Introducere: Deşi leziunile la nivelul umărului sunt frecvente, cele ale claviculei mediane sunt prea puţin explorate. O clasificare aplicată este mai puţin utilizată ca management standard. Metode: O analiză retrospectivă a leziunilor claviculare medii (MCI) pe parcursul unui stagiu de tratament de 5 ani într-un Centru de Traumatologie de nivel 1. Am analizat, printre altele, leziunile concomitente, strategiile de terapie şi clasificarea conform standardelor AO. Rezultate: 19 (2,5%) din 759 de leziuni claviculare au fost mediale (11 fracturi de tip A, 6 B şi 2 C), dintre care 27,8% au fost deplasate şi drept urmare tratate chirurgical. Osteosinteza cu placă fixă a fost utilizată în fracturi instabile şi reconstrucţia ligamentelor în articulaţia sternoclaviculară (SCJ) în cazul întreruperii acestora. 84,2% dintre pacienţi au prezentat leziuni concomitente relevante. Numeroase fracturi de mediane au fost codificate greşit ca fracturi mediale, ceea ce a limitat populaţia de studiu Concluzii: MCI a rezultat din mecanisme de vătămare cu impact puternic, adesea cu dislocare semnificativă şi leziuni concomitente. În ceea ce priveşte complexitatea leziunilor mediale, tratamentul ar trebui efectuat în spitale specializate. Fracturile instabile şi leziunile ligamentelor SCJ trebuie luate în considerare pentru tratamentul chirurgical. Fracturile mediane ar trebui să se

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RezumatDate generale: Leziunile de volet costal (FCI) sunt unele dintre cele mai grave leziuni toracice. Mai mult decât atât, o fractură de stern suplimentară (SF) chiar agravează rezultatele, cum ar fi durata ventilaţiei mecanice, prin urmare o fixare chirurgicală a fracturilor poate fi luată în considerare în anumite cazuri pentru a grăbi deconectarea ventilatorului. Această lucrare urmăreşte să sublinieze managementul diferitelor tipuri de SF în FCI. Metode: Toate cazurile tratate chirurgical (2012)(2013)(2014)(2015)(2016) Original ArticleCuvinte cheie: volet costal, fractură de stern, fractură sternală, fractură costală, osteosinteză cu placă blocată, Matrix Rib Abstract Background: Flail Chest Injuries (FCI) are one of the most severe thoracic injuries. Moreover, an additional sternal fracture (SF) even worsens the outcome, such as the duration of mechanical ventilation, therefore an surgical fixation of the fractures could be considered in certain cases to improve the weaning from the ventilator. This paper aims to emphasize on the management of different types of SF in FCI. Methods: All surgically treated cases (2012)(2013)(2014)(2015)(2016) that showed the combination of FCI and SF have been evaluated for their clinical details, the morphology of the fractures and the technical aspects of the surgical procedure in a retrospective investigation.Results: All of the SF (n=15) had been fixed by locked plate osteosynthesis through a median approach in a supine position. Three main regions of the sternum showed the need for different fixation strategies: the upper manubrium, central and lower corpus sterni. Concomitant rib fractures were addressed either through the same approach or through additional limited incisions. Conclusions: Combinations of SF and FCI are high risc injuries with high demand on surgical skills. They can be properly fixed with a locking plate osteosynthesis through a combination of limited incisions employing different types of plates depending on the type of SF.

In mid-term observation, the Metha® short-stem prosthesis shows no disadvantage in functional outcome and in survival time compared to a standard hip stem. Providing a correct indication, the Metha® short stem is a valuable option in total hip arthroplasty for younger patients with avascular osteonecrosis of the femoral head. Evaluation has shown no significant differences between aseptic osteonecrosis and other indications.

