Der Unfallchirurg
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To date, little attention has been given to greater tuberosity fractures (GTFs) in the literature. Several mechanisms of injury are described, but few authors report that a GTF is accompanied by a high rate of often unrecognized associated injuries. ⋯ The reason for a GTF seems to be an anterior shoulder dislocation or partial dislocation. In multifragmentary GTF or GTF with dislocation surgery is necessary frequently; without dislocation surgery is necessary less frequently. Associated injuries should be searched for selectively. An arthroscopy could be performed for diagnosis and therapy. In a GTF that can be treated conservatively, an MRI should be performed.
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Injury to the central slip of the extensor tendon may occur with open and also with closed injuries, such as volar dislocation of the proximal interphalangeal (PIP) joint. For adequate treatment, it is necessary to identify all injured structures. ⋯ A fixed boutonnière deformity requires recovery of joint mobility. Once joint mobility is achieved, secondary surgical reconstruction of the central slip can be performed with a tendon transfer or a tendon transplant.
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Case Reports
[Course of operative treatment of a sacral insufficiency fracture : Successful or serious treatment?]
A monolateral sacrum fracture was primarily diagnosed with a CT and treated with PMMA augmented SI screw fixation. The following CT showed an unexpected contralateral fracture which led to the need for a lumbopelvic stabilization. ⋯ Most of these fractures could only be diagnosed through MRI. It remains unclear, whether initially even the contralateral sacral ala was fractured.