Zeitschrift für Orthopädie und Unfallchirurgie
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Controlled Clinical Trial
[Comparison of clinical and radiological data in the treatment of patients with osteoporotic vertebral compression fractures using radiofrequency kyphoplasty or balloon kyphoplasty].
Since the 1990s, balloon kyphoplasty has been proven as an effective method of treating patients with painful vertebral compression fractures (VCF). The radiofrequency kyphoplasty is an innovative procedure available since 2009, for which an ultra-high viscosity cement is used. For the statistical comparison of the two methods of augmentation, the clinical and radiological data of 2 larger patient groups were evaluated. ⋯ The RFK has proven to be a clinically very effective procedure that does somewhat better than BKP in long-lasting pain relief. No differences could be detected regarding improvement of functioning and the mean restoration of mid- and anterior vertebral height. As far as the safety aspect is concerned the RFK offers the advantage of a statistically significant lower proportion of cement extrusion.
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The diagnosis and treatment of patellar dislocation is very complex. The aim of this study is to give an overview of the biomechanics of the patellofemoral joint and to point out the latest developments in diagnosis and treatment of patellar dislocation. ⋯ It seems that the predominating factors for patellar dislocation are heterogenic morphology in combination with individual predisposition. Non-surgical treatment is typically recommended for primary patellar dislocation without any osteochondral lesions and in the absence of significant risk factors for redislocation. If surgical treatment is deemed necessary, addressing the essential pathomorphology has become the primary focus.
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Comparative Study
[Comparative study on the strength of different mechanisms of operation of multidirectionally angle-stable distal radius plates].
Polyaxial angle-stable plating is thought to be particularly beneficial in the management of complex intra-articular fractures of the distal radius. The present study was performed to investigate the strength of polyaxial locking interfaces of distal radius plates. ⋯ The strength of polyaxial interfaces differs between the tested systems. A reduction of ultimate strength is due to increases of screw locking angle. The design of polyaxial locking interfaces should be investigated in human bone models.
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Fractures of the radial head and neck are the most common involving the elbow and account for 5 % of all fractures in adult individuals. Due to the complex anatomy and biomechanics of the elbow joint radial head fractures are challenging, particularly the comminuted ones. Detailed knowledge of the complex joint anatomy, biomechanics and operative approaches are indispensable for analysing and building a treatment plan. ⋯ Sophisticated reconstructive efforts with combined screw- and plate-osteosynthesis, partial resection or radial head arthroplasty are needed in comminuted fractures. The purpose of this article is to give a detailed review of the anatomy, biomechanics and fracture mechanism. Clinical examination techniques are displayed and operative approaches as well as the conservative and operative treatment algorithms are illustrated.