[Comparative evaluation of trabecular bone density in Hounsfield units in the lumbar native CT cross-section for osteoporosis diagnosis and fracture risk determination by different examiners].

Background: An increasing loss of bone mineral density (BMD) in the axial skeleton leads to osteoporosis and fractures, with an increase found in the thoracic and thoracolumbar regions.

Research Question: The extent to which an examiner-independent assessment of the extent of osteoporosis and fracture risk determination is possible by determining the trabecular density in Hounsfield units (HU) in the spine should be examined. The next question was whether quantitative BMD values can be calculated from the HU values.

Biomechanical Analysis of Diffuse Idiopathic Skeletal Hyperostosis and Osteoporosis: Vertebral Fracture Risk Evaluation Using Finite Element Modeling with Clinical and Micro-CT Data in an Elderly Donor.

Biomechanical analysis of spinal structures is crucial in the evaluation of injuries, the risk of fracture, and age-related changes. Osteoporotic vertebrae are very fragile and therefore constitute a serious risk, especially in the elderly. At present, clinically relevant decision making in fracture risk assessment is predicated upon finite element analysis (FEA), which utilizes high-resolution computed tomography (CT) scans from clinical practice alongside micro-CT scans from laboratory settings.

Distal femoral fractures: periprosthetic fractures have four times more complications than non-periprosthetic fractures and cerclage should be avoided: retrospective analysis of 206 patients.

Background: Distal femoral fractures account for less than 1% of all fractures. The therapy of choice is usually surgical stabilization. Despite advances in implant development over the past few years, complication rate remains comparatively high.

Sustainable treatment success of an Os naviculare syndrome using conservative measures, infiltration therapy, and shock waves.

Medial plantar foot pain can have various causes, and the painful Os tibiale externum should be considered in the differential diagnosis. A reliable diagnosis can be made through physical examination and multimodal imaging. We report on a 53-year-old man with severe, load-dependent pain consistent with an accessory navicular syndrome, caused by a pes planovalgus, which consecutively induced focal inflammation and tenosynovitis of the tibialis posterior tendon.

Carpal tunnel syndrome, spinal canal stenosis, cardiomyopathy, renal insufficiency, enteropathy, and diffuse myopathy as an expression of systemic ATTR amyloidosis - diagnostics and therapy.

Systemic amyloidosis is an incurable multisystem disease, caused by fibrillar protein deposits with resulting dysfunction of affected organ systems. It mostly affects patients > 60 years. Diagnosis is often delayed because the symptoms are nonspecific and highly variable.

Transoral balloon kyphoplasty in a myeloma patient with painful osseous destruction of the corpus vertebrae axis.

Multiple myeloma is the most common primary malignant disease of the spine, which can lead to pathological fractures with consecutive instability and immobilizing pain, due to osseous destruction of individual vertebral bodies. The different surgical care is challenging, although good stabilization should be achieved if possible. The resulting blocking of micro-movements leads to pain minimization.

Successful treatment of a painful os peroneum using conservative measures, infiltration therapy, and shock waves.

Lateroplantar foot pain may be caused by various entities, whereby painful os peroneum syndrome should be included in the differential diagnosis. Physical examination and multimodal imaging enable a definitive diagnosis. We report on a 59-year-old man with severe, load-dependent pain, corresponding to an os peroneum syndrome, triggered by a pes planovalgus with consecutively induced focal inflammation and tendovaginitis of the tendon of the peroneus longus muscle.

Interobserver variability in the determination of bone mineral density in Hounsfield units from differently configured fields of measurement in the cancellous bone of vertebral bodies from elderly body donors.

Background: Due to the absence of suitable diagnostic procedures, osteoporosis (OP) is frequently detected late or not at all. Many elderly persons undergo computed tomographies (CT). The routine determination of Hounsfield units (HU) in bone as a part of these examinations could close a gap here.

[Cosmetic outcome of nasal tip reconstruction with the frontonasal flap and other locoregional flaps - Cosmetic Outcome of Nasal Tip Reconstruction].

Background: This study investigates the results of nasal tip reconstruction with the frontonasal flap compared with other locoregional flaps.

Material And Methods: All nasal tip reconstructions with locoregional flaps performed during a 10-year period were included. Defect size, flap type, risk factors, comorbidities, complications, revisions, and secondary operations were retrospectively assessed.

Revisiting SFA stent technology: an updated overview on mechanical stent performance.

Objectives: The study investigated mechanical parameters of stent systems indicated for treatment of femoropopliteal (FP) arterial disease to support interpretation of clinical results and the related causalities.

Methods: Eight stent system types of same dimensions were investigated (n=2). Parameters were the profile of stent delivery system (SDS), radiopacity, trackability and pushability, bending stiffness (flexibility) and axial stiffness of expanded stents, length change during expansion, radial force, crush resistance, strut thickness and general surface condition.

Evaluation of bone density and hand grip strength in the course of drug treatment for osteoporosis : A real-world study.

Background: The aim of this clinical investigation was to assess the physical performance in osteoporotic patients undergoing drug treatment (DT) for years by measuring hand grip strength (HGS) and bone mineral density (BMD). A further aim was to detect the time until the occurrence of vertebral fractures (VF) and influencing factors.

Material And Methods: The investigation comprised 346 persons (276 women, 70 men) aged on average 66.

