Der Unfallchirurg
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Proximal tibial epiphyseal injury is a rare finding in adolescents. We report the case of a 13-year-old boy with simultaneous epiphyseal fractures of both proximal tibiae to illustrate appropriate diagnosis and treatment of this condition. The injury occurred while performing a long jump: a Salter-Harris type II fracture of the right proximal tibia was sustained at take-off and a Salter-Harris type III avulsion fracture of the left tibial tuberosity upon landing. Closed reduction and internal fixation using K-wires were performed on the right side, whereas open reduction and internal fixation were done on the left side, using a lag screw and additional McLaughlin wiring.
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Different studies confirmed the increased radiological implantation accuracy for computer-assisted total knee replacements. There was no study stating a significant influence of the navigation technique for total knee arthroplasties on the early clinical outcomes. In these two case reports we try to show special indications for a navigated total knee replacement to utilize the benefits of a navigation system as efficiently as possible. ⋯ The clinical outcomes at the 3-month follow-up were very satisfying. In case 1 the femoral nail did not have to be removed, thus decreasing surgery duration by 40-60 min. In both cases, the impossibility of using a femoral intramedullary alignment rod could be compensated for by the navigation system.
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If the standard technical guidelines are ignored so that the antirotation screw is not correctly placed during gamma nail osteosynthesis, dislocation of the hip screw is possible. In the rare cases of migration into the pelvis, the consequences may be lethal.
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This study investigated the progression and clinical relevance of biochemical resorption marker values during fracture healing in osteoporosis. ⋯ Bone resorption markers can diagnostically point to osteoporosis and are significant parameters in fracture healing.