Jan Rosenkranz - Academia.edu (original) (raw)

Papers by Jan Rosenkranz

European Journal of Trauma, 2003

Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation... more Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Setting: Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. Patients: 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects. Intervention: Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. Main Outcome Measurements: DASH, range of motion, radiologic outcome. Results: Average subjective overall performance score (DASH) 16.4 (0-36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0-23.6), 73% of the patients back to premorbid work and activities. Conclusions: Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.

Springer eBooks, Oct 6, 2006

In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen... more In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen gegenuber penetrierenden Abdominalverletzungen. Abdominalverletzungen liegen bei 20–40% der polytraumatisierten Patienten vor (Bardenheuer et al. 1997; Staib et al. 2004). Obwohl das Schadel-Hirn-Trauma die haufigste Ursache der Fruhletalitat beim polytraumatisierten Patienten darstellt, ist das Abdominaltrauma mit 19% zu einem beachtlichen Teil an der Gesamtletalitat von polytraumatisierten Patienten beteiligt. Im Gegensatz zum Schadel-Hirn-Trauma finden sich die meisten Todesfalle beim Abdominaltrauma in den ersten 6 h nach Klinikeintritt, was eine hohe zeitliche Prioritat bei Diagnostik und Therapie dieser abdominellen Verletzungen begrundet (Demetriades et al. 2004).

Operative Orthopadie Und Traumatologie, Sep 1, 2012

Minimally invasive stabilization of articular and extra-articular fractures of the distal femur w... more Minimally invasive stabilization of articular and extra-articular fractures of the distal femur with anatomically preshaped, locking compression plates. Distal extra-articular femoral fractures. Distal periprosthetic or periosteosynthetic femoral fractures. Multifragmentary articular fractures of the distal femur. Local soft tissue infection or osteitis. Patient in a supine position on a radiolucent table with both legs draped free. Fractured leg supported with a towel to release traction of the gastrocnemius muscles onto the distal fragment. Reduction and fixation of articular fractures with 3.5 mm lag screws. Indirect reduction of the metaphyseal fracture component and temporary fixation with different instruments (e.g. cerclage) or reduction to the plate with special tools (e.g. collinear reduction clamp). Submuscular epiperiosteal introduction of the plate. Plate fixation through the aiming device. Intraoperative image intensification control to check plate position and reduction with special emphasis on rotation and longitudinal axes. Continuous passive motion without range limitations from day 1. Mobilization on crutches with toe-to-tip weight bearing during the first 6 weeks. No full weight loading until osseous consolidation. Between January 2009 and November 2011, minimally invasive plate osteosynthesis using the minimally invasive cerclage passer or the collinear reduction clamp was performed in 21 patients with 23 distal femoral fractures. None of the patients suffered from postoperative malalignment or malrotation. Mean time to adequate fracture consolidation was 128 days (range 53-470 days).

Therapeutische Umschau, 2003

Neue minimalinvasive Verfahren bieten gegenüber der herkömmlichen Plattenosteosynthese am distale... more Neue minimalinvasive Verfahren bieten gegenüber der herkömmlichen Plattenosteosynthese am distalen Femur den Vorteil einer zuverlässigen Knochenheilung auch ohne Spongiosaplastiken und eines besseren Haltes auch im osteoporotischen Knochen. Zudem weisen sie niedrigere Infektraten bei vergleichbaren Fehlstellungsraten auf.

