Publications by authors named "Thomas Mittlmeier"

Background: Menopause driven decline in estrogen exposes women to risk of osteoporosis. Detection of early onset and silent progression are keys to prevent fractures and associated burdens.

Methods: In a discovery cohort of 120 postmenopausal women, we combined repeated quantitative pulse-echo ultrasonography of bone, assessment of grip strength and serum bone markers with mass-spectrometric analysis of exhaled metabolites to find breath volatile markers and quantitative cutoff levels for osteoporosis.

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Background/objectives: Vitamin D is a key factor in bone metabolism, especially in patients who have suffered fractures, a group in need of a healthy bone metabolism. In Germany, a 70-year-old person requires 20 min of sun exposure daily for sufficient endogenous production in April. While this appears to be a sufficient period on paper, it raises the question of whether sufficient synthesis is achieved, given the time and the implementation of skin cancer prevention.

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Background: The clinical benefit of locking plates in distal fibula fractures has not yet been proven. In addition, the risk of wound complications appears to be higher than with conventional tubular plates. We hypothesize that the benefits of locking plates in terms of biomechanical properties are outweighed by a higher risk of wound complications.

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Biomechanical analysis of spinal structures is crucial in the evaluation of injuries, the risk of fracture, and age-related changes. Osteoporotic vertebrae are very fragile and therefore constitute a serious risk, especially in the elderly. At present, clinically relevant decision making in fracture risk assessment is predicated upon finite element analysis (FEA), which utilizes high-resolution computed tomography (CT) scans from clinical practice alongside micro-CT scans from laboratory settings.

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Introduction: Subtalar joint arthrodesis is primarily indicated for advanced osteoarthritis, hindfoot deformity, and/or instability. During the first 6-10 weeks after surgery, there is an intermediary structurally weaker state before complete bony fusion of the calcaneus and talus occurs. Loading of the foot can lead to mechanical stresses and relative movements in the former joint gap, which can impede the fusion process.

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Purpose: To characterize the 3D geometry of the distal tibia resection area from healthy individuals using CT-based digital implantation for proper preoperative sizing of TAA tibia component placement.

Methods: Standardized CT images of healthy ankle joints serving as intra-individual references for treatment of contralateral injuries were identified. The tibial cross section dedicated to virtually host the tibial component was digitally prepared, and the size of the virtual contact surface was calculated.

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Objective: Minimally invasive stabilization of metatarsal fractures to enable adequate fracture healing in a correct position to restore anatomy and biomechanics of the foot.

Indications: A. Dislocated diaphyseal and subcapital fractures of the second to fifth metatarsal (> 3 mm, > 10° dislocation).

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In the recent past, practical blood flow restriction (pBFR) using non-pneumatic, usually elastic cuffs has been established as a cost-effective alternative to traditional blood flow restriction (BFR) using pneumatic cuffs, especially for training in large groups. This study investigated whether low-load resistance exercise with perceptually primed pBFR using an elastic knee wrap is suitable to induce similar motor performance fatigue as well as physiological and perceptual responses compared to traditional BFR using a pneumatic nylon cuff in males and females. In a randomized, counterbalanced cross-over study, 30 healthy subjects performed 4 sets (30-15-15-15 repetitions) of unilateral knee extensions at 20% of their one-repetition-maximum.

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Background: Trabeculae in vertebral bodies are unequally distributed within the cervical spine (CS), the thoracic spine (TS), and lumbar spine (LS). Such structures are also unequally distributed within the individual vertebrae. Exact knowledge of the microstructure of these entities could impact our understanding and treatment of fractures caused by osteoporosis and possibly improve surgical approaches.

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Introduction: Given the significant therapeutic gap for osteoporosis, this study aims to investigate the most common osteoporosis-related fracture. The analysis will also consider patients' serum vitamin D levels and the indications for basic osteoporosis diagnostic tests and osteoporosis therapy prior to fracture.

Materials And Methods: This prospective clinical trial included patients with distal radius fractures who underwent surgery at our hospital between 1 April 2021 and 7 April 2022.

