Christian Kleber

Christian Kleber
University of Leipzig · Klinik und Poliklinik für Orthopödie Unfallchirurgie und plastische Chirurgie die in ich die ich in die ich die (OUP)

Univ.-Prof. Dr. med.
Traumatology, Polytrauma, Pelvic trauma/surgery, Septic surgery, Emergency surgery

About

164
Publications
71,040
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1,516
Citations
Citations since 2016
62 Research Items
1104 Citations
2016201720182019202020212022050100150
2016201720182019202020212022050100150
2016201720182019202020212022050100150
2016201720182019202020212022050100150
Additional affiliations
January 2007 - present
Charité Universitätsmedizin Berlin
Position
  • Consultant, Head of AG Polytrauma

Publications

Publications (164)
Article
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Introduction Traumatic lacerations of the prepatellar (PB) and olecranon bursa (OB) are common injuries. The aim of this study was to gain descriptive data and to identify risk factors associated with complications that made revision surgery after primary bursectomy necessary. Material and methods In this retrospective monocentric study at a level...
Article
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A significant number of trauma patients die during the ICU phase of care because of a severe immune response. Interleukin-6 (IL6) plays a central role within that immune response, signaling through a membrane-bound (IL6-R) and a soluble IL6 receptor (sIL6-R). IL6 and the sIL6-R can form an agonistic IL6/sIL6-R-complex, activating numerous cells tha...
Article
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Purpose Fibular mobility after suture button stabilization (SBS) of inferior tibiofibular joint ( syndesmosis) injuries has been described. This effect is called the “flexible nature of fixation (FNF).” In this study, we aimed to quantify FNF in syndesmotic stabilization. Methods Postoperative bilateral computed tomography (CT) of ankle fractures...
Article
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The rate of occult pneumothorax in intubated and mechanically ventilated trauma patientsuntil initial computed tomography (CT) remains undetermined. The primary aims of this studywere to analyze initial chest CTs with respect to the thoracic pathology of trauma, the clinical injuryseverity, and chest tube placement (CTP) before and after CT. In a s...
Article
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Purpose Open reduction and internal fixation using anterior plate osteosynthesis currently represents the gold standard for the treatment of symphyseal disruptions. Since postoperative screw loosening with consequent implant failure is frequently observed, this study aims to evaluate if and to what extent augmentation can increase the pull-out forc...
Article
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Introduction Dislocations of hip hemiarthroplasty (HHA) are serious complications. The aim of the study was to identify clinical aspects and radiographic parameters of the hip that put patients at risk for dislocation after HHA for femoral neck fractures. Methods This retrospective analysis included elderly patients with a femoral neck fracture tr...
Article
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Factor XIII (FXIII) is a protein involved in blood clot stabilisation which also plays an important role in processes including trauma, wound healing, tissue repair, pregnancy, and even bone metabolism. Following surgery, low FXIII levels have been observed in patients with peri-operative blood loss and FXIII administration in those patients was as...
Article
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Inadvertent tracheal tube misplacement and particularly endobronchial intubation are well-known complications of emergency endotracheal intubation (ETI) in pediatric trauma patients, which require repositioning of the tube to avoid impairment of gas exchange. The main aim of study was to identify the frequency of tube misplacement and associated fa...
Article
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Methods: 60 patients with THFs were randomly and equally divided into the CPM group and non-CPM group. Both groups immediately received CPM and conventional physical therapies during hospitalization. After discharge, the non-CPM group was treated with conventional physical therapy alone, while the CPM group received conventional physical training...
Article
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As of late 2019, the COVID-19 pandemic has been a challenge to health care systems worldwide. Rapidly rising local COVID-19 incidence rates, result in demand for high hospital and intensive care bed capacities on short notice. A detailed up-to-date regional surveillance of the dynamics of the pandemic, precise prediction of required inpatient capac...