Tecnicas Quirurgicas En Ortopedia Y Traumatologia, Apr 1, 2007

Tecnica quirurgica Abordaje habitual de la osteosintesis-LISS lateral o parapatelar. Colocacion d... more Tecnica quirurgica Abordaje habitual de la osteosintesis-LISS lateral o parapatelar. Colocacion de un clavo de Schanz proximal al extremo de la placa a traves de una incision puntiforme, colocacion como habitualmente de la placa LISS y colocacion de un clavo de Schanz proximal a traves del orificio A de la placa paralelo al espacio articular. Montaje del distractor sobre los clavos de Schanz, correccion por distraccion de la longitud y del varo valgo con ayuda del metodo del cable y del anterecurvatum mediante un clavo de Schanz colocado ocasionalmente anterior en la zona supracondilea. Ocupacion de al menos dos orificios de angulo fijo tanto proximal como distalmente en la placa. Retirada del distractor AO. Montaje de la guia y colocacion del resto de tornillos a traves de la guia. Resultados Entre mayo de 1998 y septiembre del 2001se intervinieron hasta 42 fracturas de femur con placa LISS. El distractor AO se empieza a aplicar a partir de la intervencion 18. Teniendo en cuenta la curva general de aprendizaje del sistema LISS se puede valorar el ahorro de tiempo por la utilizacion del distractor AO en un 13%. Tres de las 42 facturas mostraron postoperatoriamente una desalineacion relevante en varo o en valgo; no se pudieron valorar alteraciones rotacionales. No se pudo demostrar una influencia de la utilizacion del distractor AO en la proporcion de desalineaciones dado el pequeno tamano de la muestra; de todas maneras se trata de una tasa comparable a la de cualquier serie publicada sobre facturas de femur distal.

Praxis der Viszeralchirurgie

In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen... more In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen gegenuber penetrierenden Abdominalverletzungen. Abdominalverletzungen liegen bei 20–40% der polytraumatisierten Patienten vor (Bardenheuer et al. 1997; Staib et al. 2004). Obwohl das Schadel-Hirn-Trauma die haufigste Ursache der Fruhletalitat beim polytraumatisierten Patienten darstellt, ist das Abdominaltrauma mit 19% zu einem beachtlichen Teil an der Gesamtletalitat von polytraumatisierten Patienten beteiligt. Im Gegensatz zum Schadel-Hirn-Trauma finden sich die meisten Todesfalle beim Abdominaltrauma in den ersten 6 h nach Klinikeintritt, was eine hohe zeitliche Prioritat bei Diagnostik und Therapie dieser abdominellen Verletzungen begrundet (Demetriades et al. 2004).

Study background: We investigated the clinical, radiographic and subjective outcomes of 39 patien... more Study background: We investigated the clinical, radiographic and subjective outcomes of 39 patients (42 knees) treated with trochleaplasty for recurrent dislocation of the patella at our institution. Methods: We retrospectively reviewed our operative experience of this technique both, clinically and radiographically. All patients had trochlea dysplasia of at least Dejour type B. The mean follow–up was 48.9 months (range 12–109). Validated questionnaires were used (SF–36, Tegner–Score, Lysholm–Score). Results: There was no postoperative recurrence of patellar dislocation. There were no wound problems, infections or thromboembolic complications. One patient required an evacuation of haematoma. The average of Tegner's activity Score was 5 points (55% reached 5 or more points). Mean Lysholm- Score was 81.3 points, 57, 1% (24/42) had >/= 84 points (good results), 40, 5% (17/42) >/= 90 points (excellent results). Conclusion: Trochleaplasty is a technically demanding surgical pro...

Archives of Orthopaedic and Trauma Surgery, 2006

Abb. 1 Distales Nagelende mit zwei 6-mm-Verriegelungsbolzen Abb. 2 Distales Nagelende mit einer K... more Abb. 1 Distales Nagelende mit zwei 6-mm-Verriegelungsbolzen Abb. 2 Distales Nagelende mit einer Kombination von 6-mm-Verriegelungsbolzen und Spiralklinge

Operative Orthopädie und Traumatologie, 2006

Facilitation of reduction and retention in LISS (Less Invasive Stabilizing System) plate osteosyn... more Facilitation of reduction and retention in LISS (Less Invasive Stabilizing System) plate osteosynthesis of fractures of the distal femur by application of the large AO distractor. Any distal femoral fracture suited to LISS plate osteosynthesis. Distraction can lead to a pullout of the Schanz screws in patients with pronounced osteoporosis. Supine. Normal LISS osteosynthesis with lateral or parapatellar approaches. Insertion of one Schanz screw proximal to the end of the plate through a stab incision. Introduction of the LISS plate in the usual fashion and insertion of a second Schanz screw into plate hole "A", parallel to the joint. Assembly of the distractor onto the Schanz screws, distraction of the femur to the correct length and correction of varus/valgus alignment with the aid of the cable method, as well as correction of ante- and retrocurvature by insertion of an additional Schanz screw at the anterior aspect. At least two locking head screws should be inserted into...

