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.

Evaluation of Prehospital Undertriage in Relation to Trauma Team Activation-Results from a Prospective Study in 12 Level one German Trauma Centers.

This prospective, multicenter observational cohort study was carried out in 12 trauma centers in Germany and Switzerland. Its purpose was to evaluate the rate of undertriage, as well as potential consequences, and relate these with different Trauma Team Activation Protocols (TTA-Protocols), as this has not been done before in Germany. : Each trauma center collected the data during a three-month period between December 2019 and February 2021.

Long-Term Follow-Up after Iliosacral Screw Fixation of Unstable Pelvic Ring Fractures.

(1) High-energy injuries of the pelvic ring are rare. The wide application of iliosacral screw fixation of the posterior pelvic ring is relatively new. The aim of the present study was to evaluate the long-term quality of life.

Mortality Risk Factors of Severely Injured Polytrauma Patients (Prehospital Mortality Prediction Score).

The aim of this study was to analyze the mortality of polytrauma patients and identify prediction parameters. A further aim was to create from the results a score for the prehospital predictive evaluation of 30-day survival. The study was conducted with a retrospective, observational design and was carried out unicentrically at a Level 1 Trauma Center.

[Position of trauma surgery in emergency medicine].

Background: The decision of the Federal Joint Committee has resulted in the further development of in-hospital emergency medicine through the establishment of central emergency departments and staged emergency care. In addition, the additional training in clinical acute and emergency medicine was established.

Aim: The aim of this work is on the one hand to make trauma surgeons aware of these structural changes.

Does Cement Augmentation of the Sacroiliac Screw Lead to Superior Biomechanical Results for Fixation of the Posterior Pelvic Ring? A Biomechanical Study.

: The stability of the pelvic ring mainly depends on the integrity of its posterior part. Percutaneous sacroiliac (SI) screws are widely implanted as standard of care treatment. The main risk factors for their fixation failure are related to vertical shear or transforaminal sacral fractures.

[Telemedicine in the emergency room-An extension with potential? : Results of a recent survey].

Critically injured patients pose great challenges for medical personnel in emergency room treatment. How can such a high workload due to a lack of personnel be reduced? Telemedicine can offer solutions here. With the help of external medical expertise, diagnoses and treatment processes are already significantly accelerated and optimized in other specialist areas.

Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation.

Background: Fractures of the four anterior pubic rami are described as "straddle fractures". The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2).

Methods: A straddle fracture was simulated in 16 artificial pelvises.

Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring.

Background: Incidence of pelvic ring fractures has increased over the past four decades, especially after low-impact trauma-classified as fragility fractures of the pelvis (FFP). To date, there is a lack of biomechanical evidence for the superiority of one existing fixation techniques over another. An FFP type IIc was simulated in 50 artificial pelvises, assigned to 5 study groups: Sacroiliac (SI) screw, SI screw plus supra-acetabular external fixator, SI screw plus plate, SI screw plus retrograde transpubic screw, or S1/S2 ala-ilium screws.

Impact of the first COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center.

Purpose: In Dec 2019, COVID-19 was first recognized and led to a worldwide pandemic. The German government implemented a shutdown in Mar 2020, affecting outpatient and hospital care. The aim of the present article was to evaluate the impact of the COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center in Germany.

Differentiation of Traumatic Osteoporotic and Non-Osteoporotic Vertebral AO A3 Fractures by Analyzing the Posterior Edge Morphology-A Retrospective Feasibility Study.

Background: Differentiation between traumatic osteoporotic and non-osteoporotic vertebral fractures is crucial for optimal therapy planning. We postulated that the morphology of the posterior edge of the cranial fragment of A3 vertebral fractures is different in these entities. Therefore, the purpose of this study is to develop and validate a simple method to differentiate between osteoporotic and non-osteoporotic A3 vertebral fractures by morphological analysis.

[Trends in the surgical treatment of fractures of the pelvic ring : A nationwide analysis of operations and procedures code (OPS) data between 2005 and 2017].

Aim: The aim of this study was to analyze the epidemiological trends and incidences in inpatient pelvic surgery in the period from 2005 to 2007.

Method: Approximately 194 million anonymized diagnosis-related groups (DRG) inpatient records were collected by the German Federal Statistical Office between 2005 and 2017. These data were screened for pelvic procedures, gender and age of the patients.

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation-A 15-Year Retrospective Analysis on over 640 Screws.

Background: Minimally invasive sacroiliac-screw (SI-screw) fixation of the pelvis is used in energy trauma (Arbeitsgemeinschaft für Osteosynthesefragen (AO) classified) and fragility fractures (Fragility Fracture of the Pelvis (FFP) classified). However, available clinical data are based on small case series and biomechanical data seem to be contradictory.

