Der Unfallchirurg / Intramedulläre Oberarmverlängerung

Motorisierte intramedulläre Teleskopnägel haben die Behandlung zur Oberarmverlängerung deutlich vereinfacht. Besserer Patientenkomfort, niedrige Infektionsrate und Fehlen der Regeneratfrakturen stehen den Limitierungen der Methode wie begrenzte Distraktion von derzeit maximal 5cm sowie die fehlende Anwendbarkeit bei offenen Wachstumsfugen gegenüber.(VLID)360168

Traumatic periimplant fracture after nail arthrodesis of the knee in a limb reconstruction case

Many principles of bone reconstruction were successfully applied in this unique case of a 1.92m (6 ft 3 in.) tall 15 year old boy with intercalary leg amputation. This patient suffered from a 26 cm (10.2 in.) bone loss of his left distal femur and severe soft tissue damage with an irreparable extensor mechanism after motor cycle accident.After periimplant fracture below the knee arthrodesis nail, definite treatment consisted of implant exchange to an 870 mm (34.3 in.) long custom made nail, which is to our knowledge the longest implanted arthrodesis nail in literature.Therefore the aim of the study was to present our treatment strategies and pitfalls after traumatic periimplant arthrodesis nail fracture in an unusual case of limb reconstruction. Keywords: Knee arthrodesis nail, Periimplant fracture, Renailing, Unusual cas

Archives of Orthopaedic and Trauma Surgery / Femoral shortening does not impair functional outcome after internal fixation of femoral neck fractures in non-geriatric patients

Introduction Aim of this study was to investigate the incidence and extent of femoral shortening in non-geriatric patients after internal fixation of femoral neck fractures in relation to the clinical outcome at mid-term follow-up. Materials and methods Reviewing our admission data, we identified non-geriatric patients (1865 years) with femoral neck fractures treated with either dynamic hip screw or cancellous screws between 2007 and 2015. Patients were then contacted and invited to a follow-up clinical investigation including whole-leg standing X-rays. Results A total of 40 patients with a mean age at surgery of 529 years returned for the follow-up examination. Overall, 31 patients (77.5%) had undergone a dynamic hip screw fixation, while 9 patients were treated with cancellous screws (22.5%). The median follow-up time was 65.5 months (5.5 years). We observed shortening of the ipsilateral femur neck in the majority of cases (92.5%). Still, functional outcome in the overall study population was excellent with a median Harris Hip Score of 96. Conclusions Femoral neck shortening is common in non-geriatric patients after internal fixation of femoral neck fractures. Nonetheless, observed excellent functional outcome at mid-term follow-up supports joint-preserving strategies in non-geriatric femoral neck fractures.(VLID)360069