[Diagnosis of upper arm, elbow, and proximal lower arm fractures].

The complex anatomy of the elbow joint enables a wide range of movement and complex functions in everyday and professional life. Typical injuries of this joint include a variety of different pathologies. Due to overlaying structures in plain radiographs, diagnosis of injuries to the elbow joint places high demands on the treating physicians and often needs further diagnostic imaging.

Four-Strand Core Suture Improves Flexor Tendon Repair Compared to Two-Strand Technique in a Rabbit Model.

Introduction. This study was designed to investigate the influence of the amount of suture material on the formation of peritendinous adhesions of intrasynovial flexor tendon repairs. Materials and Methods.

The effect of a collagen-elastin matrix on adhesion formation after flexor tendon repair in a rabbit model.

Purpose: The outcome of flexor tendon surgery is negatively affected by the formation of adhesions which can occur during the healing of the tendon repair. In this experimental study, we sought to prevent adhesion formation by wrapping a collagen-elastin scaffold around the repaired tendon segment.

Methods: In 28 rabbit hind legs, the flexor tendons of the third and fourth digits were cut and then repaired using a two-strand suture technique on the fourth digit and a four-strand technique on the third digit.

Vascularized Hypothenar Fat Pad Flap in Revision Surgery for Carpal Tunnel Syndrome.

Objective: To evaluate the results of the hypothenar fat pad flap in revision surgery for carpal tunnel syndrome (CTS).

Patients And Methods: We retrospectively analyzed 18 consecutive patients (14 women, 4 men) who had recurrent CTS. The average age was 61 years.

Minimum cement volume required in vertebral body augmentation--A biomechanical study comparing the permanent SpineJack device and balloon kyphoplasty in traumatic fracture.

Background: Minimally invasive treatment of vertebral fractures is basically characterized by cement augmentation. Using the combination of a permanent implant plus cement, it is now conceivable that the amount of cement can be reduced and so this augmentation could be an attractive opportunity for use in traumatic fractures in young and middle-aged patients. The objective of this study was to determine the smallest volume of cement necessary to stabilize fractured vertebrae comparing the SpineJack system to the gold standard, balloon kyphoplasty.

Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

Introduction: The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned.

Angular stable multiple screw fixation (Targon FN) versus standard SHS for the fixation of femoral neck fractures.

Objective: Head-preserving fracture care especially for the elderly may be complicated by acetabular screw penetration, cut out, delayed union or femoral head necrosis. The following comparative study analyses whether a new angular stable device may overcome these shortcomings.

Material And Methods: The Targon FN plate (BBraun/Aesculap, Germany) employs up to four angular stable telescoping screws for the fixation of the head fragment.

Intramedullary nail versus volar plate fixation of extra-articular distal radius fractures. Two year results of a prospective randomized trial.

Background: Intramedullary techniques for stabilization of displaced distal radius fractures are now available. Purported benefits include limited soft tissue dissection while affording sufficient stability to allow early wrist motion. The primary null hypothesis of this randomized trial is that there is no significant difference with respect to functional outcome, pain and disability between patients treated with either 2.

Antithrombin reduces inflammation and microcirculatory perfusion failure in closed soft-tissue injury and endotoxemia.

Background: Closed soft-tissue trauma leads to activation of the coagulation cascade and is often complicated by systemic inflammation and infection. Previous investigations have shown potent anti-inflammatory properties of antithrombin. We herein report on the action of antithrombin on skeletal muscle injury in experimental endotoxemia.

A pan-caspase inhibitor reduces myocyte apoptosis and neuropathic pain in rats with chronic constriction injury of the sciatic nerve.

Background: Chronic constriction injury is a widely used model for neuropathic pain in rats. It presents with symptoms resembling human neuropathic pain, such as spontaneous pain, hyperalgesia, and allodynia. Recently, myocyte apoptosis was found in neuropathic rats as a possible promoter of pain and motor dysfunction.

Reliability and consequences of intraoperative 3D imaging to control positions of thoracic pedicle screws.

Introduction: The insertion of thoracic pedicle screws (T1-T10) is subject to a relevant rate of malplacement. The optimum implantation procedure is still a topic of controversial debate. Currently, a postoperative computed tomography is required to evaluate the screw positions.

Hook plate fixation for acromioclavicular joint separations restores coracoclavicular distance more accurately than PDS augmentation, however presents with a high rate of acromial osteolysis.

