[Use of an new modular revision arthroplasty system for the knee reconstruction].
Abstract OBJECTIVE: Reconstruction of stable knee joint kinematics using modular axis-guided revision implants after failed knee arthroplasty surgery. INDICATIONS: Revision implant for bone defects (type Anderson Orthopaedic Research Institute [AORI] III) in case of revision arthroplasty. Primary implant in case of mediolateral instability (>grade I) or multidirectional instability. CONTRAINDICATIONS: Persistent or current joint infection, general infection (e.g. pneumonia), missing metaphysis femoral and/or tibial, insufficient extensor apparatus. SURGICAL TECHNIQUE: Standard approach exten...
Source: Operative Orthopadie und Traumatologie - July 29, 2020 Category: Orthopaedics Authors: Kohlhof H, Petershofer A, Randau T, Gravius S, Trieb K, Wirtz CD Tags: Oper Orthop Traumatol Source Type: research

[Intra-articular osteotomy for malunion of the tibial plateau].
Abstract OBJECTIVE: Restoration of anatomy of the joint surface of the tibial plateau in posttraumatic deformity. INDICATIONS: Malunions of the tibial plateau with significant intra-articular depression and/or steps. CONTRAINDICATIONS: Local or systemic infection, critical soft tissues in the area of planned incisions; advanced osteoarthritis of the knee; loss of meniscus in the involved compartment; motoric or neurophysiological impairment hindering normal knee function. SURGICAL TECHNIQUE: Malunion after posteromedial split fracture: posterior approach in prone position, osteotomy of the former fr...
Source: Operative Orthopadie und Traumatologie - July 28, 2020 Category: Orthopaedics Authors: Lobenhoffer P Tags: Oper Orthop Traumatol Source Type: research

[Distal femur replacement in extensive defects of the distal femur in revision arthroplasty].
Abstract OBJECTIVE: Use of distal femur replacement implants in advanced bone defects after multiple bone-damaging revision surgery on the knee joint. INDICATIONS: Advanced femoral bone defects (AORI IIb and III defects) in revision arthroplasty of the knee joint. CONTRAINDICATIONS: Persistent or current joint infection, general infection, defect and/or nonreconstructable insufficient extensor apparatus. SURGICAL TECHNIQUE: Standard access including existing skin scars, arthrotomy, removal of cement spacer if necessary and removal of multiple tissue samples; preparation of tibia first to define...
Source: Operative Orthopadie und Traumatologie - July 27, 2020 Category: Orthopaedics Authors: Kohlhof H, Jaenisch M, Koop S, Friedrich M, Wirtz CD Tags: Oper Orthop Traumatol Source Type: research

[Implantation of a tantalum patella during revision surgery].
iolis G Abstract OBJECTIVE: The reconstruction or restoration of a functioning patella for active extension and flexion by implantation of a tantalum patella. In spite of larger osseous defects of the patella, the goal is to achieve sufficient extensor mechanism function. INDICATIONS: Patients who have such a large bone defect in the area of the patella that implantation of a traditional patella replacement is not possible. In addition, patients with a peri-implant fracture of the patella can be treated with a tantalum patella and additional plate osteosynthesis. CONTRAINDIC...
Source: Operative Orthopadie und Traumatologie - July 20, 2020 Category: Orthopaedics Authors: Röhner E, Böhle S, Matziolis G Tags: Oper Orthop Traumatol Source Type: research

[Reconstruction of tibial metaphyseal defects with artificial components in revision arthroplasty (GenuX MK System)].
Abstract OBJECTIVE: Restoration of knee function by using tibial metaphyseal components in advanced metaphyseal bone defects after multiple bone-damaging revision surgery on the knee joint. INDICATIONS: Advanced tibial metaphyseal bone defects (Anderson Orthopaedic Research Institute [AORI] IIb and III defects) in revision arthroplasty of the knee joint. CONTRAINDICATIONS: Persistent or current joint infection, general infection (e.g., pneumonia), nonreconstructable insufficient extensor apparatus. SURGICAL TECHNIQUE: Standard access including existing skin scars, arthrotomy, removal of cement ...
Source: Operative Orthopadie und Traumatologie - July 20, 2020 Category: Orthopaedics Authors: Kohlhof H, Randau T, Kehrer M, Wirtz DC Tags: Oper Orthop Traumatol Source Type: research

Three-step technique for implantation of rotating hinge knee prostheses : Demonstration using the Enduro prosthesis.
Abstract OBJECTIVE: Implantation of an axis-guided knee prosthesis with consideration of the joint line and balanced flexion and extension gap to reduce the mechanical load on the prosthesis axis and to improve the movement of the prosthesis. INDICATIONS: Distinct unilateral instability due to ligament insufficiency in association with knee prostheses. Primary implantation of axis-guided knee prostheses with pronounced axial malalignment (>20-25° valgus or varus malalignment) or/and severe flexion contracture> 40°. Replacement of prosthesis with nonsignificant imbalance between flexion and exten...
Source: Operative Orthopadie und Traumatologie - July 10, 2020 Category: Orthopaedics Authors: Fink B, Stefanou D Tags: Oper Orthop Traumatol Source Type: research

