Abstract:
INTRODUCTION:The correct choice of a fracture-specific surgical approach with an articular accessibility in complex tibial plateau fractures to facilitate durable fracture fixation of the anatomic articular reconstruction is under debate, as the most important risk factor for malreduction in complex tibial plateau fractures is an impaired visualization of the articular surface. MATERIALS AND METHODS:Six established surgical approaches were simulated on 12 cadaver knees. The visible articular surface was labeled with an electrocautery device for each approach and subsequently analyzed with ImageJ. Areas of each hemiplateau were compared using the Student's t test. RESULTS:In the lateral tibial plateau, the dorsal 19.0 ± 5.8% of the articular surface could be exposed via the postero-lateral approach. Via the antero-lateral arthrotomy, 36.6 ± 9.4% of the anterior articular surface was visible. The additional osteotomy of the lateral femoral epicondyle significantly increased the exposure to 65.6 ± 7.7% (p < 0.001). In the medial tibial plateau, the osteotomy of the medial femoral epicondyle significantly improved visualization of the medial articular surface (62.3 ± 8.6%) compared to the postero-medial approach (14.0 ± 7.3%) and the antero-medial approach (36.9 ± 9.2%) of the articular (p < 0.001). CONCLUSIONS:Visualization of the tibial articular surface is limited through specific surgical approaches. Extension by osteotomy of the femoral epicondyle led to a significant improvement in the articular exposure without, however, obtaining sufficient visibility of the posterior joint segments, which should be included in the preoperative strategy. The proposed surgical approach-specific map of the tibial plateau may constitute an important instrument in the toolbox of an experienced surgeon to treat complex tibial plateau fractures at the highest level. LEVEL OF EVIDENCE:Level IV.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Krause M,Krüger S,Müller G,Püschel K,Frosch KHdoi
10.1007/s00402-019-03200-zsubject
Has Abstractpub_date
2019-10-01 00:00:00pages
1369-1377issue
10eissn
0936-8051issn
1434-3916pii
10.1007/s00402-019-03200-zjournal_volume
139pub_type
杂志文章abstract:INTRODUCTION:Recent reports in the adult literature reported the use of standardized radiographic measurement techniques to determine distal radioulnar joint (DRUJ) instability. The aim of this study was to evaluate the efficacy and accuracy of (1) the MRI-based modified radioulnar ratio technique and (2) the pisoscaph...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03470-y
更新日期:2020-07-01 00:00:00
abstract::Between 1973 and 1988, 108 patients with a preoperative diagnosis of spinal tuberculosis were treated by anterior extirpation and interbody fusion at Ankara University Medical Faculty, Orthopedic Surgery and Traumatology Department. In 96 cases the operations were performed intrapleurally, as Hogston described. For 12...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00932444
更新日期:1989-01-01 00:00:00
abstract::Percutaneous lumbar discectomy has gained growing interest during recent years as an alternative to open surgery for protrusions and non-sequestrated subligamentous intervertebral disc herniations. As a less invasive method it competes with chemonucleolysis. At least two modifications are known to date: automated perc...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00453143
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:In a prospective, randomised study, we compared the results of anterior cruciate ligament reconstruction using the conventional medial patellar tendon strip procedure with the Kennedy ligament augmentation device (LAD) over-the-top augmentation technique. The aim of the study was to see if the addition of th...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00402-002-0457-9
更新日期:2003-05-01 00:00:00
abstract:PURPOSE:In an alumina-on-alumina total hip arthroplasty (THA), recommended with a small inclination angle <45°, the acetabular component (cup) may be positioned more medially to be covered almost completely by host bone. The purpose of this study was to identify the correlating factors and to evaluate the outcomes of m...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1661-x
更新日期:2013-03-01 00:00:00
abstract::Dedifferentiated chondrosarcoma (DDCS) comprises approximately 10% of all chondrosarcomas and has the worst outcome with 5-year survival of 10%. The preferred localizations are femur, humerus and pelvis. We report a case of DDCS that arose in proximal phalanx of left-hand thumb of a 66-year-old man. He was admitted wi...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0538-x
更新日期:2009-02-01 00:00:00
abstract:INTRODUCTION:Internal fixation of the traumatic diastasis of symphysis pubis is an integral part of the definitive management of pelvic ring injuries. Both functional outcome and long term physiological effects of plate retention have not been clearly addressed and no specific indications regarding implant removal have...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0429-1
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. MATERIALS AND METHODS:We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol fr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2634-x
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The pathogenesis of Achilles tendon rupture remains unclear, but vascular patterns may play an important role. Hypoxia is considered to be an important factor in the aetiology of tendon degeneration. METHODS:Statements from the literature regarding the vascularization of the Achilles tendon are controversia...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-003-0491-2
更新日期:2003-11-01 00:00:00
abstract:INTRODUCTION:Laminoplasty and skip laminectomy are two specific posterior surgical approaches for multilevel cervical spondylotic myelopathy. The objective of this study was to perform a systematic review comparing the clinical results and complications of laminoplasty and skip laminectomy in the treatment of multileve...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-013-1881-8
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:The purpose of the current study was to clinically evaluate the technique of longer pull-out suture as a transmission suture for early active motion after flexor tendon repair in the proximal zone-2. METHOD:Eleven patients (eight adult male, two adult female and one child) with 19 proximal zone II flexor te...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1238-5
更新日期:2011-04-01 00:00:00
abstract::In 16 patients with an average age of 64.6 +/- 9.8 years and sudden onset of severe knee pain, the initial stage of Ahlbäck disease (spontaneous osteonecrosis of a femoral condyle) was verified by magnetic resonance imaging (MRI) and subsequent histology. The first radiological sign of osteonecrosis (flattening of the...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00703433
