Acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. Several static and dynamic operative procedures with or without primary ligament replacement have been described. Between February 2003 and March 2009 we treated 313 patients suffering from Rockwood III-V lesions of the AC joint with an AC-hook plate. 225 (72%) of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (VAS-scale) was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%). Constant score showed an average of 92.4 of 100 possible points with 89% excellent and good results and 11% satisfying results. All patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6%. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. We observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. We can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-V dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function.
Robotic-assisted total hip arthroplasty with the Orthodoc/ Robodoc system achieves equal results as compared to a manual technique. However, there was a high number of technical complications directly or indirectly related to the robot.
Equestrians wear helmets increasingly more when riding but the willingness to wear body protectors is disappointing. Protective headgear has been proven to reduce the risk of injuries but based on these data a positive effect of body protectors could not be shown. In this study safety vest users suffered from injuries of the upper body more often than those who did not wear a body protector. Children and adolescents often overestimate their skills; therefore, teaching and supervision of inexperienced young riders along with the use of protective equipment can prevent major injuries.
Twenty-five patients with closed distal tibial fractures were treated with a fixed-angle (locked) plate osteosynthesis. The study period was from 1.1.06 to 31.12.07. According to AO classification, there were three A1, eight A2, nine A3, one B2, two C1, and two C3 fractures. All patients had a follow up examination after an average of 16.6 months. Complications included a technical mistake (fixation in slight malangulation), two infections, and one non union that showed consolidation after 15 months. All other patients reached bone consolidation and full weight bearing after an average of 3.5 months. The ankle range of motion for all patients was, on average, flexion/extension 18°/35°, without restrictions on the walking distance. No loss of reduction occurred. Fixed-angle plate osteosynthesis is a good alternative to intramedullary nailing when treating closed distal lower leg fractures. It is a demanding surgical method with good clinical and functional results.
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