Is there a role for percutaneous pelvic and acetabular reconstruction?

The primary goal in the treatment of pelvic fractures is the restoration of haemodynamic stability. The secondary goal is the reconstruction of stability and symmetry of the pelvic ring. Percutaneous reconstruction can only be accepted if these goals are met.

Extending the Indication of Intramedullary Nailing of Tibial Fractures.

Intramedullary nailing is an effective and well-established method for the treatment of a wide spectrum of tibial fractures. Nevertheless, the handling of metaphyseal and open fracture remains challenging. Surgical and technical advancements have opened up new possibilities to broaden the indication of intramedullary nailing in these areas.

Intramedullary Nailing of Humeral Head and Humeral Shaft Fractures.

There is an increasing interest in intramedullary nailing for humeral fractures. Starting with diaphyseal fractures, now also proximal metaphyseal fractures of the humerus can be nailed with satisfying results. Basic ideas for humeral nailing are less invasive approaches to the humerus, less soft tissue damage, e.

Anatomical Course of the Superficial Branch of the Radial Nerve and Clinical Significance for Surgical Approaches in the Distal Forearm.

10 embalmed cadaver forearms and wrists were dissected to determine the anatomical course of the superficial branch of the radial nerve in the distal forearm. The superficial radial nerve bifurcated in two branches at a mean of 54,7 mm proximal to the radial styloid. From the styloid process of the radius, the mean distance to the closest dorsal branch of the superficial radial nerve was 3,5 mm and the mean distance to the closest volar branch was 9,8 mm.

The benefit of multislice CT in the emergency room management of polytraumatized patients.

The early treatment of polytraumatized patients needs an effective and standardized approach. Reducing time requirements for the primary diagnostic evaluation is a major concern in the early phase of polytrauma management. Multislice-CT (MSCT) is a quick and reliable method for the initial diagnostic evaluation.

Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment.

Study Design: Multicenter prospective randomized trial.

Objective: To test the hypotheses that thoracolumbar AO Type A spine fractures without neurologic deficit, managed with short-segment posterior stabilization will show an improved radiographic outcome and at least the same functional outcome as compared with nonsurgically treated thoracolumbar fractures.

Summary Of Background Data: There are various opinions regarding the ideal management of thoracolumbar Type A spine fractures without neurologic deficit.

[The cloverleaf plate for osteosythesis of humeral head fractures. Definition of the current position].

In this prospective study we evaluated the functional and radiological results obtained in 62 patients who had been treated for fracture of the humeral head by internal fixation with a cloverleaf plate. They were examined postoperatively, after 14 weeks and after an average follow-up of 75 weeks. Nine patients (14.

Ultrasound-guided spinal fracture repositioning, ligamentotaxis, and remodeling after thoracolumbar burst fractures.

Study Design: Computed tomography aided evaluation of spinal decompression by ultrasound-guided spinal fracture repositioning, ligamentotaxis, and remodeling after thoracolumbar burst fractures.

Objectives: To determine the necessity of spinal canal widening by ultrasound-guided fracture repositioning for fractures with and without neurologic deficit.

Summary Of Background Data: Ultrasound-guided spinal fracture repositioning is an alternative new approach.

Locking plates for corrective osteotomy of malunited dorsally tilted distal radial fractures: a biomechanical study.

The purpose of the study was to compare the biomechanical properties of five different palmar fixation plate designs in a distal radius osteotomy cadaver model. A 1cm metaphyseal osteotomy gap was made to simulate a corrective osteotomy and the osteotomy plated. Axial load was applied to the distal end of each construct by a material testing machine under control of a motion analysis video system.

[Shaft lengthening in hip replacement: experimental studies on bending stiffness].

Background: Cortical atrophy of the proximal femur can be seen after wearing a total hip prosthesis for several years because loads are borne distally at the prosthesis tip. To achieve stable prosthesis implantation on the one hand and proximal bone regeneration on the other hand in hip revision arthroplasty, lengthening of the shaft component distributes loading forces to the femoral shaft first. It concentrates them to the proximal femur later through a higher elasticity.

["Progressive" hypothenar hammer syndrome Indication for operative treatment].

Hypothenar hammer syndrome (HHS) is ischemia of the distal ulnar artery caused by injury to the ulnar part of the palmar arch. This disease often involves workers who frequently use the hypothenar part of the hand as a hammer. The aneurysmatic form of HHS represents an indication for operative treatment; the thrombotic form is treated mainly conservatively.

[Operative strategies in the treatment of upper limb fractures in polytraumatized patients].

Background: Optimal timing of operative treatment of upper extremity long bone fractures in polytraumatized patients depends on the type and location of the fractures, as well as on the cardiorespiratory stability of the patient, and should be early in diaphyseal fractures in order to optimize intensive care treatment. The timing of surgery in cases of upper limb fractures is secondary to life-saving therapies. The same applies to stabilization of fractures of the lower limbs, including fractures of the femur and tibial shaft.

Bending and torsional stiffness in cadaver humeri fixed with a self-locking expandable or interlocking nail system: a mechanical study.

