The influence of fracture severity on postoperative outcome and quality of life after locking plate fixation of proximal humeral fractures.

Objective: For proximal humeral fractures open reduction und internal fixation (ORIF) with a fixed-angle plate is considered the gold standard for surgical management. However, it can lead to poor functional outcomes and is associated with postoperative complications. Therefore, the purpose of this study was to investigate the influence of fracture severity by applying a new classification (simple versus complex) on clinical outcome and quality of life after ORIF of proximal humerus fractures.

[Septic Arthritis of the Hand and Wrist].

This review article addresses the epidemiology, ethology, clinic, diagnostics and therapy of infections of the wrist and small joints of the hand.

[Infections of the Hand after Bite Injuries].

Bite injuries are common. Along with the resulting complications, they represent approximately 1-2 % of all emergency department visits. In over 75 %, the hands are affected.

Neutral or Natural? Functional Impact of the Coronal Alignment in Total Knee Arthroplasty.

Total knee arthroplasty (TKA) is a very successful procedure. The alignment in TKA has been identified as being of importance to prevent early implant failure and patient dissatisfaction. Our hypothesis was that patients with a preoperative varus deformation remaining in a slight varus alignment as their natural alignment after TKA will have superior clinical results compared with patients who are restored in neutral alignment.

Synergistic effects of HBO and PRP improve bone regeneration with autologous bone grafting.

Bone defects remain a challenge for patients and orthopaedic surgeons. Autologous transfer of cancellous bone grafts remains the standard of care. However, in recent years various osteoinductive substitute materials, such as platelet rich plasma (PRP) and hyperbaric oxygen therapy (HBO) have been shown to improve bone healing.

Treating patella fractures with a fixed-angle patella plate-A prospective observational study.

Introduction: Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate.

Monteggia-like lesions - treatment strategies and one-year results.

Introduction: The eponym "Monteggia fracture" includes various patterns of complex fracture-dislocations of the proximal ulna and radius, which are not well defined yet. They are frequently described as Monteggia-like lesions or Monteggia equivalent injuries. Until today, these injury patterns have been reported rarely.

One-year results of cemented bipolar radial head prostheses for comminuted radial head fractures.

Introduction: Comminuted radial head fractures (Mason type III) continue to pose a challenge to orthopedic surgeons. When internal fixation is not possible, radial head arthroplasty has been advocated as the treatment of choice. The purpose of this retrospective study was to evaluate clinical and radiological short-term results of patients with Mason type III radial head fractures treated with a cemented bipolar radial prosthesis.

Spinal posture and pelvic position during pregnancy: a prospective rasterstereographic pilot study.

Purpose: Despite the high prevalence of low back pain during pregnancy there is still a lack in the understanding of its aetiology. Changes of the spinal posture due to the anatomical changes of the pregnant body seem to be in part responsible for the back pain. In this pilot study we assessed the potential to accurately measure the spinal posture and pelvic position during pregnancy without any harmful radiation using a spine and surface topography system.

The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting.

One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC). The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP) in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia.

Systemic capillary leak syndrome associated with a rare abdominal and four-limb compartment syndrome: a case report.

Introduction: Systemic capillary leak syndrome is a rare and life threatening disease characterized by periodic episodes of hypovolemic shock due to leakage of plasma from the intravascular to the extravascular space. It is associated with hemoconcentration, hypoalbuminemia, and generalized edema. We report the case of a patient with idiopathic systemic capillary leak syndrome who developed an unexpected and potentially fatal abdominal and four-limb compartment syndrome.

The role of erythropoietin and bone marrow concentrate in the treatment of osteochondral defects in mini-pigs.

Background: All available treatment options for osteochondral and chondral defects do not restore hyaline cartilage and are limited to decreasing associated pain, and maintaining or improving joint function. The purpose of this study was to evaluate the potential of erythropoietin (EPO) in combination with bone marrow aspiration concentrate (BMAC) in the treatment of osteochondral defects of mini-pigs.

Methods: 14 Goettinger mini-pigs, in which a 6 × 10 mm osteochondral defect in the medial femoral condyle of both knee joints was created, were randomized into four groups: biphasic scaffold alone, scaffold with EPO, scaffold with BMAC and scaffold in combination with EPO and BMAC.

Does age affect the response of pelvis and spine to simulated leg length discrepancies? A rasterstereographic pilot study.

Purpose: The purpose of this study was to investigate age differences in the response of the spine and pelvis to simulated leg length inequalities (LLIs).

