Motion preservation for hyperextension injuries of the cervical spine-an alternative to spondylodesis? A biomechanical cadaver study.

Introduction: Currently, the gold standard for the treatment of AO type B3 cervical spine injuries is anterior cervical discectomy and fusion (ACDF), leading to an iatrogenic spondylodesis of the affected segment and ultimately bearing the risk of long-term morbidity. This study evaluates the biomechanical properties of a combination of a cervical total disc replacement (CTDR) with anterior fiber tape augmentation for the treatment of AO type B3 injuries in comparison to ACDF.

Methods: 14 human cadaveric cervical spine specimens (C5/6) were biomechanically tested under four different conditions: native, after simulation of an AO type B3 injury, after ACDF and CTDR + FiberTape.

Motion preservation for open book injuries of the pubic symphysis -a biomechanical cadaver study.

Introduction: Open book injuries are challenging injuries that oftentimes require surgical treatment. Currently, treatment is performed with symphyseal plating requiring extensive surgery and entirely limiting physiological movement of the symphyseal joint, frequently resulting in implant failure. Therefore, we investigated the biomechanical properties of a minimally invasive tape suture construct (modified SpeedBridge™) as an alternative stabilization technique for the treatment of open book injuries in human cadaver pelvic rings.

Uncemented hip revision cup as an alternative for T-type acetabular fractures: A cadaveric study.

Background: The current rise in elderly patients with compromised bone quality complicates the surgical treatment of acetabular T-type fractures (AO type 62B2 fractures). There is on ongoing discussion about the treatment options, mostly consisting of an open reduction and internal fixation (ORIF) with or without primary or secondary total hip arthroplasty (THA). Yet, these patients are oftentimes unable to fulfil weight-bearing restrictions and mostly present with an unavailability of a stable anchor site.

Micro-Structural and Biomechanical Evaluation of Bioresorbable and Conventional Bone Cements for Augmentation of the Proximal Femoral Nail.

Osteoporotic proximal femur fractures are on the rise due to demographic change. The most dominant surgical treatment option for per/subtrochanteric fractures is cephalomedullary nailing. As it has been shown to increase primary stability, cement augmentation has become increasingly popular in the treatment of osteoporotic per/subtrochanteric femur fractures.

Evaluation of a New Treatment Strategy for Geriatric Fragility Fractures of the Posterior Pelvic Ring Using Sensor-Supported Insoles: A Proof-of-Concept Study.

The incidence of fragility fractures of the pelvis (FFPs) is currently rising. Surgical treatment, which is performed using sacroiliac screws, is complicated by compromised bone quality, oftentimes resulting in implant failure. The iFuse implant system aims to improve attachment and durability with promising results for sacroiliac dysfunction, though data for its feasibility on FFPs are rare.

In vivo immunomodulation of IL6 signaling in a murine multiple trauma model.

A significant number of trauma patients die during the ICU phase of care because of a severe immune response. Interleukin-6 (IL6) plays a central role within that immune response, signaling through a membrane-bound (IL6-R) and a soluble IL6 receptor (sIL6-R). IL6 and the sIL6-R can form an agonistic IL6/sIL6-R-complex, activating numerous cells that are usually not IL6 responsive, a process called trans-signaling.

Tape suture constructs for instabilities of the pubic symphysis: is the idea of motion preservation a suitable treatment option? A cadaver study.

Introduction: Current gold standard for the treatment of symphyseal disruptions includes anterior plating, almost entirely prohibiting symphyseal mobility and resulting in an iatrogenic arthrodesis followed by high rates of implant failure. Minimally invasive tape suture constructs have been found to maintain the micro mobility of ligamentous injuries, yet still providing sufficient biomechanical stability. Recently, this technique has been primarily investigated for symphyseal disruptions on synthetic pelvic models.

Does augmentation increase the pull-out force of symphyseal screws? A biomechanical cadaver study.

Purpose: Open reduction and internal fixation using anterior plate osteosynthesis currently represents the gold standard for the treatment of symphyseal disruptions. Since postoperative screw loosening with consequent implant failure is frequently observed, this study aims to evaluate if and to what extent augmentation can increase the pull-out force of symphyseal screws to improve the constructs stability.

Methods: Twelve human cadaveric anterior pelvic rings were separated at the symphyseal joint for bilateral testing, consequently achieving comparable sites.

A Novel Device for Closed Reduction and Percutaneous Fixation of Thoracolumbar Fractures.

Background/aim: Open surgical reduction/fixation of thoracolumbar fractures results in significant soft-tissue trauma and related complications. Minimally-invasive technical developments could deliver similar radiological outcomes, while avoiding the related complications. We evaluated radiological and perioperative outcomes in thoracolumbar fractures by using a novel minimally-invasive device.

