Karl Braun

• Prof. Dr.
• Technical University of Munich

Fractures of the proximal ulna range from simple olecranon fractures to complex Monteggia fractures or Monteggia-like lesions involving damage to stabilizing key structures of the elbow (i.e. coronoid process, radial head, collateral ligament complex). In complex fracture patterns a computerized tomography scan is essential to properly assess the i...

As one of the leading causes of elderly patients’ hospitalisation, proximal femur fractures (PFFs) will present an increasing socioeconomic problem in the near future. This is a result of the demographic change that is expressed by the increasing proportion of elderly people in society. Peri-operative management must be handled attentively to avoid...

A trimalleolar ankle fracture is considered unstable and treatment is generally performed operatively. Computed tomography is important for the operative planning by providing an elaborated view of the posterior malleolus. Trimalleolar ankle fractures have a rising incidence in the last decade with up to 40 per 100,000 people per year. With a growi...

Background Patients access relevant information concerning their orthopaedic surgery resources through multiple information channels before presenting for clinical treatment. Recently, artificial intelligence (AI)-powered chatbots have become another source of information for patients. The currently developed AI chat technology ChatGPT (OpenAI LP)...

Correction of a proximal tibial valgus deformity. Lateral osteoarthritis of the knee or cartilage damage in a valgus deformity > 5° with a medial proximal tibial angle (MPTA) > 90°. Medial proximal tibial angle < 90°, medial cartilage damage, medial meniscus loss. Skin incision medial of the tibial tuberosity approximately 8–10 cm. Insertion of two...

Background: Flail chest (FC) injuries are multiple adjacent segmental rib fractures, commonly associated with a high complication and mortality risk. Recent evidence suggests that the early surgical stabilization of FC injuries is beneficial for restoring breathing mechanics. However, little is known about the effects on lung volumes when invasive...

Background Flail chest (FC) injuries are segmental osseous injuries of the thorax that typically result from high-energy blunt trauma and regularly occur in multiple trauma (MT) patients. FC injuries are associated with paradoxical chest wall movements and, thus, have a high risk of respiratory insufficiency or even death. An increasing number of s...

Lengthening of the quadriceps tendon for dehiscence in chronic rupture. Chronic rupture of the quadriceps tendon with delayed diagnosis or failure of primary refixation with a dehiscence between 1 and 5 cm. Dehiscence of more than 5 cm. Reopen the old incision and lengthen it to about 20–25 cm if necessary. Visualize the rupture. Debridement of the...

Refixation of a posterior root lesion of the medial meniscus via a tibial drill tunnel and prevention of extrusion using a meniscotibial suture (centralization). Posterior root lesion of the medial meniscus. Grade 4 cartilage damage in the corresponding compartment, uncorrected varus or valgus deformities, symptomatic instabilities, extensive degen...

Replacement of superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) with an allograft. Chronic 3° isolated medial instability and combined anteromedial or posteromedial instability. Infection, open growth plates, restricted range of motion (less than E/F 0–0–90°). Longitudinal incision from medial epicondyle to superfi...

Reconstruction of a patellar tendon defect in the event of a chronic rupture. Chronic rupture of the patellar tendon due to delayed diagnosis or failure of primary refixation with a dehiscence that does not allow for anatomical refixation without patellar tendon shortening. Infection. Approximately 15 cm long incision from the tibial tuberosity to...

Correction of a severe tibial varus deformity near the knee joint with only a slight influence on leg length and patella height. Medial osteoarthritis and/or cartilage damage with a severe varus deformity > 10° with a medial proximal tibial angle (MPTA) < 80°. Femoral varus deformity with lateral distal femoral angle > 91°, severe lateral cartilage...

Background Understanding vascularity and assessing the risk of post-traumatic avascular necrosis are crucial for predicting outcomes and identifying optimal treatment options in proximal humerus fractures (PHFs). Until now, Hertel et al have been the only researchers to evaluate the intraoperative perfusion of the humeral head after fracture using...

BACKGROUND Digital solutions are gaining increasing importance and present a challenge regarding the introduction and acceptance into professional medical environments. Significant advances have been made regarding availability, safety, and ease of use of data generated by a multitude of devices and wearables. However, data security and data protec...

