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Zementwahl bei der Ballonkyphoplastie - Anforderungsprofil und klinische Eignung 舞会模式需要混凝土覆盖和药物
Pub Date : 2006-02-01 DOI: 10.1055/S-2006-923923
T. Blattert, S. Katscher, A. Weckbach
In kyphoplasty and vertebroplasty, polymethylmethacrylate (PMMA) currently represents the standard augmentation material. It is characterized, however, by a lack of osteointegration and limited biocompatibility. This paper discusses favorable properties of different types of cement and investigates the feasibility of calcium phosphate (CaP) in balloon kyphoplasty if compared to PMMA. A total of 60 fractures in 55 patients were included. Both CaP and PMMA were applied in 30 vertebra each. Complications that turned out to be cement-specific were: vascular embolism (n = 2) using PMMA; as well as subtotal "cement washout" (n = 1), and radiographic loss of correction (n = 9) due to cement failure in fractures type A3 using CaP. Currently in kyphoplasty, a routine use of CaP cannot be recommended. Due to its minor resistance to bending, extension, and shear forces if compared to PMMA, there is a higher risk of cement failure and subsequent loss of correction.
在后凸成形术和椎体成形术中,聚甲基丙烯酸甲酯(PMMA)目前是标准的增强材料。然而,它的特点是缺乏骨整合和有限的生物相容性。本文讨论了不同类型水泥的优点,并探讨了磷酸钙(CaP)在球囊后凸成形术中的可行性,并与PMMA进行了比较。共纳入55例患者的60例骨折。CaP和PMMA各应用30个椎体。水泥特异性并发症包括:使用PMMA的血管栓塞(n = 2);以及小计的“水泥冲洗”(n = 1),以及由于使用CaP的A3型骨折的水泥失效而导致的影像学矫正损失(n = 9)。目前在后凸成形术中,不推荐常规使用CaP。由于与PMMA相比,它对弯曲、拉伸和剪切力的抵抗较小,因此水泥破坏和随后的矫正损失的风险更高。
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引用次数: 4
Effektivität von Vertebroplastie und Kyphoplastie in der Aufrichtung osteoporotischer Wirbelkörperfrakturen 骨质疏松和裂在骨质疏松处骨折效果
Pub Date : 2006-02-01 DOI: 10.1055/s-2006-923924
G. Voggenreiter1, E. Lenz1, U. Obertacke2, R. Ascherl1
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引用次数: 10
Konservative versus operative Therapie der Skapulafraktur 肩胛骨骨折的保守治疗与手术治疗
Pub Date : 2006-02-01 DOI: 10.1055/s-2005-873021
E. Euler1, W. Mutschler1
Skapulafrakturen konnen meist konservativ behandelt werden. Bei instabilen Verletzungsformen, erheblicher Dislokation, verschobenen Gelenkbruchen oder komplexen Verletzungen (z. B. zusatzlicher Klavikulafraktur oder Humeruskopffraktur) ist eine operative Therapie erforderlich, um eine fruhfunktionelle Nachbehandlung zu ermoglichen und ein funktionell optimales Behandlungsresultat zu erzielen. Die unterschiedlichen Verletzungsformen werden mit Therapieempfehlungen einschlieslich operativer Zugange und Osteosynthesetechniken und Beispielen aus der Klinik vorgestellt. Durch die operative Therapie hohergradiger, d. h. schwerwiegender Verletzungsformen konnen Behandlungsresultate erreicht werden, die denjenigen nach konservativer Therapie leichterer Verletzungen entsprechen. Fractures of the scapula may be treated conservatively in most of the cases. Unstable injuries, considerable dislocation, displaced fractures of the glenoid fossa or complex injuries (i.e. additional fracture of the clavicula or fracture of the humeral head) demand ORIF to enable early functional aftertreatment and to achieve an optimal functional outcome. The various injuries are shown including recommendations for treatment, operative approaches, ORIF techniques and clinical examples. The functional outcome of high grade injuries treated by ORIF is comparable to those of low grade injuries treated conservatively.
骨折处通常只能保守地治疗。发生不稳定的伤口、严重骨折、关节破裂或复杂受伤(例如多处盆骨骨折或半人面骨折)时,需要经过外科手术治疗才能获得功能性回馈并获得可使用的最佳治疗结果。不同的受伤形式包括不同的治疗建议,有的还会从运作中进行,有的则会在诊所里提供人体合成技术,有的则在诊所里示范。于是使用一种手术疗法(疗程疗法),也就是严重受伤的病人,能够得到相当于较轻受到保守疗法疗法伤害的病人的治疗结果。碰到一个洞的机械分析不不合常规、难以置信的位置开始呈现《甲板上的正常运转》或者《洞天的轮廓》前一章《变量内嵌反应》交换文件嘛!
