Patients with Prior Craniectomy or Craniotomy Have No Increased Risk of Acute Hemorrhage after Mild Traumatic Brain Injury.

The aim of this study was to retrospectively evaluate the risk of acute hemorrhagic complications in patients after either a decompressive craniectomy or a craniotomy sustaining a recurrent mild traumatic brain injury. Furthermore, we analyze whether there is a higher risk for acute hemorrhagic complications considering patients with anticoagulation compared with patients without anticoagulation in both groups. All patients with mild traumatic brain injuries after either decompressive craniectomy or craniotomy, treated between January 2005 and December 2020 at a single level 1 trauma center, were included in this retrospective analysis.

ESTES recommendations on proximal humerus fractures in the elderly.

Purpose: The section for the skeletal trauma and sport's injuries of the European Society for Trauma and Emergency Surgery (ESTES) appointed a task force group to reach a consensus among European countries on proximal humeral fractures.

Material/methods: The task force group organized several consensus meetings until a paper with final recommendations was confirmed during the ESTES Executive Board meeting in Berlin on 25 October 2018.

Conclusion: The Recommendations compare conservative and four possible operative treatment options (ORIF, nailing, hemi- and total reverse arthroplasty) and enable the smallest common denominator for the surgical treatment among ESTES members.

Long-term results after primary augmented repair of proximal tears of the anterior cruciate ligament with the Kennedy-LAD - Does it work?

Background: The purpose of this study was to objectively evaluate the clinical functionality of the knee joint 30 years after surgical augmentation of the ACL with the "Kennedy Ligament Augmentation Device ®" (Kennedy LAD®).

Methods: The patient collective consisted of 41 patients with an average age of 59.51 years (±10.

Spine injuries in polytraumatized pediatric patients: characteristics and experience from a Level I trauma center over two decades.

Background: Spine injuries, a common component in polytrauma, are relatively rare in pediatric patients. Previous studies mainly described injuries to the cervical region, whereas information of injury patterns to the thoracic and lumbosacral region lack in the current literature. The aim of this study was to determine the incidence and characteristics of polytraumatized children and associated spine injuries in different pediatric development ages.

Retrospective analysis of emergency room thoracotomy in pediatric severe trauma patients.

Background: Although the integral role of ED thoracotomy for open cardiac massage has been extensively reviewed in adult literature, this "heroic maneuver" remains very controversial and greatly debated in children.

Methods And Results: A retrospective cohort review of emergency thoracotomies in children, performed at a European Level I trauma center between 1992 and 2008 was undertaken. Clinical manifestation, injury mechanism and surgical treatment were described, with special regard to prognostic factors and outcome.

Predictive factors influencing the outcome after gunshot injuries to the head-a retrospective cohort study.

Background: Civilian gunshot injuries to the head are relatively rare in the irenical European Union, and studies of treatment and outcomes are seldom for this region in the current literature.

Methods: A cohort of 85 patients with civilian head gunshot injuries, who were admitted to our University hospital over a period of 16 years, was reviewed retrospectively. Clinical manifestation, computed tomography scan findings, and surgical treatment were described, with special regard to prognostic factors and outcome.

Rotational and translational laxity after computer-navigated single- and double-bundle anterior cruciate ligament reconstruction.

Based on biomechanical cadaver studies, anatomic double-bundle reconstruction of the anterior cruciate ligament (ACL) was introduced to achieve better stability in the knee, particularly in respect of rotatory loads. Previously, the success of ACL reconstruction was believed to be mainly dependent on correct positioning of the graft, irrespective of the number of reconstructed bundles for which computer-assisted surgery was developed to avoid malpositioning of the tunnel. The aim of the present study is to compare rotational and translational stability after computer-navigated standard single-bundle, and anatomic double-bundle ACL reconstruction.

Ultrasonographic guidance improves the success rate of interscalene brachial plexus blockade.

Background And Objectives: The use of ultrasonography in regional anesthetic blocks has rapidly evolved over the past few years. It has been speculated that ultrasound guidance might increase success rates and reduce complications. The aim of our study is to compare the success rate and quality of interscalene brachial plexus blocks performed either with direct ultrasound visualization or with the aid of nerve stimulation to guide needle placement.

Biomechanical analysis of fracture healing in guinea-pigs.

