Thomas Heinz

Medical University of Vienna, Wien, Vienna, Austria

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Publications (38)43.66 Total impact

  • C. Kukla · C. Gaebler · M. Mousavi · V. Vécsei · T. Heinz
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    ABSTRACT: Background: Reviewing patients operatively stabilized following proximal femoral fractures we found several factors that lead to significant complications. We conducted this survey of proximal femoral fractures stabilized with the implants which were used most frequently. Purpose was to work out causes and indications to remove implants which were solely employed to stabilize proximal femoral fractures. Methods: The indication for using a Dynamic Hip Screw® (DHS) were fractures AO-Class. 31-B or 31-A1. A Gamma Locking Nail® (GN) was applied in unstable or comminuted trochanteric fractures. We retrospectively analysed 2553 patients who received either a DHS or a GN within seven years. Results: Removal of the implants was indicated in 3.2 % mostly due to complications. Most frequent 'modes of complication' that lead to the removal of one of the implants were avascular necrosis (AVN) of the femoral head (24 %), patients request (20 %) and ipsilateral shaft fractures (17 %). Conclusions: Referring to the results absolute indications to remove an implant are AVN, deep chronic infections, shaft fractures and when 'cutting out' appears.
    No preview · Article · Apr 2012 · European Surgery
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    ABSTRACT: Accurate assessment of injury severity is critical for decision making related to the prevention, triage, and treatment of several injured patients. Early estimation of mortality risk of critically injured patients is mandatory for adequate therapeutic strategies. Current risk stratification relies on clinical diagnosis and scoring systems. In our study, we hypothesized whether a simple laboratory test, the CK/CK-MB ratio, could help improving risk prediction in severely traumatized patients. In a 9-year period, 328 nonselected trauma patients were included in our retrospective study at a Level I Trauma Center up to September 2002. Data for this study were obtained from our computerized trauma database, established in September 1992. In our study population, we could show a negative correlation between Injury Severity Score (ISS) and leukocytes. A positive correlation was detected for liver enzymes and CK-MB. The correlation between ISS and Na(+) was significant. No correlation between ISS, K(+), and Hb/Ht could be observed. Exitus was associated with ISS, alteration in thrombocytes, CK, CK-MB, CRP, Crea, and Na(+). In our study population, CK-MB levels showed a significant correlation with overall surveillance in polytraumatized patients. In our opinion, this might suggest that CK-MB levels could be taken as an indirect predictor for survival. Our findings need to be proven in further prospective clinical trials.
    No preview · Article · Apr 2012 · Wiener klinische Wochenschrift
  • S Boesmueller · S Aldrian · M Schurz · T Heinz
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    ABSTRACT: Isolated meniscus tears with consecutive complete luxation of the meniscus are an exceptional injury especially in children. We report a case of an 11-year-old girl with a complete luxation of the lateral meniscus, injured by a jump from low height. Following clinical examination and magnetic resonance imaging, a surgical refixation of the entire lateral meniscus was performed. Short-time clinical and radiological follow-up was conducted.
    No preview · Article · Jul 2011 · Knee Surgery Sports Traumatology Arthroscopy
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    ABSTRACT: No consensus currently exists on the facture location of dorsally displaced distal radius fractures (DRFs). We present a systematic evaluation of the distal fracture line (DFL) location of DRFs and possible influencing factors. Determining the average location of DRFs provides a basis for developing more sensitive tests to determine bone strength using a variety of imaging techniques and for developing improved biomechanical models to test fracture characteristics and surgical implants. Initial radiographs of 157 DRFs dorsally displaced DRFs in patients aged 40-74 years were identified, patient and trauma specific data were collected, and standard radiographic measurements and (AO) fracture classification were performed. The dorsal and palmar DFL locations relative to the corresponding apex of the lunate facet were measured. The DFL was located dorsally 7.9 ± 2.7 mm and palmarly 11.7 ± 3.9 mm proximal to the corresponding lunate fossa apex. The dorsal DFL was significantly distal to the palmar one (p  < 0.001), but the two did not correlate (r² = 0.018, p = 0.095). DFL location was independent of age, energy of the fall, and fracture complexity.