Minimally invasive double-plating osteosynthesis of the distal femur.
Abstract OBJECTIVE: Technical description of minimally invasive double-plating of the distal femur. INDICATIONS: Peri- and interprosthetic distal femur fractures with limited (periprosthetic) bone stock in geriatric patients. Re-operations (delayed and non-unions; infected non-unions) of the distal femur. Distal femoral fractures or femoral shaft fractures that do not qualify for femoral nailing and where the patient is unable to comply with weight-bearing restrictions. CONTRAINDICATIONS: Peri- and interprosthetic femoral fractures with unstable knee prosthesis and local soft tissue infection. Peri- and ...
Source: Operative Orthopadie und Traumatologie - June 16, 2020 Category: Orthopaedics Authors: Beeres FJP, Emmink BL, Lanter K, Link BC, Babst R Tags: Oper Orthop Traumatol Source Type: research

[Surgical treatment of carpal tunnel syndrome: open release of the flexor retinaculum and hypothenar fat flap for revision surgery].
pies CK Abstract OBJECTIVE: Decompression of the median nerve by complete release of the flexor retinaculum and the distal antebrachial fascia. In the case of revision surgery providing of a scar-free covering of the median nerve, if necessary. INDICATIONS: Carpal tunnel release is indicated for symptomatic patients with painful paraesthesia or neurological deficits after adequate diagnostic evaluation. The hypothenar fat flap is indicated in revision surgery if a sufficient nerve bed of the median nerve is needed and to restore nerve gliding. CONTRAINDICATIONS: General operative limitations. The hy...
Source: Operative Orthopadie und Traumatologie - June 10, 2020 Category: Orthopaedics Authors: Ayache A, Unglaub F, Langer MF, Müller LP, Oppermann J, Löw S, Spies CK Tags: Oper Orthop Traumatol Source Type: research

Revision arthroplasty with rotating hinge systems for total knee arthroplasty instability.
Abstract OBJECTIVE: Restoring stability after total knee arthroplasty (TKA) and improving joint function using a cemented rotating hinge system. INDICATIONS: Ligament instability and/or osseous defects (including Anderson Orthopaedic Research Institute [AORI] classification type II defects) after primary TKA or TKA revision surgery. CONTRAINDICATIONS: Distal femoral or proximal tibial bowing requiring implant systems that provide femoral or tibial offset stems. Persistent periprosthetic infection. Poor therapeutic compliance. AORI type III defects. SURGICAL TECHNIQUE: Medial arthrotom...
Source: Operative Orthopadie und Traumatologie - May 29, 2020 Category: Orthopaedics Authors: Arnholdt J, Boelch SP, Dogan F, Hoberg M, Holzapfel BM, Rudert M Tags: Oper Orthop Traumatol Source Type: research

[Minimally invasive stand-alone fusion of the lumbosacral junction].
Abstract OBJECTIVE: Stable interbody fusion of the lumbosacral segment via an anterior retroperitoneal approach using an interbody spacer as an anterior stand-alone device which is fixed with four locking screws. INDICATIONS: Degenerative disc disease without instability or deformity; adjacent segment degeneration; pseudarthrosis. CONTRAINDICATIONS: Translational instabilities as in spondylolisthesis at the index segment; deformities; steep sacral slope. Challenging vascular situation with aortic bifurcation and/or venous confluence in front of L5/S1; osteoporosis. Relative: previous abdominal/gynecologi...
Source: Operative Orthopadie und Traumatologie - May 28, 2020 Category: Orthopaedics Authors: Stosch-Wiechert K, Krenauer A, Siepe CJ Tags: Oper Orthop Traumatol Source Type: research

[Minimally invasive transforaminal lumbar interbody fusion].
Abstract OBJECTIVE: Instrumented fusion of lumbar motion segments using a minimally invasive technique. INDICATIONS: Degenerative disc disease, segmental degeneration, degenerative spondylolisthesis, isthmic spondylolisthesis, pseudarthrosis, other spinal lumbar instabilities, disc prolapse, revision for failed back surgery syndrome, unilateral neuroforaminal stenosis, facet joint arthrosis. CONTRAINDICATIONS: High-grade spondylolisthesis (Meyerding grades III/IV, spondyloptosis), bilateral nerve root compression, vertebral fractures, tumors, high-grade spinal instabilities, primary spinal defo...
Source: Operative Orthopadie und Traumatologie - May 23, 2020 Category: Orthopaedics Authors: Hoffmann CH, Kandziora F Tags: Oper Orthop Traumatol Source Type: research

[Atraumatic femoral head necrosis in adults].
PMID: 32221631 [PubMed - in process] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - March 31, 2020 Category: Orthopaedics Authors: Roth A, Tingart M Tags: Oper Orthop Traumatol Source Type: research

