Der Unfallchirurg
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The changing age distribution in society inevitably leads to a percentage increase in osteoporotic and fatigue fractures as well as the absolute number of insufficiency fractures of the pelvic ring. Due to pain these fractures lead to a loss of mobility and autonomy. To prevent these consequences surgical treatment is increasingly being performed. ⋯ Missing long-term results, also taking into account a higher number of patients, as well as the biomechanical examination of the presented fixator configuration still have to be evaluated.
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Malnutrition in geriatric trauma patients is associated with an increased risk of complications and mortality and is therefore a key risk factor. The assessment of the affected patients plays an important role in improving the outcome of this growing patient group. ⋯ The establishment of suitable and time-effective screening instruments and their implementation are still a challenge.
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The 3D image enhancer-adjusted percutaneous triangular stabilization of geriatric pelvic ring fractures avoids implant-associated perioperative complications. Displaced fractures of the posterior pelvic ring require stable instrumentation to enable solid bony fusion in a balanced alignment and to control the risk of neurological and vascular damage. This is mandatory in high-energy injuries in young patients and especially in low-energy injuries of geriatric patients. ⋯ After percutaneous insertion of the guide wires into the L4 vertebral body, the iliac bone and transiliosacrally under 2D X‑ray control, the correct wire position is verified by the 3D scan. Then, screws are inserted and the instrumentation is completed in a standard fashion. Using this technique implant-associated perioperative complications, such as nerve and vascular damage due to screw misplacement can be reduced.
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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.