Partial weight-bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model.

Purpose: The aim of this study was to investigate the influence of medial meniscus posterior root avulsion (MMPRA) before and after surgical treatment on the biomechanics of the knee joint, including suture repair forces during daily and crutch-assisted gait movements.

Methods: MMPRA were investigated in eight human cadaver knee joint specimens by a dynamic knee joint simulator with daily (normal gait, gait with additional rotational movement, standing up, sitting down) and rehabilitation-associated movements (crutch-assisted gait with limited flexion range of motion [30°] and 30% [toe-touch weight-bearing, TTWB] and 50% of body weight [partial weight-bearing, PWB]) with simulated physiologic muscle forces. Each specimen was tested in intact, torn and repaired (transtibial suture) state.

Do we have to redefine type B-fractures of the rib cartilage?

Objectives: Aim of this work was the evaluation and validation of the AO/OTA classification of the anterior chest wall, here especially for the rib cartilage.

Methods: Study design was a retrospective analysis of patients who were hospitalized with fractures of the thoracic wall in the years 2010-2016. This resulted in a collective of n = 124 patients.

[The preventive flexion osteotomy at the head of the tibia].

We present the case of a preventive tibial plateau flexion osteotomy in an adolescent patient who had a reduced posterior slope of the tibial plateau. The patient was asymptomatic and without instability at the time. However, magnetic resonance imaging (MRI) showed a dysmorphic posterior cruciate ligament, which was interpreted as an indication for osteotomy.

The Surgical Treatment of a Bimalleolar Ankle Fracture - Tips and Tricks.

The ankle fracture - the most common fracture of the lower extremities - is usually due to pro- and supination trauma and is commonly challenging for junior doctors of orthopaedics and traumatology. To accomplish sufficient surgical results, it is necessary to have surgical experience, not only because of the surrounding fragile soft tissue, but also due to the specific anatomical structures surrounding the ankle joint and the postsurgical biomechanical stress to osteosynthesis. In the following video, the most relevant steps of surgery as well as some useful tips and tricks are mentioned.

[Intraoperative navigation of a distraction injury of the thoracic spine with very severe scoliotic alterations].

The case of a 43-year-old male patient is described, who suffered several injuries due to a traffic accident, including a distraction injury to the thoracic spine. A specific feature of this case was the existing spondylodesis with material fracture and secondary loss of reduction. Due to this, the guidewires of the pedicle screws were placed in a navigation pattern in the absence of adjustable pedicles and an abnormal screw corridor.

Long-Term Outcomes Following Single-Stage Reamed Intramedullary Exchange Nailing in Apparently Aseptic Femoral Shaft Nonunion with Unsuspected Proof of Bacteria.

The aim of this study was to evaluate detection rates and risk factors for unsuspected proof of bacteria, as well as clinical and radiologic outcomes following femoral shaft nonunion without clinical signs of infection treated by a single-stage surgical revision procedure including reamed intramedullary exchange nailing. A retrospective cohort study was performed in a European level I trauma center between January 2015 and December 2022. Fifty-eight patients were included who underwent reamed intramedullary exchange nailing as a single-step procedure for surgical revision of posttraumatic diaphyseal femoral nonunion without any indications of infection in medical history and without clinical signs of local infection.

Comparison of In Vivo Stiffness of Tendons Commonly Used for Anterior Cruciate Ligament Reconstruction - A Shear Wave Elastography Study.

Rationale And Objectives: There are currently no studies investigating the in vivo stiffness of the most commonly used autografts for anterior cruciate ligament reconstruction (ACLR) using Shear wave elastography (SWE). We hypothesize that there are differences regarding the elastic properties between the three tendons commonly used for ACLR and that they are influenced by patient-related factors.

Materials And Methods: 80 healthy subjects (25 females, 55 males, age: 25.

[Double-Level De-Rotational Osteotomy of the Knee].

Derotational osteotomies of the proximal tibia and distal femur are a common surgical treatment option in patients with a congenital or posttraumatic torsional deformity. Clinically, these patients present with isolated anterior knee pain alone or in in combination with patellofemoral instability. Since the combination of femoral and tibial deformity is common (quotation Cooke), a combined surgical treatment is needed for these cases.

[Treatment of Permanent Patellar Dislocation in Flexion by Patellar Osteotomy Combined with Modified Trochleoplasty and Tibial Tubercle Medialisation].

Patellar dislocations in flexion, which occurs permanently with every movement, is the most serious manifestation of patellofemoral malalignment. Surgical approaches to correct this problem have been mostly unsuccessful. In a new therapeutic approach, the concave posterior surface of the patella, which slides on the hypoplastic lateral condyle as if guided by splints, is seen as the main pathology.

Combined Odontoid (C2) and Atlas (C1) Fractures in Geriatric Patients: A Systematic Review and Treatment Recommendation.

Study Design: Systematic review.

Objective: The aim of this study was to conduct a systematic overview of the pathogenesis and the treatment options of combined odontoid and atlas fractures in geriatric patients.

Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science databases for articles published until February 2021 dealing with combination fractures of C1 and C2 in geriatric patients.

[The pararectus approach: surgical procedure for acetabular fractures].

Objective: The pararectus approach was rediscovered several years ago for pelvic surgery and described as an alternative approach especially for the treatment of acetabular fractures of the anterior column involving the quadrilateral plate.

Indications: For optimal visualization of acetabular fractures involving the quadrilateral plate, fractures of the anterior wall and anterior column, anterior column/posterior hemitransverse fractures, and fractures with central impression of dome fragments, the pararectus approach has proven to be a useful access.

Contraindications: The pararectus approach is not used for posterior column fractures, posterior wall fractures, combined posterior wall and posterior column fractures, transverse fractures with displaced posterior column or in combination with posterior wall fractures, and T‑fractures with displaced posterior column or in combination with posterior wall fractures.

Radial head and neck fractures in children and adolescents.

Background: Radial head and neck fractures are a rare entity in pediatric patients. Due to specific characteristics of the blood supply and remodeling potential, the correct diagnosis and initiation of appropriate therapy are crucial for the outcome. Therefore, the aim of this retrospective observational study was to present the outcome of a series of pediatric patients with radial head and neck fractures.

Double-level torsional osteotomy a treatment for the 'inwardly pointing knee' syndrome.

Introduction: A 'inwardly pointing knee' syndrome is a combined torsional deformity with increased femoral internal and tibial external torsion. After clinical and radiological verification of the torsional deformity and unsuccessful conservative therapy approach, a combined (double level) torsional osteotomy of femur and tibia might be the appropriate treatment. Here, we present the diagnostic algorithms, treatment, and outcome of combined torsional osteotomies of femur and tibia.

Biomechanical comparison of acetabular fracture fixation with stand-alone THA or in combination with plating.

Purpose: A common surgical treatment in anterior column acetabular fractures with preexisting osteoarthritis is THA, which is commonly combined with plate osteosynthesis. Implantation of a solitary revision cup cranially fixed to the os ilium is less common. The purpose of this study was to compare the stabilization of anterior column acetabular fractures fixed with a cranial socket revision cup with flange and iliac peg or with a suprapectineal plate osteosynthesis combined with an additional revision cup.

The role of low-grade infection in the pathogenesis of apparently aseptic tibial shaft nonunion.

Purpose: Aim of this study was to determine the rate of low-grade infection in patients with primarily as aseptic categorized tibial shaft nonunion and lack of clinical signs of infection.

Methods: In a retrospective study between 2006 and 2013, all patients who underwent revision surgery for treatment of tibial shaft nonunion without clinical evidence of infection were assessed. Bacterial cultures harvested during nonunion revision, C-reactive protein (CRP) and/or white blood cell (WBC) values at hospital admission, outcome, and epidemiological data were analyzed.

Complement Factor C5a Inhibits Apoptosis of Neutrophils-A Mechanism in Polytrauma?

Life-threatening polytrauma results in early activation of the complement and apoptotic system, as well as leukocytes, ultimately leading to the clearance of damaged cells. However, little is known about interactions between the complement and apoptotic systems in PMN (polymorphonuclear neutrophils) after multiple injuries. PMN from polytrauma patients and healthy volunteers were obtained and assessed for apoptotic events along the post-traumatic time course.

Early biomechanical outcome in patients with acetabular fractures treated using the pararectus approach: a gait and stair climb analysis study.

Purpose: Patients with surgically treated acetabular fractures using extensive dissection of hip muscles demonstrate an incomplete biomechanical recovery and limited joint mobility during movement. The purpose of this study was to evaluate the early biomechanical outcome in a series of patients with acetabular fractures treated using the less invasive anatomical pararectus approach.

Methods: Eight patients (48 ± 14 years, BMI 25.

The Pararectus Approach in Acetabular Surgery: Radiological and Clinical Outcome.

Objectives: To evaluate radiological fracture reduction and clinical results using the pararectus approach in complex acetabular fractures involving the anterior column.

Design: Retrospective database analysis of prospectively collected data.

Setting: Level 1 trauma center.

Functional immune monitoring in severely injured patients-A pilot study.

After severe trauma, the resulting excessive inflammatory response is countered by compensatory anti-inflammatory mechanisms. The systemic inflammatory response to trauma enhanced by inappropriately timed surgical second hits may be detrimental for the patient. On the other hand, overwhelming anti-inflammatory mechanisms may put patients at increased risk from secondary local and systemic infections.

Alcohol‑induced attenuation of post‑traumatic inflammation is not necessarily liver‑protective following trauma/hemorrhage.

Due to their high prevalence, blunt chest trauma (TxT) and hemorrhagic shock have a significant influence on the outcomes of trauma patients, causing severe modulations of the immune system and high mortality rates. Alcohol consumption in trauma patients has a high clinical impact. Studies investigating the timing of alcohol intoxication prior to trauma are limited, although there are two typical scenarios regarding alcohol consumption: Acute ('drink and drive scenario') and sub‑acute ('evening binge drinking').