The aim of this study is to answer the question whether a modified, minimally invasive Madigan/Insall operation is an appropriate treatment for acute or recurrent patellar dislocations. Between January 1, 2002 and June 30, 2005 a total of 56 patients with acute and chronic patellar dislocations were operated. The patients underwent follow-up examinations between 8 and 19 months postoperatively. Their subjective satisfaction with the result was assessed (according to Larsen and Lauridsen). 34 of the operated patients (94%) were available for follow-up. 28 of them had a good, 3 a satisfactory and 3 a poor subjective result. No re-dislocation occurred. A large number of operative techniques has been described for the treatment of acute and recurrent patellar dislocation. In our opinion, a minimally invasive operative technique, in which the patella is actively stabilized by the vastus medialis muscle, has decisive advantages compared to conventional techniques.
{"title":"Frühe Ergebnisse nach minimalinvasiver operativer Versorgung von frischen und chronisch rezidivierenden Kniescheibenluxationen bei jungen Erwachsenen","authors":"A. Appelt1","doi":"10.1055/s-2006-924391","DOIUrl":"https://doi.org/10.1055/s-2006-924391","url":null,"abstract":"The aim of this study is to answer the question whether a modified, minimally invasive Madigan/Insall operation is an appropriate treatment for acute or recurrent patellar dislocations. Between January 1, 2002 and June 30, 2005 a total of 56 patients with acute and chronic patellar dislocations were operated. The patients underwent follow-up examinations between 8 and 19 months postoperatively. Their subjective satisfaction with the result was assessed (according to Larsen and Lauridsen). 34 of the operated patients (94%) were available for follow-up. 28 of them had a good, 3 a satisfactory and 3 a poor subjective result. No re-dislocation occurred. A large number of operative techniques has been described for the treatment of acute and recurrent patellar dislocation. In our opinion, a minimally invasive operative technique, in which the patella is actively stabilized by the vastus medialis muscle, has decisive advantages compared to conventional techniques.","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"128 - 132"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-924391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58059540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Es wird uber die atypische Verwendung eines aus einer Gefasprothese zurechtgeschnittenen PTFE-Patches in der Behandlung einer rezidivierenden distalen tibiofibularen Synostose bei einem heute 37-jahrigen Mann gut 5 Jahre nach Versorgung einer dislozierten Bimalleolarfraktur und nach mehreren, jeweils nur kurzzeitig erfolgreichen operativen Synostosenresektionen berichtet. A case is reported of atypical usage of a PTFE patch (token from a vascular prothesis) in the treatment of a posttraumatic distal tibiofibular synostosis 5 years after internal fixation of a bimalleolar ankle fracture and after multiple previous resections of the alteration.
{"title":"Resektion einer mehrfach rezidivierenden distalen tibiofibularen Synostose und Interposition eines PTFE-Patches","authors":"D. Häußler1","doi":"10.1055/s-2006-924392","DOIUrl":"https://doi.org/10.1055/s-2006-924392","url":null,"abstract":"Es wird uber die atypische Verwendung eines aus einer Gefasprothese zurechtgeschnittenen PTFE-Patches in der Behandlung einer rezidivierenden distalen tibiofibularen Synostose bei einem heute 37-jahrigen Mann gut 5 Jahre nach Versorgung einer dislozierten Bimalleolarfraktur und nach mehreren, jeweils nur kurzzeitig erfolgreichen operativen Synostosenresektionen berichtet. A case is reported of atypical usage of a PTFE patch (token from a vascular prothesis) in the treatment of a posttraumatic distal tibiofibular synostosis 5 years after internal fixation of a bimalleolar ankle fracture and after multiple previous resections of the alteration.","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"133 - 136"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-924392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58059562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Complex injuries of the shoulder are comparatively rare. This article especially deals with the diagnosis and therapy of the so called “floating shoulder”. This term describes a discontinuation of the osseus and soft tissue suspension of the upper extremity from the axial skeleton, a combination of a shaft fracture of the clavicle with a neck fracture of the scapula and ligamentous rupture. By literature review and involvement of recent biomechanical studies this article will show the injury patterns that lead to instability of the shoulder girdle and the therapeutic to be employed in respective cases.