Introduction: Hook plate fixation of acromioclavicular (AC) joint separations carries the disadvantage of compulsory implant removal, occasional implant fatigue and secondary loss of reduction. This study compares the clinical and radiological outcome of a new polyaxial angular stable hook plate (HP) with absorbable polydioxansulfate (PDS) sling.

Materials And Methods: Between 2002 and 2009, out of a consecutive series of 81 patients with symptomatic Rockwood type V lesions 52 patients received clinical and radiographic follow-up (HP: n = 27; PDS: n = 25).

Ebselen reduces inflammation and microvascular perfusion failure after blunt skeletal muscle injury of the rat.

Background: Soft tissue trauma induces an local inflammatory response and yields a microvascular perfusion failure due to trauma-induced oxidative stress. Using high-resolution multifluorescence microscopy, we herein report on the efficiency of treatment with the oxygen radical scavenger ebselen to improve compromised perfusion of traumatized muscle tissue and to minimize secondary tissue damage.

Methods: By using a pneumatically driven computer-controlled impact device, closed soft tissue trauma of the left hind limb was induced in pentobarbital-anesthetized rats that received either ebselen (30 mg/kg body weight, intraperitoneally) or equal volumes of the vehicle dimethyl sulfoxide (DMSO).

Genetic control of leucocyte--endothelial cell interaction in collagen-induced arthritis.

Objective: Despite considerable work on defining disease pathways, several aspects of collagen-induced arthritis (CIA) remain poorly defined, in particular those contributing to the initiation phase of the disease. It is thought that in CIA the activation of circulating leucocytes, their interaction with the endothelial lining followed by subsequent transendothelial migration and infiltration into tissue represents the first and determining step in a complex sequence of processes mediating tissue injury. In this study we attempted to define the genetic basis of this stage of disease using genetic linkage studies, in-vivo imaging and expression profiling.

Intraoperative position determination of bone cement trocars by 3-dimensional imaging in patients with osteoporotic vertebral fractures.

Study Design: A prospective diagnostic study to evaluate the use of intraoperative 3-dimensional (3D) imaging.

Objective: To evaluate the accuracy of an intraoperative 3D imaging predicting trocar positions in osteoporotic fractured vertebral bodies before cement injection.

Summary Of Background Data: Malpositioned needles in vertebroplasty and kyphoplasty increase the risk of extravertebral cement leakage and the associated complications.

[Fixation of distal radial fractures with the Targon DR nail].

Objective: Anatomic restoration and intramedullary fixation of distal radial fractures using a hybrid between plate and nail (Targon DR). The technique provides a less invasive operative approach from radial.

Indications: Extraarticular fractures of the distal radius with dorsal comminution.

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.

Benefit and accuracy of intraoperative 3D-imaging after pedicle screw placement: a prospective study in stabilizing thoracolumbar fractures.

Internal fixation is the established dorsal standard procedure for the treatment of thoracolumbar fractures. The main problem of the procedure is the false positioning of the pedicle screws. The exact determination of pedicle screws has up to now only been possible through postoperative computed tomography.

Sublethal trauma model with systemic endotoxemia for the study of microcirculatory disorders after the second hit.

Background: Experimental models often cannot simulate the clinical situation in traumatized patients where the septic second hit finally leads to multiple organ dysfunction syndrome and death. We present an experimental animal model combining initial standardized soft tissue trauma to the left hindlimb of rats with subsequent sublethal systemic endotoxemia.

Materials And Methods: This study characterizes the influence of trauma and systemic endotoxemia on nutritive blood flow, inflammatory cell-cell interaction and tissue cell integrity in the traumatized region.

Angular and sliding stable antegrade nailing (Targon PH) for the treatment of proximal humeral fractures.

Introduction: The optimal surgical treatment for displaced proximal humeral fractures continues to be controversial. Different treatment modalities are available. Mechanical implant-related problems, however, and the preservation of the biological integrity of the humeral head remain unsolved.

Activated protein C reduces tissue hypoxia, inflammation, and apoptosis in traumatized skeletal muscle during endotoxemia.

Objective: Extensive surgical trauma leads to activation of the coagulation cascade and is often complicated by systemic inflammation and infection. Activated protein C, a natural coagulatory inhibitor, was recently shown to reduce mortality in septic patients. We herein report on the actions of activated protein C on skeletal muscle injury in experimental endotoxemia.