Abstract:
BACKGROUND:The treatment aims of periprosthetic fractures (PPF) of the distal femur are a gentle stabilization, an early load-bearing capacity and a rapid postoperative mobilization of the affected patients. For the therapy planning of PPF a standardized classification is necessary which leads to a clear and safe therapy recommendation. Despite different established classifications, there is none that includes the types of prosthesis used in the assessment. For this purpose, the objective of this work is to create a new more extensive fracture and implant-related classification of periprosthetic fractures of the distal femur based on available classifications which allows distinct therapeutic recommendations. METHODS:In a retrospective analysis all patients who were treated in the University Hospital Leipzig from 2010 to 2016 due to a distal femur fracture with total knee arthroplasty (TKA) were established. To create an implant-associated classification the cases were discussed in a panel of experienced orthopaedists and well-practiced traumatologists with a great knowledge in the field of endoprosthetics and fracture care. In this context, two experienced surgeons classified 55 consecutive fractures according to Su et al., Lewis and Rorabeck and by the new created classification. In this regard, the interobserver reliability was determined for two independent raters in terms of Cohen Kappa. RESULTS:On the basis of the most widely recognized classifications of Su et al. as well as Lewis and Rorabeck, we established an implant-dependent classification for PPF of the distal femur. In accordance with the two stated classifications four fracture types were created and defined. Moreover, the four most frequent prosthesis types were integrated. Finally, a new classification with 16 subtypes was generated based on four types of fracture and four types of prosthesis. Considering all cases the presented implant-associated classification (κ = 0.74) showed a considerably higher interobserver reliability compared to the other classifications of Su et al. (κ = 0.39) as well as Lewis and Rorabeck (κ = 0.31). Excluding the cases which were only assessable by the new classification, it still shows a higher interobserver reliability (κ = 0.70) than the other ones (κ = 0.63 or κ = 0.45). CONCLUSIONS:The new classification system for PPF of the distal femur following TKA considers fracture location and implant type. It is easy to use, shows agood interobserver reliability and allows conclusions to be drawn on treatment recommendations. Moreover, further studies on the evaluation of the classification are necessary and planned.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Fakler JKM,Pönick C,Edel M,Möbius R,Brand AG,Roth A,Josten C,Zajonz Ddoi
10.1186/s12891-017-1855-zsubject
Has Abstractpub_date
2017-11-25 00:00:00pages
490issue
1issn
1471-2474pii
10.1186/s12891-017-1855-zjournal_volume
18pub_type
杂志文章abstract:BACKGROUND:Suture anchor-based fixations of humeral greater tuberosity (GT) fractures have yielded good outcomes in both clinical and biomechanical studies. Be that as it may, the interface contact properties of these fixations have yet to be elaborated. In response, the contact characteristics of two double-row suture...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2412-8
更新日期:2019-01-17 00:00:00
abstract:BACKGROUND:Illness perceptions have been found to change over time and following health care. Hence, addressing illness perceptions alongside existing health care interventions may be important for the sustainment of health gains following rehabilitation. The aim of this study was to measure the illness perceptions of ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2474-14-28
更新日期:2013-01-16 00:00:00
abstract:BACKGROUND:Musculoskeletal ultrasound improves the accuracy of detecting the level of disease activity (DA) in RA patients, although its impact on the final treatment decision in a real clinical setting is uncertain. The objectives were to define the percentage of clinical scenarios from an ongoing cohort of RA outpati...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-017-1747-2
更新日期:2017-09-11 00:00:00
abstract:BACKGROUND:Shoulder disorders are common problems in primary health care. The course of disease of patients consulting for a new episode of a shoulder problem has been thought to be benign. In this prospective cohort study, we assessed the one-year consumption of medical resources and clinical outcome of shoulder disor...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-14-348
更新日期:2013-12-13 00:00:00
abstract:BACKGROUND:Exercise programmes have shown to be important for the prevention of fractures in patients with established osteoporosis. However, few studies have evaluated the effect of such programmes for women with low bone mineral density (BMD) (osteoporosis or osteopenia) who have already suffered a fracture. Studies ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-015-0811-z
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conse...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-017-1854-0
更新日期:2017-11-22 00:00:00
abstract:BACKGROUND:Standard plate fixation can be used to treat intraarticular olecranon fractures with satisfactory functional recovery, but its use is accompanied by implant related complications. This retrospective study reports on the functional outcome of intraarticular olecranon fractures treated with a central tension p...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-14-308
更新日期:2013-10-28 00:00:00
abstract:BACKGROUND:To investigate (1) the association of specific biomechanical factors with knee osteoarthritis and knee osteoarthritis development, and (2) the impact of other relevant risk factors on this association. METHODS:MEDLINE, EMBASE, CINAHL and SPORTDiscus were searched up until April 2017. Studies were included i...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,meta分析
doi:10.1186/s12891-018-2202-8
更新日期:2018-07-28 00:00:00
abstract:BACKGROUND:Intra-articular tranexamic acid (TXA) as an adjunct to intravenous TXA was reported to decrease perioperative blood loss during unilateral total knee arthroplasty (TKA). However, there have been no randomized controlled trials comparing intravenous versus combined intravenous and intra-articular TXA administ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12891-019-2890-8
更新日期:2019-10-22 00:00:00
abstract:BACKGROUND:Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patien...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-8-22
更新日期:2007-02-28 00:00:00
abstract:BACKGROUND:The prone leg extension (PLE) is a clinical test used to evaluate the function of the lumbopelvis. It has been theorized that a normal and consistent pattern of muscle activation exists. Previous research has found two contradictory patterns of muscle activation during PLE in normal individuals. One study sh...