Article
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Background The presence or absence of an implant has a major impact on the type of joint infection therapy. Thus, the aim of this study was the examination of potential differences in the spectrum of pathogens in patients with periprosthetic joint infections (PJI) as compared to patients with native joint infections (NJI). Methods In this retrospe...
Article
Introduction: The complex and dynamic situation in the current pandemic requires a regionally coordinated and interconnected cooperation between the different stakeholders within the health care system, such as the inpatient sector or the public health service. The aim of this study is to analyze health care management during the COVID-19 pandemic...
Article
Background Emergency departments in Germany are confronted with increasing numbers of patients. In order to manage the growing demand for medical care, standardized triage systems have been introduced throughout the country and are required by law.Objectives After implementation of the Manchester Triage System in the surgical emergency department o...
Article
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Unstable pelvic injuries are rare (3–8% of all fractures) but are associated with a mortality of up to 30%. An effective way to treat venous and cancellous sources of bleeding prehospital is to reduce intrapelvic volume with external noninvasive pelvic stabilizers. Scientifically reliable data regarding pelvic volume reduction and applicable pressu...
Conference Paper
Neben der medizinischen Qualifikation des Rettungsdienstpersonals stellen v.a. logistische und einsatztaktische Aspekte eine Herausforderung dar. Hierbei ist das Hauptproblem der Rettungskette die bedarfsgerechte Alarmierung von Rettungskräften und v.a. der Luftrettung. Trotz immensen Fortschrittes der Technik müssen Rettungsleitstellendisponenten...
Chapter
Die „Reverse-oblique-Fraktur“ (31A3 nach AO-Klassifikation) stellt eine seltene Form (5 %) der pertrochantären Femurfraktur dar. Aufgrund hoher biomechanischer Instabilität, meist schwerer Dislokation und der hohen Morbidität und Mortalität jeglicher konservativer Verfahren stellt die operative Therapie den Goldstandard dar. Aufgrund höherer biomec...
Article
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Objective: Minimally invasive osteosynthesis of distal fibula fractures serves as a biomechanically stable and soft-tissue-friendly fixation method in the case of an unstable fracture, poor bone quality, and/or critical soft tissue conditions with restoration of the length, axis and rotation of the distal fibula as well as stabilization of the ank...
Article
External noninvasive pelvic stabilizers, also referred to as pelvic binders, can be used by emergency medical services on scene as well as in the hospital shock-room if there is a pelvic injury as a consequence of an accident causing a diverging pelvic ring (open-book fracture). Commercially available external noninvasive pelvic stabilizers can be...
Article
Objectives: Clinically, procalcitonin represents the most widely used biomarker of sepsis worldwide with unclear pathophysiologic significance to date. Pharmacologically, procalcitonin was shown to signal through both calcitonin receptor and calcitonin gene-related peptide receptor in vitro, yet the identity of its biologically relevant receptor r...
Article
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Objective of surgery: Joint-spanning transfixation of the ankle joint aims at mostly temporary retention of the reduction, i.e. restoring length and axial alignment and stabilization of the ankle mortise in highly unstable fractures around the ankle and under critical soft tissue conditions. In selected cases, external fixation serves as an additi...
Conference Paper
With the publication of the AIS revision of 2015 by the Association for the Advancement of Automotive Medicine a classification of injury severity is available that reflects the current status in the care of road accident victims and their probability of survival. The aim of this study is to forecast the number of injured road users of MAIS 2+ and...
Article
Zusammenfassung Das Trauma ist nach wie vor eine der führenden Todesursachen. Interdisziplinäre Analysen verstorbener Traumapatienten zeigten eine Rate vermeidbarer Todesfälle von ca. 15%. Definitiv vermeidbare Traumatodesfälle waren bedingt durch unbehandelte Spannungspneumothoraces, unerkannte Verletzungen, Blutungssituationen und Erstickungsvorg...
