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BACKGROUND: Ankle sprains are one of the most frequent injuries of the musculoskeletal system. The injury pattern determines the treatment and are crucial for the outcome. Nonoperative treatment is commonly recommended for isolated injuries of the lateral ligaments but no standard strategy exists in combined ankle ligament injuries. The goal of this national survey was to achieve an overview about the current diagnostic strategies and common treatment concepts in Germany. MATERIAL AND METHODS: All members of the German Society for Orthopaedics and Trauma Surgery (DGOU) were invited to participate in an anonymous survey about the diagnostic and therapeutic approach in cases of ankle sprains...

BACKGROUND: Gait is the manner or style of walking, involving motor control and coordination to adapt to the surrounding environment. Knowing the kinesthetic markers of normal gait is essential for the diagnosis of certain pathologies or the generation of intelligent ortho-prostheses for the treatment or prevention of gait disorders. The aim of the present study was to identify the key features of normal human gait using inertial unit (IMU) recordings in a walking test. METHODS: Gait analysis was conducted on 32 healthy participants (age range 19-29 years) at speeds of 2 km/h and 4 km/h using a treadmill...

OPERATION GOAL: The aims of the surgical treatment are the anatomical reduction of the articular surface and stabilization of a multifragmentary patella fracture with a distal pole fragment using plate osteosynthesis and additive suture tape cerclage to secure the distal fragment. INDICATION: Demonstration of the surgical procedure for a multifragmentary patella fracture in the knee joint of a male cadaver. SURGICAL TECHNIQUE: Start with a median prepatellar skin incision and splitting of the bursa and surrounding fascia...

GOAL: Objective: to see if, in elderly patients with traumatic thoracolumbar fracture, standing X-rays with orthoses 24-48 hours after admission can predict vertebral collapse after consolidation Material and methods: Prospective cohort study endorsed by the Clinical Research Ethics Committee. INCLUSION CRITERIA: age >65 years, acute thoracolumbar junciton fracture due to fall, hospital admission, treatment with orthesis. EXCLUSION CRITERIA: various levels, suspected malignancy, non-immediate fracture or atraumatic...

OBJECTIVE: Neutralizing a posteromedial rotatory instability (PMRI) caused by coronoid deficiency by restoration of the humeroulnar joint surface with an autologous iliac crest bone graft. INDICATIONS: Surgery is indicated in patients with chronic deficiency of the anteromedial facet of the coronoid with subsequent PMRI. CONTRAINDICATIONS: Coronoid reconstruction is not recommended in patients with advanced osteoarthritis of the elbow caused by subluxation of the humeroulnar joint...

OBJECTIVE: To see if, in elderly patients with traumatic thoracolumbar fracture, standing X-rays with orthoses 24-48h after admission can predict vertebral collapse after consolidation. MATERIAL AND METHODS: Prospective cohort study endorsed by the Clinical Research Ethics Committee. INCLUSION CRITERIA: age >65 years, acute thoracolumbar junction fracture due to fall, hospital admission, treatment with orthesis. EXCLUSION CRITERIA: various levels, suspected malignancy, non-immediate fracture or atraumatic...

Introduction: Hypertrophy of the nail folds is a common condition. It occurs by alteration of shape, partial loss, or absence of the nail, resulting in loss of the nail fold physiological limit. This can also occur by the friction of the nail with the nail fold. Consequently, there is an increase in the volume of the lateral or distal nail fold and a decrease in the space of the nail bed and the nail plate. Management of this onychodystrophy may be conservative or surgical. Case Presentation: We present a case of distal nail embedding after trauma, submitted to conservative treatment...

OBJECTIVE: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the ability of children to walk. METHODS: Children who underwent in utero repair of OSD and had formal neurological assessment after 2.5 years of age were compared regarding their ability to walk in relation to pre-surgical predictors. RESULTS: Sixty-nine children fulfilled the inclusion criteria...

BACKGROUND: Individuals with chronic ankle instability (CAI) have an increased risk for recurrent injuries. The preventive effects of external ankle supports are not fully understood. This study aimed to examine the effect of elastic ankle support on running ankle kinematics. METHODS: 3D running gait analysis of individuals with and without CAI was conducted at three-minute-running trials at 2.78 m/s with and without elastic ankle support in a randomised order. Ankle kinematics and intra-individual standard deviations (variability) were calculated at each percent of the running gait cycle...

OBJECTIVE: Anatomical restoration of the function and anatomy of the talocrural joint, anatomical reduction of fractures of the lateral and medial malleoli and to address ligamentous instability when achieving exercise stability. INDICATIONS: Dislocated and intra-articular fractures of the lateral and medial malleoli. CONTRAINDICATIONS: Infections, peripheral arterial occlusive disease, critical soft tissue conditions. SURGICAL TECHNIQUE: Placement in a supine position, lateral and medial access, reduction of the fractures by manipulation of the fragments with Kirschner wires or use of reduction clamps, control of the joint reduction, definitive fixation with traction screws and plate osteosynthesis of the distal fibula, screw, tension-band or plate osteosynthesis of the medial malleolus, in cases of syndesmosis instability exact restoration of the talocrural joint by implantation of adjusting screws, alternatively dynamic fixation with a suture-button system...