Novel minimally invasive tape suture osteosynthesis for instabilities of the pubic symphysis: a biomechanical study.

Introduction: Open book fractures are challenging injuries oftentimes requiring surgical treatment. The current treatment of choice is symphyseal plating, which requires extensive surgery and entirely limits physiological movement of the symphyseal joint, frequently resulting in implant failure. Therefore, we investigated the biomechanical properties of a semi-rigid implant (modified SpeedBridge) as a minimally invasive tape suture construct for the treatment of open book fractures and evaluated the superiority of two techniques of implementation: criss-cross vs.

Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis.

Background: Due to an aging society, more and more surgeons are confronted with fragility fractures of the pelvis (FFPs). The aim of treatment of such patients should be the quickest possible mobilization with full weight-bearing. Up to now however, there are no data on loading of the lower extremities in patients suffering FFPs.

Resomer C212© in vertebroplasty or kyphoplasty: A feasibility study on artificial bones with biomechanical and thermal evaluation.

Background: Vertebroplasty and kyphoplasty are now well-established methods for treating compression fractures of vertebral bodies (AO type A) as well as vertebral body metastases [1, 2, 3]. However, polymethylmethacrylate (PMMA) augmented vertebrae show fractures of subsequent vertebral bodies due to the increased stability of the augmented vertebral body [4]. Resorbable cements are currently only used experimentally.

The T-pod is as stable as supraacetabular fixation using 1 or 2 Schanz screws in partially unstable pelvic fractures: a biomechanical study.

Introduction: Unstable fractures of the pelvis remain the predominant cause of severe hemorrhage, shock and early death in severely injured patients. The use of pelvic binders has become increasingly popular, particularly in the preclinical setting. There is currently insufficient evidence available about the stability of the pelvic binder versus supraacetabular fixation using 1 or 2 Schanz screws.

Intraoperative use of cortical step sign and diameter difference sign: Accuracy, inter-rater agreement and influence of surgical experience in subtrochanteric transverse fractures.

Background: The cortical step sign (CSS) and diameter difference sign (DDS) are radiographic tools for torsional alignment control in intramedullary nailing. They have been found to be highly relevant in objective radiographic measurements, but for intraoperative visual identification they lack sufficient evidence yet. The aim of this experimental study was to evaluate their (1) accuracy, (2) inter-rater agreement, (3) predictors of correct identification for clinically relevant maltorsion (CRM: ≥15°), and (4) positive and negative predictive values.

Biomechanical stability of sacroiliac screw osteosynthesis with and without cement augmentation.

Background: Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws.

3D printing method for next-day acetabular fracture surgery using a surface filtering pipeline: feasibility and 1-year clinical results.

Introduction: In orthopedic surgery, 3D printing is a technology with promising medical applications. Publications show promising results in acetabular fracture surgery over the last years using 3D printing. However, only little information about the workflow and circumstances of how to properly derive the 3D printed fracture model out of a CT scan is published.

Tape suture for stabilization of incomplete posterior pelvic ring fractures-biomechanical analysis of a new minimally invasive treatment for incomplete lateral compression pelvic ring fractures.

Background: Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring.

Biomechanical comparison of minimally invasive treatment options for Type C unstable fractures of the pelvic ring.

Background: The definite treatment of pelvic C fractures presents a widely discussed issue and undergoes continuous evolution. While the stabilization of the posterior ring has been studied extensively, the fixation of the anterior pelvic ring continuous to be rarely investigated. The importance of the simultaneous stabilization however lays in the earlier mobilization and prevention of long-term damage to the pelvis.

Fluoroscopic Marker-Based Guidance System Improves Gamma Lag Screw Placement During Nailing of Intertrochanteric Fractures: A Randomized Controlled Trial.

Objectives: To determine whether a fluoroscopy-based navigation system would improve tip-apex distance (TAD) compared with the conventional technique.

Design: Randomized controlled trial.

Setting: Level 1 trauma center.

Modified less invasive anterior subcutaneous fixator for unstable Tile-C-pelvic ring fractures: a biomechanical study.

Background: Operative procedures for unstable pelvic ring fractures remain controversially discussed. Minimally invasive treatment options for pelvic ring fractures have several benefits for the patient. But they can also provide disadvantages.

Radiographic cortical thickness parameters as predictors of rotational alignment in proximal femur fractures: A cadaveric study.

Radiographic assessment tools such as the cortical step sign (CSS) or the diameter difference sign (DDS) aim to identify clinically relevant rotational malalignment after long bone fracture fixation. We aimed to analyze the effect of rotational malalignment on CSS and DDS parameters in a subtrochanteric fracture model and to construct a prognostic model to identify clinically relevant rotational malalignment. A subtrochanteric transverse osteotomy was set in human femora.