Erroneous Classification and Coding as a Limitation for Big Data Analyses: Causes and Impacts Illustrated by the Diagnosis of Clavicle Injuries.

: Clavicle injuries are common and seem to be frequently subject to diagnostic misclassification. The accurate identification of clavicle fractures is essential, particularly for registry and Big Data analyses. This study aims to assess the frequency of diagnostic errors in clavicle injury classifications.

Predictors of prolonged hospital stay of pelvic ring and acetabular fractures - a retrospective analysis in a 10-year period of a level 1 trauma center.

Background: Pelvic ring and acetabular fractures are among the most complicated and severe injury patterns in orthopaedic trauma surgery. Inpatient treatment is not only costly but also very time-consuming. The aim of this study is to identify predictors leading to a prolonged length of hospital stay.

Self-assessment and learning motivation in emergency point-of-care ultrasound: an online pilot investigation in German physicians.

Introduction: Learning motivation is essential to obtain and maintain ultrasound competencies in emergency medicine. One's competencies herein and the need for ongoing training are best evaluated by self-assessment. This may be flawed by overconfidence effects - the belief to be better than others or better than tests reveal.

Lumbar Magnetic Resonance Imaging Shows Sex-Specific Alterations During Musculoskeletal Aging-A Radio-Anatomic Investigation Involving 202 Individuals.

: Musculoskeletal aging can clinically hardly be distinguished from degenerative disease, especially if symptoms are nonspecific, like lower back pain and reduced physical resilience. However, age-related changes are considered to be physiological until they cause osteoporotic fractures or sarcopenia-related restrictions. This radio-anatomic investigation examines whether findings in lumbar magnetic resonance imaging (MRI) mirror age- and sex-related musculoskeletal differences that help to identify the onset of sarcopenia.

Cell Salvage Using the Autotransfusion Device CATSmart: A Randomized Controlled Bicentric Trial Evaluating the Quality of Two New Flex Wash Programs.

Background: The use of cell salvage and autologous blood transfusion is an important and widespread method of blood conservation during surgeries with expected high blood loss. The continuous autotransfusion device CATSmart (Fresenius Kabi, Germany) contains two new washing programs on the device called Flex wash 3 and Flex wash 5. To the best of our knowledge, there are no published clinical data regarding the performance of the two new washing programs.

Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants.

Background And Purpose:  We aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective.

Methods:  This is a multinational combined arthroplasty registry study. Each arthroplasty registry performed Cox-regression analysis of their data and reported the crude and adjusted hazard ratios (HR) with an a priori designed data form.

Head-Shaft Angle Influences Isometric Shoulder Strength Levels after Intramedullary Nailing of Proximal Humerus Fractures: A Pilot Study.

Background: Proximal humerus fractures are common fractures of the elderly population which can lead to long-term compromise of a patient's shoulder function. Closed reduction and internal fixation with intramedullary nailing is a well-established surgical technique yielding good outcomes, as perceived by patients, obtained via Patient-Reported Outcome Measures, and objectified by clinical shoulder testing. Apart from conventional range-of-motion testing and clinical shoulder tests, strength testing of the shoulder is a yet-neglected but meaningful and standardizable outcome parameter.

The need for state-of-the-art orthopedic surgical technology in low- to middle income countries : The case of distraction epiphyseolysis for limb lengthening in children with fibular hemimelia in Uzbekistan.

Introduction: Amongst low- to middle income countries (LMIC), outdated and poorly documented orthopedic interventions may pose patients at risk for complications, serious adverse events (SAE) and unsatisfactory results, contradicting the World Health Organization's (WHO) Safe Surgery mandates. Use cases of conditions managed inadequately in LMIC environments are necessary to increase awareness of stakeholders and overcome deficiencies in collaboration with high-income countries (HIC).

Materials And Methods: Methodological and clinical experts from the BG Kliniken and the Charité, Berlin, Germany, were invited to investigate established processes for musculoskeletal disorders and injuries in Tashkent, Uzbekistan.

Historical Perspectives on the Evolution of Spino-Pelvic Fixation and its Implications on Clinical Care A Narrative Review.

Study Design: Broad narrative review.

Objectives: To review and summarize the evolution of spinopelvic fixation (SPF) and its implications on clinical care.

Methods: A thorough review of peer-reviewed literature was performed on the historical evolution of sacropelvic fixation techniques and their respective advantages and disadvantages.

Clinical and radiological outcome of surgical hallux valgus correction: open versus minimally invasive.

Introduction: Hallux valgus (HV) is the most common forefoot deformity. Surgical correction of HV aims to reduce pain, preserve joints, and re-establish foot function while restoring the hallux valgus angle (HVA) and intermetatarsal angle (IMA). Many surgical procedures have been proposed, including open and minimally invasive (MI) techniques.

Development and evaluation of a point-of-care ultrasound curriculum for paramedics in Germany - a prospective observational study and comparison.

Background: Point-of-care ultrasound (POCUS) is steadily growing in use in prehospital emergency medicine. While currently used primarily by emergency physicians, POCUS could also be employed by paramedics to support diagnosis and decision-making. Yet to date, no paramedicine-targeted POCUS curricula exist in Germany.

The social class of orthopedic rehabilitation patients: Are there differences in subjective health, return to work motivation, and participation in aftercare interventions?

This longitudinal quasi-experimental study examines the relationship between social class, subjective health, motivation to return to work (RTW) following medical rehabilitation, and participation in aftercare interventions, utilizing the Social Cognitive Theory of Social Class. To do so, a prospective multicentric study was conducted. The analysis was based on data from N = 1044 orthopedic rehabilitation patients in three clinics in Germany.

