Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients.

Background: Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.

Extended Coagulation Profiling in Isolated Traumatic Brain Injury: A CENTER-TBI Analysis.

Background: Trauma-induced coagulopathy in traumatic brain injury (TBI) remains associated with high rates of complications, unfavorable outcomes, and mortality. The underlying mechanisms are largely unknown. Embedded in the prospective multinational Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, coagulation profiles beyond standard conventional coagulation assays were assessed in patients with isolated TBI within the very early hours of injury.

Immediate mobilization of distal radius fractures stabilized by volar locking plate results in a better short-term outcome than a five week immobilization: A prospective randomized trial.

Objective: To evaluate the impact of immediate (first day after surgery) mobilization compared to standard five weeks cast immobilization on the functional outcome after volar locking plate fixation of distal radius fractures.

Design: Prospective randomized parallel group comparative trial.

Setting: Trauma Hospital, Austria.

Relation of the lumbosacral trunk to the sacro-iliac joint.

This study aims to evaluate the relation between the lumbosacral trunk (LT) and the sacro-iliac joint (SIJ). In forty anatomic specimens (hemipelves) a classical antero-lateral approach to the SIJ was performed. The SIJ was marked at the linea terminalis (reference point A).

Danger zone - The spermatic cord during anterior plating of the symphysis pubis.

Background: Distances between anatomic landmarks and anatomic structures at risk are often underestimated by surgeons.

Purpose: The goal of the study was to evaluate the distances between anatomic landmarks and the spermatic cord in case of anterior plating of the symphysis.

Methods: A total of 25 pelves (50 hemipelves) of male embalmed cadavers were dissected.

In vitro testing of silver-containing spacer in periprosthetic infection management.

Deep infection is a serious complication in endoprosthetic surgery. In correlation to the patient local or systemic compromising factors conservative and surgical proceedings has to be evaluated. Systemic antibiotic therapy is the gold standard in infection management.

Projection of the A1-Pulley of the Thumb onto Superficial Anatomical Landmarks: An Anatomical Study and a Useful Guide to Surgeons.

Background: The aim of our study was to project the A1-pulley of the thumb onto the total thumb length to enable its complete division with and without direct sight.

Materials And Methods: The study involved 50 hands from adult human cadavers. The proximal and distal borders of the A1-pulley were measured with reference to the first metacarpophalangeal joint (MCPJ).

Three-dimensional morphometry of the first two sacral segments and its impact on safe transiliac-transsacral screw placement.

Introduction: Percutaneous screw fixation of the posterior pelvic ring is a popular technique to treat unstable pelvic ring lesions. This technique is practicable in both, the high-energy pelvic ring fractures, mostly in the young population as well as the osteoporotic fractures in the elderly. Risk of the transiliac-transsacral screw positioning is that the critical area of nerve root exit has to be passed twice.

Definition of a Risk Zone for the Axillary Nerve Based on Superficial Landmarks.

Background: The aim of this study was to investigate the axillary nerve's location along superficial anatomical landmarks, and to define a convenient risk zone.

Methods: A total of 123 upper extremities were evaluated. After dissection of the axillary nerve, the vertical distance between the upper border of the anterolateral edge of the acromion and the proximal border of the nerve was measured.

Successful salvage via re-osseointegration of a loosened implant in a patient with transtibial amputation.

Case Description: Osseointegration is a relatively new technique for prosthetic limb attachment that offers various improvements for patients with amputation and facilitates joint preservation. We present a case of implant loosening during rehabilitation in a patient with transtibial amputation that was successfully managed through a combination of measures, aiming to promote re-osseointegration of the implant.

Objectives: Not much is known about structured management of adverse events after osseointegration.

Optimal pin position in supraacetabular external fixation.

Background: This study focuses on (i) the length of the intraosseous part of the supraacetabular pin using the insertion technique from the spina iliaca anterior inferior to the cortical part of the incisura ischiadica major, (ii) the angle of insertion of the supraacetabular pin in the transversal plane and (iii) gender-specific differences of the measured results.

