Rare primary dedifferentiated liposarcoma of the thoracic spine: A case report and literature review.

Introduction: Primary dedifferentiated liposarcomas of the spine mark a rare tumor entity.

Research Question And Case Description: We present a rare case of a primary dedifferentiated liposarcoma of the thoracic spine. A 36-year-old previously completely healthy woman presented with a sudden ascending paresthesia of both legs, persistently increasing over the course of two days before initial presentation.

Early Corrections after Failed Ankle Fracture Fixation.

Even minor residual fragment malpositioning after internal fixation of ankle fractures is associated with a worse prognosis. Frequent causes for non-anatomical reduction are fibular shortening due to comminuted fractures or poor bone quality, translational or rotational malpositioning of the distal fibula within the tibial incisura with unstable syndesmosis injuries, and inadequately addressed bony avulsions of the tibiofibular syndesmosis. After operative treatment of fracture dislocations with syndesmotic fixation, in case of complex fracture pathoanatomy, and with suspected non-anatomic reduction in postoperative radiographs, computed tomography imaging of both ankles should be performed.

When does intraoperative 3D-imaging play a role in transpedicular C2 screw placement?

Introduction: The stabilization of an atlantoaxial (C1-C2) instability is demanding due to a complex atlantoaxial anatomy with proximity to the spinal cord, a variable run of the vertebral artery (VA) and narrow C2 pedicles. We perfomed the Goel & Harms fusion in combination with an intraoperative 3D imaging to ensure correct screw placement in the C2 pedicle. We hypothesized, that narrow C2 pedicles lead to a higher malposition rate of screws by perforation of the pedicle wall.

Temporal profile of inflammatory response to fracture and hemorrhagic shock: Proposal of a novel long-term survival murine multiple trauma model.

Hemorrhagic shock (hS) interacts with the posttraumatic immune response and fracture healing in multiple trauma. Due to the lack of a long-term survival multiple trauma animal models, no standardized analysis of fracture healing referring the impact of multiple trauma on fracture healing was performed. We propose a new long-term survival (21 days) murine multiple trauma model combining hS (microsurgical cannulation of carotid artery, withdrawl of blood and continuously blood pressure measurement), femoral (osteotomy/external fixation) and tibial fracture (3-point bending technique/antegrade nail).

Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study.

Background: Tibiotalocalcaneal arthrodesis is a salvage option for severe ankle and hindfoot deformities, arthritis of the ankle and subtalar joints, avascular necrosis of the talus, failed total ankle arthroplasty, and Charcot arthropathy. This multicenter study reports clinical experience with the hindfoot arthrodesis nail (HAN) in the treatment of patients with severe ankle and foot abnormalities.

Methods: Seven participating clinics from Europe and North America recruited 38 patients who underwent ankle/subtalar arthrodesis using retrograde nailing with the HAN.

Are pentraxin 3 and transsignaling early markers for immunologic injury severity in polytrauma? A pilot study.

Background: Inflammatory-related conditions and organ failure (OF) lead to late trauma mortality. Cytokine profiles can predict adverse events and mortality, potentially guiding treatment strategies (damage control surgery versus early total care). However, the specific cytokines to predict the clinical course in polytraumatized patients are not fully identified.

Overall distribution of trauma-related deaths in Berlin 2010: advancement or stagnation of German trauma management?

Background: Trauma is the leading cause of death among children, adolescents, and young adults. The latest data from the German Trauma Registry reveals a constant decrease in trauma mortality, indicating that 11.6 % of all trauma patients in 2010 died in hospital.

Surgical intensive care unit--the trauma surgery perspective.

Purpose: This review addresses and summarizes the key issues and unique specific intensive care treatment of adult patients from the trauma surgery perspective.

Materials And Methods: The cornerstones of successful surgical intensive care management are fluid resuscitation, transfusion protocol and extracorporeal organ replacement therapies. The injury-type specific complications and unique pathophysiologic regulatory mechanisms of the traumatized patients influencing the critical care treatment are discussed.

