Arthroscopic Screw Fixation Technique for Transverse Glenoid Fractures.

Transverse glenoid fractures with a cranial coracoglenoidal fragment (Ideberg type III) can lead to detrimental post-traumatic sequelae. Open surgery requires an extensive surgical approach. Arthroscopic procedures are highly challenging with respect to both fracture reduction and screw osteosynthesis.

Epicondylopathia humeri radialis.

Background: Lateral epicondylitis is a common orthopaedic condition often massively restricting the quality of life of the affected patients. There are a wide variety of treatment options - with varying levels of evidence.

Method: The following statements and recommendations are based on the current German S2k guideline Epicondylopathia radialis humeri (AWMF registry number: 033 - 2019).

The influence on resection line during supracervical hysterectomy: physiological extension of endometrial cells in the cervix uteri.

Objective: A straight resection of corpus uteri using the sacrouterine ligament as landmark is a common method during supracervical hysterectomy. Subsequent spotting rates of up to 25% suggest the existence of residual endometrial glands in the remaining cervical tissue, casting doubt on the landmark qualities of the sacrouterine ligament. Fifty-one females who underwent total laparoscopic hysterectomy for benign diseases were investigated.

Management of shoulder instability: the current state of treatment among German orthopaedic surgeons.

Introduction: The aim of this study was to evaluate the current state of treatment in traumatic anterior shoulder dislocation in Germany and to detect changes over the last 12 years.

Methods: Seven hundred ninety-six trauma and/or orthopaedic departments were found in the German hospital directory 2012. The websites of each department were searched for the email address of the responsible shoulder surgeon (if applicable) or the head of the department.

Current status of ACL reconstruction in Germany.

Introduction: Reconstruction of the anterior cruciate ligament (ACL) is characterized by a variety of possibilities concerning its implementation. Different choices for grafts, fixation methods and tunnel positioning, as well as diverse technical tools are available and have clinical significance. Besides specific pre- and post-operative procedures, different indications for surgery and further surgeon-/clinic-related factors add variability to the treatment.

The Coracohumeral Distance in Shoulders With Traumatic and Degenerative Subscapularis Tendon Tears.

Background: A reduced coracohumeral distance (CHD) is thought to be responsible for subcoracoid impingement. This only accounts for degenerative tendon tears. In traumatic tears, the subcoracoid space should be normal.

Press-fit fixation using autologous bone in the tibial canal causes less enlargement of bone tunnel diameter in ACL reconstruction--a CT scan analysis three months postoperatively.

Background: Bone tunnel enlargement is a phenomenon present in all anterior cruciate ligament (ACL)- reconstruction techniques. It was hypothesized that press-fit fixation using a free autograft bone plug reduces the overall tunnel size in the tibial tunnel.

Methods: In a prospective cohort study twelve patients who underwent primary ACL reconstruction using an autologous quadriceps tendon graft and adding a free bone block for press-fit fixation (PF) in the tibial tunnel were matched to twelve patients who underwent ACL reconstruction with a hamstring graft and interference screw fixation (IF).

Fluoroscopic control allows for precise tunnel positioning in MPFL reconstruction.

Purpose: In MPFL reconstruction, anatomical graft positioning is required to restore physiological joint biomechanics and patellofemoral stability. Considerable rates of non-anatomical femoral tunnel placement exist. The purpose of this study was to analyse whether intraoperative fluoroscopic control is applicable to reduce variability of femoral tunnel positioning.

Differences in acromial morphology of shoulders in patients with degenerative and traumatic supraspinatus tendon tears.

Purpose: Distinct characteristics of acromial morphology seem to be one factor for the development of degenerative supraspinatus tendon tears. Thus, it is questionable whether patients with traumatic tendon tears also present these parameters. The hypothesis of the present study was that the acromial morphology of patients with degenerative supraspinatus tendon tears differs from patients with traumatic tears.

Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report.

Introduction: Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described.

Soft tissue injury of the shoulder after single non-dislocating trauma: prevalence and spectrum of intraoperative findings during shoulder arthroscopy and treatment results.

Background And Purpose: The purpose of our study was to present the spectrum and prevalence of intraarticular lesions in patients with shoulder pain after a single non-dislocating shoulder trauma and to evaluate the clinical results according to pathology and workers' compensation status.

Methods: Sixty consecutive patients (61 shoulders) with shoulder pain following a single non-dislocating shoulder trauma had shoulder arthroscopy. The indication for surgery was either persistent pain for 3 months or longer after trauma and/or an intraarticular lesion on MRI.

Variability of tunnel positioning in ACL reconstruction.

Introduction: Since tunnel positioning is one of the key factors in anterior cruciate ligament (ACL) reconstruction and the variability of tunnel positioning in ACL reconstruction has so far never been analyzed, the objective of this study was to determine the inter- and intra-observer variability of tibial and femoral tunnel positioning in ACL reconstruction.

Materials And Methods: In an operating room setup, 13 surgeons were asked to identify the tunnel positions in one and the same ACL-deficient cadaver knee. Using a fluoroscopic based ACL navigation system, tunnel positions were digitally measured in a test/re-test scenario.

Moderate value of non-contrast magnetic resonance imaging after non-dislocating shoulder trauma.

Purpose: The purpose of the present study was to determine the value of shoulder magnetic resonance imaging (MRI) obtained in the community setting interpreted by musculoskeletal radiologists in patients with shoulder pain initiated by a single non-dislocating shoulder trauma.