[Reduction and fixation of tibia plateau fractures : Tips and tactics based on the 3-column concept].
Abstract OBJECTIVE: The surgical management of tibial plateau fractures remains a challenge. The aim of surgery is the anatomical reconstruction of the joint surface with correct length, axis and rotation. The goal of osteosynthesis is to maintain a stable reduction to allow bone healing and functional aftercare. The continued advancements in 3D computed tomography has changed, the classification systems and, in parallel, the treatment strategies significantly changed. The 3‑column concept of Luo et al. has proven to be advantageous for planning of access, reduction and stabilisation. INDICATIONS:...
Source: Operative Orthopadie und Traumatologie - March 31, 2020 Category: Orthopaedics Authors: Kuner E, Beeres FJP, Cagienard F, Babst R, Link BC Tags: Oper Orthop Traumatol Source Type: research

[The mono- and multisegmental ventral minimally invasive approach to the lumbar spine (OLIF) in lumbar deformities].
Abstract OBJECTIVE: Minimally invasive anterolateral approach to the lumbar spine (oblique lateral interbody fusion, OLIF) to correct lumbar deformities. INDICATIONS: Ventral release in degenerative lumbar scoliosis or segmental kyphosis and intervertebral spondylodesis. CONTRAINDICATIONS: No absolute contraindications. Relative contraindications are previous (left-sided) retroperitoneal interventions or status after peritonitis with pronounced retroperitoneal scarring. Vascular anomalies with extremely lateral common iliac vein (especially with segmentation disorders in the penultimate mobile segment). ...
Source: Operative Orthopadie und Traumatologie - March 16, 2020 Category: Orthopaedics Authors: Mehren C, Wanke-Jellinek L, Krenauer A, Korge A Tags: Oper Orthop Traumatol Source Type: research

[The Facet Wedge: a minimally invasive technique for posterior segmental intra-articular fusion].
e A Abstract OBJECTIVE: Minimally invasive posterior segmental instrumentation and intra-articular fusion with the Facet Wedge device. INDICATIONS: All fusion indications in degenerative disc disease without significant translational instability, postnucleotomy syndrome, spondylarthrosis, discitis. CONTRAINDICATIONS: Translatory instabilities, status after decompression with partial facet joint resection, spondylolysis in the affected segment. SURGICAL TECHNIQUE: Through a 3 cm skin incision, blunt transmuscular approach to the corresponding facet joint L1/2 to L5/S1. Opening of the joint cap...
Source: Operative Orthopadie und Traumatologie - March 16, 2020 Category: Orthopaedics Authors: Mehren C, Sauer D, Würtinger C, Korge A Tags: Oper Orthop Traumatol Source Type: research

[Technique of all arthroscopic autologous chondrocyte implantation (ACI) for the treatment of cartilage defects in the knee].
chter J Abstract OBJECTIVE: All arthroscopic treatment of deep cartilage defects in the knee for reconstruction of the articular surface. INDICATIONS: Focal cartilage defects of the knee (ICRS ≥ grade 3) from a size of 2.5 cm2 and more. CONTRAINDICATIONS: Osteoarthritis (Kellgren-Lawrence > grade 2), osseus defect situation, cartilage lesion of the opposing articular surfaces (ICRS > grade 2), instability, malalignment (>3-4°), inflammatory joint diseases. SURGICAL TECHNIQUE: First procedure (cell harvesting): Treatment of additional p...
Source: Operative Orthopadie und Traumatologie - March 10, 2020 Category: Orthopaedics Authors: Schlumberger M, Schuster P, Bülow HJ, Mayer P, Eichinger M, Immendörfer M, Richter J Tags: Oper Orthop Traumatol Source Type: research

[Modified advanced core decompression (mACD)].
r M Abstract OBJECTIVE: The modified advanced core decompression (mACD) combines the advantages of a low invasive core decompression with maximal removal of osteonecrotic bone and a biologic reconstruction of the resulting bone defect. INDICATIONS: Avascular (atraumatic) osteonecrosis of the femoral head (ARCO stage II). CONTRAINDICATIONS: Subchondral fractures (ARCO stage III); advanced osteoarthritis (e.g., ACRO stage IV); persisting risk factors such as high-dose corticoid therapy, chemotherapy, alcohol abuse; open growth plates; history of side effects or intolerance to compo...
Source: Operative Orthopadie und Traumatologie - March 9, 2020 Category: Orthopaedics Authors: Landgraeber S, Jäger M Tags: Oper Orthop Traumatol Source Type: research

Revision of unicompartmental knee arthroplasty using the in situ referencing technique.
apfel BM Abstract OBJECTIVE: Revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) with the in situ referencing technique aiming to preserve as much ligament function and epi-metaphyseal bone stock as possible. INDICATIONS: Aseptic loosening, progression of osteoarthritis, periprosthetic fracture, periprosthetic infection, arthrofibrosis, polyethylene wear, malalignment, instability, femoro-tibial impingement. CONTRAINDICATIONS: Unexplained pain, localized or systemic active infection (anywhere). SURGICAL TECHNIQUE: Referencing for the tibia and the femur cuts is perf...
Source: Operative Orthopadie und Traumatologie - March 5, 2020 Category: Orthopaedics Authors: Weißenberger M, Petersen N, Bölch S, Rak D, Arnholdt J, Rudert M, Holzapfel BM Tags: Oper Orthop Traumatol Source Type: research

