acute ankle sprains are frequently accompanied by syndesmotic injuries. These injuries are often overlooked in clinical examinations. The aim of this study was (1) to evaluate the incidence of syndesmotic injuries in acute ankle sprains using MRI, (2) to determine the accuracy of common clinical diagnostic tests, (3) to analyse their inter-rater reliability, and (4) to evaluate the role of clinical symptoms in the diagnosis of syndesmotic injuries.

Next generation distal locking for intramedullary nails using an electromagnetic X-ray-radiation-free real-time navigation system.

Background: Distal locking marks one challenging step during intramedullary nailing that can lead to an increased irradiation and prolonged operation times. The aim of this study was to evaluate the reliability and efficacy of an X-ray-radiation-free real-time navigation system for distal locking procedures.

Methods: A prospective randomized cadaver study with 50 standard free-hand fluoroscopic-guided and 50 electromagnetic-guided distal locking procedures was performed.

Retrograde drilling of talar osteochondritis dissecans lesions: a feasibility and accuracy analysis of a novel electromagnetic navigation method versus a standard fluoroscopic method.

Purpose: A novel method using an electromagnetic navigation system (ENS) was developed, and its feasibility and accuracy for retrograde drilling procedures were evaluated and compared with the standard freehand fluoroscopic method in an experimental setting.

Methods: A controlled laboratory study of 16 standard freehand fluoroscopically guided and 16 electromagnetically navigated retrograde drilling procedures was performed on 4 cadaveric human ankle joints. Four artificial cartilage lesions were consecutively set, 2 on the medial and 2 on the lateral talar dome.

Accuracy analysis of a novel electromagnetic navigation procedure versus a standard fluoroscopic method for retrograde drilling of osteochondritis dissecans lesions of the knee.

Background: Retrograde drilling for osteochondritis dissecans (OCD) remains a challenging operation.

Purpose: A novel radiation-free electromagnetic navigation system (ENS)-based method was developed and its feasibility and accuracy for retrograde drilling procedures evaluated and compared with the standard freehand fluoroscopic method in an experimental setting.

Study Design: Controlled laboratory study.

Arthroscopically assisted retrograde drilling for osteochondritis dissecans (OCD) lesions of the knee.

Purpose: Accurate retrograde drilling for osteochondritis dissecans lesions remains technically challenging. A novel, radiation-free method using an electromagnetic guidance system was developed, and its feasibility and accuracy for retrograde drilling procedures evaluated in an experimental setting.

Methods: Sixteen arthroscopically assisted, electromagnetically guided retrograde drilling procedures were performed in 4 human cadaveric knee joints.

A comparative biomechanical analysis of fixation devices for unstable femoral neck fractures: the Intertan versus cannulated screws or a dynamic hip screw.

Background: First introduced in 2005, the "Intertan" (IT), an intramedullary nail with two cephalocervical screws, has become an increasingly popular option for treating intertrochanteric fractures. The purpose of this study was to identify the utility of this device for stabilization of unstable femoral neck fractures compared with cannulated screws (CS) and a dynamic hip screw (DHS).

Methods: Twenty-four human cadaveric femurs were harvested and assigned to three groups that were matched with regard to bone mineral density (BMD).

The impact of BMI on polytrauma outcome.

Background: Varying results have been reported concerning the effect of body mass index (BMI) on polytrauma outcome. Although most studies focus on obesity and its associated preexisting medical diseases as a predictor for increased mortality rates, there is evidence that polytrauma patients with underweight also face an inferior outcome.

Methods: Records of 5766 trauma patients (minimum 18 years of age, Injury Severity Score ≥ 16, treated from 2004 to 2008) documented in the Trauma Registry of the German Society for Trauma Surgery were subclassified into 4 BMI groups and analysed to assess the impact of BMI on polytrauma outcome.

Effects of increased bone formation on fracture healing in mice.

Background: Fracture healing is a complex and sequential process. One important step in fracture healing is callus remodeling. As we could previously show, an increase of osteoclast bone resorption as a result of estrogen deficiency impairs the fracture healing process.

The distal radius, the most frequent fracture localization in humans: a histomorphometric analysis of the microarchitecture of 60 human distal radii and its changes in aging.

Background: The distal radius is the most frequent fracture localization in humans. Although younger patients receive a distal radius fracture after an adequate trauma, elderly patients suffer fractures through low-energy mechanisms. Low-energy fractures are hallmarks of osteoporosis.

Effects of estrogen on fracture healing in mice.

Background: Fracture healing is a complex and sequential process. One important step in fracture healing is callus remodeling. Estrogen deficiency is known to increase osteoclast bone resorption, whereas estrogen replacement can reverse this effect.

Biomechanical evaluation of peri- and interprosthetic fractures of the femur.

Background: Because of an increasing life expectancy of patients and the rising number of joint replacements, peri- and interprosthetic femoral fractures are a common occurrence in most trauma centers. This study was designed to answer two primary questions. First, whether the fracture risk increases with two intramedullary implants in one femur; and second, whether a compression plate osteosynthesis is sufficient for stabilizing an interprosthetic fracture.

Proximal Humeral Fractures: Nailing.

Treating proximal humeral fractures surgically has always been a challenge for the orthopaedic trauma surgeon. The challenge was and is due to numerous factors such as the specific anatomy of the proximal humerus, problems of an adequate approach and exposure of the fracture and different fracture fragments, possible iatrogenic injuries to the rotator cuff on approach and the detrimental effects of the former on the latter's gliding and contracting ability after surgery. Furthermore, the very different fracture patterns that can occur at the proximal humerus, the shear number of fragments which can be of extremely bad bone quality, the necessity for anatomic reduction of these fragments with an implant that will allow for a stable osteosynthesis and at the meantime will not impinge in the subacromial area and lastly, the intention of the physician-in-charge to commence with physical therapy as soon as possible post OP.

Antegrade nailing of humeral head fractures with captured interlocking screws.

Objectives/design: To assess the functional outcome after treatment of proximal humeral fractures with a new antegrade nail that provides angular and sliding stability. INTERVENTION/PATIENTS: Ninety-seven patients were treated during a 4-year period between April 2000 and March 2004. All patients were followed for 6 months, 51 patients (53%) for 12 months, and 31 patients (32%) for 24 months.

Surgery of skeletal metastases.

During a period of 5 years, 74 female and 27 male patients with an average age of 63.3 years underwent a total of 117 operations for the management of impending ( n=41) or already existing ( n=76) pathologic fractures due to osseous metastases. The average stay in hospital was 17.