Surgical stabilisation of rib fractures in non-ventilated patients: a retrospective propensity-matched analysis using the data from the trauma registry of the German Trauma Society (TraumaRegister DGU).

Purpose: Severe thorax trauma including multiple rib fractures and flail chest deformity are leading causes of death in trauma patients. Increasing evidence supports the use of surgical stabilisation of rib fractures (SSRF) in these patients. However, there is currently a paucity of evidence for its use in non-ventilator-dependent patients.

Bilateral Iliosacral and Transsacral Screws Are Biomechanically Favorable and Reduce the Risk for Fracture Progression in Fragility Fractures of the Pelvis-A Finite Element Analysis.

(1) Background: The incidence of fragility fractures of the pelvis (FFP) has increased significantly over the past decades. Unilateral non-displaced fractures, defined as FFP II, are the most common type of fracture. When conservative treatment fails, surgical treatment is indicated.

Treatment of Proximal Humeral Fractures in Older Patients During COVID-19 Pandemic in Germany.

Purpose: The COVID-19 pandemic had a severe influence on the entire health sector. Until today, the effect of a SARS-CoV-2 infection on older patients with a proximal humeral fracture (PHF) is unknown. This study examined the following questions: Did the incidence of PHF of older people in Germany vary during the pandemic? Did the treatment change between the lockdown and non-lockdown periods? Was a SARS-CoV-2 infection associated with a worse outcome?

Methods: Retrospective claims data of the BARMER health insurance were analysed.

Stress radiography of medial knee instability provides a reliable correlation with the severity of injury and medial joint space opening-A robotic biomechanical cadaveric study.

Purpose: The medial collateral ligament (MCL), and posterior oblique ligament (POL) are the primary valgus stabilisers of the knee, and clinical examinations in grading valgus instability can be inherently subjective. Stress radiography of medial-sided knee injuries provides objective diagnosis and was analysed in this study. We hypothesised that (1) medial joint space opening would increase cutting the superficial MCL (sMCL), POL and anterior cruciate ligament (ACL); (2) isolated deep MCL (dMCL) injury would not increase medial joint space opening; (3) medial joint space opening would increase at higher flexion angles.

Biology-inspired dynamic microphysiological system approaches to revolutionize basic research, healthcare and animal welfare.

The regular workshops held by the Center for Alternatives to Animal Testing (CAAT) on biology-inspired microphysiological systems (MPS) taking place every four years, have become a reliable measure to assess fundamental scientific, industrial and regulatory trends for translational science in the MPS-field from a bird's eye view. The 2023 workshop participants at that time concluded that the technology as used within academia has matured significantly, underlined by the broad use of MPS and the steadily increasing number of high quality research publications - yet, broad industry adoption of MPS has been slow, despite strong interest. Academic research using MPS primarily aims to accurately recapitulate human biology in MPS-based organ models in areas where traditional models have been lacking key elements of human physiology, thereby enabling breakthrough discoveries for life sciences.

[Which diagnostic tests are indicated in the emergency department after trauma to the cervical spine?].

Injuries to the cervical spine are a diagnostic challenge as, although they are rare in relation to the overall population, they should not be overlooked under any circumstances. This article presents the diagnostic procedure in the emergency department, starting with the patient's medical history and subsequently clinical and neurological examinations. As a result, the clinical decision tools national emergency X‑radiography utilization study (NEXUS) criteria and the Canadian C‑spine rule (CCR) are discussed.

A flat posterior cruciate ligament reconstruction restores native knee kinematics, comparable to a double-bundle reconstruction-A biomechanical robotic investigation.

Purpose: To biomechanically evaluate a flat posterior cruciate ligament (PCL) reconstruction utilizing rectangular femoral bone tunnels.

Methods: Eight fresh-frozen human knee specimens were tested in a six-degrees-of-freedom robotic test setup. In each testing step, a force-controlled test protocol was performed, including 89 N posterior tibial translation (PTT) in neutral, internal and external rotation, from 0 to 90° of flexion.

