Zeitschrift für Orthopädie und Unfallchirurgie
-
Proximal femoral fractures are common in the elderly. Surgical and postoperative complications are of major importance in this population. Numerous factors affecting the treatment results could be identified so far. The effect of surgeons' experience in terms of educational status is not entirely clarified yet. The aim of the present study was to analyse the effect of surgeons' educational status on the outcome in proximal femoral fractures. Therefore treatment results were compared in terms of individual surgeons' experience. Furthermore, the surgical education concept of our department was evaluated. ⋯ Apart from cutting/suture time, surgeons' educational status had no statistically significant impact on the rate of complications, rate of blood transfusions, hospital mortality and in-hospital stay. It can be presumed that surgical education according to our educational concept has no negative effects on treatment quality of patients with proximal femoral fractures. Differences in cutting/suture time give a hint for the additional expense that is connected with surgical education.
-
The residency program for a specialist in orthopedics and trauma surgery is facing fundamental changes based on an initiative originating from the working group "medical training" of the German Medical Association (GMA). A survey indicated that 50 % of all trainees are dissatisfied with their current situation. It appears important to integrate the ideas and wishes of current orthopedic residents in a novel training concept. To assess this a survey was performed by the Young Forum of the German Society for Orthopedics und Trauma Surgery. ⋯ The upcoming changes in residency program for orthopedics and trauma surgery offer the opportunity for a well structured and practical oriented residency program. It could be a further step in increasing satisfaction in this profession.
-
Percutaneous cement augmentation systems have been proven to be an effective treatment for vertebral compression fractures in the last 10 years. A special form available since 2009 is the radiofrequency kyphoplasty (RF) in which the applied energy raises the viscosity of the cement. The aim of this study is to find out if a smaller cement amount in radiofrequency kyphoplasty can also restore vertebral body height in osteoporotic vertebral compression fractures. ⋯ With a mean cement volume of 3.0 ml radiofrequency kyphoplasty achieves rapid and short-term improvements of clinical symptoms with a significant restoration of vertebral body height. There was no correlation between restoration of vertebral body height and pain relief. With a cement leakage of 4.1 % RF kyphoplasty is a safe and effective minimally invasive percutaneous cement augmentation procedure. Our data confirm the higher safety described in literature for kyphoplasty in contrast to vertebroplasty.
-
The limited evidence available on the diagnosis and treatment of olecranon and prepatellar bursitis indicates nationally varying treatment approaches. Therefore the aim of this study was to survey the current treatment concepts of olecranon and prepatellar bursitis in Austria. ⋯ Significant differences were found between ÖGO and ÖGU, with the latter favouring a surgical treatment approach in cases of SB and NSB. However, the international literature argues for a conservative treatment approach. Further high quality research is needed to establish an evidence-based treatment approach.
-
Osteoporosis is a widespread disease characterised by low bone mass and structural deterioration of bone resulting in an increased susceptibility to fractures. Osteoporosis affects women more frequently than men; every second woman older than 50 years suffers from an osteoporotic fracture, frequently a vertebral fracture. The aim of this study was to induce osteoporosis in rats to establish an osteoporotic small-animal model that simulates the human pathology particularly in the spine. Therefore, bone density parameters, which are routinely determined in the spine of osteoporotic patients, were investigated by Dual-Energy X-ray Absorptiometry (DEXA). ⋯ A reproducible vertebral osteoporosis can be generated in a rat model by combination of ovariectomy with administration of a calcium/vitamin D3 deficient diet. T- and Z-values of this experimental group mimicked values obtained from osteoporotic patients, reflecting a simulation of their pathology. Interestingly, the increase in bone area over time with the steady BMC results in lower mineral density (BMD) of the OVX + diet group. Therefore, this rat model presents a reliable experimental set-up that may serve as a tool to better understand and treat osteoporosis.