Operative Orthopädie und Traumatologie (Operat Orthop Traumatol )

Publisher: Springer Verlag


Die Operative Orthopädie und Traumatologie wendet sich an alle operativ tätigen Orthopäden Traumatologen Handchirurgen Sportärzte Ärzte anderer chirurgischer Fachrichtungen und niedergelassene Unfallchirurgen und Orthopäden die zur Patientenberatung und Operationsvorbereitung wie auch zur Nachsorge fundierte Informationen zu aktuellen Operationsmethoden benötigen. Die Zeitschrift erscheint in deutscher englischer und spanischer Sprache und stellt bewährte sowie neue Operationsverfahren in einheitlich strukturierten und aufwendig illustrierten Beiträgen dar. Jeder Operationsschritt wird durch eine eigene Zeichnung illustriert und in der Legende ausführlich beschrieben. Von den Indikationen Kontraindikationen der Patientenaufklärung und Operationsvorbereitung bis hin zur Nachsorge werden alle Gesichtspunkte Schritt für Schritt vorgestellt. Auch auf Vor- und Nachteile mögliche Komplikationen Fehler und Gefahren der Methoden sowie aussagekräftige Ergebnisse mit ihren Bewertungskriterien wird ausführlich eingegangen. Damit ermöglicht die Operative Orthopädie und Traumatologie allen orthopädisch traumatologisch und chirurgisch Tätigen eine effektive Fort- und Weiterbildung und Hilfestellung im Alltag und bietet eine ständig wachsende und aktualisierte Operationslehre.

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    Operative Orthopädie und Traumatologie (Online)
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Springer Verlag

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the technique of all-posterior vertebral body replacement using an expandable cage and angled instruments. This method facilitates implant seating with limited posterior decompression useful in the setting of metastatic disease. Patients with metastatic disease of the thoracic spine with or without spinal cord compression. Patients with a limited life expectancy of less than 6 months. Multiple foci of metastatic disease in the spine. A hemilaminectomy was performed followed by nerve root sacrifice. The pleura was mobilized away from the vertebral body, after which decompression and tumor resection was performed from an all-posterior approach. An expandable vertebral body cage was inserted with a rotational manoeuvre and expanded in situ. The patient was mobilized on postoperative day 1. A chest X-ray is also recommended to exclude incidental pneumothorax. Four patients were operated by an all-posterior vertebral body replacement during a 6-month period. The average length of surgical procedure was 187 min (range 165-220 min). No patient required a transthoracic approach. There were no intra- or postoperative complications and all patients could be discharged to home self-ambulating.
    Operative Orthopädie und Traumatologie 12/2014;
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    ABSTRACT: Pain reduction in the affected metacarpophalangeal joint (MP joint) by synovectomy, loose body extraction and resection of intraarticular scars. Synovitis in rheumatoid arthritis (RA) not responding to antirheumatic treatment, primary and secondary degenerative arthritis, osteochondral lesions, loose bodies, foreign bodies, capsular contracture, septic arthritis, posttraumatic arthralgia (old collateral ligament injury), intraarticular fractures. Established biomechanical changes in RA such as ulnar deviation and palmar subluxation with extensor tendon luxation of the MP joint. Advanced radiologic changes in degenerative arthritis. Joint instability in posttraumatic conditions. Fresh skin lesion near portals. Longitudinal traction of the affected finger in a Chinese finger trap. The joint is filled with Ringer solution. Placement of a radial and ulnar dorsal portal at joint space level, through the extensor hood, at the dorsal border of the collateral ligaments. Diagnostic arthroscopy. In case of insufficient visibility (i.e., bulky synovitis in RA) "blind" shaving in the dorsal recess at first. Completion of synovectomy under sight. If necessary additional ablation of synovial tissue by a radiofrequency (RF) electrosurgical system. Use of arthroscope (1.9 mm) with a 30° angle of vision and shaver (aggressive cutter; 2.0 mm). Low-suction drain, soft padded dressing. Immediate postoperative mobilization for the full range of finger movement. In 106 MP joint arthroscopies from 2009-2011, very high patient satisfaction was achieved. Best results were obtained in RA, even in advanced radiologic changes (Larsen stages 1-3). Only in Larsen stage 4 results were rated lower. In early stages of degenerative arthritis (Kellgren-Lawrence 0-2), patient satisfaction was also very high, however decreased rapidly with increasing degree of radiologic changes. The results in posttraumatic cases are promising.