Analysis of compartment syndromes in lower extremity pediatric and adolescent trauma - are there predictors of a late onset?

Introduction: Purpose of the study was to answer the question, if there are common fracture or injury characteristics, which help to identify patient at risk for a secondary compartment syndrome.

Materials And Methods: Between 2003 and 2022 all children and adolescents who were treated for a traumatic compartment syndrome in a lower extremity were retrospectively evaluated. Patient's demographics were recorded, the underlying trauma mechanism identified.

May the 4th be with you: mixed-methods best-evidence synthesis on 4th-generation alumina-zirconia ceramic bearings in total hip arthroplasty.

Purpose: To assess utility, benefits, and risks of 4th-generation alumina-zirconia ceramic pairings in elective total hip arthroplasty (THA).

Methods: A comprehensive mixed-methods best-evidence synthesis using data from systematic reviews, randomized controlled trials (RCTs), prospective and retrospective cohort studies, as well as joint replacement registries, was conducted to estimate overall revision and survival rates, periprosthetic infection, bearing fractures, and noise phenomena with 4th-generation alumina-zirconia ceramic versus other tribological couplings in elective THA. The systematic review part across multiple databases was registered with PROSPERO (CRD42023418076), and individual study data were extracted for statistical re-analysis.

Normative Values for Sternoclavicular Joint and Clavicle Anatomy Based on MR Imaging: A Comprehensive Analysis of 1591 Healthy Participants.

The clavicle remains one of the most fractured bones in the human body, despite the fact that little is known about the MR imaging of it and the adjacent sternoclavicular joint. This study aims to establish standardized values for the diameters of the clavicle as well as the angles of the sternoclavicular joint using whole-body MRI scans of a large and healthy population and to examine further possible correlations between diameters and angles and influencing factors like BMI, weight, height, sex, and age. This study reviewed whole-body MRI scans from the Study of Health in Pomerania (SHIP), a German population-based cross-sectional study in Mecklenburg-Western Pomerania.

Effect of Multiantibiotic-Loaded Bone Cement on the Treatment of Periprosthetic Joint Infections of Hip and Knee Arthroplasties-A Single-Center Retrospective Study.

Background: Two-stage septic revision is the prevailing method for addressing late periprosthetic infections. Using at least dual-antibiotic-impregnated bone cement leads to synergistic effects with a more efficient elution of individual antibiotics. Recent data on the success rates of multiantibiotic cement spacers in two-stage revisions are rare.

Applying the German S2k-Guideline for Diagnosis and Treatment of Spondylodiscitis-A 5-Year Retrospective Evaluation of Patients without Neurological Symptoms.

Spondylodiscitis is a rather rare condition with an annual incidence of 1-7 per 100,000. Thus, empirical data on the treatment of this disease are limited. In 2020, the first German guideline for the diagnosis and treatment of spondylodiscitis was published.

[An update on clinical gait analysis : Current developments and applications].

The objective acquisition and assessment of joint movements and loads using instrumented gait analysis has become an established tool in clinical diagnostics. In particular, marker-based 3D gait analyses make use of an increasingly comprehensive database for the assessment of orthopaedic or neurological questions. Based on this data and medical-scientific experience, increasingly reliable approaches and evaluation strategies are emerging, which also draw on methods from artificial intelligence and musculoskeletal modelling.

How Useful Is Preoperative Aspiration before Revision of Unicompartmental Knee Prostheses Because of Osteoarthritis in the Other Compartments?

Aim: Periprosthetic joint infections (PJIs) of unicompartmental knee arthroplasties (UKAs) can lead to secondary osteoarthritis of the other compartments. The objective of this study was to identify the frequency of PJIs in cases of UKA with progressed secondary osteoarthritis and the result of septic one-stage revision in these cases to verify the value of preoperative aspiration in cases of secondary osteoarthritis of UKA.

Methods: We retrospectively reviewed 97 patients with a unicompartmental arthroplasty who underwent revision surgery to a total knee arthroplasty (TKA) between January 2013 and March 2021 because of subsequent osteoarthritis.

Diagnostics in Late Periprosthetic Infections-Challenges and Solutions.

The rising number of arthroplasties is combined with a rising number of periprosthetic joint infections, which leads to life-concerning consequences for the patients, including extended antibiotic treatment, further surgery and increased mortality. The heterogeneity of the symptoms and inflammatory response of the patients due to, e.g.

[Latent safety threats in a pediatric emergency department: Using in situ simulation to test a new trauma room concept].

Introduction: Structured emergency room concepts have been shown to contribute to patient safety. Until now there has been no uniform emergency room concept for critically ill and seriously injured children and adolescents in the emergency room at the Altona Children's Hospital in Hamburg. This concept has been newly developed in interdisciplinary cooperation and includes the use of new clinical premises as well as new responsibilities and team compositions.

Aseptic midterm survival rates between different cemented tibial stem designs in hinged total knee arthroplasty: a 6-year evaluation from the German Arthroplasty Registry.

Introduction: The rate of revision TKA and thus the use of hinged implants (HI) steadily rises. Aseptic loosening lies on the top of the failure patterns. However, no evidence exists until now based on national scale high-caseloads that analyzes the impact of cemented HI stem-design on aseptic survival rates.

A literature review and expert consensus statement on diagnostics in suspected metal implant allergy.

Background: Although rare, allergic reactions to metal implants represent a diagnostic challenge in view of missing guidelines.

Objectives: To develop an European expert consensus on characteristics of metal allergy reactions and the utility of various diagnostic tools in suspected metal implant allergy.

Methods: A nominal group technique (NGT) was applied to develop consensus statements.