Regional variations in the intra- and intervertebral trabecular microarchitecture of the osteoporotic axial skeleton.

Trabecular structures in vertebral bodies are unequally distributed in the cervical, thoracic and lumbar spine, and also within individual vertebrae. Knowledge of the microstructure of these entities could influence our comprehension and treatment of osteoporotic fractures, and even surgical procedures. Appropriate investigations may clarify the pathomechanisms of various osteoporotic fractures (fish, wedge-shaped, and flat vertebrae).

A rare case of severely elevated septic parameters caused by intercurrent juvenile rheumatoid arthritis despite dual trauma surgery.

Procalcitonin (PCT) and C-reactive protein (CRP) are considered markers used in clinical practice to differentiate bacterial infections from autoimmune origin. Here we evaluate a rare case of a male patient diagnosed with juvenile idiopathic arthritis. The patient presented repeatedly to our department with atraumatic femoral head necrosis, traumatic medial femoral neck fracture and peri-implant femoral fracture.

Comparative outcome of different treatment options for fragility fractures of the sacrum.

Background: Fragility fractures of the sacrum (FFS) have been detected more and more frequently in recent times, and the incidence will continue to increase due to increasing life expectancy. The aim of this study was to compare the clinical outcome of conservative, interventional and surgical treatment of FFS.

Methods: Retrospectively, 292 patients (276 women, 16 men) with confirmed FFS were followed up over a period of 2 years.

[Impact of osteoporosis on physical performance parameters of middle-aged and elderly individuals-a cross-sectional study].

Background: Osteoporosis (OP) in the elderly is accompanied by reduced muscle mass and reduced muscle strength, also known as sarcopenia. This results in functional limitations and a high risk of falls and injuries. The determination of physical performance parameters such as grip strength and trunk strength on the one hand, and balance abilities on the other, provide information about the individual's general neuromuscular condition and serve as an indicator of physical performance in the elderly.

Histomorphometric analysis of osteocyte density and trabecular structure of 92 vertebral bodies of different ages and genders.

Background: Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density - a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies.

Methods: Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072).

[Sacral fragility fractures: risk factors and outcomes after cement sacroplasty].

Background: The objective of the present study on patients with fragility fractures of the sacrum (FFS) was to assess existing risk factors and clinical outcomes after cement sacroplasty (CSP).

Patients And Methods: 68 patients (64 women, 4 men) with previous FFS were followed up retrospectively. CT and MRI images were used to classify fractures according to Denis et al.

[Insufficiency fractures of the spine in relation to cancellous bone density : An in vitro study].

Background: The risk of osteoporotic insufficiency fractures (Fx) at the axial skeleton increases with decreasing bone density, with an accumulation in the thoracic and thoracolumbar regions. To better understand the differential distribution of Fx along the spine, morphological and osteodensitometric studies were performed by computed tomography (CT) in the various spine sections. In addition, we aimed to clarify whether Hounsfield units (HU) found on CT examinations from other indications correlate with bone density and could be grounds for osteologic diagnosis.

Breaking strength and bone microarchitecture in osteoporosis: a biomechanical approximation based on load tests in 104 human vertebrae from the cervical, thoracic, and lumbar spines of 13 body donors.

Background: The purpose of the study was to investigate associations between biomechanical resilience (failure load, failure strength) and the microarchitecture of cancellous bone in the vertebrae of human cadavers with low bone density with or without vertebral fractures (VFx).

Methods: Spines were removed from 13 body donors (approval no. A 2017-0072) and analyzed in regard to bone mineral density (BMD), Hounsfield units (HU), and fracture count (Fx) with the aid of high-resolution CT images.

A rare case of internal hernia through the foramen of Winslow.

Internal hernia is a rare cause of intestinal obstruction. The risk of internal herniation is higher in some patients after abdominal surgery or with certain anatomical anomalies. Here, we present a case of an 80-year-old patient with incarcerated internal hernia through the foramen of Winslow due to an anatomical abnormality.

Why Insufficiency Fractures are Rarely Found in the Cervical Spine, Even with Osteoporosis.

Introduction: The human bone structure changes with an increase in age. Both material and structural properties affect bone strength. Despite the ageing of society, however, hardly any data are available on these parameters for elderly individuals.

Multifocal neuroendocrine tumour of the small bowel presenting as an incarcerated incisional hernia: a surgical challenge in a high-risk patient.

Neuroendocrine tumours (NET) of the small bowel present significant clinical challenges, such as their rate of metastasis at initial presentation, common multifocality and understaging even with gold standard imaging. Here, we present a case of a high-risk surgical patient with a complex medical history initially presenting as an acute abdomen due to an incarcerated incisional hernia. He was found at emergency laparotomy to have three small NET deposits in a 30-cm segment of incarcerated ileum which was resected.

Complex nasal reconstruction for skin cancer and posttraumatic deformity using a modified frontonasal flap - Case report.

Introduction And Importance: Reconstruction of the nasal tip is challenging, especially when large defects are associated with compromised nasal soft tissues and framework. The frontonasal flap is an axial-pattern myocutaneous flap from the glabella and nasal dorsum that allows for various modifications in flap design to cover medium sized defects of the nasal tip.

Case Presentation: A 66-year-old male patient presented with a large and ulcerated squamous cell carcinoma of the nasal tip that was associated with substantial posttraumatic damage of the nasal soft tissue envelope and cartilaginous vault of the dorsum.