Der Unfallchirurg
-
The most common cause of degeneration of the posterior tibial tendon is a congenital valgus deformity of the calcaneus. Other associated pathologies are forefoot supination, forefoot abduction and shortening of the gastrocnemius muscle. ⋯ The correction of the hindfoot deformity as well as the subsequent treatment of the different components of the pathology lead to a significant improvement in foot function. Pre-existing degenerative alterations are limiting factors.
-
Percutaneous internal fixation of pelvic fractures is increasing in popularity with multiple new techniques reported. ⋯ Percutaneous fixation of pelvic fractures requires high-quality imaging and can be aided by computer navigation. Safe techniques are reproducible; however, not all patients and fracture patterns can be treated using these techniques.
-
Review
[Rupture of the tendon of the tibialis anterior muscle : Etiology, clinical symptoms and treatment].
Ruptures of the tendon of the tibialis anterior muscle tend to occur in the context of degenerative impairments. This mainly affects the distal avascular portion of the tendon. Owing to the good compensation through the extensor hallucis longus and extensor digitorum muscles, diagnosis is often delayed. ⋯ An operative procedure is indicated when there is corresponding suffering due to pressure and functional impairment. The direct end-to-end reconstruction of the tendon is only rarely possible in cases of delayed diagnosis due to the degenerative situation and the retraction of the tendon stumps. Depending on the defect size and the tendon quality, various operative techniques, such as rotationplasty, free transplants or tendon transfer can be used.
-
Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. ⋯ Improved image volume, resolution, and software capability have allowed surgeons to obtain high-quality, wide field views of bony anatomy that can include the uninjured side as a comparison. In this paper, the evolution of intraoperative 3D imaging over the past 25 years is discussed.
-
Injuries of the peroneal tendons are rare and often overlooked. Typical pathologies are tendinitis, tears and dislocation. Accompanying injuries are fractures. They are often associated with instability in the ankle and rearfoot deformities; therefore, these pathologies should be excluded or taken into consideration in the treatment. The clinical examination is crucial for the diagnosis. ⋯ Rehabilitation after operative treatment is demanding and prolonged especially after operative therapy of peroneal tendon tears. The results to be expected appear promising.