Mid- to long-term results after bipolar radial head arthroplasty.

Background Radial head arthroplasty is considered the treatment of choice for unreconstructable radial head fractures in the acute fracture situation. Although short-term results in the current literature are promising, replacement of the radial head remains controversial as long-term results are still missing. We report our 8.8-year results after treatment with a bipolar radial head prosthesis by Judet. Materials and methods In our department, 19 patients were treated with bipolar radial head arthroplasty between 1997 and 2001. Seventeen of these patients—14 men and 3 women—were examined retrospectively after 106 months (range, 78-139). Of these, 9 patients were treated primarily, 7 patien…

Soft Tissue Management and Postoperative Care

The acute compartment syndrome is a limb-threatening complication. Although the diagnosis is primarily based on clinical evaluation, intracompartmental pressure monitoring may be required in specific situations. Surgical decompression is the only adequate treatment. Any delay in surgical management increases the risk of late sequellae.

Osteosynthese am proximalen Humerus mittels winkelstabiler Platte oder Doppelplatte: eine vergleichende biomechanische Untersuchung / Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study

Internal fixation of fractures of the proximal humerus needs a high stability of fixation to avoid secondary loss of fixation. This is especially important in osteoporotic bone. In an experimental study, the biomechanical properties of the angle-fixed Philos plate (internal fixator) and a double-plate osteosynthesis using two one-third tubular plates were assessed. The fracture model was an unstable three-part fracture (AO type B2). Eight pairs of human cadaveric humeri were submitted to axial load and torque. In the first part of the study, it was assessed to which degree the original stiffness of the humeri could be restored after the osteotomy by the osteosynthesis procedure. Subsequentl…

Internal Fixation of Proximal Humeral Fractures: Current Concepts

Fractures of the proximal humerus are an increasingly common type of injury. Mainly elderly patients with osteoporotic bone are affected. Whereas non-displaced and stable fractures are managed successfully with conservative treatment, there is no general agreement on the surgical strategy for displaced and unstable two- to four-part fractures. The clinical outcome is influenced by the fracture type and concomitant injury to the rotator cuff. Extensive surgical manipulation of the soft tissues, non-anatomic and/or unstable fixation as well as technical errors are important contributing factors to poor clinical results. Goals of surgical treatment are to restore anatomy, to achieve fixation t…

Transverse sacral fracture with intrapelvic intrusion of the lumbosacral spine: case report and review of the literature.

Radiological analysis, operative management and functional outcome of open book pelvic lesions: a 13-year cohort study.

Abstract We present the clinical and radiological outcome of a 13-year cohort study of 38 open book pelvic lesions. All patients were treated in one Level I Trauma centre. In the posterior pelvis, sacro-iliac diastasis was seen in 31 patients, sacral fracture in 7. In all patients with sacro-iliac diastasis, the pubic bone was inferiorly displaced on the primary ap pelvic overview on the side of injury. All but one patient was treated with open reduction and internal fixation of the symphysis pubis. Additional stabilization of the posterior pelvis was done in 9 patients. 32 patients were seen after a median follow up of 84 months. Majeed score and SF-36 questionnaire were used. Functional o…

Staged Reconstruction of Pelvic Ring Disruption: Differences in Morbidity, Mortality, Radiologic Results, and Functional Outcomes Between B1, B2/B3, and C-Type Lesions

To analyze injury pattern, surgical therapy, radiologic results, and functional outcome in unstable B-type and C-type pelvic ring fractures.Retrospective study.Level I University Trauma Center.Two-hundred-twenty-two consecutive patients, admitted during a nine-year period with unstable B-type (n = 100) and C-type (n = 122) pelvic ring injuries, of whom 122 (61.3 percent of surviving patients) were eligible for evaluation with a minimum follow-up of one year.Staged reconstruction dependent upon injury pattern. Emergency external compression of the pelvic ring in case of hemodynamic instability. Management of associated lesions. Secondary open reduction and internal fracture fixation.Assessme…

Stabilization of fatigue fractures of the dorsal pelvis with a trans-sacral bar. Operative technique and outcome.

Abstract Introduction Due to ageing of our population the number of fatigue fractures of the pelvic ring is steadily growing. These fractures are often treated with bed rest but may result in a disabling immobility with severe pain. An operative treatment is an option in these cases. The aim of operative treatment is bony healing obtained by stable fixation giving back to the patient's previous mobility. Optimal surgical treatment is currently under debate. Sacroiliac screw fixation and sacroplasty are used for stabilization of the dorsal pelvis. Due to the technique and the low density of spongious sacral bone, no or only low compression in the fracture site is obtained, which may inhibit …