    No preview · Article · Apr 2011 · Journal of Orthopaedic Research
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    ABSTRACT: Recent studies indicate alterations of local and systemic growth factor level during fracture healing. As a result, osteogenic and angiogenic growth factors allow us to monitor fracture healing on a molecular level. We hypothesised that closed intramedullary (IM) reaming and nail fixation, in contrast to open reduction and internal plate fixation (ORIF), could exert an effect on the cellular elements present in the intramedullary canal, leading to increased release of mediators. The purpose of the study was to investigate whether different osteosynthesis techniques influence the released quantity of cytokines. A total of 34 patients with tibia fractures treated with IM fixation and 19 patients treated with ORIF were included in the study. In addition to clinical and radiological examination, serum concentrations of transforming growth factor beta 1(TGF-β1), macrophage-colony stimulating factor (M-CSF) and vascular endothelial growth factor (VEGF), were analysed at 1, 2, 4, 6, 8, 12, and 24 weeks after surgery. Expression of TGF-β1 and M-CSF was increased during the first 2 weeks of fracture healing in patients treated with the IM fixation technique compared with those treated by ORIF. After 24 weeks, M-CSF levels in patients with IM fixation were clearly higher. Conversely, VEGF levels were higher during the first 2 weeks of fracture healing in patients treated by ORIF compared with IM fixation. However, these results were not significant. Our results show that 1 week after surgery neither reamed IM fixation nor ORIF of the tibia could increase the expression of VEGF, M-CSF and TGF-β1 in its favour.
    No preview · Article · Dec 2010 · Injury
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    ABSTRACT: Pathologic fractures of long bones are common complications of the metastatic disease; however, the influence of the primary tumor, the stage of metastatic disease, different surgical techniques, and the postoperative mobility on the postoperative survival has not been clearly defined. The aim of this retrospective study was to evaluate outcome after surgical treatment for pathologic femur fractures. A consecutive series of 142 patients with metastatic fractures of femur were retrospectively studied. The operative treatment was based on intramedullary fixation (n = 94), gliding screws (n = 15), other extramedullary fixation devices (n = 7), and arthroplasty (n = 23). Seventeen percent and 6% of the patients survived 1 year and 2 years, respectively, postoperatively. Postoperative survival was higher in patients with pathologic femur fractures because of breast carcinoma than in patients with other primary tumors. The rate of complications for patients with intramedullary stabilization, gliding screw fixation, and endoprosthetic replacement was 3.2%, 20%, and 8.6%, respectively. Although many studies describe the endoprosthetic replacement as the safer method to treat pathologic femur fractures, our data showed that intramedullary stabilization and endoprosthetic replacement to be safe, and equivalent alternatives to treat complete pathologic fractures of the femur in patients with advanced metastatic disease.
    No preview · Article · May 2009 · The Journal of trauma
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    ABSTRACT: Due to the advances in oncological therapy, the life expectancy of patients with malignant tumours and the incidence of pathological fractures have increased over the last decades. Pathological fractures of the long bones are common complications of metastatic disease; however, the outcome of different surgical techniques for the treatment of these fractures has not been clearly defined. The aim of this study was to evaluate differences in patient's survival and postoperative complications after the treatment of pathological fractures of the long bones. Eighty-eight patients with 96 pathological fractures of the long bones were analysed retrospectively. Seventy-five patients with 83 fractures received surgical treatment. The operative treatments used were intramedullary fixation, gliding screws, plate osteosynthesis or arthroplasty. Five patients were still alive at the end of data collection at a median time of 42.5 months, and 16.2% survived 1 year, 7% 2 years and 4% more than 3 years postoperatively. All surgically treated patients had a reduction of local pain and were able to walk after the operation. The overall rate of complications was 8%. Early palliative treatment of pathological fractures of the long bones is indicated in most patients in the advanced stage of metastatic disease. The low complication rate, reduction of local pain and early mobilisation justify the surgical stabilisation of fractures in this cohort of patients.
    Full-text · Article · Jan 2007 · International Orthopaedics
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    ABSTRACT: S-100B and NSE proteins are considered to be neurobiochemical markers for the brain damage. The aim of this study was to consider the diagnostic and prognostic validity of the initial serum levels of S-100B and NSE in clinical use. Forty-five patients with traumatic brain injury were included in this prospective study. Neurologic examination and CCT-scan were performed. S-100B and NSE were analysed. Patients were divided in two groups depending on the severity of injury. The results showed a significant difference between the S-100B serum concentration and the two groups-minor head injuries and severe head injuries. A statistically significant correlation was observed between an increase of S-100B and NSE serum values and a cerebral pathological finding in CT scans. The clear correlation between S-100B and NSE serum concentrations and CCT findings does not validate both markers as an independent predictor of diagnosis and prognosis of brain injury.