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引用次数: 6
Ballonkyphoplastie: Indikation, Diagnostik, operative Technik, Ergebnisse. Teil 1 抽搐分析技术和结果第一部分
Pub Date : 2006-02-01 DOI: 10.1055/s-2006-923921
S. Glasmacher, T. Blattert, H. Siekmann, C. Josten
Balloon kyphoplasty is a relatively new minimal-invasive method for stabilization and pain relief of osteoporotic fractures. At first two Yamshidi needles are slided transpediculary into the vertebral body. The balloons, inserted through these hollow needles, are being filled up to reduce the fractured vertebral body and to create cavities. After removal of the balloons these cavities are being filled with cement (PMMA). The primary indication is the osteoporotic fracture. Depending on the fracture's age and type this treatment can lead to complete reduction. Though limited on A-fractures, current developments of these balloons open up new opportunities, possibly providing a broader range of applications. Compared to vertebroplasty this technique presents fewer complications at equal success in reducing pain.
球囊后凸成形术是一种相对较新的微创方法,用于骨质疏松性骨折的稳定和疼痛缓解。首先,两根雅氏针经椎弓根滑入椎体。通过这些空心针插入的气球被填充,以减少骨折的椎体并产生空腔。在移除气球后,这些空洞被水泥(PMMA)填充。主要指征是骨质疏松性骨折。根据骨折的年龄和类型,这种治疗可以导致完全复位。虽然在a型裂缝上受到限制,但目前的发展为这些气球开辟了新的机会,可能提供更广泛的应用。与椎体成形术相比,该技术在减轻疼痛方面同样成功,并发症更少。
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引用次数: 1
Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions 超声检查:一种诊断Hill-Sachs病变的高效方法
Pub Date : 2006-02-01 DOI: 10.1055/s-2005-873017
I. Dudkiewicz1, A. Blankstein2
Purpose: Material and Methods: Results: Conclusions:
目的:材料与方法:结果:
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引用次数: 1
Ballonkyphoplastie: Indikation, Diagnostik, operative Technik, Ergebnisse. Teil 2 抽搐分析技术和结果第2部分
Pub Date : 2006-02-01 DOI: 10.1055/s-2006-923922
T. Blattert, S. Glasmacher, C. Josten
Im Rahmen einer prospektiven klinischen Studie wurden mittels perkutaner Ballonkyphoplastie unter Verwendung eines Polymethylmethacrylat-Zementes stabilisierte Wirbelkorper erfasst. Pra- und postoperativ erfolgte die Erhebung folgender Daten: subjektive Schmerzbeurteilung, bisegmentaler Grund-Deckplatten-Winkel (GDW2) sowie Wirbelkorpervorder- und ‐hinterkantenhohe. Insgesamt wurden 62 Wirbelkorper bei 40 Patienten mit Schmerzsymptomatik eingeschlossen. Das durchschnittliche Patientenalter lag bei 74 Jahren (57 - 90). 31 Patienten gaben einen durchschnittlich drei Wochen zuruckliegenden Zeitpunkt des Schmerzbeginns an, 9 Patienten konnten sich nicht an den Beginn der Schmerzen erinnern. Die Lokalisation der Fraktur betraf nur die thorakolumbale Wirbelsaule, wobei es sich ausschlieslich um Typ-A-Verletzungen handelte. 39 von 40 Patienten auserten postoperativ eine deutliche subjektive Schmerzlinderung. Die durchschnittliche Aufrichtung des GDW2 betrug 5,8°. Die Wirbelkorpervorderkante konnte durchschnittlich um 7,4 mm, die Hinterkante um 3,0 mm aufgerichtet werden. Neurologische Komplikationen traten nicht auf. In 7 Fallen kam es zu einer Zementextrusion (davon 3-mal nach epidural), die jedoch ohne klinische Folgen blieb. Viermal platzte der Ballon und zweimal kam es im weiteren Verlauf innerhalb von 3 Monaten zu Anschlussfrakturen benachbarter Wirbelkorper. Die Ballonkyphoplastie ist ein geeignetes, wenig traumatisierendes Verfahren zur operativen Behandlung insbesondere der osteoporotischen Wirbelkorperfraktur des alteren Menschen mit regelhafter deutlicher Schmerzreduktion. All vertebrae stabilized with polymethylmethacrylate by means of percutaneous balloon kyphoplasty were evaluated within a prospective clinical study. Pre- and postoperatively, the following data were acquired: subjective rating of pain, bisegmental endplate-angle (EA2), anterior and posterior height of vertebra. Altogether, 62 vertebrae of 40 patients suffering from acute pain could be included into the study. The average patient age was 74 years (57 - 90). 