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RezumatDate generale: Ligamentul costoclavicular (CLL) asigură cea mai strânsă stabilitate în cadrul articulaţiei sternoclaviculare (SCJ) urmată de mult citatele ligamentele sternoclaviculare (SCL). Distrugerea lor poate provoca instabilitate severă a SCJ. Opţiunile diferite de tratament, cum ar fi utilizarea plăcilor, a firelor sau a tendoanelor autologe, sunt asociate, în principal, cu rezultate funcţionale limitate. Ar putea o stabilizare a CCL asociată cu o fixare anatomică a SCL să asigure o reconstrucţie suficientă a SCJ? Metode: Un bărbat în vârstă de 58 de ani a prezentat o instabilitate anterioară severă şi dureroasă a SCJ după o cădere pe umăr cu 8 săptămâni în urmă. SCJ a fost reconstruit printr-o procedură deschisă, stabilizând CCL folosind 2 coarde strânse şi o sutură anatomică a SCL. Controlul a fost efectuat la 78 de săptămâni după operaţie. Rezultate: Reducerea SCJ a avut succes. Investigaţiile radiologice au demonstrat poziţia anatomică a SCJ. Durerea a scăzut în cursul primelor 6 săptămâni. Pacientul a prezentat o evoluţie fără complicaţii şi s-a întors la lucru în calitate de fermier la 6 luni după procedură. Concluzii: Stabilizarea inovatoare a CCL cu coarde strânse asociată suturii SCL poate permite reconstrucţia anatomică a SCJ, ţinând cont de rezultatele cosmetice şi funcţionale.

It has been known for several years that orthopaedic and trauma clinics suffer from a shortage of young people, due to the substantial loss in attractiveness. The Youth Forum OU has been addressing this problem for many years, by initiating many projects such as the Summer School to counteract this trend. The purpose of this research is to evaluate the success of Summer Schools since 2009. The Youth Forum OU performed a survey in December 2014 to answer the research question on the basis of an internet-based poll of the student participants in all Summer Schools between 2009 and 2014. Following data cleansing, 121 students and former students were included in the survey. Seventy-two completed questionnaires were collected and included in the evaluation. The survey included 40 % of Summer School participants, with a mean age of 27.3 years (SD ± 2.95); 50 % were female. Participation in the Summer School helped 50 % of the respondents to decide to start advanced study in orthopaedics and/or traumatology (OU). One third of these Summer School participants had already finished a university degree; 100 % are now residents in orthopaedics and/or traumatology. Regardless of prior plans, 87.2 % of participants are now residents in OU. Thirty-three are still students: 78.8 % have already decided to work in OU. The survey also served to identify the factors positively and negatively associated with OU. Unfavourable factors included the reputation of OU, and the difficulty of reconciling family and work. Favourable factors included surgical work and personal experience during university studies. The aim of this study was to evaluate whether the efforts of the Youth Forum OU, the German Society for Orthopaedics and Traumatology (DGOU) and the local hospitals lead to increased interest in OU. The answer to this question is positive. This is particularly true for those students who did not plan to become an orthopaedic or trauma surgeon before participating in a Summer School. In conclusion, the efforts to recruit residents for OU by using Summer Schools were successful. Moreover, this research offers approaches to counteract the loss of attractiveness of OU.

BACKGROUND: Controversy exists on whether gender-specific anatomic differences in the human knee have to be taken into account by gender-specific design in total knee replacement (TKR). We evaluated total knees that were implanted in both genders. OBJECTIVE: This paper will describe the influence of gender on the outcome after a unisex total knee arthroplasty. METHODS: 52 total knee prostheses (mobile bearing Brehm Precision Knee R , BPK) were implanted in 48 patients (16 male, 32 female, 4 bilateral). Median follow-up was 15 months. HSS score, KSS score, ROM, VAS, and radiologic axis were used as outcome measures. We also obtained preoperative scores of these parameters, creating difference parameters respectively. All surgeries were performed by a single surgeon. RESULTS: No significant difference could be determined between genders for postoperative parameters and difference between preoperative and postoperative parameters between both groups. Women scored higher on HSS score preoperatively and postoperatively with 50.0 and 91.0 points versus 47.0 and 88.0 points in the male group. On KSS score, the female group scored higher preoperatively and postoperatively as well, with 79.0 and 174.0 points versus the male group with 74.0 and 168.0. CONCLUSION: As the results obtained with this unisex prosthesis system were not statistically significant when compared for gender, we conclude the BPK currently addresses gender-specific anatomic differences sufficiently.