    No preview · Article · Jun 2006 · Brain Injury
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    ABSTRACT: The intra-articular migration of a femoral interference screw is a rare complication after anterior cruciate ligament (ACL) reconstruction in the knee. Only a few reports of cases have been published within the last few years and different approaches toward this complication have been described. We report the case of a 23-year-old female patient who was admitted with knee pain after undergoing an ACL reconstruction 4 years previously. After the clinical examination, a knee radiograph in 2 planes revealed a dislocated femoral interference screw lying in the popliteal fossa. During arthroscopy, the interference screw was retrieved through an additional posteromedial portal to avoid an arthrotomy. The causes for intra-articular screw migration are multiple and most cases were reported in the early postoperative period. The arthroscopic removal of a screw is recommended because of the lower morbidity.
    No preview · Article · Dec 2005 · Arthroscopy The Journal of Arthroscopic and Related Surgery
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    ABSTRACT: In order to reduce pulmonary complcationsafter reaming and intramedullary nailing, a solid 8.5 mm femoral nail was developed. Clinical application of the femoral nail in 25 cases of diaphyseal fractures showed promising results. The series consisted of 21 closed fractures, three Grade I fractures, and one Grade IIIB open fracture. A solid femoral nail was applied eight times in the course of polytrauma, in six patients with multiple injuries, and in 11 patients with isolated femoral fractures. Application was bilateral in three patients. The rate of union was 92% at 6 months postoperatively. Reaming and renailing were necessary in one patient with a deux étages and in one with a pathological fracture. In the latter, nail failure occured. Bone grafting was needed in one case of a pathological fracture. Locking-screw breakage was observed in three (12%) cases 12 to 15 weeks postoperatively but did not lead to any additional complications. There was one intraoperative complication but no infections were observed. The exellent results of unreamed nailing with the solid femoral nail consequently led to its use as the primary method of treatment of femoral fractures associated with polytrauma, multiple injuries, thoracic trauma, narrow medullary cavity, and pathological fractures, in the presence of concomitiant peripheral vascular diseases.
    Full-text · Article · May 2005 · Osteosynthesis and Trauma Care
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    ABSTRACT: The implant Helix-Wire is a treatment device that is used since 1997. It provides minimally invasive stabilization of subcapital humeral fractures. The implant is inserted through a small lateral entrance and a cortical hole drilled into the intramedullary space of the proximal humeral shaft and drilled into the humeral head for fracture stabilization. After careful preoperative planning and successful repositioning of the fracture the technique can be performed without difficulty. A review of 35 patients with subcapital humeral fractures, who were operated using the titanium wire helix between 1998 and 2000, was carried out. Clinical and radiological results were documented. After an average time of 11.5 months 13 patients were examined according to the Constant Score: 5 good or excellent, 4 fair and 4 bad results were achieved. We conclude that this implant provides sufficient stabilization of subcapital humeral fractures classified as AO 11 A2, 11 A3.1, 11A3.2, 11B1.1, 11B1.2. It does not offer an advantage for the treatment of unstable fractures with multiple fragments or cancellous bone deficiency (11 A3.3, 11 B2.2, 11 B2.3).
    No preview · Article · Nov 2002 · Wiener klinische Wochenschrift
  • C Kukla · C Gaebler · R W Pichl · R Prokesch · G Heinze · T Heinz
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    ABSTRACT: An experimental study was performed on 20 cadaveric human proximal femurs to investigate both the reproducibility of their mechanical behavior under uniaxial compression and the correlation of mechanical properties with geometric dimensions and bone density. These variables were assessed by radiography, physical measurement, and dual-energy X-ray absorptiometry (DEXA). The specimens were immobilized, loaded to the point of fracture, and analyzed with the help of a materials testing machine. The fractures invariably showed a similar pattern both in location (i.e. at the femoral neck) and in nature (i.e. "axial-shear" type according to the AO classification system). The mechanical properties of the tested proximal femurs correlated negatively with age (r = -0.39) and positively with sex (male femurs were stronger and correlated more closely than female femurs, P = 0.005). They showed a strong positive correlation with head diameter (r = 0.713, P = 0.0004), a moderate positive correlation with both neck axis length (r = 0.63) and neck diameter (r = 0.502), and a slight positive correlation with femoral neck-shaft angle (r = 0.326). All DEXA-based densitometry measures turned out to be powerful predictors of fracture force. The establishment of this solidly reproducible fracture model based on standardized loading conditions should have implications for future research on osteopenia/osteoporosis and preventive stabilization techniques.