European Journal of Trauma, 2003

Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation... more Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Setting: Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. Patients: 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects. Intervention: Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. Main Outcome Measurements: DASH, range of motion, radiologic outcome. Results: Average subjective overall performance score (DASH) 16.4 (0-36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0-23.6), 73% of the patients back to premorbid work and activities. Conclusions: Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.

Springer eBooks, Oct 6, 2006

In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen... more In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen gegenuber penetrierenden Abdominalverletzungen. Abdominalverletzungen liegen bei 20–40% der polytraumatisierten Patienten vor (Bardenheuer et al. 1997; Staib et al. 2004). Obwohl das Schadel-Hirn-Trauma die haufigste Ursache der Fruhletalitat beim polytraumatisierten Patienten darstellt, ist das Abdominaltrauma mit 19% zu einem beachtlichen Teil an der Gesamtletalitat von polytraumatisierten Patienten beteiligt. Im Gegensatz zum Schadel-Hirn-Trauma finden sich die meisten Todesfalle beim Abdominaltrauma in den ersten 6 h nach Klinikeintritt, was eine hohe zeitliche Prioritat bei Diagnostik und Therapie dieser abdominellen Verletzungen begrundet (Demetriades et al. 2004).

Operative Orthopadie Und Traumatologie, Sep 1, 2012

Minimally invasive stabilization of articular and extra-articular fractures of the distal femur w... more Minimally invasive stabilization of articular and extra-articular fractures of the distal femur with anatomically preshaped, locking compression plates. Distal extra-articular femoral fractures. Distal periprosthetic or periosteosynthetic femoral fractures. Multifragmentary articular fractures of the distal femur. Local soft tissue infection or osteitis. Patient in a supine position on a radiolucent table with both legs draped free. Fractured leg supported with a towel to release traction of the gastrocnemius muscles onto the distal fragment. Reduction and fixation of articular fractures with 3.5 mm lag screws. Indirect reduction of the metaphyseal fracture component and temporary fixation with different instruments (e.g. cerclage) or reduction to the plate with special tools (e.g. collinear reduction clamp). Submuscular epiperiosteal introduction of the plate. Plate fixation through the aiming device. Intraoperative image intensification control to check plate position and reduction with special emphasis on rotation and longitudinal axes. Continuous passive motion without range limitations from day 1. Mobilization on crutches with toe-to-tip weight bearing during the first 6 weeks. No full weight loading until osseous consolidation. Between January 2009 and November 2011, minimally invasive plate osteosynthesis using the minimally invasive cerclage passer or the collinear reduction clamp was performed in 21 patients with 23 distal femoral fractures. None of the patients suffered from postoperative malalignment or malrotation. Mean time to adequate fracture consolidation was 128 days (range 53-470 days).

Therapeutische Umschau, 2003

Neue minimalinvasive Verfahren bieten gegenüber der herkömmlichen Plattenosteosynthese am distale... more Neue minimalinvasive Verfahren bieten gegenüber der herkömmlichen Plattenosteosynthese am distalen Femur den Vorteil einer zuverlässigen Knochenheilung auch ohne Spongiosaplastiken und eines besseren Haltes auch im osteoporotischen Knochen. Zudem weisen sie niedrigere Infektraten bei vergleichbaren Fehlstellungsraten auf.

Tecnicas Quirurgicas En Ortopedia Y Traumatologia, Apr 1, 2007

Tecnica quirurgica Abordaje habitual de la osteosintesis-LISS lateral o parapatelar. Colocacion d... more Tecnica quirurgica Abordaje habitual de la osteosintesis-LISS lateral o parapatelar. Colocacion de un clavo de Schanz proximal al extremo de la placa a traves de una incision puntiforme, colocacion como habitualmente de la placa LISS y colocacion de un clavo de Schanz proximal a traves del orificio A de la placa paralelo al espacio articular. Montaje del distractor sobre los clavos de Schanz, correccion por distraccion de la longitud y del varo valgo con ayuda del metodo del cable y del anterecurvatum mediante un clavo de Schanz colocado ocasionalmente anterior en la zona supracondilea. Ocupacion de al menos dos orificios de angulo fijo tanto proximal como distalmente en la placa. Retirada del distractor AO. Montaje de la guia y colocacion del resto de tornillos a traves de la guia. Resultados Entre mayo de 1998 y septiembre del 2001se intervinieron hasta 42 fracturas de femur con placa LISS. El distractor AO se empieza a aplicar a partir de la intervencion 18. Teniendo en cuenta la curva general de aprendizaje del sistema LISS se puede valorar el ahorro de tiempo por la utilizacion del distractor AO en un 13%. Tres de las 42 facturas mostraron postoperatoriamente una desalineacion relevante en varo o en valgo; no se pudieron valorar alteraciones rotacionales. No se pudo demostrar una influencia de la utilizacion del distractor AO en la proporcion de desalineaciones dado el pequeno tamano de la muestra; de todas maneras se trata de una tasa comparable a la de cualquier serie publicada sobre facturas de femur distal.