Background Digital solutions are gaining increasing importance and present a challenge regarding their introduction and acceptance into professional medical environments. Significant advances have been made regarding the availability, safety, and ease of use of data generated by a multitude of devices and wearables. However, data security and data...

Reduction of increased reclination of the tibial plateau (posterior slope) to improve the anterior stability of the knee joint. Increased posterior reclination of the tibial plateau greater than 12° in combination with recurrent instability after anterior cruciate ligament (ACL) reconstruction. Hyperextension of more than 15° (relative). Anterior s...

Background: Digital solutions are gaining increasing importance and present a challenge regarding the introduction and acceptance into professional medical environments. The latter aspect is largely caused by regulatory and legislative burdens hindering the adoption of new technologies. Although significant advances have been made regarding availab...

Aims. This study aimed to assess the safety and efficacy of microporous polysaccharide hemospheres (MPSHs) in managing blood loss and reducing the risk of postoperative haematoma and early periprosthetic joint infection (PJI) following total hip arthroplasty (THA) for femoral neck fracture (FNF), in the context of the existing treatment challenges....

The aim of this Technical Note is to reconstruct the medial collateral ligament complex with the superior medial collateral ligament and posterior oblique ligament as anatomically as possible. An allograft or contralateral semitendinosus autograft is used for anatomic reconstruction of the superior medial collateral ligament and posterior oblique l...

Background: The femoral neck system (FNS) was introduced as a minimally invasive fixation device for managing femoral neck fractures. Objective: To compare radiographic, clinical, and patient-reported outcome measures (PROMs) of femoral neck fracture patients following FNS compared to dynamic hip screw (DHS) implantation combined with an anti-rotat...

Digital innovation options in orthopedics and traumatology

Objective: Breaking has gained public attention as a form of sports activity. The associated intense movements of the hip joints are possibly linked to the development of femoroacetabular impingement (FAI). Therefore, this study aimed to assess clinical and radiographic FAI measures in professional breakers compared to hobby athletes. Methods: T...

Ligament bracing is the bridging of ruptured ligament fibers with a suture cord. As the posterior cruciate ligament (PCL) has a good intrinsic healing potential due to its vascular supply, it is basically suitable for this type of treatment. The treatment of PCL ruptures depends on the type of rupture and the accompanying injuries. For isolated PCL...

Unstable syndesmosis injuries represent an indication for surgical treatment. The principle of surgical treatment of syndesmosis injuries is to prevent diastasis of the fibula and tibia with an implant after repositioning (internal ligament bracing). In the case of implants the new flexible cord fixation represents an increasingly used and safe alt...

Arthroscopic reconstruction of the posterior cruciate ligament (PCL) is indicated in patients with symptomatic posterior instability with a posterior translation > 8 mm. Accompanying instabilities of the posterolateral or posteromedial joint corner should also always be treated. The operation begins with harvesting of the semitendinosus and gracili...

Background: Electric personal mobility devices (ePMDs) have conquered cityscapes, leading to increased reports of associated injuries. However, it remains elusive whether people who present to an emergency department (ED) after an accident are more severely injured when previously using non-electric personal mobility devices (PMDs) or ePMDs. Method...

This study evaluated the reliability and comprehensiveness of the Unified classification system (UCPF), Wright & Cofield, Worland and Kirchhoff classifications and related treatment recommendations for periprosthetic shoulder fractures (PPSFx). Two shoulder arthroplasty specialists (experts) and two orthopaedic residents (non-experts) assessed 20 h...

This study evaluated bony healing and clinical results after medial open-wedge HTO to compare the outcome of the LOQTEQ® HTO plate and the TomoFix™ internal plate fixator. A prospective, non-randomised, comparative study was undertaken. The same surgical technique for the medial open-wedge HTO was used in two treatment groups. In Group 1, the TomoF...

The indication for transosseous repair of the patellar tendon is a rupture at the distal pole of the patella or at the tibial tuberosity. In the case of intratendinous ruptures, the ruptured tendon bundles must be approximated with sutures. After exposure of the rupture site through a longitudinal incision (approximately 10–15 cm), the insertion an...