31 patients suffered from pain for three weeks on average, whereas 9 patients were not able to recall the onset of pain. Fractures were only localized within the thoracolumbar spine with only A type of injuries occurring. 39 of 40 patients experienced marked pain-relief postoperatively. Average correction of EA2 was 5.8°. The anterior vertebral height could be restored by 7.4 mm on average, posterior height by 3.0 mm. There were no neurological complications postoperatively. In 7 vertebrae, we saw intraoperative leakage of cement (3 out of these with epidural leakage), however, no clinical consequences had to be noted. There were 4 cases of intraoperative balloon perforation, and 2 cases of subsequent vertebral body fractures in the adjacent level within the first 3 months. Balloon kyphoplasty is an efficient, and minimally-invasive therapeutic option for the treatment of painful vertebral body fractures having its focus
一项预测临床试验描述了使用甲基苯丙胺凝固剂稳定的脊椎纤维,使用后甲烯酮测定法进行预测试验。Pra和postoperativ并收集以下数据:主观Schmerzbeurteilung bisegmentaler Grund-Deckplatten-Winkel (GDW2)以及Wirbelkorpervorder‐hinterkantenhohe .共包括62名有疼痛症状的病人。病人的平均年龄是74岁(57—90岁)。31名病人表明平均三星期才能开始痛苦,9名病人不记得开始痛苦。骨折的明确地点只涉及胸腔脊椎和a型伤口。40名病人中,有39位术后病人具有明显的主观疼痛感。平均,GDW2建立起来是58°.漩涡前端平均有7.4毫米,后面却有3 . 0毫米。神经并发症没有发生。当涉及到水泥泄漏时,有7个地方发生了水泥泄漏(其中3次是外膜放射性),但没有药物的影响。气球裂了四次,还有两次发生在3个月之内的、相邻的断骨。脊椎骨成份是适当的、治疗创伤适度的外科手术,特别是针对老人骨质疏松、严重减少疼痛的致幻方法。使用多形式的开门和后来的干尸数据可以看到这是潘的主观成绩,富于专业知识的成绩(EA2),前阶和后阶瞬间醒来。阿尔多gether 62名患者喝酒后产生的年约七十四岁31病人从痛苦中得到三星期治疗,而九名病人无法回忆起痛苦放松点是尾部肌肉﹙40岁病人﹙恭喜﹚平均指数correction of EA2什么5.8°.且慢笔记本里说纳维尔胡扯胡扯这里没有神经管理学后综合症。《工资对话》第7集有4个装腔次输入气泡以及2个次修正后身体表面的旋块巴厘匹司是一个合成物和微创侵入治疗方法
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引用次数: 4
Faktor-XIII-Mangel als Ursache ausgedehnter intramuskulärer Hämatome beim chirurgisch-geriatrischen Patienten: Ein Fallbeispiel 因子xiii缺位,是指手术肉质病人胃大增的原因:一个案例
Pub Date : 2006-02-01 DOI: 10.1055/s-2006-923913
C. Nitschke1, F. Holz1
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引用次数: 0
Fehler und Komplikationen bei der Kyphoplastie 圣体中
Pub Date : 2006-02-01 DOI: 10.1055/s-2006-923919
S. Katscher1, T. Blattert1, S. Glasmacher1, O. Gonschorek2, C. Josten1
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引用次数: 3
Der zementfreie CLS-Titangeradschaft - Langzeitergebnisse, Indikationen und Limitationen 没水泥的十字形干扰时间模拟、笛和边缘
Pub Date : 2005-12-01 DOI: 10.1055/s-2005-872995
P. Aldinger,1, A. Jung1, D. Parsch1, S. Breusch1
. Abstract The uncemented CLS stem has been in clinical use since 1985. With over 350000 implantations it has become one of the most frequently implanted uncemented femoral hip stems in Europe. Even in femoral deformities and in the hands of surgeons with differing levels of surgical training the long term results have been demonstrated to be outstanding. In this article the long term results, indications and limitations of a straight co-rundum blasted titanium femoral component with a follow-up up to 20 years are discussed. The insertion of an uncemented straight femoral component is a lot simpler and susceptible to less sources of error than a well cemented hip stem. It can provide more consistent and durable results even in femoral de-formities.
. 自1985年以来,未胶结CLS干细胞在临床应用。超过35万例植入,它已成为欧洲最常见的植入非骨水泥股骨髋关节干之一。即使在股骨畸形和不同程度的手术训练的外科医生手中,长期的结果已被证明是杰出的。在本文中,长期结果,适应症和局限性的直共刚囊爆破钛股假体与随访长达20年进行了讨论。非骨水泥直股假体的置入比骨水泥良好的髋关节假体更简单,容易受到更少误差的影响。它可以提供更一致和持久的结果,即使在股畸形。
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引用次数: 5
Ein einfaches Bewertungssystem zur Einschätzung von Handverletzungen hinsichtlich der resultierenden Arbeitsunfähigkeit 一个简单的评估系统评估导致的残障和残障
Pub Date : 2005-12-01 DOI: 10.1055/s-2005-873018
N. Wachter1, P. Katzmaier1, G. Krischak1, J. Gülke1, M. Mentzel1, L. Kinzl1, T. Ebinger1
Hintergrund: Material und Methoden: Ergebnisse: Schlussfolgerung: Background: Material and Methods: Results: Conclusion:
背景:材料与方法:结果:结论:
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引用次数: 0
期刊
Aktuelle Traumatologie
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