Recurrent osteoid osteoma: interstitial laser ablation under magnetic resonance imaging guidance.

Thermal ablation has become a therapy of choice in the treatment of osteoid osteomas. To date, computed tomography has been the standard imaging modality for minimally invasive treatment regimes. We report a case of a 46-year-old man with a recurrent osteoid osteoma in the right tibial head after CT-guided drill excision and repeat treatment with laser ablation under open high-field MRI guidance.

Microcirculatory sequelae of the rotator cuff after antegrade nailing in proximal humerus fracture.

Introduction: Antegrade nailing allows a stable fixation and, thus, an early functional after treatment in proximal humerus fractures. Since the surgical procedure in antegrade humeral nailing requires a split of the supraspinatus tendon, the question arises whether the surgical approach causes microcirculatory dysfunction of the tendon.

Materials And Methods: A total of 15 consecutive patients suffering from proximal humerus fractures were enrolled.

Angular stable anterior plating following thoracolumbar corpectomy reveals superior segmental stability compared to conventional polyaxial plate fixation.

Study Design: Biomechanical in vitro testing of primary and secondary stability in 12 human thoracolumbar spinal specimens using a spine simulator.

Objective: In a corpectomy model anterior plate systems were investigated for their ability to restore spinal stability particularly focusing on the influence of angular stability, bone mineral density (BMD) and failure mode.

Summary Of Background Data: The concept of isolated anterior column reconstruction following thoracolumbar fractures using newly developed minimally invasive spine surgical techniques has attracted major clinical interest.

Initial intramuscular perfusion pressure predicts early skeletal muscle function following isolated tibial fractures.

Background: The severity of associated soft tissue trauma in complex injuries of the extremities guides fracture treatment and decisively determines patient's prognosis. Trauma-induced microvascular dysfunction and increased tissue pressure is known to trigger secondary soft tissue damage and seems to adversely affect skeletal muscle function.

Methods: 20 patients with isolated tibial fractures were included.

Image guidance in pelvic and acetabular surgery--expectations, success and limitations.

During the last decade navigation techniques in pelvic and acetabular surgery have been described. Nowadays, available techniques include CT-based navigation, 2D C-arm navigation and 3D C-arm navigation. The main indication is the navigated percutaneous SI screw fixation, but acetabular screw fixations are also reported.

Autologous bone marrow-derived cells enhance muscle strength following skeletal muscle crush injury in rats.

Insufficient post-traumatic skeletal muscle regeneration with consecutive functional deficiency continues to be a serious problem in orthopedic and trauma surgery. Transplantation of autologous muscle precursor cells has shown encouraging results in muscle trauma treatment but is associated with significant donor site morbidity. In contrast to this, bone marrow-derived (BMD) cells can be obtained without any functional deficit by puncture.

Noninvasive in vivo analysis of the human hepatic microcirculation using orthogonal polorization spectral imaging.

Background: Analysis of hepatic microvascular perfusion in humans by direct imaging has been impossible so far. Orthogonal polarization spectral (OPS) imaging represents a new technology that combines simultaneous epi-illumination of the subject with linearly polarized light and noninvasive imaging of the microcirculation by reflectance spectrophotometry. The aim of this study was to evaluate the feasibility of studying the human hepatic microcirculation by OPS imaging in vivo and to define microcirculatory parameters for physiologic conditions.

Coincidence of recurrent arthritis and Behçet's disease following anterior cruciate ligament reconstruction.

Chronic recurrent inflammation with joint effusion following anterior cruciate ligament (ACL) reconstruction is common. We report an unusual case of a patient also suffering from undiagnosed Behçet's disease. The patient had chronic recurrent joint effusions of the knee 7 years after traumatic rupture of the ACL and autologous tendon reconstruction using a hamstring tendon autograft.