{"title":"Komplexverletzung der Schulter - Floating Shoulder","authors":"W. Köstler1, P. Strohm1, N. Südkamp1","doi":"10.1055/s-2006-924389","DOIUrl":"https://doi.org/10.1055/s-2006-924389","url":null,"abstract":"Complex injuries of the shoulder are comparatively rare. This article especially deals with the diagnosis and therapy of the so called “floating shoulder”. This term describes a discontinuation of the osseus and soft tissue suspension of the upper extremity from the axial skeleton, a combination of a shaft fracture of the clavicle with a neck fracture of the scapula and ligamentous rupture. By literature review and involvement of recent biomechanical studies this article will show the injury patterns that lead to instability of the shoulder girdle and the therapeutic to be employed in respective cases.","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"118 - 121"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-924389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58059483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Operative Behandlung von Frakturen des thorakolumbalen Überganges mit spinalem Einstand unter besonderer Berücksichtigung der Methode der ventralen spinalen Clearance","authors":"A. Loch1, K. Winker1","doi":"10.1055/s-2006-923894","DOIUrl":"https://doi.org/10.1055/s-2006-923894","url":null,"abstract":"Ziel: Studiendesign: Ergebnisse: Schlussfolgerungen: Introduction: Aims: Design: Results: Conclusions:","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"59 - 71"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-923894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Andermahr1, K. Mader2, A. Elsner3, A. Prokop1, J. Isenberg1, A. Jubel1
{"title":"Perkutane Fixation des distalen Radius - Sind perkutane Spickdrahttechniken noch indiziert?","authors":"J. Andermahr1, K. Mader2, A. Elsner3, A. Prokop1, J. Isenberg1, A. Jubel1","doi":"10.1055/s-2006-923920","DOIUrl":"https://doi.org/10.1055/s-2006-923920","url":null,"abstract":"","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"78 - 85"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-923920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Die Cross-Pinfixation (CP-Fixation) des BPTB-Transplantates femoralseitig in der Frontcross-Technik (FC-Technik) mit einem CB5-Pin und tibial in Abhängigkeit von der Patellarsehnenlänge ebenfalls in der FC-Technik oder in der Transcross-Technik (TCTechnik) mit zwei CB3-Pins ist ein neuartiges biologisches und stabiles Fixationsverfahren. An porcinen Testpräparaten mit tibialer CP-Fixation des BPTB-Transplantates wurde unter Zugbelastung in der Tunnellängsachse für die TCP-Fixation eine mittl. max. Verankerungsfestigkeit von 745 ± 158 N und für die FCPFixation von 906 ± 136 N ermittelt. Bei zyklischer submaximaler Belastung zwischen 50 und 360 N betrug die mittl. max. Blockbewegung im Tunnel nach 1000 Lastzyklen für die TCP-Fixation 1,3 ± 0,16 mm und für die FCP-Fixation 1,2 ± 0,9 mm. Die Blockbewegungen waren reversibel. Die FCP-Fixation des 15 – 20 mm langen patellaren Knochenblockes im femoralen Sackloch und des 20– 25 mm langen tibialen Knochenblockes im tibialen Tunnel erfordert keine Zugangserweiterung oder zweiten Zugang. Für die korrekte Pinkanalanlage und Pinplatzierung hat sich das Merete CPFIX-System bewährt. Nach der femoralen Fixation muss die tibiale CP-Fixation bei voller Kniestreckung durchgeführt werden, um bei der sehr gelenknahen Transplantatfixation postoperative Streckhemmungen zu vermeiden. Die CP-Fixation hat keine Transplantattraumatisierung zur Folge und ermöglicht eine Rundumeinheilung der Transplantatblöcke. Die CB-Pins zeigen eine vollständige Osteointegration, die im Röntgenbild sichtbar nach 6 – 8 Monaten beginnt und sich über einen Zeitraum von 2 –3 Jahren erstreckt. Zusammenfassend ist auf der Basis der biomechanischen Testresultate und der positiven klinischen Abstract