    No preview · Article · Jul 2002 · Injury
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    ABSTRACT: This study assessed the influence of driving speed and revolution rate per minute of two reamers on femoral intramedullary pressure increases and fat intravasation. The AO and Howmedica reamers were tested in four groups with different combinations of driving speed and revolution rate per minute in both femurs in a sheep model. The 24 animals were exposed to hemorrhagic shock after midshaft osteotomy and were resuscitated before reaming of both femoral shafts. Controlled reaming was performed at 15 and 50 mm/second driving speed with 150 and 450 revolutions per minute. Fat intravasation and intramedullary pressure were measured by transesophageal echocardiography, Gurd test, and a piezoelectric gauge, respectively. Low driving speed and high revolutions per minute with the smaller cored reamer led to lower intramedullary pressure changes. The same reaming parameters led to greater pulmonary stress during surgery of the second side. Reaming with a smaller cored reamer and modified reaming parameters leads to a lower increase in intramedullary pressure and reduces the amount of fat intravasation. Primary reamed intramedullary nailing should be done after resuscitation at a low driving speed and high revolutions per minute with a smaller cored reamer to minimize the risk of pulmonary dysfunction.
    No preview · Article · Feb 2002 · Clinical Orthopaedics and Related Research
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    ABSTRACT: We retrospectively analyzed 1334 patients who were implanted standard gamma interlocking nails (SGN) to stabilize trochanteric femoral fractures over the years 1992-1998. Reoperation to remove the nails was performed in 37 patients, in 9 of them purely because of pain. Three out of these 9 patients with removed SGN suffered femoral neck fractures in the early postoperative course after having been mobilized to full weight-bearing capacity. This complication was not observed with other implant systems and, considering the notoriously high complication rate of femoral neck fractures, severely reduces the value of the SGN concept per se. These findings in combination with other known shortcomings of SGNs prompted us to conduct an experimental study on the fracture force of excavated femurs addressing the hypothesis that the specific design of the SGN is responsible for the occurrence of fatigue fractures of the femoral neck. Eighteen matched pairs of fresh human cadaveric proximal femurs, which were treated by insertion and removal of (i) SGNs or (ii) dynamic hip screws (DHS) or (iii) by excavation in the absence of an implant, were subjected to incremental loading cycles and compared to the untreated contralateral femurs. Overall, the fracture force was found to be significantly lower among the treated than among the untreated bones. However, the fracture force required after removal of the DHS system was still significantly higher than for SGN or excavation alone. In this way, our findings demonstrate that removing relatively big implants such as SGN can cause serious complications such as femoral neck fractures. We therefore recommend to leave this type of device in place even after fracture healing except in cases of deep and chronic infection.
    No preview · Article · Jan 2002 · Journal of Biomechanics
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    ABSTRACT: The continuous increase in the number of fractures of the proximal femur is directly attributable to the worldwide increase in life expectancy. The standard version of the Gamma Interlocking-Nail (standard Gamma nail [SGN], 200-mm length, 10-degree valgus curvature, two distal locking bolts) was designed because of the demands in orthopedic hip surgery to develop an implant stable enough to mobilize old patients as soon as possible to avoid further morbidity and mortality. Between the years 1992 and 1998, 1,000 consecutive patients with peritrochanteric fractures were stabilized by using the SGN and included in this study. Special emphasis was given to the evaluation of the learning curve of the department of traumatology (not of single surgeons) and the influence of prognostic factors on the outcome of such operations. The results of this study show that increasing "department experience" resulted in a reduction of the intraoperative complication rate by a factor of 0.5 (p = 0.0001) per year. This means that even an inhomogeneous mass of 78 surgeons can lower the rate of intraoperative complications by 50% per year because of increased experience. The number of early postoperative complications annually decreased by a factor of 0.8 (p = 0.0042). Late postoperative complications correlate negatively with the patient's age (odds ratio, 0.9; p = 0.0001).
