Der Unfallchirurg
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Review Meta Analysis Comparative Study
[Susceptibility to infections and behavior of stainless steel : Comparison with titanium implants in traumatology].
Despite modern treatment options, implant-associated infections (IAI) remain a severe and challenging complication in the treatment of trauma patients. Almost 30 years after the introduction of implants made of titanium alloy into the treatment of trauma patients, there is still no uniform consensus regarding the clinical benefit of titanium alloy in the context of patients with IAI. ⋯ Considerable debate remains concerning the influence of the implant material on the susceptibility to IAI; however, the available literature shows that despite slight tendencies, there is no proof of titanium alloy being favorable in the susceptibility to IAI. Furthermore, the literature shows that the design of plates for osteosynthesis might influence IAI. In particular, plates that cause less soft tissue damage and preserve perfusion of the periosteum proved to be beneficial regarding IAI.
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Review Meta Analysis
[Titanium or steel as osteosynthesis material : Systematic literature search for clinical evidence].
The selection of the appropriate implant material, stainless steel or titanium, is still the decision of the surgeon and/or the affiliated institution. Additionally, remarkable international differences can be found between the different markets, which cannot really be explained. ⋯ This systematic literature search did not provide any clinical evidence for material-related differences between titanium or stainless steel implants for fracture fixation. Based on the current clinical evidence both titanium and steel implants can be considered to be of equal value. The reported difficulties with implant removal are not reflected in the published literature.
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Review Meta Analysis
[Compatibility and allergies of osteosynthesis materials].
Metal implants for osteosynthesis are nowadays standard in orthopedic and trauma surgery. Steel implants, especially cerclages, bands and wires, can show more corrosion due to friction and lead to encapsulation in connective tissue with fluid borders even without loosening. Corrosion and fluid borders are potentially more susceptible to incompatibility and infections. ⋯ Problems may occur in material removal, especially with titanium implants because material fractures occur more frequently. Particularly with fixed angle constructions, the blocking of titanium-titanium bonding and/or screws in bone can occur by adhesion and ingrowth. Apart from single case reports there is no evidence that modern steel implants cause more allergic reactions than titanium; therefore, in the treatment by osteosynthesis the stability, risk of loosening, manifestation of allergies and the possibility of material removal must always be considered.
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Review Meta Analysis
[Outcome in traumatic brain injury : Considered from a neurological viewpoint].
There are many studies on the prognosis and mortality for the acute care of traumatic brain injury (TBI) during the first year. Prediction of the long-term outcome after TBI is more difficult, and can be ascribed to indistinct methods and the necessity of taking into account multiple influencing factors. ⋯ Environmental factors are most predictive of long-term TBI outcome. The awareness of the interaction of all these factors requires a individualized long-term rehabilitation.
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Review Meta Analysis
[Periprosthetic fractures following total hip and knee arthroplasty : Risk factors, epidemiological aspects, diagnostics and classification systems].
Periprosthetic fractures following hip and knee arthroplasty are potentially severe complications. As a fundament in diagnostic and therapeutic procedures, specific classification systems are necessary to ensure an optimal individualized treatment of these sometimes complicated fractures. ⋯ In addition, the recently introduced unified classification system (UCS), which is applicable to any location of periprosthetic fractures, is described in detail. Initial studies have shown a reliable applicability of the UCS to periprosthetic hip and knee fractures.