Background: In recent years, endoscopic treatment of pelvic ring injuries has emerged. In addition to the complex 3D anatomy of the bony pelvis, a particular challenge is its embedding in the surrounding soft tissue structures. It is known from other surgical specialties that the preparation can be facilitated by using surgical robot systems.
View Article and Find Full Text PDFIn the Anglo-American world the field of surgeon well-being is already very prominent, while in Germany it is still underrepresented. In this article, we aim to analyze the challenges and factors that affect the well-being of surgeons, including stress, burnout, workload, job satisfaction, autonomy, leadership, teamwork and work-life integration. Additionally, we discuss the connection between surgeon well-being and the shortage of new talent in surgery, which is currently being exacerbated by increasing treatment and physician demands, the age development of specialists and an overall high turnover.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
September 2024
The diagnosis and treatment of non-unions still represents an interdisciplinary challenge. Therefore, prevention, early detection and specific treatment are of great importance. Non-unions of the upper extremities, although less common than that of the lower extremities, requires special attention for successful treatment due to the central role of the shoulder girdle and arm in day to day activities.
View Article and Find Full Text PDFThe elderly exhibit a reduced healing capacity after fracture, which is often associated with delayed or failed bone healing. This is due to a plethora of factors, such as an impaired bone vascular system and delayed angiogenesis. The phosphodiesterase-5 (PDE-5) inhibitor sildenafil exerts pro-angiogenic and pro-osteogenic effects.
View Article and Find Full Text PDFFracture healing in the aged is associated with a reduced healing capacity, which often results in delayed healing or non-union formation. Many factors may contribute to this deterioration of bone regeneration, including a reduced 'angiogenic trauma response'. The phosphodiesterase-3 (PDE-3) inhibitor cilostazol has been shown to exert pro-angiogenic and pro-osteogenic effects in preclinical studies.
View Article and Find Full Text PDFUnfallchirurgie (Heidelb)
May 2024
Introduction: The overall frequency of proximal femoral fractures means that we are repeatedly confronted with failed healing and implant failure, despite a relatively low nonunion rate especially in intertrochanteric fractures (< 5%). The aim of this paper is to present our approach to treating these nonunions of the proximal femur and discuss the treatment results.
Material And Methods: Between 2009 and 2023, patients with nonunion of the proximal femur were retrospectively identified and analyzed.
Delayed functional recovery after injury is associated with significant personal and socioeconomic burden. Identification of patients at risk for a prolonged recovery after a musculoskeletal injury is thus of high relevance. The aim of the current study was to show the feasibility of using a machine learning assisted model to predict functional recovery based on the pre- and immediate post injury patient activity as measured with wearable systems in trauma patients.
View Article and Find Full Text PDFArthritic disorders have become one of the main contributors to the global burden of disease. Today, they are one of the leading causes of chronic pain and disability worldwide. Current therapies are incapable of treating pain sufficiently and preventing disease progression.
View Article and Find Full Text PDFFalls in senior home residents are common. Individual preventive training can lower the fall risk. To detect the need for training, a systematic assessment of the individual fall risk is needed.
View Article and Find Full Text PDFNon-union formation represents a major complication in trauma and orthopedic surgery. The phosphodiesterase-5 (PDE-5) inhibitor sildenafil has been shown to exert pro-angiogenic and pro-osteogenic effects in vitro and in vivo. Therefore, the aim of the present study was to analyze the impact of sildenafil in an atrophic non-union model in mice.
View Article and Find Full Text PDFNonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, belong to the most prescribed analgesic medication after traumatic injuries. However, there is accumulating evidence that NSAIDs impair fracture healing. Because bone regeneration in aged patients is subject to significant changes in cell differentiation and proliferation as well as a markedly altered pharmacological action of drugs, we herein analyzed the effects of diclofenac on bone healing in aged mice using a stable closed femoral facture model.
View Article and Find Full Text PDFUnfallchirurgie (Heidelb)
February 2023
Open reduction and internal fixation are the gold standard for the treatment of dislocated acetabular fractures. A primary joint replacement is only justified in isolated cases. The indications are merely non-reconstructable acetabular fractures, accompanying displaced fractures of the femoral neck and non-reconstructable fractures of the femoral head.
View Article and Find Full Text PDFNon-union formation represents a major complication in trauma surgery. Adequate vascularization has been recognized as vital for bone healing. However, the role of vascularization in the pathophysiology of non-union formation remains elusive.
View Article and Find Full Text PDFIntroduction: The "floating hip" is a rare and complex fracture involving the pelvis and the ipsilateral femur and is therefore difficult to treat. Data and studies on this topic are still scarce. The optimal strategy for surgical treatment and thus the resulting quality of treatment are still being debated; a femur-first strategy is often the preferred treatment.
View Article and Find Full Text PDFCement augmentation of sacroiliac (SI) screws in the posterior pelvic ring has been shown to provide greater biomechanical stability in cadaveric studies. Pelvic ring fractures are relatively rare compared to the total number of fractures. Nevertheless, the 1‑year mortality rate of up to 27% is very high, especially for geriatric pelvic ring fractures and is also largely associated with reduced mobility due to the fracture.
View Article and Find Full Text PDFBackground: The mechanical boundary conditions of the non-union and osteosynthetic construct are a key determinant of fracture healing after revision surgery. Aim of this study was to introduce a movement analysis and simulation workflow to determine the mechanical conditions during non-union healing in vivo.
Material And Methods: On an individual case basis after non-union revision surgery we performed an accelerometry-based movement analysis.
Background And Purpose: In fracture healing, ischemia caused by vascular injuries, chronic vascular diseases, and metabolic comorbidities is one of the major risk factors for delayed union and non-union formation. To gain novel insights into the molecular and cellular pathology of ischemic fracture healing, appropriate animal models are needed. Murine models are of particular interest, as they allow to study the molecular aspects of fracture healing due to the availability of both a large number of murine antibodies and gene-targeted animals.
View Article and Find Full Text PDFPurpose: The Pararectus approach has been introduced as an alternative anterior approach to the Stoppa approach in acetabular surgery. There is no evidence which approach should be preferred, especially regarding approach-related complications. Therefore, aim of this registry study was to compare the Pararectus approach to the Stoppa approach regarding complications and quality of reduction.
View Article and Find Full Text PDFThe incidence of distal femur fractures increases in the geriatric patient. The primary treatment goal in these fractures is early mobilisation to prevent secondary injuries associated with immobility. In light of the increasing spectrum of therapeutic options for postoperative fracture treatment, including double plating, nail-plate combination and distal femur replacement as postoperative treatments, weight-bearing recommendations are becoming increasingly important.
View Article and Find Full Text PDFBMC Musculoskelet Disord
March 2022
Background: Pelvic fractures are often associated with spine injury in polytrauma patients. This study aimed to determine whether concomitant spine injury influence the surgical outcome of pelvic fracture.
Methods: We performed a retrospective analysis of data of patients registered in the German Pelvic Registry between January 2003 and December 2017.