{"title":"Cross-Pinfixation des Patellarsehnentransplantates zum Ersatz des vorderen Kreuzbandes mit biointegrablen CB-Pins - Biomechanik und Operationstechnik","authors":"L. Gotzen1, D. Jorda1, R. Strehl1","doi":"10.1055/s-2006-924078","DOIUrl":"https://doi.org/10.1055/s-2006-924078","url":null,"abstract":"Die Cross-Pinfixation (CP-Fixation) des BPTB-Transplantates femoralseitig in der Frontcross-Technik (FC-Technik) mit einem CB5-Pin und tibial in Abhängigkeit von der Patellarsehnenlänge ebenfalls in der FC-Technik oder in der Transcross-Technik (TCTechnik) mit zwei CB3-Pins ist ein neuartiges biologisches und stabiles Fixationsverfahren. An porcinen Testpräparaten mit tibialer CP-Fixation des BPTB-Transplantates wurde unter Zugbelastung in der Tunnellängsachse für die TCP-Fixation eine mittl. max. Verankerungsfestigkeit von 745 ± 158 N und für die FCPFixation von 906 ± 136 N ermittelt. Bei zyklischer submaximaler Belastung zwischen 50 und 360 N betrug die mittl. max. Blockbewegung im Tunnel nach 1000 Lastzyklen für die TCP-Fixation 1,3 ± 0,16 mm und für die FCP-Fixation 1,2 ± 0,9 mm. Die Blockbewegungen waren reversibel. Die FCP-Fixation des 15 – 20 mm langen patellaren Knochenblockes im femoralen Sackloch und des 20– 25 mm langen tibialen Knochenblockes im tibialen Tunnel erfordert keine Zugangserweiterung oder zweiten Zugang. Für die korrekte Pinkanalanlage und Pinplatzierung hat sich das Merete CPFIX-System bewährt. Nach der femoralen Fixation muss die tibiale CP-Fixation bei voller Kniestreckung durchgeführt werden, um bei der sehr gelenknahen Transplantatfixation postoperative Streckhemmungen zu vermeiden. Die CP-Fixation hat keine Transplantattraumatisierung zur Folge und ermöglicht eine Rundumeinheilung der Transplantatblöcke. Die CB-Pins zeigen eine vollständige Osteointegration, die im Röntgenbild sichtbar nach 6 – 8 Monaten beginnt und sich über einen Zeitraum von 2 –3 Jahren erstreckt. Zusammenfassend ist auf der Basis der biomechanischen Testresultate und der positiven klinischen Abstract","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"72 - 77"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-924078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58058117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ergeb-Abstract High failure rates due to instability and redisplacement are re-ported using the dynamic hip screw-fixation of femoral neck fractures in the elderly. This fact was the reason for the development of the dynamic hip nail (DHN) which has a TU cross-section profile and should provide more resistance against cutting through the femoral head trabecular bone than the commonly used DHS. For a comparing stability investigation fixation of vertical femoral neck osteotomies in eight pairs of macroscopically normal cadaver femora was performed with either the DHS supplemented proximally with a parallel 6.5 mm cancellous screw or the DHN. Fixed in a testing machine at an adduction angle of 9 (cid:2) the specimens were vertically loaded from 1 kN up to 4.5 kN with a stepwise increase of 0.5 kN and 500 load cycles within each load level. The applied loads were increased until a distal displacement of the femoral heads of 2 mm was measured. From the recorded loads and number of cycles at the 2 mm distal head displacement the overall load bearing capacity of the DHS-and DHN-osteosyntheses were calculated in kN. The test results indicated that the DHN provided a much more stronger support for the femoral head against dynamic vertical compression loads than the DHS. In three of the eight DHN-osteosyntheses the 2 mm distal head displacement did not occur after 500 cycles at the maximal load of 4.5
{"title":"Vergleichende Stabilitätsuntersuchungen an DHS- und DHN-Osteosynthesen subkapitaler Pauwels-III-Osteotomien als Modell höhergradig instabiler medialer Schenkelhalsfrakturen","authors":"R. Strehl1, L. Gotzen1","doi":"10.1055/s-2006-923914","DOIUrl":"https://doi.org/10.1055/s-2006-923914","url":null,"abstract":"Ergeb-Abstract High failure rates due to instability and redisplacement are re-ported using the dynamic hip screw-fixation of femoral neck fractures in the elderly. This fact was the reason for the development of the dynamic hip nail (DHN) which has a TU cross-section profile and should provide more resistance against cutting through the femoral head trabecular bone than the commonly used DHS. For a comparing stability investigation fixation of vertical femoral neck osteotomies in eight pairs of macroscopically normal cadaver femora was performed with either the DHS supplemented proximally with a parallel 6.5 mm cancellous screw or the DHN. Fixed in a testing machine at an adduction angle of 9 (cid:2) the specimens were vertically loaded from 1 kN up to 4.5 kN with a stepwise increase of 0.5 kN and 500 load cycles within each load level. The applied loads were increased until a distal displacement of the femoral heads of 2 mm was measured. From the recorded loads and number of cycles at the 2 mm distal head displacement the overall load bearing capacity of the DHS-and DHN-osteosyntheses were calculated in kN. The test results indicated that the DHN provided a much more stronger support for the femoral head against dynamic vertical compression loads than the DHS. In three of the eight DHN-osteosyntheses the 2 mm distal head displacement did not occur after 500 cycles at the maximal load of 4.5","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"53 - 58"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-923914","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Meinig1, N. Haberland2, B. Böhm1, N. Wagner1, K. Asmus3