Objective: Exertional rhabdomyolysis results from a breakdown of skeletal muscle cells after intense exercise in otherwise healthy patients, causing increased levels of creatine kinase (CK) or myoglobin, as well as urine dipstick positive for blood, and may result in kidney insufficiency. The aim of this study was to outline the current perspectiv...

Patellar tendon rupture can occur spontaneously or as result of trauma. Ruptures without adequate trauma are usually due to previous degenerative damage to the tendon. The mechanism of trauma is mostly an eccentric load on the tendon. The typical age for a patellar tendon rupture is between 25 and 40 years. Men are affected more often than women. A...

Introduction Rigid cervical spine following trauma immobilization is recommended to reduce neurological disability and provide spinal stability. Soft collars have been proposed as a good alternative because of the complications related to rigid collars. The purpose of this study was to perform a systematic review on soft and rigid collars in the pr...

Relevant social networks for orthopedics and trauma surgery are LinkedIn, Facebook, Instagram, Twitter, Youtube and Researchgate. These often enable a direct and rapid communication exchange among physicians, physical therapists, practices and hospitals, scientific societies, scientific journals, insurance companies, medical technology and pharmace...

Following the outbreak of SARS-CoV-2, several elective surgeries were cancelled, and rehabilitation units were closed. This has led to difficulties for patients seeking access to rehabilitation in order to achieve the best possible outcome. New applications with or without sensors were developed to address this need, but the outcome has not been ex...

Introduction There is a paucity of literature regarding serum C-reactive protein (CRP) in the evaluation of a shoulder periprosthetic joint infection (PJI). The purpose of the current study was to establish cutoff values for diagnosing shoulder PJI and evaluate the influence of the type of infecting microorganism and the classification subgroups ac...

Distal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. However, this can be missed without careful examination, especially in patients experiencing altered mental status. The aim of this study was to analyze the mecha...

Zusammenfassung Die proximale Femurfraktur ist eine Frakturentität mit ansteigender Prävalenz, ein Effekt, welcher durch die zunehmende Alterung der Allgemeinbevölkerung noch zusätzlich verstärkt werden wird. In der Summe stellt sie sowohl die Operateure als auch das deutsche Gesundheitssystem als Ganzes vor Herausforderungen. Zudem führt ein steti...

Background: Periprosthetic joint infection (PJI) represents a serious complication following total hip (THA) and knee arthroplasty (TKA). When preoperative synovial fluid cultures remain inconclusive, open incisional joint biopsy (OIB) can support causative microorganism identification. Objective: This study investigates the potential benefit of...

Background: Chronic osteomyelitis (OM) is a progressive but mostly low-grade infection of the bones. The management of this disease is highly challenging for physicians. Despite systematic treatment approaches, recurrence rates are high. Further, functional and patient-reported outcome data are lacking, especially after osseous defects are filled w...

Background Type 2 diabetes mellitus (T2DM) patients show a markedly higher fracture risk and impaired fracture healing when compared to non-diabetic patients. However in contrast to type 1 diabetes mellitus, bone mineral density in T2DM is known to be normal or even regionally elevated, also known as diabetic bone disease. Charcot arthropathy is a...

Background and Objective: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less fluoroscopy time compared to previous systems. The aim of this study was...

Background The demographic transition leads to a continuously growing number of elderly patients who receive therapeutic anticoagulation by reason of several comorbidities. Though therapeutic anticoagulation may reduce the number of embolic complications in these patients, major complications such as bleeding complications need to be kept in mind w...

Introduction Intramedullary (IM) fixation is the dominant treatment for pertrochanteric and femoral shaft fractures. In comparison to plate osteosynthesis (PO), IM fixation offers greater biomechanical stability and reduced non-union rates. Due to the minimally invasive nature, IM fixations are less prone to approach-associated complications, such...

Tibial pilon fractures were first described by Étienne Destot in 1911. He used the French word “pilon” (i.e., pestle), to describe the mechanical function of the distal tibia in the ankle joint. This term has further been used to portray the mechanism involved in tibial pilon fractures in which the distal tibia acts as a pestle with heavy axial for...

Background: E-scooter usage was lawfully approved in Germany in June 2019. Since then, a marked increase of e-scooter drivers has been noticed. Evidence concerning factors that may affect the severity of these injuries is limited. The study aimed to retrospectively analyze e-scooter-related injuries in a major German city. Methods: All patients...

