0000000000154548
AUTHOR
Raphael Küchle
Olecranon fractures in adults: factors influencing outcome.
In a retrospective, non-randomized study, we reviewed our experience with the operative treatment of olecranon fractures to find out which factors correlate with subjective complaints and functional outcome. A total of 95 consecutive olecranon fractures were operatively treated in our level I trauma institution between 1 March 1992 and 1 March 2000. Medical records and X-rays of all patients were evaluated. Three patients died, 23 were lost to follow-up. Fifty-eight of 69 available patients (84.0%) were reviewed clinically and/or radiologically after a mean time of 36 months. Fracture type, fracture classification, associated lesions, technical correctness of osteosynthesis, age and comorbi…
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…
The influence of bone allograft processing on osteoblast attachment and function
In order to assess the influence of eight different sterilisation and disinfection methods for bone allografts on adhesion, proliferation, and differentiation of human bone marrow stromal cells (BMSC), cells were grown in culture and then plated onto pieces of human bone allografts. Following processing methods were tested: autoclavation (AUT), low-temperature-plasma sterilisation of demineralised allografts (D-LTP), ethylene oxide sterilisation (EtO), fresh frozen bone (FFB), 80 degrees C-thermodisinfection (80 degrees C), gamma-irradiation (Gamma), chemical solvent disinfection (CSD), and Barrycidal-disinfection (BAR). The seeding efficiency was determined after one hour to detect the num…
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…
Intraoperative C-arm CT imaging in angular stable plate osteosynthesis of distal radius fractures
The purpose of this study was to analyze the practicability and benefit of intraoperative C-arm computed tomography (CT) imaging in volar plate osteosynthesis of unstable distal radius fractures. During a 1 year period, intraoperative three dimensional (3D) imaging with the ARCADIS Orbic 3D was performed in addition to standard fluoroscopy in 51 cases. The volar angular stable plate oesteosyntheses were analyzed intraoperatively and, if necessary, improved immediately. The duration of the scan and radiation exposure dose were measured. On average, performance of the scan and analysis of the CT dataset took 6.7 minutes. In 31.3% of the surgeries a misplacement of screws was detected and cor…
Diagnosing and staging of pancreatic carcinoma-what is necessary?
The aim of the present prospective observational study was to diagnose and stage pancreatic carcinoma with a minimum of diagnostic procedures. Our experiences in 307 patients with a histologically confirmed pancreatic carcinoma show that for diagnosing pancreatic carcinoma sonography and computed tomography are sufficient in 95% of the cases. The combination of both has a sensitivity equal to that of endoscopic retrograde cholangiopancreatography (ERCP; 96.8 vs. 98.7%; n.s., χ<sup>2</sup> test). ERCP is only indicated in cases with negative sonography and computed tomography, and suspicion of pancreatic cancer. For tumor staging, the routine performance of angiography cannot be …