[Specialized trauma surgery: do we need it at all?].

Despite maximally motivated and professionally outstanding young talent, the particularly stressful surgical disciplines have recruitment concerns. In recent years various sections and subsidiary societies of the German Society for Orthopedics and Trauma Surgery (DGOU) have developed and distributed personnel and institution-related certificates. Organ-specific and procedure-specific certificates are very popular to confer increased visibility to individuals and institutions.

Knotless Suture Anchors Display Favorable Elongation but an Inferior Ultimate Failure Load Versus Titanium Suture Anchors and All-Suture Anchors: A Biomechanical Comparison in a Porcine Model.

Background: Several types of suture anchors, which differ in their working principles, are available for fixation of ligamentous structures in knee surgery. How the choice of a suture anchor type influences the biomechanical stability of ligament fixation is largely unknown.

Purpose: To compare the biomechanical properties of different suture anchor designs regarding primary stability for tendon fixation and repair in medial collateral ligament (MCL) surgery.

Fixation of Takeuchi Type II/III lateral hinge fractures provides favourable stability of a medial open wedge high tibial osteotomy-A biomechanical study.

Purpose: To investigate the biomechanical consequences of osteosynthesis of lateral hinge fractures (LHFs) in medial open wedge high tibial osteotomy (MOWHTO).

Methods: Sixteen fresh-frozen human cadaveric proximal tibiae underwent MOWHTO fixed with an ipsilateral locking compression plate. The specimens were assigned to two clusters simulating LHFs according to the Takeuchi classification: (1) Type II fracture; and (2) Type III fracture.

Proximal tibial anatomical axis and anterior tibial cortex-based measurements of posterior tibial slope on lateral radiographs differ least from actual posterior tibial slope-A biomechanical study.

Purpose: To compare different measurement techniques of the posterior tibial slope (PTS) on lateral radiographs with the actual in situ PTS and evaluate the effect of tibial malrotation and image section length.

Methods: Actual PTS was measured on eight fresh-frozen tibiae using a portable 6-axis measuring arm with an accuracy of ±0.01°.

Molecular scale nanophotonics: hot carriers, strong coupling, and electrically driven plasmonic processes.

Plasmonic modes confined to metallic nanostructures at the atomic and molecular scale push the boundaries of light-matter interactions. Within these extreme plasmonic structures of ultrathin nanogaps, coupled nanoparticles, and tunnelling junctions, new physical phenomena arise when plasmon resonances couple to electronic, exitonic, or vibrational excitations, as well as the efficient generation of non-radiative hot carriers. This review surveys the latest experimental and theoretical advances in the regime of extreme nano-plasmonics, with an emphasis on plasmon-induced hot carriers, strong coupling effects, and electrically driven processes at the molecular scale.

The Effect of C-Arm Position on Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.

Background: Medial patellofemoral ligament (MPFL) reconstruction is a common treatment for patellar instability. Yet nearly 40% of revisions result from femoral tunnel misplacement. One reason may be the positioning of the C-arm relative to the knee.

Anterior Slope-Modifying Osteotomies Alter the Length Change Behavior of the Superficial Medial Collateral Ligament: A Biomechanical Study.

Background: Increased tibial slope has been shown to lead to higher rates of anterior cruciate ligament graft failure. A slope-decreasing osteotomy can reduce in situ anterior cruciate ligament force and may mitigate this risk. However, how this procedure may affect the length change behavior of the medial ligamentous structures is unknown.

Targeting Pseudomonas aeruginosa biofilm with an evolutionary trained bacteriophage cocktail exploiting phage resistance trade-offs.

Spread of multidrug-resistant Pseudomonas aeruginosa strains threatens to render currently available antibiotics obsolete, with limited prospects for the development of new antibiotics. Lytic bacteriophages, the viruses of bacteria, represent a path to combat this threat. In vitro-directed evolution is traditionally applied to expand the bacteriophage host range or increase bacterial suppression in planktonic cultures.