To validate the hypothesis that healing of fractures can be accelerated by oral administered L-arginine a guinea-pig model was chosen. A diaphyseal defect fracture was established in the right femur of each of the 32 small animals and stabilized. According to randomization groups the oral administration was realized (2 or 4 weeks medication / solvent).

Unplanned 10-year retention of an external fixator for a proximal tibial fracture.

A 45-year-old homeless male patient did not return for follow-up for routine removal 72 days after an external fixator had been placed for a grade II open fracture of the proximal tibia. Ten years later, he was accidentally referred to our institution for newly incurred fractures of the femoral neck on the same side and also for an opposite-side medial malleolus fracture. The patient was still homeless, with signs of poor personal hygiene, but the original external fixator was in place.

The influence of oral L-arginine on fracture healing: an animal study.

Background: The known biological activities of nitric oxide suggest a role in bone healing. We hypothesized that L-arginine, a source of nitric oxide, expedites the healing process of stabilized diaphyseal defects.

Type Of Study: Prospective blinded animal study.

Measuring the pressure pattern of the joint surface in the uninjured knee.

Purpose: Testing an applicable intraoperative system for measuring surface pressure in knee joints, simulating as accurately as possible operating theatre conditions.

Type Of Study: Cadaver study.

Methods: Pressure probes were introduced into the knee joints medially and laterally (K 6900 quad probes) in five cadavers, providing real-time data with computerized data recording (K-scan system, manuf.

Cyclops and cyclopoid formation after anterior cruciate ligament reconstruction: clinical and histomorphological differences.

Prospectively, 119 patients were pursued clinically and by follow-up-arthroscopy for the occurrence of a "cyclops syndrome" after ACL reconstruction with a patellar tendon autograft, augmented by LAD. Twenty-one patients showed nodular formations. Ten of these (group 1) developed early clinical evidence of a "cyclops syndrome" with a mean extension deficit of 19 degrees before follow-up-arthroscopy, on average 5.

Braided polypropylene augmentation device in reconstructive surgery of the anterior cruciate ligament: long-term clinical performance of 594 patients and short-term arthroscopic results, failure analysis by scanning electron microscopy, and synovial histomorphology.

Long-term clinical results and short-term arthroscopic and microscopic findings from two augmented reconstruction procedures for the ruptured anterior cruciate ligament are reported. The braided polypropylene ligament augmentation device (Kennedy model) was used with temporary double-end fixation in 279 patients to augment the attachment of the anterior cruciate ligament after acute proximal rupture and in 315 patients to augment a bone-tendon-bone autograft, mainly after chronic instability. Check arthroscopy was performed and the metal fixation hardware was removed after a mean of 11 months.

Measurement of stress-strain relationship and stress relaxation in various synthetic ligaments.

In an experimental study various synthetic augmentation devices for knee ligament surgery were tested in a servo-mechanical universal tensile testing machine under uniaxial loading. Two tests were done to elucidate the mechanical behaviour: stress relaxation and stress-strain relationship. Regarding the point of failure or rupture, the strongest ligament was the Trevira at 1800 N, followed by the 8-mm-wide Kennedy LAD at 1720 N.

Synthetic augmented repair of proximal ruptures of the anterior cruciate ligament. Long-term results of 66 patients.

The long-term results (five-to eight-year follow-up evaluation) of 66 patients with high proximal ruptures of the anterior cruciate ligament (ACL) who were treated operatively are presented in a retrospective and uncontrolled study. Technique of surgery was the reinsertion of the ACL in a multiple suture loop technique, augmented with Kennedy-LAD (ligament augmentation device) on over the top route in temporary double-end fixation. This technique was used in patients with proximal rupture of the anterior cruciate ligament found at arthroscopy.

[Importance of measuring stability and function in knee ligament surgery].

To compare results in knee ligament surgery between different surgeons and between different centers, too, is difficult. We investigated if an improvement can be achieved by using easy to handle methods of measurement. The long-term results of 180 patients who underwent ACL surgery between 1983 and 1986 (n = 191) were evaluated.

[Control arthroscopy following alloplastically augmented anterior cruciate ligament reconstruction].

97 patients who had their ACL replaced with ligamentum patellae transplant augmented with LAD were reviewed arthroscopically after an average period of 9.1 months (4-22 months). 52 patients whose metal implants have been removed are virtually symptom-free clinically (no swelling, stable knee joint, extension limitation of less than 5 degrees, less than 10 degrees limitation of flexion).