[Surgical decompression of the peroneal nerve at the level of the fibular head].
Abstract OBJECTIVE: Functional and sensible regeneration of deficits related to common peroneal nerve palsy. INDICATIONS: Functional deficits like foot drop, malfunctioning pronation, foot in supination and sensible deficits located at the anterior and lateral lower leg, the dorsum of the foot, the extension side of toes 1-4 and the interdigital space between toe 1 and 2, for positive Hoffmann-Tinel sign located at the fibular head and steppage gait. CONTRAINDICATIONS: Infection, spinal cord damage and spinal cord tumors with related sensitivity disorders and paralysis, advanced multiple s...
Source: Operative Orthopadie und Traumatologie - February 25, 2020 Category: Orthopaedics Authors: Heinrich K, Pumberger P, Schwaiger K, Schaffler G, Hladik M, Wechselberger G Tags: Oper Orthop Traumatol Source Type: research

[Palmar radioscapholunate arthrodesis with distal scaphoidectomy].
Abstract OBJECTIVE: Radioscapholunate (RSL) arthrodesis with distal scaphoidectomy using an angular stable plate and palmar access in post-traumatic or degenerative osteoarthritis limited to the radiocarpal joint. INDICATIONS: Osteoarthritis limited to the radiocarpal joint with intact mediocarpal joint after malunited intra-articular distal radius fractures, rheumatoid osteoarthritis, scapholunate advanced collapse (SLAC) up to stage II. CONTRAINDICATIONS: Mediocarpal osteoarthritis, poor patient compliance, SLAC from stage III, osteitis. SURGICAL TECHNIQUE: The palmar RSL arthrodesis is ...
Source: Operative Orthopadie und Traumatologie - February 25, 2020 Category: Orthopaedics Authors: Quadlbauer S, Leixnering M, Rosenauer R, Jurkowitsch J, Hausner T, Pezzei C Tags: Oper Orthop Traumatol Source Type: research

[Pedicled vascularized iliac bone graft for treatment of osteonecrosis of the femoral head].
Abstract OBJECTIVE: Illustration of a nowadays only rarely performed operative procedure for the treatment of osteonecrosis of the femoral head to prevent or at least delay advanced arthrosis and the need for a total hip replacement. The pedicled vascularized iliac bone graft is raised without the need for special microsurgical techniques and has less vascular complications often seen in free vascularized grafts. INDICATIONS: Early stages of osteonecrosis of the femoral head stages II and III according to the Association Research Circulation Osseous (ARCO) up to the detection of fracture l...
Source: Operative Orthopadie und Traumatologie - February 12, 2020 Category: Orthopaedics Authors: Asmus A, Vogel K, Vogel A, Eichenauer F, Kim S, Eisenschenk A Tags: Oper Orthop Traumatol Source Type: research

[Regional anesthesia options in trauma and orthopedic surgery].
PMID: 32040682 [PubMed - in process] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - February 1, 2020 Category: Orthopaedics Authors: Dresing K Tags: Oper Orthop Traumatol Source Type: research

Suprapatellar nailing of fractures of the tibia.
Abstract OBJECTIVE: Intramedullary nailing of tibia fractures via a suprapatellar, transarticular approach with the knee joint in 20-30° of flexion and the use of specific protection tubes to preserve intra-articular structures. INDICATIONS: Extra-articular fractures of the proximal tibia; simple and comminuted fractures of the tibia diaphysis; segmental diaphyseal fractures of the tibia; extra-articular fractures of the distal tibia and fractures with simple intra-articular distal extension; floating knee injuries. CONTRAINDICATIONS: Gustilo grade 3C open fractures of the tibia; severe sof...
Source: Operative Orthopadie und Traumatologie - January 29, 2020 Category: Orthopaedics Authors: Hessmann MH, Buhl M, Finkemeier C, Khoury A, Mosheiff R, Blauth M Tags: Oper Orthop Traumatol Source Type: research

[Ankle block].
Abstract OBJECTIVE: The so-called ankle block represents a local anesthesia form which enables easy performance of all surgical procedures of the foot and ankle. INDICATIONS: Interventions distal to the medial and lateral malleoli. CONTRAINDICATIONS: Acute and chronic infections in the area of injection; allergy to the local anesthesia. SURGICAL TECHNIQUE: All five sensory foot nerves are blocked. The two deep lying nerves, the tibial nerve and the deep fibular nerve, can be directly anesthetized perineurally using anatomical landmarks. The other three nerves are subcutaneously infiltrated near...
Source: Operative Orthopadie und Traumatologie - January 15, 2020 Category: Orthopaedics Authors: Kaller P, Hohenberger G, Holweg P, Seibert FJ, Ornig M Tags: Oper Orthop Traumatol Source Type: research