Introduction Distal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. The aim of this study was to analyse the mechanism and level of injury, demographics, and associated injuries in distal radius fractures with ipsilat...

Background While potentially timesaving, there is no program to automatically transform diagnosis codes of the ICD-10 German modification (ICD-10-GM) into the injury severity score (ISS). Objective To develop a mapping method from ICD-10-GM into ICD-10 clinical modification (ICD-10-CM) to calculate the abbreviated injury scale (AIS) and ISS of eac...

Aims The follow-up interval of a study represents an important aspect that is frequently mentioned in the title of the manuscript. Authors arbitrarily define whether the follow-up of their study is short-, mid-, or long-term. There is no clear consensus in that regard and definitions show a large range of variation. It was therefore the aim of this...

Background The importance of emergency rooms (ERs) as everyday healthcare suppliers is growing. Due to increasing patient flows, hospitals are forced to raise physicians’ and caregivers’ headcount continuously to meet the new demand of patients seeing the ER as primary point of contact in non-emergency situations. Patients from various cultural and...

Die Digitalisierung des Gesundheitswesens ist global unaufhaltsam ebenso wie omnipräsent. In Deutschland existiert hierzu eine Vielzahl an Initiativen, Institutionen und eine breite Basis an Innovatoren. Der Status quo ist begrüßenswert, jedoch bedarf es der weiteren Koordination und Kommunikation, um zielführend eine Strategie für die Zukunft des...

Background: Fractures of the proximal femur constitute daily work in orthopedic trauma surgery. With the continuous increase of obesity in the general population, surgeons face several known technical challenges. The aim of this study was to investigate the association of high body mass index (BMI) in patients with proximal femur fractures with in...

Background: Aim of the present study is the evaluation of ultrasound as a physical method for virus inactivation in human plasma products prior to transfusion. Our study is focused on achieving a high level of virus inactivation simultaneously leaving blood products unaltered, measured by the level of degradation of coagulation factors, especially...

This article reports the case of an 81-year-old male patient under treatment with oral anticoagulation who suffered delayed compartment syndrome of the upper arm from arterial capillary hemorrhage after shovelling snow. The diagnosis was made 48 h after the initial symptoms in the emergency surgical department of the Klinikum rechts der Isar (Münch...

Die Knochenbruchheilung stellt einen deutlich längeren und komplexeren Heilungsprozess im Vergleich zu anderen Geweben im Körper dar. Die Besonderheit liegt in der Tatsache begründet, dass der Wiederaufbau des Knochens mit denselben biomechanischen und biochemischen Eigenschaften und ohne minderwertige fibröse Narbe stattfindet und somit eine Resti...

Background: Intensive care unit (ICU) capacity is a scant and precious resource in hospitals. Therefore, an optimal occupancy rate as well as detailed occupation planning is of great importance. Most literature deals with admission to the ICU, while only few discuss discharge from the ICU. Specifically, a delay of transfer from the ICU can cause a...

Background and Aim Costs for the treatment of diabetes and its comorbidities are a major international issue. A recent randomized clinical trial showed that the introduction of color range indicator (CRI)-based glucose meters (GMs) positively affects the HbA1c of patients with type 1 and type 2 diabetes, when compared to GMs without a CRI. This bud...

Wird die Digitalisierung in der Medizin die klare und einfache Antwort auf all unsere Herausforderungen und Probleme im modernen Gesundheitswesen sein? Wir stehen heutzutage älteren Patienten mit mehr Komorbiditäten gegenüber, die eine komplexere Diagnostik und Therapie in einem Umfeld mit zunehmendem bürokratischem und rechtlichem Aufwand erforder...

While the elbow is the second most commonly dislocated joint in adults, Monteggia fractures and Monteggia-like-lesions remain rare and complex entities, approximately accounting for 2–7% of all proximal forearm fractures and 0.7% of all elbow fractures and dislocations [1–4]. Monteggia fractures are defined as an ulnar-based forearm fracture in com...

Background: There are many approved patient-related outcome measurement tools regarding ankle pathologies. However, there is none incorporating the range of motion (ROM) as an objective parameter. Most instruments focus on subjective parameters such as pain and impairment at work or daily living. Furthermore, the majority is only applicable to a s...

