Operative Orthopädie und Traumatologie

OBJECTIVE: Anterior stabilization of the spine with a lateral approach to insert a large and broad cage creating a better bearing surface to restore or maintain the lumbar lordosis. INDICATIONS: Degenerative scoliosis as well as revision surgery for stenosis of the neuroforamen. Lumbar corpectomies between L2/3 and L4/5 can be approached as well. CONTRAINDICATIONS: The segment L5/S1 is not suitable for the transmuscular approach...

OBJECTIVE: The pararectus approach was rediscovered several years ago for pelvic surgery and described as an alternative approach especially for the treatment of acetabular fractures of the anterior column involving the quadrilateral plate. INDICATIONS: For optimal visualization of acetabular fractures involving the quadrilateral plate, fractures of the anterior wall and anterior column, anterior column/posterior hemitransverse fractures, and fractures with central impression of dome fragments, the pararectus approach has proven to be a useful access...

No abstract text is available yet for this article.

OBJECTIVE: Treatment of comminuted clavicle shaft fractures with minimally invasive plate osteosynthesis (MIPO). INDICATIONS: Multifragmentary (≥ 2 intermediate fragments) clavicle shaft fractures with no need for anatomical reduction (AO 15.2B and 15.2C). Even simple fractures (AO 15.2A) with significant soft tissue injuries Tscherne grade I-III are suitable. CONTRAINDICATIONS: Medial or lateral clavicle fractures as well as simple fracture pattern where anatomical reduction is indispensable...

OBJECTIVE: Treatment of acetabular cartilage defects using autologous cartilage fragments. INDICATIONS: Acetabular cartilage damage (1-6 cm2 ) associated with femoroacetabular impingement syndrome (FAIS). CONTRAINDICATIONS: Advanced osteoarthritis (≥ 2 according to Tönnis) and extensive acetabular cartilage damage > 6 cm2 . Lack of labral containment due to irreparable labral damage. SURGICAL TECHNIQUE: Arthroscopic preparation of the acetabular cartilage damage and removal of unstable cartilage fragments using a 4...

OBJECTIVE: Puncture of large joints is performed for diagnostic purposes on the one hand and for the treatment of joint pathologies on the other. Puncture can be used for rapid pain relief by relieving effusions or intra-articular hematomas. The obtained puncture specimen allows immediate visual assessment and subsequent microscopic-cytological and microbiological evaluation in the laboratory. INDICATIONS: The indication for puncture of a large joint is for diagnosis and/or therapy of inflammatory, traumatic or postoperative joint problems...

OBJECTIVE: To provide a natural scaffold, good quality cells, and growth factors to facilitate replacement of the complete osteochondral unit with matching talar curvature for large osteochondral lesions of the lateral talar dome. INDICATIONS: Symptomatic primary and non-primary lateral osteochondral lesions of the talus not responding to conservative treatment. The anterior-posterior or medial-lateral diameter should exceed 10 mm on computed tomography (CT) for primary lesions; for secondary lesions, there are no size limitations...

No abstract text is available yet for this article.

OBJECTIVE: Improved accuracy of spinal instrumentation with the use of intraoperative CT (iCT). INDICATIONS: All types of posterior spinal instrumentation. CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: After fixation of the spinal clamp, an intraoperative CT (iCT) is performed. The image data set can then be used for navigation of the spinal implants. The arrangement of the devices, positioning of the patient, and the exact fixation of the clamp depend on the operation technique and the anatomical region...

OBJECTIVE: Treatment of Achilles insertional calcific tendinosis through a longitudinal midline incision approach with optional resection of the retrocalcaneal bursa and calcaneal tuberosity (Haglund's deformity). INDICATIONS: Calcific Achilles tendinosis, dorsal heel spur, insertional tendinosis. CONTRAINDICATIONS: General medical contraindications to surgical interventions. Fracture, infection. SURGICAL TECHNIQUE: Longitudinal skin incision medial of the Achilles tendon...

OBJECTIVE: Aim of surgical treatment is the primary stabilization of the unstable elbow following a ligamentous elbow dislocation. INDICATIONS: Ligamentous elbow dislocations are typically accompanied by injuries to the surrounding musculature and collateral ligaments of the elbow joint. Surgical treatment is indicated in case of failure of nonoperative therapy, i.e., when a dislocation can only be prevented in immobilization > 90° and pronation of the elbow or an active muscular centering of the elbow fails after 5-7 days...

OBJECTIVE: Pedicle screw-based posterior instrumentation of the spine. INDICATIONS: Instability of the spine due to trauma, infection, degenerative spinal disease or tumor. CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: Robot-assisted navigated pedicle screw placement. POSTOPERATIVE MANAGEMENT: Early functional mobilization starting on the first postoperative day. RESULTS: A study by Lee et al...

No abstract text is available yet for this article.

OBJECTIVE: Safe placement of posterior cervical-sacral pedicle screws, S2-Ala-iliac screws, iliac screws, transarticular screws C1/2, translaminar screws C2 or cervical lateral mass screws under the guidance of spinal navigation. INDICATIONS: All posterior spinal instrumentations with screws: instabilities and deformities of rheumatic, traumatic, neoplastic, infectious, iatrogenic or congenital origin; multilevel cervical spinal stenosis with degenerative instability or kyphosis of the affected spinal segment...

OBJECTIVE: Computer navigation is used in patients with spine fractures to optimize the accuracy of pedicle screws and thereby reduce intra- and postoperative complications, such as injuries to vessels, nerves and accompanying structures. In addition, the ideal screw length and diameter for each pedicle can be detected to ensure optimal stability. INDICATIONS: Intraoperative navigation is suitable for the treatment of spine fractures, which require dorsal stabilization or fusion...

OBJECTIVE: Reduction of pain and swelling over the Achilles tendon insertion while maintaining function. INDICATIONS: Strong, intolerable pain over the Achilles tendon insertion with chronic, calcifying insertional tendinopathy that does not respond to non-operative treatment over a minimum of 6 months. CONTRAINDICATIONS: Chronic wounds or severe circulatory deficits at the foot or ankle, irradiating or projected pain, complex regional pain syndrome (CRPS)...

No abstract text is available yet for this article.

OBJECTIVE: Osteotomy of iliac-pubic and ischial bone in order to cover the lateralized femoral head with the acetabulum. With the restoration of the containment of the hip joint, the acetabulum functions as a template for the femoral head, thus, allowing it to keep its sphericity during the vulnerable stages of Legg-Calve-Perthes disease. INDICATIONS: Lateralized femoral head in severe Legg-Calve-Perthes disease and visible head at risk signs on the radiographs...

OBJECTIVE: The proximal femoral varus osteotomy (FVO) aims to re-centre the femoral head in the acetabular socket after prognostically unfavourable subluxation, e.g. in Legg-Calve-Perthes disease (LCPD). INDICATIONS: No unified indication criteria have been defined yet for containment therapy in LCPD. However, specific radiographic features related to deformity development, age at diagnosis or onset and classifications describing pathomorphological changes in the femoral head related to bone necrosis can support decisionmaking...

OBJECTIVE: Restoration of the anatomy and the original length of the muscle-tendon unit in triceps tendon ruptures. INDICATIONS: Acute and chronic triceps tendon ruptures with persisting symptoms and significant strength deficits. CONTRAINDICATIONS: Infections and tumors in the surgical area. SURGICAL TECHNIQUE: Prone position. Skin incision over the distal triceps in a lateral direction around the olecranon. Mobilization of the tendon and débridement of the olecranon...