    Operative Orthopädie und Traumatologie 12/2014; 26(6):564-72.
  • Operative Orthopädie und Traumatologie 12/2014; 26(6):537-8.
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    ABSTRACT: Insertion of a small joint arthroscope into the proximal and distal parts of the distal radioulnar joint (DRUJ) allows visualization of the proximal pouch of the DRUJ, the joint surfaces of the sigmoid notch and the ulnar head, the convexity of the ulnar head and the proximal ulnar-sided surface of the triangular fibrocartilage complex (TFCC). Evaluation of joint pathologies in ulnar-sided wrist pain, especially in cases without diagnostic findings in standard X-rays and MRI, suspected cartilage lesions without osteochondral changes (signs of osteoarthritis), undefined swelling of the DRUJ in suspected synovitis, removal of loose bodies and arthroscopical synovialectomy, suspected lesions of the deep part of the TFCC, respectively foveal avulsions, wear or superficial tears of the proximal TFCC and arthroscopic-assisted ulnar shortening. Significant changes of the local topographical anatomy, extensive scar formation, ulna plus variance, local infection or open wounds, affected sensibility in the area of the dorsal branch of the ulnar nerve, fractures of the sigmoid notch or the ulnar head, capsular tears causing effusion of irrigation fluid. In vertical extension of the wrist, two portals are created on the dorsal side of the DRUJ between the extensor digiti minimi and extensor carpi ulnaris tendons. Partial visualization of the ulnar head, the sigmoid notch, the proximal pouch of the DRUJ, and the proximal surface of the TFCC. Following isolated diagnostic arthroscopies immobilization of the wrist in a semicircular ulnar-sided cast for 1 week. No extensive load to the wrist for 4 weeks. Still rarely performed procedure for diagnosis and therapy of ulnar-sided wrist pain. Technically demanding with a flat learning curve and anatomy-related obstacles. A complete view of the joint is not always accessible. Rare complications are injuries of the extensor digiti minimi tendon as well as contusion or sectioning of the transverse branch of the dorsal branch of the ulnar nerve. In distinct cases this procedure offers valuable additional information about the distal radioulnar joint.
    Operative Orthopädie und Traumatologie 12/2014; 26(6):547-55.
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    ABSTRACT: Minimally invasive approach to the wrist in order to diagnose and treat different wrist pathologies. Diagnosis of unclear chronic pain syndromes, cartilage status, intra-articular ligament structures as well as post-traumatic and inflammatory conditions of the wrist. Treatment of ulnar impaction syndrome, dorsal ganglia and also in fracture treatment and various different wrist interventions. Soft tissue infections around the wrist, severe scarring may impede access to the joint. Supine position with the forearm upright and in neutral position, the elbow flexed by 90°, axial traction of 3-4 kg. Superficial stab incision, blunt preparation through joint capsule, insertion of optic through 3-4 portal and probe through 4-5 portal, and radial and ulnar midcarpal portals, respectively. Either sodium chloride, CO2 or air is used as arthroscopy medium. Diagnostic round with standardized examination of all parts of the joint. Standardized written and high quality photo and/or video documentation to facilitate understandability of the findings. Forearm cast for 1 week, limited load for 2 more weeks, then load is increased to normal.
    Operative Orthopädie und Traumatologie 12/2014; 26(6):539-46.