Technical Report
Analyse der Änderungen in der AIS-Revision 2015 im Vergleich zum AIS 2008 Erarbeitung von Recodierungsvorschriften für alle ca. 2000 AIS-Codes Einarbeitung der AIS 2015-Klassifikation in das GIDAS-Schema Erstellung einer Diagnoseliste/Codierhilfe analog zur bestehenden Liste für AIS 2008) Anpassung des GIDAS-Codebooks inkl. Erstellung neuer Variabl...
Article
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Background context Calciphylaxis is a rare complication of secondary hyperparathyroidism caused by calcifications of small blood vessels in the skin and soft tissue. The disease occurs almost exclusively in patients with chronic kidney disease and has an incidence of approximately 50 cases per year in Germany [1]. Purpose We present a case of a 61...
Chapter
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Der geschilderte Fall illustriert, besonders bei entsprechender Ri- sikokonstellation, die Notwendig- keit einer gezielten Bestimmung der FXIII Aktivität. Patienten mit fortgeschrittener Leberfunktions- störung weisen neben einer in- suffizienten Synthese hepatischer Gerinnungsfaktoren ein erhöhtes Risiko für exazerbierte Verläu- fe systemischer En...
Article
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Die Überlebensrate bei (stumpfem oder penetrierendem) traumatischem Herz-Kreislauf-Stillstand nach durchgeführter PHRT beträgt für alle 205 eingeschlossenen PHRT-Patienten 12%. Eine Differenzierung zwischen dem Outcome der verschiedenen Verletzungsmechanismen konnte innerhalb dieses Reviews nicht untersucht werden. Ein Überlebensvorteil der penetri...
Article
Tibial shaft fractures are among one of the most common diaphyseal fractures of long bones in humans. The most common accident mechanisms are traffic accidents (37.5%), sports accidents (30.9%), tripping (17.8%) followed by acts of violence (4.5%). The clinical examination, correct fracture classification and the degree of soft tissue damage is cru...
Article
Background The definite treatment of pelvic C-fractures presents a widely discussed issue and undergoes continuous evolution. While the stabilization of the posterior ring has been studied extensively, the fixation of the anterior pelvic ring continuous to be rarely investigated. The importance of the simultaneous stabilization however lays in the...
Article
Ankle fractures and associated ligamentous injuries are the most common injuries of a load-bearing joint. There is still no general consensus with respect to the pathomechanism, the treatment indications and surgical techniques. The medium and long-term results are affected by a particularly high risk of posttraumatic arthritis in bimalleolar and t...
Article
Background: Trauma is the third leading cause of death worldwide after cardiovascular and oncologic diseases. Predominant causes of trauma-related death (TD) are severe traumatic brain injury (sTBI), hemorrhagic shock, and multiple organ failure. An analysis of TD is required in order to review the quality of trauma care and grasp how well the ent...
Chapter
Grundsätzlich gilt für den Notarzt des öffentlichen Rettungsdienstes dieselbe Verpflichtung zur Leichenschau wie für jeden anderen Arzt. Allerdings sind die landesrechtlichen Vorschriften in Bestattungsgesetzen, Rettungsdienstgesetzen und Leichenschauverordnungen zu dieser Frage uneinheitlich oder treffen keine explizite Aussage. So haben die meist...
Article
Background: The definite treatment of pelvic C fractures presents a widely discussed issue and undergoes continuous evolution. While the stabilization of the posterior ring has been studied extensively, the fixation of the anterior pelvic ring continuous to be rarely investigated. The importance of the simultaneous stabilization however lays in th...
Article
Zusammenfassung Das Polytrauma stellt eine der führenden Todesursachen des jungen Menschen dar. Im Rahmen des Managements mit Zielsetzung der weiteren Verbesserung des Überlebens rückt zunehmend die Präklinik in den Fokus. Zudem besteht ein Spannungsfeld aus Notwendigkeit von Erfahrung und manuellen Fähigkeiten mit invasiven Rettungstechniken einer...
Article
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There is increasing evidence that T lymphocytes play a key role in controlling endogenous regeneration. Regeneration appears to be impaired in case of local accumulation of CD8+ effector T cells (TEFF), impairing endogenous regeneration by increasing a primary "useful" inflammation toward a damaging level. Thus, rescuing regeneration by regulating...