[Plate osteosynthesis of the coronoid process of the ulna].
LP Abstract OBJECTIVE: The aim of surgical treatment is reconstruction of the coronoid process' bony anatomy. INDICATIONS: Large shear fractures of the coronoid process (Regan-Morrey type II-III, O'Driscoll "tip" subtype 2 and "basal" subtype 1-2) and fractures of the anteromedial facet (O'Driscoll "anteromedial" subtype 1-3) can occur isolated or as part of the "terrible triad" injuries to the elbow. Due to the resulting instability of these injuries, surgical reconstruction is generally indicated. CONTRAINDICATIONS: In case of major accompany...
Source: Operative Orthopadie und Traumatologie - January 15, 2020 Category: Orthopaedics Authors: Rausch V, Hackl M, Seybold D, Wegmann K, Müller LP Tags: Oper Orthop Traumatol Source Type: research

[Arthroscopic tibiotalocalcaneal arthrodesis using an intramedullary locking nail].
Polzer H Abstract OBJECTIVE: Arthroscopic tibiotalocalcaneal arthrodesis (TTCA) aims at reconstructing a pain-free, orthograde, and functional limb with reduced invasiveness and lower complication rates compared to open arthrodesis. INDICATIONS: Combined osteoarthritis of the ankle and subtalar joint or hindfoot malalignment. CONTRAINDICATIONS: Osteomyelitis/deep soft tissue infections, talus necrosis, severe deformity of hindfoot or distal tibia, pronounced boney defect, indication for combined total ankle replacement and subtalar fusion. SURGICAL TECHNIQUE: Patient in supine position; arthros...
Source: Operative Orthopadie und Traumatologie - January 10, 2020 Category: Orthopaedics Authors: Baumbach SF, Maßen F, Böcker W, Polzer H Tags: Oper Orthop Traumatol Source Type: research

[Distal hand block].
Abstract OBJECTIVE: Peripheral nerve blocks in hand surgery. INDICATIONS: Short operations on the hand. CONTRAINDICATIONS: Long operations, polyneuropathy, local anesthesia allergy. TECHNIQUE: Identification of landmarks, skin disinfection, local anesthesia injection, surgery. POSTOPERATIVE MANAGEMENT: Postoperative monitoring. RESULTS: We performed 75 hand surgeries using distal nerve blocks over 3 years (between 2015 and 2018) in our department. In all, 60% (n = 45) of cases belong to the innervation region of the median nerve, 28% of cases (n = 21) belong to ...
Source: Operative Orthopadie und Traumatologie - January 2, 2020 Category: Orthopaedics Authors: Tezval M, Spering C Tags: Oper Orthop Traumatol Source Type: research

Dank an die Gutachterinnen und Gutachter 2019.
Authors: PMID: 31811346 [PubMed - as supplied by publisher] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - December 6, 2019 Category: Orthopaedics Tags: Oper Orthop Traumatol Source Type: research

[Minimally invasive techniques for stabilization of the pelvic ring and acetabulum].
PMID: 31773236 [PubMed - in process] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - November 28, 2019 Category: Orthopaedics Authors: Krappinger D Tags: Oper Orthop Traumatol Source Type: research

[Core decompression ("conventional method") in atraumatic osteonecrosis of the hip].
[Core decompression ("conventional method") in atraumatic osteonecrosis of the hip]. Oper Orthop Traumatol. 2019 Nov 21;: Authors: Benignus C, Lüring C, Beckmann J Abstract OBJECTIVE: Retrograde drilling of a necrotic zone within the femoral head to reduce intraosseous pressure and stimulate revascularization. INDICATIONS: Atraumatic osteonecrosis of the hip ARCO stage I (reversible) and ARCO stage II (potentially reversible) with a medial or central necrotic zone  30%, infections. SURGICAL TECHNIQUE: Supine position. Visualization of the necrotic zo...
Source: Operative Orthopadie und Traumatologie - November 21, 2019 Category: Orthopaedics Authors: Benignus C, Lüring C, Beckmann J Tags: Oper Orthop Traumatol Source Type: research

[Open repair of proximal hamstring tears].
Abstract OBJECTIVE: Surgical refixation intends to restore the continuity of the hamstrings and anatomically reattach the torn tendons. INDICATIONS: In patients with 2‑tendon tear/ruptur with more than 2 cm retraction or with complete 3‑tendon tears, surgical fixation should be performed. CONTRAINDICATIONS: Massive obesity, immobility. SURGICAL TECHNIQUE: Surgery is performed via a transverse skin incision in the gluteal fold. Refixation of the torn tendons is achieved by means of suture anchors on the footprint of the ischial tuberosity. POSTOPERATIVE MANAGEMENT: Postoperative treat...
Source: Operative Orthopadie und Traumatologie - November 21, 2019 Category: Orthopaedics Authors: Partenheimer A, Lill H Tags: Oper Orthop Traumatol Source Type: research