Methods: The present single center retrospective cohort study investigated percutaneous SI-screw fixation and augmentation over 15 years.

The S2-Alar-Iliac Screw for Pelvic Trauma.

Percutaneous sacro-iliac screw osteosynthesis is considered to be standard of care for most posterior pelvic ring fractures. However, special situations require alternative strategies for sufficient stabilization. In these cases, stabilization can often be achieved using posterior instrumentation e.

Diagnostic accuracy of different clinical screening criteria for blunt cerebrovascular injuries compared with liberal state of the art computed tomography angiography in major trauma.

Background: Blunt cerebrovascular injuries (BCVI) can significantly impact morbidity and mortality if undetected and, therefore, untreated. Two diagnostic concepts are standard practice in major trauma management: Application of clinical screening criteria (CSC) does or does not recommend consecutive computed tomography angiography (CTA) of head and neck. In contrast, liberal CTA usage integrates into diagnostic protocols for suspected major trauma.

Complex biomechanical properties of non-augmented and augmented pedicle screws in human vertebrae with reduced bone density.

Background: In osteoporotic bone, the quality of the bone-to-implant interface is decreased, which may lead to early implant failure. Screw anchorage can be improved by augmentation. This effect is mainly investigated with a pull-out test.

[Effects of the new injury type catalogue of the German statutory accident insurance on a center for severe injury type procedures].

Unlabelled: The development of the numbers of cases involved in accident insurance consultant procedures (DAV), injury type procedures (VAV) and severe injury type procedures (SAV) after the introduction of the new injury type catalogue from 1 July 2018 is presented. Furthermore, possible alterations to organizational aspects, such as operating room times and average duration of hospitalization are presented. A first critical assessment of the modifications in the new catalogue was carried out, particularly with reference to the newly introduced section on complications (section 11).

Recommendations for the Diagnostic Testing and Therapy of Atlas Fractures.

In a consensus process with four sessions in 2017, the working group on "the upper cervical spine" of the German Society for Orthopaedic and Trauma Surgery (DGOU) formulated "Therapeutic Recommendations for the Diagnosis and Treatment of Fractures to the Upper Cervical Spine", incorporating their own experience and current literature. The following article describes the recommendations for the atlas vertebra. About 10% of all cervical spine injuries include the axis vertebra.

Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Study Design: Expert consensus.

Objectives: To establish treatment recommendations for subaxial cervical spine injuries based on current literature and the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma.

Methods: This recommendation summarizes the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma.

Recommendations for Diagnosis and Treatment of Fractures of the Ring of Axis.

In a consensus process with four sessions in 2017, the working group "upper cervical spine" of the German Society for Orthopaedics and Trauma Surgery (DGOU) formulated "Therapeutic Recommendations for the Diagnosis and Treatment of Upper Cervical Fractures", taking their own experience and the current literature into consideration. The following article describes the recommendations for axis ring fractures (traumatic spondylolysis C2). About 19 to 49% of all cervical spine injuries include the axis vertebra.

Imaging of Spontaneous and Traumatic Cervical Artery Dissection : Comparison of Typical CT Angiographic Features.

Introduction: Cervical artery dissection (CAD) is an important etiology of ischemic stroke and early recognition is vital to protect patients from the major complication of cerebral embolization by administration of anticoagulants. The etiology of arterial dissections differ and can be either spontaneous or traumatic. Even though the historical gold standard is still catheter angiography, recent studies suggest a good performance of computed tomography angiography (CTA) for detection of CAD.

[Subaxial Cervical Spine Injuries: Treatment Recommendations of the German Orthopedic and Trauma Society].

In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used.

Management of destructive Candida albicans spondylodiscitis of the cervical spine: a systematic analysis of literature illustrated by an unusual case.

Purpose: Candida induced spondylodiscitis of the cervical spine in immunocompetent patients is an extremely rare infectious complication. Since clinical symptoms might be nonspecific, therapeutic latency can lead to permanent spinal cord damage, sepsis and fatal complications. Surgical debridement is strongly recommended but there is no standard antimycotic regime for postsurgical treatment.

Biomechanical characteristics of pedicle screws in osteoporotic vertebrae-comparing a new cadaver corpectomy model and pure pull-out testing.

Currently, evaluation of the stability of spinal instrumentations often focuses on simple pull-out or cyclic loading. However, the loading characteristics and the specimen alignment rarely simulate physiological loading conditions, or the clinical situation itself. The purpose of this study was to develop an alternative setup and parameters to compare static and dynamic characteristics of pedicle screws at the bone-implant interface in lumbar osteoporotic cadavers.