Methods: In 56 of 61 consecutive patients who underwent shoulder arthroscopy due to pain after a single non-dislocating shoulder trauma, the data sets of non-contrast MRI were complete. These were retrospectively interpreted by three radiologists specialized on musculoskeletal MRI who were blinded for patients' history and who did not have access to the reports of arthroscopy.

Variability of tunnel positioning in fluoroscopic-assisted ACL reconstruction.

Purpose: Intraoperative fluoroscopy has been proposed as a feasible method to improve the accuracy of anatomical tunnel positioning. However, it has so far not been determined, whether this technique reduces the variability of tunnel positioning in a clinical set-up. Therefore, the purpose of this study was to determine the variability of tunnel positions applying intraoperative fluoroscopy.

Variability of landmark acquisition affects tunnel calculation in image-free ACL navigation.

Purpose: The purpose of this study was to determine the inter- and intraobserver variability of intraarticular landmark identification for tunnel position calculation in image-free anterior cruciate ligament (ACL) navigation.

Methods: In a test/retest scenario, thirteen experienced ACL surgeons (>50 reconstructions year) experienced in image-free ACL navigation were asked to identify the landmarks required for image-free ACL navigation in the same cadaver knee. Landmark positions were registered using a fluoroscopic ACL navigation system.

Low inter- and intraobserver variability allows for reliable tunnel measurement in ACL reconstruction using the quadrant method.

Introduction: Correct anatomic tunnel positions are essential in anterior cruciate ligament (ACL) reconstruction. To establish recommendations for tunnel positioning based on anatomical findings and to compare tunnel positions with clinical results, different radiological measurement methods as the quadrant method exist. Comparing the data of different observers requires the validation of the reliability of measurement methods.

Current state of treatment of acute acromioclavicular joint injuries in Germany: is there a difference between specialists and non-specialists? A survey of German trauma and orthopaedic departments.

Purpose: The purpose of this study was to evaluate currently preferred treatment strategies as well as the acceptance of new arthroscopic techniques among German orthopaedic surgeons. We assumed that surgeons specialized in shoulder surgery and arthroscopy would treat acute acromioclavicular joint dislocations different to non-specialized surgeons.

Methods: Seven hundred and ninety-six orthopaedic and/or trauma departments were found through the German hospital directory of 2012.

High complication rate following distal biceps refixation with cortical button.

Purpose: There are several methods for the refixation of the distal biceps tendon which show a variable complication rate. The aim of the present study was to evaluate the clinical outcome and complication rate after distal biceps repair in cortical button technique.

Methods: Clinical results, complications, strength of elbow flexion and supination and radiological evidence of heterotopic ossification in patients reporting persistent pain were evaluated in 27 male patients after an average of 36.

Correlation of acromial morphology with impingement syndrome and rotator cuff tears.

Background And Purpose: Indications for acromioplasty are based on clinical symptoms and are generally supported by typical changes in acromial morphology on standard radiographs. We evaluated 5 commonly used radiographic parameters of acromial morphology and assessed the association between different radiographic characteristics on the one hand and subacromial impingement or rotator cuff tears on the other.

Patients And Methods: We measured acromial type (Bigliani), acromial slope (AS), acromial tilt (AT), lateral acromial angle (LAA), and acromion index (AI) on standard radiographs from 50 patients with full-thickness supraspinatus tendon tears, 50 patients with subacromial impingement, and 50 controls without subacromial pathology.

Administration of fibrinogen concentrate in exsanguinating trauma patients is associated with improved survival at 6 hours but not at discharge.

Background: Despite poor evidence and high costs, fibrinogen concentrate (FC) represents one of the most frequently used hemostatic agents in exsanguinating trauma. The aim was to assess whether the administration of FC in severely injured patients was associated with improved outcomes.

Methods: Patients documented in the Trauma Registry of the German Society for Trauma Surgery (primary admissions, Injury Severity Score [ISS] ≥16) who had received FC during initial care between emergency department (ED) arrival and intensive care unit admission (FC+) were matched with patients who had not received FC (FC-).

Epidemiology of extremity injuries in multiple trauma patients.

Background: Previous studies have suggested that distinct extremity injuries are associated with worse outcome following major trauma. The aim of the present study was to determine epidemiological data of extremity injuries in multiple trauma patients with respect to prevalence, injury pattern, specific mechanisms of injury and their impact on mortality.

Methods: The Trauma Register of the German Society for Trauma Surgery anonymously documents data on critically injured patients since 1993.

Acromial morphology in patients with calcific tendinitis of the shoulder.

Purpose: The purpose of this study was to evaluate whether the morphology of the acromion in calcific tendinitis differs from controls without subacromial pathology and matches subacromial impingement.

Methods: Digital radiographs of 150 shoulders were evaluated with the open source DICOM-Viewer OsiriX. 50 patients had symptomatic calcific tendinitis of the shoulder, 50 had subacromial impingement without calcifications or rotator cuff tears, 50 with bruised shoulder that were previously asymptomatic served as controls.

Excellent results of lesser tuberosity transfer in acute locked posterior shoulder dislocation.

Purpose: The aim of the present study was to evaluate the clinical and radiological results of lesser tuberosity transfer in acute locked posterior shoulder dislocation with a humeral head defect between 25 and 45 %.

Methods: Clinical and radiological results of seven patients with locked posterior shoulder dislocation with a humeral head defect between 25 and 45 % which were managed with a modification of the McLaughlin procedure within 14 days after injury were evaluated retrospectively after a mean follow-up of 41 months.

Results: All shoulders remained stable.