Methods: Images of uninjured pelves from 49 patients (64-line computed tomography scanner) were evaluated, and virtual external fixator pins were positioned using a three-dimensional reconstructions of computed tomography scans. The length of the pins and the insertion angle were investigated.

Effectiveness of reverse total shoulder arthroplasty for primary and secondary fracture care: mid-term outcomes in a single-centre experience.

Background: The introduction of reverse total shoulder arthroplasty (RSA) as a treatment option in complex proximal humeral fractures, has significantly extended the surgical armamentarium. The aim of this study was to investigate the mid-term outcome following fracture RSA in acute or sequelae, as well as salvage procedures. It was hypothesized that revision RSA (SRSA) leads to similar mid-term results as primary fracture treatment by RSA (PRSA).

Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis.

Background: Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood.

Methods: This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI.

Tracheal intubation in traumatic brain injury: a multicentre prospective observational study.

Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity.

Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters.

The 2-2-2-20-20 concept for supraacetabular schanz screw insertion without additional radiography.

Purpose: Application of supraacetabular Schanz screws is usually performed under image intensifier guidance. The aim of this study was to perform it without imaging, with the hypothesis that, respecting anatomical landmarks, pre- and intraoperative fluoroscopy can be avoided.

Material & Methods: Insertion of the supra-acetabular Schanz screws was performed by two trauma surgery residents in a study sample of 14 human adult cadavers which had been embalmed by use of Thiel`s method.

Informed consent procedures in patients with an acute inability to provide informed consent: Policy and practice in the CENTER-TBI study.

Purpose: Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice.

Patellar Tendon Length is Associated with Lower Extremity Length but Not Gender.

Background: The aim of this study was to evaluate the patellar tendon length (PTL) with focus on gender differences and possible correlations with the total leg length (TLL) and the long bones of the lower extremity.

Materials And Methods: The sample involved 50 paired lower extremities from human adult cadavers. The TLL was measured between the medial malleolus and the apex of the greater trochanter.

Functional and radiological outcome of distal radius fractures stabilized by volar-locking plate with a minimum follow-up of 1 year.

Introduction: Distal radius fractures (DRF) are the most common fractures of the upper extremities and incidence is expected to continue rising as life expectancy increases. Palmar locking plate stabilizing has since become the standard treatment for dorsally displaced DRF. Main aim of this study was to investigate correlation between radiological and clinical outcome in patients stabilized by palmar locking plate with a minimum follow-up of one year.

Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures.

A wide range of different classifications exist for distal radius fractures (DRF). Most of them are based on plane X-rays and do not give us any information on how to treat these fractures. A biomechanical understanding of the mechanical forces underlying each fracture type is important to treat each injury specifically and ensure the optimal choice for stabilization.

Rehabilitation after distal radius fractures: is there a need for immobilization and physiotherapy?

Although the literature generally agrees that displaced distal radius fractures require surgery, no single consensus exists concerning the length of immobilization and type of post-operative physiotherapeutic rehabilitation program. Palmar locking plate fixation represents a very stable fixation of the distal radius, and was assessed biomechanically in various studies. Surprisingly, most authors report additional immobilization after plate fixation.

Indications, surgical approach, reduction, and stabilization techniques of distal radius fractures.

Distal Radius fractures (DRF) are one of the most common injuries in the upper extremity and incidence is expected to rise due to a growing elderly population. The complex decision to treat patients operatively or conservatively depends on a large variety of parameters which have to be considered. No unanimous consensus has been reached yet, which operative approach and fixation technique would produce the best postoperative functional results with lowest complication rates.

Complications after operatively treated distal radius fractures.

In the recent years, treatment of distal radius fractures (DRF) has advanced considerably. Surgical fixation with palmar angular stable plate has gained popularity, due to a reported lower complication rate when compared to dorsal fixation. The type of trauma or injury, surgical procedure and impaired bone quality are all contributors to complications in DRF.

Salvage procedure after malunited distal radius fractures and management of pain and stiffness.

Indications for surgical treatment of distal radius fractures (DRF) remain controversial in the literature, especially in elderly patients. Complication rates after operatively treated DRF are low and well documented. These include malunion, degenerative osteoarthritis in the radiocarpal joint and subsequently pain and impaired hand function.