Discovery of BAY-405: An Azaindole-Based MAP4K1 Inhibitor for the Enhancement of T-Cell Immunity against Cancer.

Mitogen-activated protein kinase kinase kinase kinase 1 (MAP4K1) is a serine/threonine kinase that acts as an immune checkpoint downstream of T-cell receptor stimulation. MAP4K1 activity is enhanced by prostaglandin E2 (PGE2) and transforming growth factor beta (TGFβ), immune modulators commonly present in the tumor microenvironment. Therefore, its pharmacological inhibition is an attractive immuno-oncology concept for inducing therapeutic T-cell responses in cancer patients.

Specific fibre areas in the femoral footprint of the posterior cruciate ligament act as a major contributor in resisting posterior tibial displacement: A biomechanical robotic investigation.

Purpose: Similar to the anterior cruciate ligament, the femoral footprint of the posterior cruciate ligament (PCL) is composed of different fibre areas, possibly having distinct biomechanical functions. The aim of this study was to determine the role of different fibre areas of the femoral footprint of the PCL in restraining posterior tibial translation (PTT).

Methods: A sequential cutting study was performed on eight fresh-frozen human knee specimens, utilizing a six-degrees-of-freedom robotic test setup.

Improving the Care of Severe, Open Fractures and Postoperative Infections of the Lower Extremities: Protocol for an Interdisciplinary Treatment Approach.

Background: Patients with open fractures often experience complications during their injury. The treatments incur high costs. Interdisciplinary cooperation between different medical disciplines may improve treatment outcomes.

Arthroscopic Centralization of the Medial Meniscus Reduces Load on a Posterior Root Repair Under Dynamic Varus Loading: A Biomechanical Investigation.

Background: In addition to the integrity of the meniscal hoop function, both the anterior and posterior meniscus roots as well as the meniscotibial and meniscofemoral ligaments are crucial in restraining meniscal extrusion. However, the interaction and load sharing between the roots and these peripheral attachments (PAs) are not known.

Purposes: To investigate the influence of an insufficiency of the PAs on the forces acting on a posterior medial meniscus root repair (PMMRR) in both neutral and varus alignment and to explore whether meniscal centralization reduces these forces.

Combined PCL instabilities cannot be identified using posterior stress radiographs in external or internal rotation: A cadaveric study.

Purpose: Posterior stress radiography is recommended to identify isolated or combined posterior cruciate ligament (PCL) deficiencies. The posterior drawer in internal (IR) or external rotation (ER) helps to differentiate between these combined instabilities. The purpose of this study was to evaluate posterior stress radiography (PSR) in isolated and combined PCL deficiency with IR and ER compared to PSR in neutral rotation (NR) for diagnosing combined PCL instabilities.

Primary Stability of Kyphoplasty in Incomplete Vertebral Body Burst Fractures in Osteoporosis: A Biomechanical Investigation.

The objective of our study was to biomechanically evaluate the use of kyphoplasty to stabilize post-traumatic segmental instability in incomplete burst fractures of the vertebrae. The study was performed on 14 osteoporotic spine postmortem samples (Th11-L3). First, acquisition of the native multisegmental kinematics in our robot-based spine tester with three-dimensional motion analysis was set as a baseline for each sample.

Biomechanical Comparisons between One- and Two-Compartment Devices for Reconstructing Vertebrae by Kyphoplasty.

Background: This biomechanical in vitro study compared two kyphoplasty devices for the extent of height reconstruction, load-bearing capacity, cement volume, and adjacent fracture under cyclic loading.

Methods: Multisegmental (T11-L3) specimens were mounted into a testing machine and subjected to compression, creating an incomplete burst fracture of L1. Kyphoplasty was performed using a one- or two-compartment device.