journal_title:BMC musculoskeletal disorders
pub_type: 临床试验,杂志文章
doi:10.1186/1471-2474-5-3
更新日期:2004-02-10 00:00:00
abstract:BACKGROUND:Plasma d-dimer levels have been associated with the status of tumor progression or oncological outcomes in cancer. Although there are many evidences suggesting the involvement of procoagulant trend in musculoskeletal sarcoma, no clinical data on d-dimer levels and oncological outcome of musculoskeletal sarco...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-250
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Clinicians and patients lack an evidence-based framework by which to judge individual-level recovery following total knee arthroplasty (TKA) surgery, thus impeding personalized treatment approaches for this elective surgery. Our study aimed to develop and validate a reference chart for monitoring recovery of...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03493-x
更新日期:2020-07-22 00:00:00
abstract:BACKGROUND:The Hueter-Volkmann law describes growth principles around joints and joint deformation. It states that decreased stress leads to increased growth and that excessive stress leads to growth retardation. Aim of this study was to test the possible results of this principle by measuring the effect of dorsal hume...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-14-107
更新日期:2013-03-22 00:00:00
abstract:BACKGROUND:Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management o...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-15-141
更新日期:2014-04-29 00:00:00
abstract:BACKGROUND:Internalised stigma is theorized to be the internalisation and legitimisation of stereotypes of the diagnosis held in society and has not been quantified within patients with Rheumatoid Arthritis. This study aimed to: validate a modified version of a measure of internalised stigma, (the Internalised Stigma o...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1089-5
更新日期:2016-06-02 00:00:00
abstract:BACKGROUND:In cerebral palsy (CP) there is an increased risk of scoliosis. It is important to identify a progressive scoliosis early-on because the results of surgery depend on the magnitude of the curve. The Swedish follow-up program for cerebral palsy (CPUP) includes clinical examinations of the spine. The reliabilit...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-015-0801-1
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:Musculoskeletal complaints of arm, neck, and shoulder (CANS) can lead to loss of work productivity. To assess the functional consequences of impairments in work, patient-reported outcomes can be important. The Hand Function Sort (HFS) is a 62-item pictorial questionnaire that focuses on work task performance...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2649-2
更新日期:2019-06-07 00:00:00
abstract:BACKGROUND:The Foot and Ankle Ability Measure (FAAM) is a self reported questionnaire for patients with foot and ankle disorders available in English, German, and Persian. This study plans to translate the FAAM from English to French (FAAM-F) and assess the validity and reliability of this new version. METHODS:The FAA...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-40
更新日期:2011-02-08 00:00:00
abstract:BACKGROUND:Shoulder pain is the third most common reason for consultation with a physiotherapist and up to 26% of the general population might be expected to experience an episode at any one time. Disorders of the shoulder muscles and tendons (rotator cuff) are thought to be the commonest cause of this pain. The long-t...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2474-13-62
更新日期:2012-04-30 00:00:00
abstract:BACKGROUND:Previous studies suggested that pre-operative comorbidity was a risk factor for worse outcomes after TKA. To our knowledge, studies have not examined whether postoperative changes in comorbidity impact pain and function outcomes longitudinally. Our objective was to examine if increasing comorbidity postopera...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1261-y
更新日期:2016-10-07 00:00:00
abstract:BACKGROUND:We investigated the clinical value of posterior percutaneous endoscopic decompression (PED) for single-segment cervical spondylotic myelopathy (CSM) and cervical spondylotic radiculopathy (CSR). METHODS:Clinical data from February 2016 to March 2018 were collected for 32 patients with single-segment CSM or ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2920-6
更新日期:2019-11-18 00:00:00
abstract:BACKGROUND:Obesity is one of the most important risk factors for osteoarthritis (OA) in knee(s). However, the relationship between obesity and OA in hand(s) and hip(s) remains controversial and needs further investigation. The purpose of this study was to investigate the impact of obesity on incident osteoarthritis (OA...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-9-132
更新日期:2008-10-02 00:00:00
abstract:BACKGROUND:The Goutallier Classification is a semi quantitative classification system to determine the amount of fatty degeneration in rotator cuff muscles. Although initially proposed for axial computer tomography scans it is currently applied to magnet-resonance-imaging-scans. The role for its clinical use is controv...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1216-3
更新日期:2016-08-22 00:00:00
abstract:BACKGROUND:The optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1475-7
更新日期:2017-03-14 00:00:00
abstract:BACKGROUND:Movement control impairment reduces active control of movement. Patients with this might form an important subgroup among patients with mechanical cervical pain. Diagnosis is based on the observation of active movement tests. Although widely used clinically, few studies have been performed to determine the r...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-15-402
更新日期:2014-11-29 00:00:00
abstract:BACKGROUND:Lateral condylar humerus fractures (LCHFs) are the second most common pediatric distal humerus fractures. Open reduction and internal fixation is recommended for fractures displaced by more than 2 mm. Few studies described using closed reduction and percutaneous pinning (CRPP) for treating fractures with gre...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03738-9
更新日期:2020-10-27 00:00:00
abstract:BACKGROUND:Charcot neuroarthropathy is a systemic disease that generates pathological changes in the musculoskeletal system, causing instability, dislocations, and deformities. Charcot neuroarthropathy of the knee, due to either diabetes mellitus or syringomyelia, is anecdotally reported with the epidemic of the diseas...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2873-9
更新日期:2019-10-30 00:00:00
abstract:BACKGROUND:There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. The aim of this study was to evaluate the clinical outcomes of our newly developed one-stage anterior debridement and fusion combined with dual screw-rod construct anterior instrument underneath the ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-0902-5
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:There is a demand for a flexible and individually tailored patient education to meet patients' specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and pri...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-017-1689-8
更新日期:2017-08-02 00:00:00