Purpose: The aim of this retrospective study was to evaluate the clinical outcome and complication rate of intramedullary cortical button repair for distal biceps tendon rupture (partial and complete tears). Methods: Between 2010 and 2014, a total of 28 patients with an acute distal biceps tendon rupture underwent intramedullary cortical button...

Background: Management of distal humeral fractures remains to be one of the most challenging aspects in trauma surgery. Low profile plating systems with variable angle screw fixation represent a crucial advancement to the established angular stable locking plates with considerable attention in current research. The aim of the prospective randomize...

The treatment of complex elbow dislocation fractures is a challenge to both the treating surgeon as well as to the patient due to the complex bony and soft tissue anatomy of the joint. In order to establish an expedient treatment algorithm, all osseous and ligamentous injuries need to be thoroughly assessed. Furthermore, a detailed knowledge of the...

While modern orthopedic surgery regards open reduction and fixation of fractures as the best treatment strategy, the conservative therapeutic approach with the core principles closed reduction - external casting - delayed mobilizations poses a currently underestimated and scarcely implemented alternative. Given the correct indication and applicatio...

While modern orthopedic surgery views open reduction and fixation of fractures as the best treatment strategy, the conservati- ve therapeutic approach with the core principles »closed reduction – external casting – delayed mobilization«, poses a currently underestimated and scarcely implemented alternative. Given the correct indication and applicat...

Anterior tibial pseudoaneurysm is a rare complication after interlocking screw insertion in tibial nailing. We present the case of a 28-year-old male patient with this complication with a 6-week delay after tibial nailing of a right tibial fracture type 42-A1 of the Association for the Study of Internal Fixation (AO/ASIF) classification. On present...

Die Ellenbogengelenkluxation ist bei Erwachsenen die zweithäufigste Luxationsform. Unterschieden wird dabei die „einfache“ Luxation im Sinne einer isolierten Verletzung des Kapsel-Band-Komplexes und die komplexe Luxation mit Beteiligung der knöchernen Gelenkpartner. Als Sonderform einer Ellenbogenluxationsfraktur beschreibt die sogenannte Terrible-...

A paradigm shift in the treatment of elderly patients has recently taken place leading to an increase in joint replacement surgery. The aim of this article is to highlight new developments and to present a treatment algorithm for femoral neck fractures. The age limit must be individually determined considering the comorbidities and perioperative ri...

C-reactive protein (CRP) is a common laboratory infection marker in blood-serum of patients. In all diverse medical departments CRP is often used, and also in orthopaedics CRP is proved to be very helpful in diagnosis and monitor of infections. CRP in most fields is superior to conventional and newer infection parameter and is a basic parameter for...

A 28-year-old male patient was initially conservatively treated by a general physician for muscle strain of the right calf after a bowling game. Due to increasing pain and swelling of the lower leg 5 days later, the differential diagnosis of a deep vein thrombosis was considered. Furthermore, the onset of neurological deficits and problems with rai...

We report the case of a 51-year-old male patient who sustained a liver rupture following mechanical cardiopulmonary resuscitation (CPR) with the LUCAS® system. The patient was under anticoagulation and developed an abdominal compartment syndrome. Although the use of mechanical CPR devices, such as the LUCAS® system and the load distributing band (A...

Radiation therapy plays an essential part in modern treatment regimes of musculoskeletal tumors. Nevertheless damage to the surrounding tissue does occur inevitably. Postradiogenic changes of bone are associated with decreased stability and an increased fracture rate. The orthopedic surgeon therefore faces a challenging situation with altered bone...

Fractures of the clavicle present very common injuries with a peak of incidence in young active patients. Recently published randomized clinical trials demonstrated an improved functional outcome and a lower rate of nonunions in comparison to non-operative treatment. Anterior chest wall numbness due to injury of the supraclavicular nerve and postop...

INTRODUCTION While plate fixation remains the gold standard for surgical treatment for displaced mid-shaft clavicle fractures (DMCF), intramedullary fixation has emerged as a promising alternative. However, due to its more demanding technique and depending on the fracture's nature, an open reduction can be necessary. Aim of this study was to compar...