Methods: A total of 107 subjects, separated into three age groups (group 1: 20-39 years, group 2: 40-59 years, group 3: >60 years), were used to evaluate for any age effects in the response to LLIs. LLIs of +10, +20, and +30 mm were simulated with a simulation platform on both sides, and the respective changes of pelvic position (pelvic obliquity, pelvic torsion) and spinal posture (lateral deviation, surface rotation, kyphotic, and lordotic angles) were measured with a rasterstereographic system.

Concentration of platelets and growth factors in platelet-rich plasma from Goettingen minipigs.

In minipigs little is known about the concentration of growth factors in plasma, despite their major role in several patho-physiological processes such as healing of fractures. This prompted us to study the concentration of platelets and selected growth factors in plasma and platelet-rich plasma (PRP) preparation of sixteen Goettingen minipigs. Platelet concentrations increased significantly in PRP in comparison to native blood plasma.

Treatment of scaphoid waist fractures with the HCS screw.

The aim of the study was to evaluate the clinical results of the Headless Compression Screw (HCS, Synthes) when used for treatment of acute scaphoid waist fractures. The new screw design generates interfragmentary compression with use of a compression sleeve. Twenty-one patients were treated for acute scaphoid waist fractures type B2 with HCS screws.

Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate.

This biomechanical study is the first to compare 3 fixation methods-bilateral fixed-angle plate, modified anterior tension wiring, and cannulated lag screws with anterior tension wiring-in multifragmentary distal patella fractures. A T-shaped 3-part fracture simulating a multifragmentary articular distal patella fracture (AO/OTA 34-C2.2) was created in 18 human cadaver knee specimens.

Bone marrow aspiration concentrate and platelet rich plasma for osteochondral repair in a porcine osteochondral defect model.

Background: Bone marrow aspiration concentrate (BMAC) may possess a high potency for cartilage and osseous defect healing because it contains stem cells and multiple growth factors. Alternatively, platelet rich plasma (PRP), which contains a cocktail of multiple growth factors released from enriched activated thrombocytes may potentially stimulate the mesenchymal stem cells (MSCs) in bone marrow to proliferate and differentiate.

Methods: A critical size osteochondral defect (10×6 mm) in both medial femoral condyles was created in 14 Goettinger mini-pigs.

Evaluation of a novel spine and surface topography system for dynamic spinal curvature analysis during gait.

Introduction: The assessment of spinal deformities with rasterstereography can enhance the understanding, as well as can reduce the number of x-rays needed. However, to date this technique only allows measurements under static conditions. Since it would be of great value to be able to also analyze the spine in dynamic conditions, the present study evaluated a novel rasterstereographic system.

The use of biodegradable sutures for the fixation of tibial eminence fractures in children: a comparison using PDS II, Vicryl and FiberWire.

Background: Arthroscopic suture fixation of tibial eminence fractures using FiberWire is a favorable therapeutic option. The application of biodegradable material may be of advantage especially during childhood. The aim of this study was to evaluate the biomechanical properties using the biodegradable suture materials PDS II and Vicryl compared with FiberWire.

Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography.

Purpose: Leg length inequalities (LLIs) can result in an increased energy consumption, abnormal gait or osteoarthritis of the hip. In a previous study we simulated different LLIs of up to 15 mm and evaluated their effects on the pelvic position and spinal posture. We found a correlation between LLIs and resulting changes of the pelvic position.

Decreasing mortality after femoral neck fracture treated with bipolar hemiarthroplasty during the last twenty years.

Purpose: The aim of our study was to investigate trends over time in the mortality of elderly patients after femoral neck fractures treated with bipolar hemiarthroplasty.

Methods: Altogether 487 cases of femoral neck fracture treated with bipolar hemiarthroplasty were observed during a 20-year period. Mortality rates were calculated for five years postoperatively.

Biomechanical cadaver testing of a fixed-angle plate in comparison to tension wiring and screw fixation in transverse patella fractures.

Introduction: Operative treatment of patella fractures is frequently associated with implant failure and secondary dislocation which can be attributed to the employed hardware. Therefore, a 2.7 mm fixed-angle plate designed for the treatment of patella fractures was tested biomechanically against the currently preferred methods of fixation.

Cyclic long-term loading of a bilateral fixed-angle plate in comparison with tension band wiring with K-wires or cannulated screws in transverse patella fractures.

Purpose: A bilateral fixed-angle plate was biomechanically compared to the two currently preferred methods of osteosynthesis for transverse patella fractures. It was hypothesized that the new angle-stable implant would provide a secure and sustainable fracture fixation, superior to the established standard techniques.

Methods: Twenty-one identical patellae made of polyurethane foam (Sawbones(®)), osteotomized to create a transverse two-part fracture, were fixed with modified anterior tension wiring, cannulated lag screws with anterior tension wiring or bilateral polyaxial 2.