A 70-year-old female patient treated with methotrexate for diffuse cutaneous systemic sclerosis (SSc) came up with mechanical pain over the left thumb for several months. SSc was diagnosed based on a clinical picture associating puffy fingers, skin sclerosis, wrist arthralgia, pulmonary hypertension, presence of antinuclear factors and antibodies against Topoisomerase-I. Her complaint was attributed to first carpometacarpal joint osteoarthritis and treated with orthesis, which did not provide pain relief after 5 months of regular use...

Os subtibiale is a low prevalence accessory bone of the ankle. This bone is located in the posterior colliculus of the tibial medial malleolus, both in paediatric and adult ages. It can cause pain, redness and/or swelling, which can lead to a mistaken diagnosis of avulsion fracture. Adequate anatomical knowledge is crucial. First, we present the case of a school-aged boy, seen at the outpatient clinic for a 2-month history of pain in both inner ankles after an injury. Second, we present the case of an adult patient with a 3-day history of right medial ankle pain, with no previous injury, evaluated at the Emergency Department...

AIM: In Canada, 100,000 people suffer a traumatic brain injury (TBI) every year. The prevalence of moderate to severe TBI is highest for young men, who will live an average of 50 years with this chronic condition associated with physical, emotional and cognitive deficits. Meal preparation, a complex activity with high safety risks, is one of the most significant activities impacted by TBI. Technology shows great promise to support their overall functioning, but no context-aware technology is available to support meal preparation for this population...

STUDY DESIGN: Nonrandomized, retrospective, comparative, and single-center trial. OBJECTIVE: The aim of this study is to compare the long-term clinical and radiographic results of thoracolumbar burst fractures in neurologically intact patients, treated surgically or nonsurgically with the aim to optimize their management. SUMMARY OF BACKGROUND DATA: There is an ongoing controversy regarding the treatment of thoracolumbar burst fractures (TLBF) (A3, A4) in neurologically intact patients...

We report on a 14 months old toddler who sustained a traumatic hemipelvectomy by being crushed between a car and a stone wall. After stabilization in the resuscitation room he was treated operatively by laparotomy, osteosynthesis of the pelvic ring, reconstruction of the both external iliac vessels and the urethra and reposition of the testicles. After 66 days he was discharged into rehabilitation. Implants were removed after eight months. 20 months after the injury, the leg was plegic, initial radiological signs of femoral head necrosis showed up but the infant was able to walk with an orthesis and a walker...

OBJECTIVE: Anatomical reduction and fixation of complex talar fractures (Hawkins type III and IV, Marti type III and IV) using a medial approach. INDICATIONS: Displaced talar fractures (Hawkins type III and IV, Marti type III and IV) with the need for a medial malleolar osteotomy or the simultaneous treatment of a medial malleolus fracture. CONTRAINDICATIONS: High perioperative risk, severe soft tissue injuries in the medial approach area, infected soft tissues...

INTRODUCTION: The mobilization of patients with diabetic foot syndrome after surgical treatment by debridement or partial amputation is usually difficult in daily practice and in inpatient care. AIM AND METHOD: A case report - with a representative case showing the innovative possibilities of an alternative mobilization option by means of a new orthesis ("iWALK 2.0® "; IWALKFree® Inc., Mansfield, Ontario, Canada) after surgical therapy of diabetic gangrene, exemplified by the successful clinical course...

BACKGROUND: Rotator cuff tears are one of the most frequently treated disorders in arthroscopic surgery. Besides the different surgical options, there are differences in the postoperative aftercare. In this observational study the function, handling and comfort of two different ortheses (ADVAGOshoulder vs. standard abduction orthesis) were compared. PATIENTS AND METHODS: 53 patients with a rotator cuff tear (n = 25 ADVAGOshoulder, n = 28 standard abduction orthesis) were examined and questioned before and after the surgical treatment based on the DASH Score, a modified Constant Score, the function, handling and everyday practicality of their orthesis...

In the last decades alterations in the skull shape have increased at the expense of plagiocephaly, as consequence of the American Academy of Pediatrics recommendations to sleep the infant in the supine position. The clinician must differentiate between positional plagiocephaly and craniosynostosis, since if a cranial synostosis is proven, the therapeutic behavior will be potentially neurosurgical. Although three-dimensional skull tomography with bone window is the study of greater sensitivity and diagnostic specificity, the majority of cases can be confirmed by the clinic, reserving the radiography or ultrasound with a suture approach for doubtful cases...