Zeitschrift für Orthopädie und Unfallchirurgie
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Review Meta Analysis
[Diagnostic and therapeutic management of primary and recurrent patellar dislocations - analysis of a nationwide survey and the current literature].
Patellar dislocations are a common injury of the knee joint. During patella dislocations injuries of soft-tissue structures can occur that can destabilise the patella and lead to recurrent dislocations. There are also congenital pathologies that predispose to patella dislocations. In the current literature, diagnostics and treatment of patellar dislocations are frequently discussed. Therefore the aim of our survey was to analyse and summarise actual diagnostic and therapeutic strategies regarding primary and recurrent patella dislocations. ⋯ The results of our survey showed diagnostic and therapeutic procedures in the participating departments which are in accordance with recommendations in recent publications. The clinical importance of the MPFL reconstruction was observed for primary and recurrent patella dislocation. In addition, conservative treatment is still the most common treatment after primary dislocation of the patella.
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Clinical Trial
[Pseudarthrosis following surgically treated forearm fractures in children and adolescents].
Due to the changing attitude of treating paediatric forearm fractures increasingly towards the surgical stabilisation rather than conservatively by the method of elastic stable intramedullary nailing (ESIN), we are confronted with complications which have not been described in childhood previously. Pseudarthrosis following surgically treated forearm fractures in children is only found in single reports with none in the German-speaking area. The goal of this study is to define predisposing factors which may lead to pseudarthrosis after surgery for forearm fractures. ⋯ Pseudarthrosis of the forearm following surgical treatment of forearm fractures in children and adolescents mainly occurred in the middle third of the ulna. In primarily open fractures or in cases which needed to be openly reduced the risk of pseudarthrosis formation was higher. Inadequate osteosynthetic stabilisation is another factor to contribute to difficulties in fracture healing. Despite of the possibility of pseudarthrosis, the indication to ESIN treatment in paediatric forearm fractures is not doubted. It is important to keep the surgical trauma as small as possible if open reduction is required in order to not disturb the perfusion of the bone.
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Clinical Trial
[Angular and sliding stable internal fixation of proximal humerus fractures using the "Varion" intramedullary nail].
Intramedullary angular and sliding stable interlocking nails are attracting increasing attention in the treatment of fractures of the proximal humerus. This prospective study evaluates the clinical and radiological outcome of the "Varion" nail osteosynthesis system. Additionally we analysed the impact of the postoperative head-shaft angle on the functional outcome. ⋯ The "Varion nail" provides safe and effective treatment of even complicated proximal humerus fractures with good clinical and functional results. The optimum angle between head and shaft axis lies between 141 and 150°.
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The Young Forum of the German Society of Orthopedics and Traumatology is an interest group of young orthopedics and trauma surgeons in Germany. Besides dealing with topics of political interest, the group tries to arouse enthusiasm and interest for musculoskeletal surgery by means of new lectures and teaching methods. An example is the newly invented optional subject for students at the Medical School in Göttingen (Germany). ⋯ The course is divided in two main parts: a theoretical (16 hours) and a practical (10 hours) one. A good ratio of lectures, skills stations and workshops was on choice. This article explains the course in detail and shows a first evaluation result.
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Only limited data are available concerning the effect of ventral thoracoscopic spondylodesis (VTS) on elderly patients and the medium-term outcome. ⋯ Also in older patients VTS seems to be an adequate treatment of traumatic burst fractures of the thoracolumbar spine. Perioperative pulmonary complications were easy to handle and had no effect on the clinical outcome. Postoperative radiographs showed only little loss of correction, in four cases iatrogenic damage of the cover-plate led to a distinct loss of correction. Careful and accurate preparation of the cover plates is therefore decisive.