Article
Purpose: Questionnaire survey among the members of the German Spine Society (Deutsche Wirbelsäulen-Gesellschaft, DWG) to objectify oncological infrastructure and current standard of care in spinal tumor treatment in Germany. Methods: All DWG-members were contacted via the society's e-mail and asked to respond in anonymized form to a related ques...
Article
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Background and objective Patient triage has a key function within the scope of the successful management of mass disasters and ensures the correct resource allocation. Analysis of unheralded hospital disaster training in Berlin hospitals revealed triage problems referring the correct classification of patients in the triage categories and relevant...
Article
Zusammenfassung Das Kniegelenk zählt zu den häufig verletzten Gelenkregionen. Neben knöchernen Verletzungen spielen Sehnen-, Band- und Knorpelschäden eine zentrale Rolle. Das Spektrum der Verletzungsmuster ist breit und reicht von einfachen Niedrigrasanztrauma bis hin zum polytraumtisierten Patienten. Kombinierte osteoligamentäre Verletzungen stell...
Article
Ein Massenanfall von Verletzten (MANV) stellt für Rettungsdienste und Krankenhäuser eine Herausforderung dar. Neben einem Krankenhauseinsatzplan sind eine Mitarbeiterschulung und die Durchführung von Übungen als essenzielle Vorbereitung anzusehen. Die organisatorischen und finanziellen Belastungen einer MANV-Übung im Krankenhaus sind enorm. In eine...
Article
Background The incidence and character of civil mass casualty incidents (MCI) has changed in the last decades, in particular because of the rising number of terrorist attacks. As a result, the question arises whether commonly used tools of prevention and prehospital planning, including the distribution of triage categories (T1 severely injured/T2 s...
Article
Mit der wachsenden Bedrohungslage und dem Anstieg der Terror-Anschläge – vor allem in Westeuropa – gibt es einen Grund mehr, Versorgungskonzepte für Massenanfälle von Verletzten (MANV) der Prüfung und Überarbeitung zu unterziehen. Die vergangenen Jahre haben gezeigt, dass es nicht nur in Großstädten zu Terror-Anschlägen kommen aknn und auch Klinike...
Article
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We present the case of a 54-year-old male involved into a high-impact car accident as driver of a transport van suffering traumatic aortic rupture and primarily successful resuscitation. The casualty presumably missed the ending of a traffic congestion and crashed into the rear of a semitrailer leading to entrapment of his abdomen between the steer...
Article
Introduction: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The pr...
Article
Background Regarding survival and quality of life recent mass casualty incidents again emphasize the importance of early identification of the correct degree of injury/illness to enable prioritization of treatment amongst patients and their transportation to an appropriate hospital. The present study investigated existing triage algorithms in terms...
Article
Background: Regarding survival and quality of life, recent mass casualty incidents have once more emphasized the importance of early identification of the correct degree of injury or illness, to enable prioritizing treatment of patients and transportation to an appropriate hospital. The present study investigated international triage algorithms in...
Article
Background: Traumatic vascular injuries, seldom but potentially life-threatening, pose diagnostic and therapeutic challenges. Injuries of large vessels with consecutive haemorrhagic shock are the most frequent cause of traumatic cardiac arrest. Vascular injuries are predominantly located at the limbs and manifest themselves via bleeding or ischemia...
Article
Zusammenfassung Aufgrund optimierter systemischer onkologischer Therapien und deutlich weiterentwickelter chirurgischer Verfahren zur Resektion und Defektrekonstruktion ist eine gesteigerte Lebenserwartung von Patienten mit muskuloskeletalen Tumoren zu verzeichnen. Insbesondere steigt die Inzidenz von skeletalen Metastasen primärer Tumoren mit oste...
Article
Large segmental bone defect reconstruction with sufficient functional restoration is one of the most demanding challenges in orthopedic surgery. Available regenerative treatment options, as the vascularized bone graft transfer, the Masquelet technique or the Ilizarov distraction osteogenesis, are associated with specific indications and distinct li...