Praxis der Viszeralchirurgie

In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen... more In Mitteleuropa uberwiegt das stumpfe Abdominaltrauma als Folge von Verkehrs- und Arbeitsunfallen gegenuber penetrierenden Abdominalverletzungen. Abdominalverletzungen liegen bei 20–40% der polytraumatisierten Patienten vor (Bardenheuer et al. 1997; Staib et al. 2004). Obwohl das Schadel-Hirn-Trauma die haufigste Ursache der Fruhletalitat beim polytraumatisierten Patienten darstellt, ist das Abdominaltrauma mit 19% zu einem beachtlichen Teil an der Gesamtletalitat von polytraumatisierten Patienten beteiligt. Im Gegensatz zum Schadel-Hirn-Trauma finden sich die meisten Todesfalle beim Abdominaltrauma in den ersten 6 h nach Klinikeintritt, was eine hohe zeitliche Prioritat bei Diagnostik und Therapie dieser abdominellen Verletzungen begrundet (Demetriades et al. 2004).

Study background: We investigated the clinical, radiographic and subjective outcomes of 39 patien... more Study background: We investigated the clinical, radiographic and subjective outcomes of 39 patients (42 knees) treated with trochleaplasty for recurrent dislocation of the patella at our institution. Methods: We retrospectively reviewed our operative experience of this technique both, clinically and radiographically. All patients had trochlea dysplasia of at least Dejour type B. The mean follow–up was 48.9 months (range 12–109). Validated questionnaires were used (SF–36, Tegner–Score, Lysholm–Score). Results: There was no postoperative recurrence of patellar dislocation. There were no wound problems, infections or thromboembolic complications. One patient required an evacuation of haematoma. The average of Tegner's activity Score was 5 points (55% reached 5 or more points). Mean Lysholm- Score was 81.3 points, 57, 1% (24/42) had >/= 84 points (good results), 40, 5% (17/42) >/= 90 points (excellent results). Conclusion: Trochleaplasty is a technically demanding surgical pro...

Archives of Orthopaedic and Trauma Surgery, 2006

Abb. 1 Distales Nagelende mit zwei 6-mm-Verriegelungsbolzen Abb. 2 Distales Nagelende mit einer K... more Abb. 1 Distales Nagelende mit zwei 6-mm-Verriegelungsbolzen Abb. 2 Distales Nagelende mit einer Kombination von 6-mm-Verriegelungsbolzen und Spiralklinge

Operative Orthopädie und Traumatologie, 2006

Facilitation of reduction and retention in LISS (Less Invasive Stabilizing System) plate osteosyn... more Facilitation of reduction and retention in LISS (Less Invasive Stabilizing System) plate osteosynthesis of fractures of the distal femur by application of the large AO distractor. Any distal femoral fracture suited to LISS plate osteosynthesis. Distraction can lead to a pullout of the Schanz screws in patients with pronounced osteoporosis. Supine. Normal LISS osteosynthesis with lateral or parapatellar approaches. Insertion of one Schanz screw proximal to the end of the plate through a stab incision. Introduction of the LISS plate in the usual fashion and insertion of a second Schanz screw into plate hole "A", parallel to the joint. Assembly of the distractor onto the Schanz screws, distraction of the femur to the correct length and correction of varus/valgus alignment with the aid of the cable method, as well as correction of ante- and retrocurvature by insertion of an additional Schanz screw at the anterior aspect. At least two locking head screws should be inserted into...