    No preview · Article · Aug 2001 · The Journal of trauma
  • Gholam Pajenda · Vilmos Vécsei · Brian Reddy · Thomas Heinz
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    ABSTRACT: Fractures of the neck and body of the talus present as one of the most challenging and rare injuries. These fractures are often associated with other ankle, foot, and skeletal injuries, which complicate their treatment. The clinical course of 50 patients with a mean age of 29 years with a severe talus fracture between 1992 and 1997 is presented. According to the Hawkins classification there were 16 (32%) of type I, 14 (28%) of type II, 9 (18%) of type III, and 11 (22%) of type IV. Forty-three patients (86%) underwent operative treatment: 27 (63%) by open reduction and internal fixation with screws, seven (16%) by external fixation, five (12%) with percutaneous screws, and four (9%) by closed reduction with K-wire fixation. Mild osteoarthritis of the talocrural joint was seen in 14 patients (28%) and severe osteoarthritis in 10 patients (20%), five of whom required subsequent arthrodesis of the ankle joint. Arthrodesis of the subtalar joint was observed in 4 cases. Avascular necrosis with collapse of the talar body was seen in four patients (8%). The function of the ankle joint was evaluated according to the Weber score. Patients with talus fractures of Hawkins' type I and II had considerably better outcomes (with 95% being excellent or good) than individuals suffering dislocated fractures with involvement of the articulating surface with 70% good results in Hawkins' type III and 10% good results in Hawkins' type IV fractures. For the evaluation of the vitality of the talus body in cases with titanium implants, the authors used magnetic resonance imaging and intraosseous phlebography in cases with stainless steel implants. The displaced talus fractures must be treated by closed and, if necessary, open reduction with internal fixation. The initial postoperative management should consist of ambulation without weightbearing until radiographic appearance of trabecular bone in the fracture zone, indicating revascularization, can be manifested.
    No preview · Article · Nov 2000 · The Journal of Foot and Ankle Surgery
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    ABSTRACT: Background: The development of the intramedullary nail in stabilisation of very distal femur fractures through retrograde technique has become an essential form of treatment of these difficult fractures. The Supracondylar Nail (SCN) is a modified form of the implants applied until now, such as the Green-Seligson-Henry Nail (GSH). The locking and compression system of the double angled device presented significant advantages. The cannulated condyle screws enable a transverse compression of condyl fragments even in osteoporotic bone. This additional possibility of stabilisation increases the chance of closed reconstruction and fixation,which is favorable for early ambulation. Methods: In a retrospective analysis, 34 patients, who had received a retrograde nail were followed up over a span of 3 years. This group consisted of 28 women and 6 men with an average of age of 62.4 years (15-97). 16 patients, treated with SCN and 17 patients, who had received a GSH nail in a similar study were followed up. Results: The fractures were classified according to AO parameters; with 19 fractures of the typ A and 15 of typ C. Five patients suffered from multiple trauma (or polytrauma) and one died 19 days after accident. Beside 2 pathiologic and four open fractures, one patient had a chain-injury. Among the older patients, most had fallen at home, whereas younger patients usually had fallen from great hights (often suicid attempts) or been injured in car accidents. 14 Patients had presented with implants in the proximal femur. A closed reduction and sufficient stabilisation were possible in all cases. Depending on the fracture typ and additional morbidity the patients were mobilised as soon as possible under partial weight-bearing. 6-10 month following injury the patients were classified according to the Leung-Score. There we saw a definitive improvement when using the SCN, as opposed to the GSH nail. The results were analysed furthermore according to bone consolidation and axis deviation. Only one fracture showed non-union. This septic pseudarthrosis had to have intermediary treatment with a prosthesis. Conclusions: All fractures but one showed good bone consolidation with lower rates of complications compared to alternative methods. Advantages of closed, intramedullary technique were evident.