Article
Background: Traumatic vascular injuries, seldom but potentially life-threatening, pose diagnostic and therapeutic challenges. Injuries of large vessels with consecutive haemorrhagic shock are the most frequent cause of traumatic cardiac arrest. Vascular injuries are predominantly located at the limbs and manifest themselves via bleeding or ischemia...
Article
Full-text available
Objective: In sepsis, the disease course of critically ill patients is often complicated by muscle failure leading to ICU-acquired weakness. The myokine transforming growth factor-?1 increases during inflammation and mediates muscle atrophy in vivo. We observed that the transforming growth factor-?1 inhibitor, secreted frizzled-related protein 2,...
Article
There are considerable similarities and intersections between forensic medicine and emergency medicine. This applies especially to frustraneously resuscitated patients or other lethal clinical courses of traumatized patients who are subject to latter forensic autopsy. Cooperation between departments of emergency and forensic medicine not only has e...
Article
The purpose of this study was to evaluate the surgical effort of total knee arthroplasty (TKA) for posttraumatic osteoarthritis (PTOA) compared with primary osteoarthritis (OA). A total of 1841 TKAs were analyzed, including 170 patients with PTOA, that resulted from soft tissue trauma in 83 patients and fractures in 87 patients. Results showed that...
Article
Trauma is a leading cause of death in Western industrialized nations and of high socio-economic importance. Sufficient prehospital trauma care is extremely demanding, but such missions in Germany are rare, especially in ground-based emergency medical service. Resuscitation after trauma means to address all potentially reversible causes of cardiac a...
Chapter
Insbesondere der Notfallmedizin kommt an Bord eine besondere Bedeutung zu. Als höchste, unter Umständen lebensrettende notfallmedizinische Eskalationsstufe ist die kardiopulmonale Reanimation (CPR) aus internistischer oder traumatologischer Ursache anzusehen, welche nicht nur unter medizinischen oder forensischen, sondern auch unter berufspolitisch...
Chapter
Todesfälle an Bord von Schiffen konfrontieren den Schiffsarzt mit besonderen Herausforderungen. Die Todesfeststellung geschieht anhand des Vorliegens mindestens eines der drei sicheren Todeszeichen: Leichenflecke; Leichenstarre oder Fäulnis. Zur Dokumentation der Todesfeststellung wird – in Analogie zu herkömmlichen Todesbescheinigungen – eine „Vor...
Chapter
In diesem Kapitel sollen die maritimen Aspekte der Chirurgie an Bord abgehandelt werden. Der chirurgische Notfall ist die häufigste Krankheitsursache in der Berufsschifffahrt. Bei chirurgischen Erkrankungen an Bord muss zwischen chronischen und akuten Erkrankungen unterschieden werden. Weiterhin handelt es sich vorwiegend um Fälle aus dem orthopädi...
Chapter
Unter Berücksichtigung der speziellen Situation an Bord und der regelhaften Unmöglichkeit einer schnellen Einlieferung des Patienten in eine Klinik ergibt sich auch die Notwendigkeit einer notfallmedizinischen Qualifikation von ärztlichem Personal an Bord von Schiffen: Eine fundamentierte notfallmedizinische Ausbildung ist zu fordern und die Basist...
Article
Full-text available
Peri-implant infections (PII) are one of the most frequent postoperative complications and require an individualized combined surgical and antibiotic management. In this review article we provide up to date scientific knowledge regarding the pathogenesis, classification, diagnosis and therapy of PII. The aim of this article is to explain the ration...
Article
Die notfallmedizinische Forschung unterliegt besonderen Bedingungen. Notfallpatienten werden z. B. als einwilligungsunfähig angesehen. Notfallmedizinische Daten können demzufolge seltener erhoben werden als solche aus kontrollierten klinischen Studien. Nach notfallmedizinischer BehandlungVerstorbene werden dagegen nicht selten in rechtsmedizinische...