[Unilateral approach for over the top bilateral lumbar decompression].
Abstract OBJECTIVE: The main goal is bilateral microsurgical decompression of the cauda equina using a unilateral over the top approach. The challenge is to achieve decompression with minimal iatrogenic trauma to anatomical structures in the approach region and in the target area. INDICATIONS: Degenerative spinal disorders including lumbar central stenosis, lumbar lateral recess spinal stenosis, and foraminal narrowing. This technique is performed in patients presenting primarily with neurogenic claudication, leg or buttock symptoms, heaviness in the legs with or without radicular symptoms, with or without ne...
Source: Operative Orthopadie und Traumatologie - November 14, 2019 Category: Orthopaedics Authors: Heider FC, Mayer HM Tags: Oper Orthop Traumatol Source Type: research

[Reconstruction of the deep fibers of the distal radioulnar ligaments facilitating a  tendon graft-Adams' procedure].
[Reconstruction of the deep fibers of the distal radioulnar ligaments facilitating a tendon graft-Adams' procedure]. Oper Orthop Traumatol. 2019 Nov 13;: Authors: Spies CK, Langer MF, Müller LP, Unglaub F Abstract GOAL: Anatomical reconstruction of the deep fibers of the distal radioulnar ligaments to stabilise the distal radioulnar joint. INDICATIONS: Multidirectional instability of the distal radioulnar joint without the possibility for anatomic refixation of the distal radioulnar ligaments. CONTRAINDICATIONS: General operative contraindications, infection, insufficient soft tiss...
Source: Operative Orthopadie und Traumatologie - November 13, 2019 Category: Orthopaedics Authors: Spies CK, Langer MF, Müller LP, Unglaub F Tags: Oper Orthop Traumatol Source Type: research

[Acetabular revision arthroplasty with a  novel cementless augment-and-modular-cage system (MRS-C) : Surgical technique and preliminary clinical results].
[Acetabular revision arthroplasty with a novel cementless augment-and-modular-cage system (MRS-C) : Surgical technique and preliminary clinical results]. Oper Orthop Traumatol. 2019 Nov 13;: Authors: Wirtz DC, Wacker M, Jaenisch M, Gravius S, Roessler PP Abstract OBJECTIVE: Optimal reconstruction of acetabular anatomy and primarily stable bridging even of large bone defects in hip revision surgery by intraoperative cementless application of highly modular components of the MRS-TITAN Comfort (MRS-C) system according to the augment-and-modular-cage principle. INDICATIONS: Acetabular defect sit...
Source: Operative Orthopadie und Traumatologie - November 13, 2019 Category: Orthopaedics Authors: Wirtz DC, Wacker M, Jaenisch M, Gravius S, Roessler PP Tags: Oper Orthop Traumatol Source Type: research

[Surgical treatment of snapping triceps syndrome].
Abstract OBJECTIVE: Treatment of a persistently painful snapping triceps and possibly snapping ulnar nerve. INDICATION: Snapping triceps. CONTRAINDICATIONS: General surgical risks. SURGICAL TECHNIQUE: Following the anterior transposition of the ulnar nerve (subcutaneously or submuscular), the snapping portion of the triceps tendon is transsected and reinforced, and transposition of the medial triceps margin into the central triceps portion is carried out. POSTOPERATIVE MANAGEMENT: Cast for 5-7 days; for a total of 6 weeks functional exercise without maximum flexion and resis...
Source: Operative Orthopadie und Traumatologie - November 5, 2019 Category: Orthopaedics Authors: Schoch C, Geyer M Tags: Oper Orthop Traumatol Source Type: research

[Oberst's block anesthesia].
Abstract OBJECTIVE: Complete anesthesia of the phalanges of the fingers and toes. INDICATIONS: All lesions distal to the metacarpophalangeal/metatarsophalangeal joint. CONTRAINDICATIONS: Local infections at the injection site. Lesions proximal to the metacarpophalangeal/metatarsophalangeal joint. TECHNIQUE: A subcutaneous deposit of a 0.5-2% local anesthetic is administered dorsoradially and dorsoulnarly at the base of the metacarpophalangeal/metatarsophalangeal joint. With the cannula advanced to palmar, an additional 0.5-1.5 ml is then administered to achieve complete anesthesia. ...
Source: Operative Orthopadie und Traumatologie - October 24, 2019 Category: Orthopaedics Authors: Saul D, Roch J, Lehmann W, Dresing K Tags: Oper Orthop Traumatol Source Type: research

Fluoroscopically guided acetabular posterior column screw fixation via an anterior approach.
Abstract OBJECTIVE: Safe posterior column screw fixation via an anterior approach under two-dimensional fluoroscopic control. INDICATIONS: Anterior column with posterior hemitransverse fractures (ACPHF); transverse fractures; two-column fractures and T‑type fractures without relevant residual displacement of the posterior column after reduction of the anterior column and the quadrilateral plate. CONTRAINDICATION: Acetabular fractures requiring direct open reduction via a posterior approach; very narrow osseous corridor in preoperative planning; insufficient intraoperative fluoroscopic visualizatio...
Source: Operative Orthopadie und Traumatologie - October 16, 2019 Category: Orthopaedics Authors: Krappinger D, Schwendinger P, Lindtner RA Tags: Oper Orthop Traumatol Source Type: research

