Der Unfallchirurg
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Review Case Reports
[Surgical treatment strategy for traumatic luxation of the posterior tibial tendon : Case report and literature review].
Based on a case study, the injury pattern and surgical procedure for traumatic dislocation of the posterior tibial tendon is presented. A 32-year-old ice hockey player suffered a direct impact from a puck at the dorsomedial aspect of the inner ankle. ⋯ An open wedge osteotomy and suture anchor refixation of the retinaculum were performed. This procedure is described in the context of a review of the literature.
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Injuries to the subaxial cervical spine are increasing and have a high risk for neurological injury in comparison to the thoracic and lumbar spine. The current treatment recommendations according to the recommendations of the section spine of the German Society for Orthopaedics and Trauma (DGOU) and the S1 guidelines of the German Society for Trauma Surgery are summarized in this article. ⋯ Injuries should be classified according to the AOSpine classification for subaxial injuries. Based on this classification, a decision on a conservative or operative treatment regimen as well as individual details of the treatment can be made.
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A small proportion of patients with exertional leg pain (ELP) have deep posterior chronic exertional compartment syndrome (dp-CECS). These individuals report pain, tightness and cramps deep in the calf muscles that are elicited by exercise, but may also be present during rest to a lesser extent. Physical examination often reveals painful palpation of the flexor muscles in the area immediately dorsomedial to the tibial bone. ⋯ Various entities may mimic or coincide with dp-CECS, including medial tibial stress syndrome (MTSS) and popliteal artery entrapment syndrome (PAES). Fasciotomy of multiple flexor muscles is the only treatment that achieves a beneficial outcome. The aim of this overview is to discuss the diagnosis and management of dp-CECS.
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Non-union represents a severe complication and a major socioeconomic challenge in orthopedics and trauma surgery. Timely and reliable diagnostics are obligatory to be able to carry out the treatment of non-unions in a patient-specific and efficient manner. ⋯ It can display the microperfusion inside the non-union gap in real time and provide valuable information for exclusion of an infection or on the healing progress after revision surgery. An establishment of this diagnostic modality in routine orthopedic trauma surgery contributes to optimization of the treatment of non-unions.
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Training under conditions of blood flow restriction (BFR) has recently been advocated as an option for alternative training in athletes. ⋯ Various approaches for implementation of BFR in athletes can be found in the literature. These approaches differ in the frequency, force used, duration and finally type of implementation of BFR itself. Clear recommendations for training cannot be given to date and the individual weighing up of possibilities and supervised implementation of BFR in athlete training by the trainer are still necessary.