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Article Synopsis
  • The biology of osseointegration for intramedullary implants depends on factors like design, press-fit anchoring, and the wear and tear on the prosthesis over time, impacting how well they bond with bone.
  • Proper material and surface engineering are necessary for stimulating bone growth to ensure implants remain stable and effective, while relative movement can increase infection risk.
  • A two-step implantation process for a standard Endo-Fix Stem and a single-step for custom-made implants demonstrate effective osseointegration, particularly critical for patients with severe limb loss due to trauma.
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Purpose: Patients with tibial plateau fractures (TPF) are at risk of long-term hampered bipedal locomotion. A retrospective single-center study using patient-related outcome measures and a sophisticated assessment of walking abilities was conducted.

Methods: Adults receiving surgical treatment of an isolated TPF between January 2012 and December 2016 received the KOOS questionnaire together with the invitation for an extensive follow-up examination on the clinical outcome including standardized assessment of the walking abilities (loadsol system).

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Muscle injuries often result in functional limitations due to insufficient healing. This study assessed the influence of calcitriol and vitamin D Receptor Modulator 2 (VDRM2) on muscle regeneration in male Wistar rats following open blunt muscle injury. The injured left soleus muscle of the rats was treated for the first four days after trauma with local injections of either calcitriol, VDRM2, or a 10% ethanol solution (control).

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Stress fractures belong to the group of atraumatic fractures. A low-impact and repetitive load is the underlying cause and no fracture would occur under physiological circumstances. The conventional X‑ray examination remains the initial imaging modality when a stress fracture is suspected.

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Injuries of the ankle joint show lesions of the lateral ligamentous apparatus with an incidence of 1 in 1000 cases. With a range of 0.3-0.

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Background: Stabilization of extra-articular distal radius fractures by wrist joint bridging (WB) dynamic fixation allows for early motion of the wrist, but relies on exact positioning of the device. In fact, physiological movement appeared to be compromised with even distinctly aberrant positioning of such device. To investigate this issue in more detail, we developed an in-vitro testing apparatus suitable for assessing the forces required for flexion and extension of the wrist.

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Injuries of the ankle joint show lesions of the lateral ligamentous apparatus with an incidence of 1 in 1000 cases. With a range of 0.3-0.

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Purpose: This study investigated the acute effects of a static balance exercise combined with different blood flow restriction (BFR) pressures on motor performance fatigue development and recovery as well as physiological and perceptual responses during exercise in males and females.

Methods: Twenty-four recreational active males (n = 13) and females (n = 11) performed static balance exercise on a BOSU ball (3 sets of 60 s with 30 s rest in-between) on three separate (> 3 days) laboratory visits with three different BFR pressures (80% arterial occlusion pressure [AOP], 40%AOP, 30 mmHg [SHAM]) in random order. During exercise, activity of various leg muscles, vastus lateralis muscle oxygenation, and ratings of effort and pain perception were recorded.

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In the basic entirety of stress fractures, insufficiency fractures are defined as fractures caused by prolonged normal or physiological loading of a bone with insufficient elastic resistance. This clearly distinguishes it from fatigue fractures, in which excessive loads are continuously applied to a bone with normal elastic resistance. According to Pentecost (1964) both entities of stress fracture result from "the inherent inability of the bone to withstand stress applied without violence in a rhythmical, repeated, subthreshold manner".

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Skeletal muscle trauma is a common injury with a range of severity. Adenosine, lidocaine and Mg (ALM) is a protective solution and improves tissue perfusion and coagulopathy. Male Wistar rats were anesthetized and subjected to standardized skeletal muscle trauma of the left soleus muscle with the protection of the neurovascular structures.

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Testosterone deficiency in males is linked to various pathological conditions, including muscle and bone loss. This study evaluated the potential of different training modalities to counteract these losses in hypogonadal male rats. A total of 54 male Wistar rats underwent either castration (ORX, = 18) or sham castration ( = 18), with 18 castrated rats engaging in uphill, level, or downhill interval treadmill training.

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Introduction: Palmar plate fixation of the distal radius fracture involves dissecting the pronator quadratus (PQ). This is regardless of whether the approach is radial or ulnar to the flexor carpi radialis (FCR) tendon. It is not yet clear whether and to what extent this dissection leads to a functional loss of pronation or pronation strength.

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Background: Within a few months coronavirus disease 2019 (COVID-19) spread around the world. Some studies showed a significant reduction in medical consultations. Due to new discussions about restrictions in the case of rising COVID-19 case numbers, this study investigated the consequences of the COVID-19 pandemic on surgical emergencies at the Rostock University Medical Center and compared the results to the years before.

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