[Infiltration anesthesia].
Abstract OBJECTIVE: Complete anesthesia of any skin and soft tissue area by intradermal, subcutaneous, or intramuscular injections. INDICATIONS: Small injuries or incisions in limbs or trunk, minor surgery on the face/jaw (e.g., on the teeth), or postoperative analgesia (local infiltration anesthesia, LIA). CONTRAINDICATIONS: Local infections at the injection site. SURGICAL TECHNIQUE: By means of intradermal, subcutaneous or intramuscular administration, a grandeur arises, here the local anesthetic blocks nerve transmission. If anesthetized distal to end arteries, vasoconstrictors (e.g., epinep...
Source: Operative Orthopadie und Traumatologie - October 14, 2019 Category: Orthopaedics Authors: Saul D, Roch J, Lehmann W, Dresing K Tags: Oper Orthop Traumatol Source Type: research

[Fast track concepts in total knee arthroplasty: use of tranexamic acid and local intra-articular anesthesia technique].
r M Abstract OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment ...
Source: Operative Orthopadie und Traumatologie - September 13, 2019 Category: Orthopaedics Authors: Petersen W, Bierke S, Hees T, Karpinski K, Häner M Tags: Oper Orthop Traumatol Source Type: research

[Hand and wrist fractures].
PMID: 31515580 [PubMed - as supplied by publisher] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - September 12, 2019 Category: Orthopaedics Authors: Spies CK, Unglaub F Tags: Oper Orthop Traumatol Source Type: research

3D image-guided surgery for fragility fractures of the sacrum.
Abstract OBJECTIVE: Stabilizing sacral fragility fractures without radiation exposure to the surgical team. INDICATIONS: Non-displaced or minimally displaced unilateral or bilateral transalar, transforaminal or central sacral fractures in weak and osteoporotic bone. CONTRAINDICATIONS: Displaced or highly unstable sacral fractures. Patients under therapeutic anticoagulation. Patients needing fast track orthopedic surgery. SURGICAL TECHNIQUE: Prone position. Reference clamp installation on posterior iliac crest. Initial 3D scan of posterior pelvic ring. Image-guided virtual determination of 2-3 i...
Source: Operative Orthopadie und Traumatologie - September 12, 2019 Category: Orthopaedics Authors: Balling H Tags: Oper Orthop Traumatol Source Type: research

[All-arthroscopic fixation of tibial posterior cruciate ligament avulsion fractures with a  suture-button technique].
[All-arthroscopic fixation of tibial posterior cruciate ligament avulsion fractures with a suture-button technique]. Oper Orthop Traumatol. 2019 Sep 06;: Authors: Forkel P, Imhoff AB, Achtnich A, Willinger L Abstract OBJECTIVE: To restore the posterior stability of the knee after a tibial posterior cruciate ligament (PCL) avulsion with a suture-button construct. INDICATIONS: Acute solid and monofragment bony avulsion of the tibial PCL insertion. CONTRAINDICATIONS: Chronic condition of avulsion fractures or posterior instability, multifragment avulsions, thin bone pieces, advan...
Source: Operative Orthopadie und Traumatologie - September 6, 2019 Category: Orthopaedics Authors: Forkel P, Imhoff AB, Achtnich A, Willinger L Tags: Oper Orthop Traumatol Source Type: research

[Open reduction and screw/plate osteosynthesis of metacarpal fractures].
b F Abstract OBJECTIVE: Anatomic reduction and stabile fixation for immediate mobilisation and restoration of unrestricted function. INDICATIONS: Instabile metacarpal fractures with or without malrotation, dislocated metacarpal fractures with malrotation or finger extension deficit, longitudinally shortened metacarpal fractures with finger extension deficit. CONTRAINDICATIONS: Persistent infections (empyema, osteomyelitis, phlegmon) SURGICAL TECHNIQUE: Longitudinal intermetacarpal incision along the fracture zone, debridement of the fracture zone with retainment of periost, anatomic reduction and retenti...
Source: Operative Orthopadie und Traumatologie - September 5, 2019 Category: Orthopaedics Authors: Spies CK, Langer M, Hohendorff B, Müller LP, Oppermann J, Unglaub F Tags: Oper Orthop Traumatol Source Type: research

[Intravenous regional anesthesia].
Abstract OBJECTIVE: Intravenous regional anesthesia. INDICATIONS: Short duration hand operations. CONTRAINDICATIONS: Open wounds, lengthy operations, local infections, polyneuropathy, Raynaud syndrome, allergy to local anesthetics. TECHNIQUE: Insertion of an intravenous cannula, attachment of a double lumen cuff, Esmarch's tourniquet, injection of the local anesthetic, stepwise pumping up the tourniquet, surgery, stepwise removal of the tourniquet. POSTOPERATIVE MANAGEMENT: Postoperative monitoring of the patient after the end of anesthesia. RESULTS: Over a time period of 2 years (Jan...
Source: Operative Orthopadie und Traumatologie - August 29, 2019 Category: Orthopaedics Authors: Tezval M, Spering C Tags: Oper Orthop Traumatol Source Type: research