Objectives: This study was designed to gain data about a new expandable, noninterlocked intramedullary nail's capacity to stabilize unstable transverse humeral shaft fractures without the need for interlocking, thus making nail implantation simpler and to prove our goal hypothesis: that in a midshaft osteotomy of the humeral shaft the expandable humeral nail will show the same bending and torsional stiffness as an interlocked humeral nail, when implanted correctly according to the manufacturer's instructions.

Design: Pair randomization.

Setting: Mechanical laboratory testing.

The influence of bone allograft processing on osteoblast attachment and function.

In order to assess the influence of eight different sterilisation and disinfection methods for bone allografts on adhesion, proliferation, and differentiation of human bone marrow stromal cells (BMSC), cells were grown in culture and then plated onto pieces of human bone allografts. Following processing methods were tested: autoclavation (AUT), low-temperature-plasma sterilisation of demineralised allografts (D-LTP), ethylene oxide sterilisation (EtO), fresh frozen bone (FFB), 80 degrees C-thermodisinfection (80 degrees C), gamma-irradiation (Gamma), chemical solvent disinfection (CSD), and Barrycidal-disinfection (BAR). The seeding efficiency was determined after one hour to detect the number of attached cells before mitosis started.

Primary total elbow replacement for fractures of the distal humerus.

Objective: Achieving stability and pain-free function for osteoporotic intraarticular multifragmentary fractures of the distal humerus in elderly patients by primary total elbow replacement (TER).

Indications: Non-soft-tissue-attached fragments, poor-quality bone, where stable osteosynthesis is not attainable. Severely comminuted intraarticular closed type C fractures according to the AO classification with multiple small bone/cartilage fragments.

Locked plate fixation and intramedullary nailing for proximal humerus fractures: a biomechanical evaluation.

Background: Internal fixation of proximal humeral fractures is associated with a considerable secondary malalignment rate. Fixed-angle implants have been suggested to increase the stability of fixation.

Methods: The biomechanical properties of four different implants were tested.

[MRT-induced burns in tattooed patients. Case report of an traumatic surgery patient].

Skin burns to patients with tattoos during MRI procedures are reported but rare complications. MRI scans are being used more often also as diagnostic procedures in trauma patients. In this article we present the case of a patient after trauma of the vertebral column who experienced burning pain at the site of a tattoo on the distal femur during the MRI examination, necessitating cessation of this procedure.

[Complex pelvic trauma caused by an accidental side split].

Complex pelvic ring fractures are defined as injuries of the pelvic ring in association with lesions of the pelvic organs or the pelvic soft tissues. These injuries are typically caused by high-energy accidents. In contrast to the typical mechanism of injury a case is described in which a low energy trauma led to a complex pelvic ring trauma.

[Are angle-fixed implants with elastic properties advantageous for the internal fixation of proximal humerus fractures?].

There is a recent interest for the use of angle-fixed plates in the management of proximal humerus fractures. Rigid implants might be associated with an increased risk of cutting-out. In order to analyse the potential beneficial effects of the implant elasticity on fracture fixation, the biomechanical properties of a rigid and an elastic angle-fixed plating system were assessed in an experimental study.

[Surgical treatment of type I capitellar-humeral fractures using the Henry ventral approach approach. Short- and medium-term results].

Capitellar fractures are rare. Despite adequate surgical treatment, patients suffer frequently from limited range of motion, osteonecrosis, and neurological deficits. The purpose of this retrospective study was to evaluate short- and medium-term surgical results in seven patients who had type I capitellar fractures according to Bryan and Morrey.

Distal humerus fractures in elderly patients: results after open reduction and internal fixation.

Problem: Fractures of the distal humerus are difficult to treat. In elderly patients, diminished bone mineral quality and increased trauma-associated joint destruction may make stable joint reconstruction even more problematic. Furthermore, comorbidities and poor tolerance of joint immobilization might be additional factors which influence elbow function negatively.

Spontaneous defect remodeling in a distal humerus fracture with extensive osseous loss: a case report of a complex elbow fracture.

Sideswipe injuries to the elbow cause complex fracture patterns and remain difficult management problems. The authors report a case of spontaneous bone remodeling of an extensive metaphyseal defect zone.

Olecranon fractures in adults: factors influencing outcome.

In a retrospective, non-randomized study, we reviewed our experience with the operative treatment of olecranon fractures to find out which factors correlate with subjective complaints and functional outcome. A total of 95 consecutive olecranon fractures were operatively treated in our level I trauma institution between 1 March 1992 and 1 March 2000. Medical records and X-rays of all patients were evaluated.

Friction of ceramic and metal hip hemi-endoprostheses against cadaveric acetabula.

Introduction: Studies of hip arthroplasty have dealt mainly with total endoprosthesis, while tribology measurement values of hemi-endoprosthetic implants are rare. The small amount of experimental tribological data concerning materials of hemi-endoprosthetic implants in the form of pendulum trials, animal experiments, in vivo measurements on human hip joints and pin on disc studies report friction coefficients between 0.014 and 0.

[Internal fixation of proximal humerus fractures].

Background: Intramedullary nails and angle-fixed plates have recently been used in proximal humerus fractures. Rigid implants might be associated with an increased risk of failure in osteoporotic conditions.

Methods: Unstable fractures of the surgical neck were created in 24 pairs of human humeri.