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    ABSTRACT: The aim of arthroscopically assisted treatment of tibial plateau fractures is to achieve minimally invasive reduction and internal fixation of the joint fracture of the tibial plateau. Using the arthroscopic procedure, both the approach morbidity and the control of the articular reduction can be optimized. Displaced tibia plateau fractures of AO type A1 and B1/2/3 or Tscherne P2. Strongly displaced tibial plateau fractures, which require an open surgical approach and stabilization with plate fixation (e.g., AO type C fractures or Moore type 5 fractures); 2nd and 3rd degree open fractures. Danger of compartment syndrome. Planning of the surgical approach and confirmation of the indication by CT imaging. Diagnostic arthroscopy of the knee joint with treatment of associated injuries and confirming the indications for arthroscopically assisted reduction. Under arthroscopic control, insertion of an ACL tibial aiming device. In the central portion of the dislocated fracture fragment, a 2.4 mm K-wire is placed with the help of the aiming device. Opening of the outer cortex using a cannulated drill (9-11 mm diameter), introduction of a cannulated plunger below the fracture resulting in reduction of the fracture and compression of the cancellous bone below the fracture. Simultaneously the reduction is controlled by arthroscopy. Finally, the fracture is fixed using minimally invasive screw fixation (3.5-7.3 mm cancellous screws with washers) or by plate osteosynthesis (e.g., support plate). The metaphyseal defect can optionally be filled with bone substitute material. Rehabilitation is dependent on the extent of the fracture. In arthroscopically treated fractures, partial weight bearing of 20 kg over a period of 6-12 weeks is usually necessary.
    Operative Orthopädie und Traumatologie 12/2014; 26(6):573-90.
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    ABSTRACT: Trapeziometacarpal arthroscopy improves diagnostic and therapeutic options in pathologies of the carpometacarpal (CMC) I joint. Pathologic conditions of the CMC I joint which are not sufficiently diagnosed by X-rays or MRI. Pathologic conditions of the CMC I joint in which trapeziometacarpal arthroscopy is not expected to make a contribution to diagnosis or therapy. Trapeziometacarpal arthroscopy using a 1.9 mm arthroscope after instillation of physiological solution. Thumb cast sparing the interphalangeal joint for 1 week, then functional therapy. Trapeziometacarpal arthroscopy improves diagnosis of CMC I pathologies and gives new therapeutic options, a field which is still rapidly expanding.
    Operative Orthopädie und Traumatologie 12/2014; 26(6):556-63.
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    ABSTRACT: Treatment of posteromedial proximal tibia fracture dislocation (medial Moore type II, Schatzker IV) with a one-incision technique.
    Operative Orthopädie und Traumatologie 11/2014;
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    ABSTRACT: Providing a surgical approach similar to the Kocher-Langenbeck but having improved anterosuperior access, less risk of injury to branches of the inferior gluteal nerve supplying the anterior portion of the gluteus maximus muscle, and improved cosmesis.
    Operative Orthopädie und Traumatologie 11/2014;
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    ABSTRACT: Alternative sacrum fixation with double-plate osteosynthesis in vertical unstable pelvic fractures. The surgical technique allows anatomic reduction and osteosynthesis of the sacrum component.
    Operative Orthopädie und Traumatologie 11/2014;
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    ABSTRACT: The aim of the treatment is reduction of hip pain through arthroscopic synovectomy of the hip joint, reduction in activity of the synovial disease and removal of loose bodies in chondromatosis.
    Operative Orthopädie und Traumatologie 10/2014; 26(5):469-86.
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    ABSTRACT: Hip revision arthroplasty of a loose stem in the case of Vancouver type B2 and B3 periprosthetic fractures and cerclage wiring of the femoral shaft.
    Operative Orthopädie und Traumatologie 10/2014; 26(5):455-468.
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    ABSTRACT: Pain reduction and improvement of range of motion.
    Operative Orthopädie und Traumatologie 08/2014;
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    ABSTRACT: Treatment of focal cartilage defects (traumatic or osteochondrosis dissecans) of the talus using a collagen matrix. The goal is to stabilize the superclot formed after microfracturing to accommodate cartilage repair. The procedure can be carried out via miniarthrotomy, without medial malleolus osteotomy.
    Operative Orthopädie und Traumatologie 06/2014;
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    ABSTRACT: The aim of open anatomic reconstruction of the acromioclavicular (AC) joint is combined reconstruction of the AC and coracoclavicular ligaments using a tendon graft.
    Operative Orthopädie und Traumatologie 06/2014; 26(3):237-44.
  • Operative Orthopädie und Traumatologie 06/2014; 26(3):217.
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    ABSTRACT: Arthroscopic resection of the painful and degenerative altered acromioclavicular (AC) joint without destabilization of the joint and therefore pain relief and improvement in function.
    Operative Orthopädie und Traumatologie 06/2014; 26(3):245-53.