    No preview · Article · Jan 2000 · Acta Chirurgica Austriaca
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    ABSTRACT: Zusammenfassung Grundlagen: Die Entwicklung eines intramedullären Nagels zur Stabilisierung distaler Femurfrakturen in retrograder Technik war ein wesentlicher Beitrag in der Behandlung dieser sehr schwierig zu versorgenden Knochenbrüche. Der SCN (Supracondylar Nail) ist eine Modifizierung bisher bekannter retrograd anzuwendender Implantate, wie etwa des GSH-(Green-Seligson-Henry)-Nagels. Deutliche Vorteile zeigte das distale Verriegelungs- und Kompressionssystem des doppelt geknickten soliden Kraftträgers. Die kanülierte Kondylenschraube erlaubt eine transversale Kompression der kondylären Bruchfragmente auch bei osteoporotischem Knochen. Diese zusätzliche Stabilisierungsmöglichkeit erhöht die Chance auf eine geschlossene Kondylenrekonstruktion und verbessert die Möglichkeiten der Frühmobilisation. Methodik: In einer retrospektiven Analyse wurden 34 Patienten, die in einem Zeitraum von 3 Jahren mit einem retrograden Nagel operativ versorgt wurden nachuntersucht. Das Patientenkollektiv umfaßt 28 Frauen und 6 Männer mit einem Durchschnittsalter von 62,4 Jahren (15–97 Jahre). Sechzehn Patienten, die mit einem SCN Nagel versorgt wurden, und 17 Patienten, bei denen ein GSH Nagel Verwendung fand wurden nachuntersucht. Ergebnisse: Die Frakturen teilten sich nach der AO Klassifikation in 19 Frakturen vom Typ A und 15 vom Typ C. Fünf Patienten erlitten ein Polytrauma, einer dieser verstarb nach 19 Tagen. Neben 2 pathologischen und 4 offenen Frakturen fand sich bei einem Patienten eine Kettenverletzung. Bei alten Patienten waren häusliche Stürze die häufigste Unfallursache, während bei Patienten geringeren Alters Stürze aus großer Höhe, oft in suizidaler Absicht, sowie Verkehrsunfälle die Hauptursache darstellten. Es fanden sich 14 Patienten mit liegenden Implantaten im Bereich des proximalen Oberschenkels. Eine gedeckte Reposition und eine suffiziente Stabilisierung waren in allen Fällen möglich. Abhängig von der Frakturform und den zusätzlichen Erkrankungen erfolgte eine Mobilisierung mit Teilbelastung zum frühest möglichen Zeitpunkt. Die Ergebnisse werden in bezug auf knöcherne Konsolidierung, Achsenergebnis und der Auswertung nach Leung zur Darstellung gebracht. Eine einzige Fraktur konnte nicht zur Ausheilung gebracht werden. Diese septische Pseudarthrose mußte mit einer Prothese im Intervall behandelt werden. Schlußfolgerungen: Mit Ausnahme einer Fraktur konnten bei allen anderen eine knöcherne Konsolidierung unter geringerer Komplikationsrate als bei Alternativverfahren erreicht werden. Die Vorteile einer geschlossenen, intramedullären Technik waren evident.
    No preview · Article · Jan 2000 · Acta Chirurgica Austriaca
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    ABSTRACT: Different implants have been developed in the past years for internal stabilization of distal femoral fractures. In a retrospective analysis the GSHN (Green-Seligson-Henry Nail) was compared with the new SCN-nail (Supra-Condylary Nail). New are the anatomical rounding, the new condylar screw with a nut and the distal interlocking screw. From January 1997 to July 1998 16 patients with 17 fractures (age 17 to 94 years, mean 55.1 years) were treated with a SCN. Results were compared with 17 patients (age 16 to 92 years, mean 62.4 years) who were stabilized with a GSHN from October 1994 to May 1997. Using the OTA classification there were 55.9% Type A and 44.1% Type C fractures. The follow-up period was 7.7 months (6.7 to 10.1 months). Comparing the results of the examination the group of patients treated with the SCN had less pain (Leung Score) and an increased proportion of anatomical correct healing results. Both groups are not big enough to find statistical significant differences. The use of the new nail showed technical advantages during surgery, reflecting also in better healing results.
    No preview · Article · Nov 1999 · European Journal of Trauma
  • M Greitbauer · T Heinz · C Gaebler · V Vécsei

    No preview · Article · May 1999 · Journal of Orthopaedic Trauma

Publication Stats

461 Citations
43.66 Total Impact Points


  • 2001-2012
    • Medical University of Vienna
      • • Department of Radiology
      • • Center for Anatomy and Cell Biology
      Wien, Vienna, Austria
  • 1992-2012
    • University of Vienna
      • Clinic for Trauma Surgery
      Vienna, Vienna, Austria
  • 2000-2009
    • Vienna General Hospital
      Wien, Vienna, Austria