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:The airbag is an established car safety device. However, recent studies pointed out that even the airbag might cause injuries. Nevertheless, most physicians do consider a lower risk in accident victims sustaining severe injury of the chest, when a deployed frontal airbag has been reported. We set out to ve...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-006-0181-y
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Vacuum-assisted closure (VAC) therapy is a sophisticated development of a standard surgical procedure. The purpose of this study is to evaluate the clinical efficacy of managing adult osteomyelitis with VAC therapy. MATERIALS AND METHODS:We included a total of 68 patients that developed osteomyelitis with...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1197-x
更新日期:2011-02-01 00:00:00
abstract::Extended thromboprophylaxis is vital in patients undergoing total hip arthroplasty (THA) because of the prolonged risk of venous thromboembolism (VTE). Despite evidence that extended prophylaxis can reduce the incidence of symptomatic VTE in this high-risk patient population and the evidence-based guideline recommenda...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0930-9
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2439-3
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:Treatment of diaphyseal forearm fractures by open reduction and internal plate fixation is a well-accepted strategy. In a variety of fracture localizations, the use of bridging plate fixation with locking compression plates (LCP) has been shown to improve biomechanical and biological characteristics. Only ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1119-y
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Osteopetrosis is caused by general increase in bone density and obliteration of the medullary canal. Fractures are a frequent complication and their management is considered a challenge due to increased resistance to reaming and screw positioning; reduction maneuvers have to be done more carefully to avoid...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-2144-z
更新日期:2015-03-01 00:00:00
abstract:PURPOSE:The purpose of this study is to evaluate the radiographic and clinical outcomes of the Frag-Loc(®) compression screw with palmar plate fixation on distal radius fractures that include a displaced dorsoulnar fragment. PATIENTS AND METHODS:This retrospective comparative study enrolled 48 patients who had an unst...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2290-y
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to evaluate the results of a contoured focal articular femoral condyle resurfacing prosthetic in the treatment of full-thickness cartilage and osteochondral defects at the medial femoral condyle of the knee beyond 5 years. METHODS:In a multicenter case series, preoperative an...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00402-011-1323-4
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:Many studies have identified factors prognostic for soft tissue sarcomas of local recurrence, and distant metastasis. Several studies demonstrated that some subsets of patients could be safely treated by surgery alone, with acceptable rates of local recurrence. The aim of this study was to better clarify t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1255-4
更新日期:2011-05-01 00:00:00
abstract::In the patient with scarring of just the central band and lateral bands, there is a loss of active and passive flexion of the proximal interphalangeal (PIP) joint because the lateral bands have lost their normal volar shift. Surgical freeing of the lateral bands from the central band using parallel incisions may be re...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00443462
更新日期:1991-01-01 00:00:00
abstract:INTRODUCTION:Trigger finger and thumb are amongst the most common hand disabilities seen by orthopaedic surgeons. Surgical release of the first annular pulley (A1) is generally indicated when non-operative treatment fails. We present the long-term results of open operative treatment of trigger finger or trigger thumb i...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0802-8
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:The minimally invasive plate osteosynthesis (MIPO) technique has been introduced recently. The extensive comminuted fractures of the distal radial metaphysis with diaphyseal involvement are probably good indications for MIPO technique because of less extensive dissection and soft-tissue stripping. The purp...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2162-5
更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:Freiberg disease is defined as osteochondrosis of the metatarsal head and typically occurs in adolescents with sporting activity. This study aimed to evaluate the sporting activity of young athletes after osteochondral autograft transplantation (OAT) for Freiberg disease. MATERIALS AND METHODS:OAT for Fre...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2712-0
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Correct anatomic tunnel positions are essential in anterior cruciate ligament (ACL) reconstruction. To establish recommendations for tunnel positioning based on anatomical findings and to compare tunnel positions with clinical results, different radiological measurement methods as the quadrant method exist...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-1931-x
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:To evaluate the kinetic amplitude and direction of the long head of the biceps tendon (LHB) within the pulley and the proximal bicipital groove, we performed a 3T-magnetic resonance-throwing motion analysis. MATERIALS AND METHODS:This prospective study was performed on a 3T-MRI scanner. A T2-weighted-3D s...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1865-8
更新日期:2013-12-01 00:00:00
abstract::We describe a case of a 68-year-old patient presenting with pathological hip fracture and multiple pulmonary metastases, who has been operated without a prior histological diagnosis. The hip lesion was thought to be a metastasis of an unknown primary tumor. The proximal part of the femur was resected and replaced by a...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00936214
更新日期:1989-01-01 00:00:00
abstract::Using a model of meniscal injury in rabbit, the effects of hyaluronic acid (HA) injection into the joint on the rate of filling area and the cell shape in the defects were studied. After a cylindrical defect was made in the anterior horn of the lateral meniscus, HA was injected into the joint once a week. At 1 and 6 w...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050255
更新日期:1998-01-01 00:00:00
abstract::In the period 1969-1991, 46 extensor indicis proprius tendon transfers were performed for functional loss of extensor pollicis longus. The long-term function of the thumb was reviewed in 22 patients with an average follow-up of 7 years. Based on Geldmacher's evaluation scheme for assessment of the results of extensor ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00426181
更新日期:1994-01-01 00:00:00