0000000000023849
AUTHOR
S.-o. Dietz
Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature
AbstractFragility fractures of the pelvic ring (FFP) are increasing in frequency and require challenging treatment. A new comprehensive classification considers both fracture morphology and degree of instability. The classification system also provides recommendations for type and invasiveness of treatment. In this article, a literature review of treatment alternatives is presented and compared with our own experiences. Whereas FFP Type I lesions can be treated conservatively, FFP Types III and IV require surgical treatment. For FFP Type II lessions, percutaneous fixation techniques should be considered after a trial of conservative treatment. FFP Type III lesions need open reduction and in…
Volar and dorsal mid-shaft forearm plating using DCP and LC-DCP: interference with the interosseous membrane and forearm-kinematics.
Purpose To clarify if dorsal plate osteosynthesis of the forearm shaft is associated with impingement of the interosseous membrane (IOM) and if rotational kinematics of the forearm are influenced. Background Forearm fractures are treated by separate incisions. Osteosynthesis via one approach in proximal forearm fractures was associated with higher rates of synostosis. It has been claimed that this is due to IOM impingement. Materials and methods 16 forearms of fresh frozen cadavers were dissected until only radius, ulna and the IOM remained. To preserve physiological forearm rotation, the elbow joint, the distal radio-ulnar joint and the carpus remained intact. In group 1, LC-DC and DC plat…
Isolated fractures of the greater tuberosity of the proximal humerus
Background and purpose The diagnosis and treatment of isolated greater tuberosity fractures of the proximal humerus is not clear-cut. We retrospectively assessed the clinical and radiographic outcome of isolated greater tuberosity fractures. Patients and methods 30 patients (mean age 58 (26–85) years, 19 women) with 30 closed isolated greater tuberosity fractures were reassessed after an average follow-up time of 3 years with DASH score and Constant score. Radiographic outcome was assessed on standard plain radiographs. Results 14 of 17 patients with undisplaced or slightly displaced fractures (≤ 5 mm) were treated nonoperatively and had good clinical outcome (mean DASH score of 13, mean Co…
Two-year results of vertebral body stenting for the treatment of traumatic incomplete burst fractures.
Vertebral body stenting (VBS) was developed to prevent loss of reduction after balloon deflation during kyphoplasty. The aim of this study is the radiological and clinical mid-term evaluation of traumatic incomplete burst fractures treated by vertebral body stenting.This retrospective study included patients with traumatic thoracolumbar incomplete burst fractures treated with VBS between 2009 and 2010. The outcome was evaluated with the visual analogue pain scale (VAS), the Oswestry Disability Score (ODI), the SF-36 Health Survey and radiologically assessed.Eighteen patients with an average age of 74.8 years were treated with VBS. Twelve were female and six were male. Two years after the op…
Progress of instability in fragility fractures of the pelvis: An observational study.
Abstract Fragility fractures of the pelvis (FFP) are an increasing entity among elderly persons. Characteristics are different from high-energy pelvic trauma. Little is known about the natural course of FFP in conservative and after operative treatment. Materials and methods Medical charts and radiologic data of 148 patients with an FFP, who were admitted in a 3-year period, were analysed retrospectively. Incidence and characteristics of fracture progression (FP) were noted. Results Patients presenting early after a traumatic event had more often non-displaced fractures, fractures with lower FFP Type classification and were more frequently treated conservatively. FP was observed in 21 cases…
Retrograde nailing versus locking plate osteosynthesis of proximal humeral fractures: a biomechanical study
Background In locking plate osteosynthesis of proximal humeral fractures, secondary varus malalignment is a specific complication. Retron nails (Tantum AG, Neumunster, Germany), among others, have been designed to improve medial support of the calcar humeri. The aim of our biomechanical study was to examine whether Retron nails provide increased stiffness for axial loads and adequate stiffness for torsional loads when compared with Philos plates (Synthes AG, Umkirch, Germany). Materials and methods Twenty-two fresh-frozen paired humeri were collected. After potting the specimens, intact bones were exposed to sinusoidal axial (10-120 N) and torsional (±2.5 Nm) loading for 8 cycles to calcula…