Objectives To evaluate the performance of 3D T1w spoiled gradient-echo (T1SGRE) and ultra-short echo time (UTE) MRI sequences for the detection and assessment of vertebral fractures and degenerative bone changes compared with conventional CT. Methods Fractures (n = 44) and degenerative changes (n = 60 spinal segments) were evaluated in 30 patients (65 ± 14 years, 18 women) on CT and 3-T MRI, including CT-like images derived from T1SGRE and UTE. Two radiologists evaluated morphological features on both modalities: Genant and AO/Magerl classifications, anterior/posterior vertebral height, fracture age; disc height, neuroforaminal diameter, grades of spondylolisthesis, osteophytes, sclerosis, and facet joint degeneration. Diagnostic accuracy and agreement between MRI and CT and between radiologists were assessed using crosstabs, weighted κ, and intraclass correlation coefficients. Image quality was graded on a Likert scale. Results For fracture detection, sensitivity, specificity, and accuracy were 0.95, 0.98, and 0.97 for T1SGRE and 0.91, 0.96, and 0.95 for UTE. Agreement between T1SGRE and CT was substantial to excellent (e.g., Genant: κ, 0.92 [95% confidence interval, 0.83–1.00]; AO/Magerl: κ, 0.90 [0.76–1.00]; osteophytes: κ, 0.91 [0.82–1.00]; sclerosis: κ, 0.68 [0.48–0.88]; spondylolisthesis: ICCs, 0.99 [0.99–1.00]). Agreement between UTE and CT was lower, ranging from moderate (e.g., sclerosis: κ, 0.43 [0.26–0.60]) to excellent (spondylolisthesis: ICC, 0.99 [0.99–1.00]). Inter-reader agreement was substantial to excellent (0.52–1.00), respectively, for all parameters. Median image quality of T1SGRE was rated significantly higher than that of UTE (p < 0.001). Conclusions Morphologic assessment of bone pathologies of the spine using MRI was feasible and comparable to CT, with T1SGRE being more robust than UTE. Key Points • Vertebral fractures and degenerative bone changes can be assessed on CT-like MR images, with 3D T1w spoiled gradient-echo–based images showing a high diagnostic accuracy and agreement with CT. • This could enable MRI to precisely assess bone morphology, and 3D T1SGRE MRI sequences may substitute additional spinal CT examinations in the future. • Image quality and robustness of T1SGRE sequences are higher than those of UTE MRI for the assessment of bone structures.

If calcaneofibular ligament insufficiency is established, its reconstruction or repair should receive priority over that of other ankle or subtalar periarticular soft-tissue structures.

Purpose Proximal hamstring tendon avulsions lead to a significant loss of strength and a functional deficit of the respective lower limb and surgery is the recommended treatment. Only little is known about the clinical outcomes and complications when comparing acute and chronic management as well as partial and complete tears. Therefore, the purpose of this study was to investigate the clinical results and the complication rate of patients after surgical treatment of proximal hamstring tendon injuries. It was hypothesized that surgical treatment of an acute proximal hamstring avulsion would lead to a superior clinical outcome with a low complication rate and high return to sports rate compared to chronic cases and partial avulsions. Methods Patients who underwent proximal hamstring tendon repair between 2008 and 2015 were retrospectively evaluated with a minimum follow up of 2 years. Outcome measurements were obtained by means of Lysholm score, Harris Hip Score, Visual Analog Scale, and Tegner Activity Scale. Return to sports (RTS) rate was determined. Postoperative adverse events were recorded and complications reported. Patients’ outcomes were compared between acute/chronic repair and partial/complete injury patterns. Results Ninety‐four of 120 (78.3%) were available for final assessment at a mean follow‐up of 56.2 ± 27.2 months. Clinical outcome measures were excellent and did not differ between the treatment groups or between the different injury patterns. RTS was achieved by 86.2% of the patients and was significantly superior after acute treatment (p < 0.05). The overall complication rate was 8.5% and significantly higher in complete tears compared to partial tears and in delay compared to acute surgery (p < 0.05). Conclusion Surgical treatment of proximal hamstring tendon avulsions results in excellent clinical outcome scores and a high RTS rate. Open surgical treatment has shown to be a safe procedure with a low complication rate. Surgical timing is important, as early surgical intervention provides a higher RTS rate and a lower complication rate than delayed surgery and should therefore be preferred in clinical practice. Repair of partial and complete tears lead to similar clinical outcome, but a higher complication rate in complete avulsions. Level of evidence Level IV.

Zusammenfassung Hintergrund Seit ihrer Zulassung in Deutschland im Juli 2019 erfreuen sich E‑Scooter zunehmender Popularität. Diese steigende Beliebtheit und die einfache Zugänglichkeit der E‑Scooter für jedermann haben jedoch auch zu teils schweren Unfällen geführt. Ziel der Arbeit Das Ziel dieser Studie war es, die Art und Schwere der Verletzungen, die in direktem Zusammenhang mit der Nutzung von E‑Scootern in einer deutschen Millionenstadt stehen, zu analysieren und hieraus Schlüsse für zukünftige Sicherheitskonzepte und Verhaltensregeln zu ziehen. Methodik Alle Patienten, die sich aufgrund eines Unfalls mit einem E‑Scooter in der interdisziplinären Notaufnahme des Klinikums rechts der Isar, Universitätsklinikum der Technischen Universität München, zwischen dem 01.07.2019 und dem 01.04.2020 vorstellten, wurden erfasst und sowohl demografische Daten als auch Informationen zu Traumamechanismus und den entstandenen Verletzungen dokumentiert. Ergebnisse Im oben genannten Zeitraum wurden prospektiv 60 Patienten erfasst, wovon 34 (56,7 %) Männer waren. Durchschnittlich waren die Patienten 34,7 Jahre (18 bis 73 Jahre) alt. Unter Alkoholeinfluss fuhren 22 Patienten (36,7 %); ein Helm wurde lediglich von einer Person getragen. Verletzungen des Kopfes waren mit Abstand am häufigsten, gefolgt von Verletzungen der oberen und der unteren Extremität (Radiusköpfchenfraktur n = 5, Riss-Quetsch-Wunden an Fuß/Sprunggelenk n = 8). 2 Patienten (3,3 %) waren schwer verletzt (ISS ≥16) Diskussion Mit zunehmender Beliebtheit der E‑Scooter steigt auch die Anzahl an Verletzungen. Am häufigsten ist die Kopfregion betroffen, weshalb zukünftig eine Helmpflicht sinnvoll erscheint. Zudem sollten eine breitere Informationskampagne und strengere polizeiliche Kontrollen im Hinblick auf die Vielzahl an alkoholisierten Unfallopfern erfolgen.