Einleitung: Material und Methode: Ergebnisse: Diskussion: Introduction: Materials and Methods: Results: Conclusion:
前言:材料与方法:讨论:介绍:材料与方法:结果:结论:
{"title":"Die navigierte Verschraubung des Iliosakralgelenkes nach traumatischer Dislokation","authors":"H. Meinig1, N. Haberland2, B. Böhm1, N. Wagner1, K. Asmus3","doi":"10.1055/s-2006-923912","DOIUrl":"https://doi.org/10.1055/s-2006-923912","url":null,"abstract":"Einleitung: Material und Methode: Ergebnisse: Diskussion: Introduction: Materials and Methods: Results: Conclusion:","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"86 - 90"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-923912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Einsiedel1, D. Seitz1, M. Schultheiss1, L. Kinzl1, A. Schmelz1
We examined all patients that underwent amputation or reconstructive surgery for endangered limbs due to trauma or other reasons (ischemia, infection) between 1.1.1980 and 31.12.2005 at the Department of Trauma, Hand and Reconstructive Surgery of Ulm University. We analyzed therapeutic and diagnostic strategies as well as the development of frequenzy of ablations or re-constructive surgery over the years. 2200 amputations were performed in the period of regard, 745 of upper and 1455 of lower limbs. In the same time 1783 successful operations in order to save extremities were performed, 860 in the upper and 923 in the lower limb. 46 patients (2%) had a “MESS” (mangled extremity severity score) of six or more points indicating the need for amputation, thus these limbs were saved. 1450 ablations were done between 1980 and 1990, but only 750 from 1991 until the end of 2005. 60% of the operations in the lower and 83% of those in upper limbs were “minor” ablations (toes, finger, forefoot) whileas 17% of amputations in the upper and 40% in the lower extremities were “major” resections up to complete leg and arm. Using single typical cases treated in our institution, we discuss indication and contraindication for saving of limbs under critical conditions. In addition to surgical and medical aspects, psychosocial and familiar surroundings of the patients may not be neglected when deciding if a limb can be saved or not.
{"title":"Amputation oder Rekonstruktion - Extremitätenerhalt in Grenzsituationen","authors":"T. Einsiedel1, D. Seitz1, M. Schultheiss1, L. Kinzl1, A. Schmelz1","doi":"10.1055/s-2006-924077","DOIUrl":"https://doi.org/10.1055/s-2006-924077","url":null,"abstract":"We examined all patients that underwent amputation or reconstructive surgery for endangered limbs due to trauma or other reasons (ischemia, infection) between 1.1.1980 and 31.12.2005 at the Department of Trauma, Hand and Reconstructive Surgery of Ulm University. We analyzed therapeutic and diagnostic strategies as well as the development of frequenzy of ablations or re-constructive surgery over the years. 2200 amputations were performed in the period of regard, 745 of upper and 1455 of lower limbs. In the same time 1783 successful operations in order to save extremities were performed, 860 in the upper and 923 in the lower limb. 46 patients (2%) had a “MESS” (mangled extremity severity score) of six or more points indicating the need for amputation, thus these limbs were saved. 1450 ablations were done between 1980 and 1990, but only 750 from 1991 until the end of 2005. 60% of the operations in the lower and 83% of those in upper limbs were “minor” ablations (toes, finger, forefoot) whileas 17% of amputations in the upper and 40% in the lower extremities were “major” resections up to complete leg and arm. Using single typical cases treated in our institution, we discuss indication and contraindication for saving of limbs under critical conditions. In addition to surgical and medical aspects, psychosocial and familiar surroundings of the patients may not be neglected when deciding if a limb can be saved or not.","PeriodicalId":75462,"journal":{"name":"Aktuelle Traumatologie","volume":"36 1","pages":"91 - 102"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-2006-924077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58058106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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