[Palmar angular stable plate fixation of nonunions and comminuted fractures of the scaphoid].
Abstract OBJECTIVE: Stabilization of comminuted fractures and nonunions of the scaphoid with an angular stable low-profile scaphoid plate. INDICATIONS: Scaphoid nonunions with a large palmar defect, second and third surgical procedure after previous stabilization by headless compression screw (HCS). Comminuted fractures of the scaphoid that cannot be sufficiently stabilized by screws. CONTRAINDICATIONS: Radio- and midcarpal osteoarthritis, small proximal pole fragments, fragmentation of the proximal pole. SURGICAL TECHNIQUE: The scaphoid is accessed by a palmar approach. After correcting t...
Source: Operative Orthopadie und Traumatologie - August 21, 2019 Category: Orthopaedics Authors: Quadlbauer S, Pezzei C, Jurkowitsch J, Krimmer H, Sauerbier M, Hausner T, Leixnering M Tags: Oper Orthop Traumatol Source Type: research

[Special situations and complication management in spinal surgery].
PMID: 31388711 [PubMed - in process] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - August 1, 2019 Category: Orthopaedics Authors: Lehmann W Tags: Oper Orthop Traumatol Source Type: research

[Indications and techniques of arthroscopic anterior and lateral acromioplasty].
Abstract OBJECTIVE: Arthroscopic anterior acromioplasty (AAAP) for treatment of symptomatic subacromial spur. Arthroscopic lateral acromioplasty (ALAP) to reduce a pathological critical shoulder angle (CSA) and prevent rotator cuff re-tear after reconstruction. INDICATIONS: AAAP is indicated for acromial impingement due to an anterolateral acromial spur with or without bursa-sided rotator cuff lesion. ALAP is indicated concomitant to arthroscopic rotator cuff repair if the CSA is pathologically increased. RELATIVE CONTRAINDICATIONS: Irreparable rotator cuff tear with acetabularization of the acromio...
Source: Operative Orthopadie und Traumatologie - July 30, 2019 Category: Orthopaedics Authors: Rueckl K, Ernstbrunner L, Reichel T, Bouaicha S, Barthel T, Rudert M, Plumhoff P Tags: Oper Orthop Traumatol Source Type: research

[Surgical approaches to the hand].
s C Abstract OBJECTIVE: Accessibility of any anatomical structure of the hand via surgical approach. INDICATIONS: Any surgical treatment of the hand. CONTRAINDICATIONS: Any contraindication to surgical treatment of the hand. SURGICAL TECHNIQUE: Skin incision at the hand with access to any anatomical structure. POSTOPERATIVE MANAGEMENT: Postoperative treatment depends on the disease and hand surgery performed. PMID: 31359070 [PubMed - as supplied by publisher] (Source: Operative Orthopadie und Traumatologie)
Source: Operative Orthopadie und Traumatologie - July 29, 2019 Category: Orthopaedics Authors: Hohendorff B, Unglaub F, Spies CK, Wegmann K, Müller LP, Ries C Tags: Oper Orthop Traumatol Source Type: research

[Percutaneous treatment of unstable fractures of the base of the middle phalanx : Technique according to Hintringer and Ender].
Abstract OBJECTIVE: Reconstruction of intra-articular impression fractures of the middle phalanx by percutaneous reduction over a small dorsal cortical window. Stabilization by lattice-like arranged K‑wires. INDICATIONS: Impression fractures of the base of the middle phalanx with or without dislocation in the proximal interphalangeal joint. CONTRAINDICATIONS: Fractures extending to the shaft of the middle phalanx. SURGICAL TECHNIQUE: By a cortical window at the dorsum of the middle phalanx (through the tendon free triangle) the impression fracture is reduced from the medullary cavity. Re...
Source: Operative Orthopadie und Traumatologie - July 25, 2019 Category: Orthopaedics Authors: Quadlbauer S, Pezzei C, Hintringer W, Hausner T, Leixnering M Tags: Oper Orthop Traumatol Source Type: research

[Incidental durotomy: intraoperative aid in ten steps].
Abstract OBJECTIVE: Management of the intradural structures safely, closure of the dura according to the tear, and minimizing the epidural dead space. INDICATIONS: Incidental durotomy (ID). CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: 1. Bone removal until whole dural tear is visible (if necessary); 2. intradural inspection; 3. reposition the fibers; 4. perform an inside patch (if ID > 5 mm); 5. dural closure; 6. outside patch; 7. Valsalva maneuver; 8. epidural pedicled muscle flap; 9. multilayer wound closure; 10. lumbar drainage of ce...
Source: Operative Orthopadie und Traumatologie - July 19, 2019 Category: Orthopaedics Authors: Papavero L, Kothe R Tags: Oper Orthop Traumatol Source Type: research