Diabetes mellitus type 2 (2DM) is associated with altered bone quality. In order to analyze associated changes on a molecular level, we investigated the gene expression of key factors of osteoblast metabolism in type 2 diabetics. Total mRNA and protein of bone samples from 2DM patients and non-diabetic patients were isolated, and subsequently, reve...

Patients with chronic liver diseases frequently exhibit decreased bone mineral densities (BMD), which is defined as hepatic osteodystrophy (HOD). HOD is a multifactorial disease whose regulatory mechanisms are barely understood. Thus, an early diagnosis and therapy is hardly possible. Therefore, the aim of our study consisted in characterizing a mo...

Supplementary Figure: CCl4 treatment damages hepatocytes but not osteoblasts. (a) Primary human hepatocytes (N = 5, n ≥ 4) and primary human osteoblasts (N = 6, n = 4) were stimulated repeatedly (4 times) with 0, 1, 2 and 10 mM CCl4. After 96 h cell viability was determined by resazurin conversion. Reduced cell viability was observed only in hepato...

Proximal femur fracture, a typical fracture of the elderly, is often associated with morbidity, reduced quality of life, impaired physical function and increased mortality. There exists evidence that responses of the hematopoietic microenvironment to fractures change with age. Therefore, we investigated oxidative stress markers and oxidative stress...

Bouldern gehört zu den modernen Trendsportarten. Als sportarttypische Verletzungen sind überwiegend degenerative Überlastungsschäden durch die dauerhafte Flexionsstellung der Finger wie z. B. Ringbandverletzungen (sog. „Kletterfinger“) bekannt. Berichte über spezifische, akuttraumatische Verletzungen des Ellenbogengelenks liegen in der Literatur bi...

Ein 52-jähriger Patient zog sich eine Augenbrauenplatzwunde links nach einem Sturz im Bad zu. Hierbei zersprang die vom Patienten getragene Brille mit Kunststoffgläsern. Die Erstversorgung der Platzwunde mittels Steristrips erfolgte durch eine Pflegekraft nach kurzer, oberflächlicher Wundinspektion durch den diensthabenden Arzt. Vier Wochen später...

Approximately half of all polytrauma patients suffer from a severe chest injury including serial rib fracture and lung contusion. Usually, these injuries are successfully treated non-operatively by pain management and breathing therapy. Furthermore, polytrauma patients often require insertion of chest tubes due to a hemato-/pneumothorax. In severe...

The single-center, open-label, four-arm, exploratory study investigates the relation of different anti-diabetics to serum levels of active TGF-beta, a known pro-fibrotic stimulus, before and after a defined test meal. We investigated sera of patients with type 2 diabetes mellitus (T2DM) treated with metformin and sulfonylurea, insulin glargine or a...

The aim of this biomechanical in vitro study was to compare the novel technique of double intramedullary cortical button (DICB) fixation with the well-established method of suture anchor (SA) fixation for distal biceps tendon repair. A matched-pair analysis (24 human cadaveric radii) was performed with respect to cyclic loadings and failure strengt...

Bouldering is a new trend sport which has become popular in recent years. From April 2011 to June 2012 a total of 5 patients with elbow dislocations from bouldering were admitted to our level 1 trauma center. The injuries varied from simple elbow dislocations to complex fracture dislocations. Elbow dislocations occurred during falling backwards whe...

BACKGROUND: Fractures of the lower extremity are a common reason for presentation to an emergency room. The aim of this study was to evaluate a new immobilization and x-ray splint (Andante®, ForMed) in the emergency room. METHODS: From April 2010 to August 2010 all patients presenting with a fracture of the lower extremity were included in the stud...

Hintergrund Die initiale Lagerung einer frakturierten unteren Extremität stellt ein relevantes Problem dar. Ziel dieser Studie war die Evaluation einer neuartigen Lagerungs- und Röntgenschiene (Andante®, ForMed) in der Notaufnahme und im Notfallröntgen. Methoden Zwischen 04/10 und 08/10 wurden alle Patienten im Fall einer Fraktur der unteren Extre...

Cigarette consumption increases oxidative stress in many organs. Increased oxidative stress harms bone cells, which negatively affects bone-matter and -sta-bility. This leads to an increased fracture risk and delayed fracture healing in smokers. A supporting therapy with antioxidants could be of great benefit for surgeons dealing with delayed fract...