No abstract

Internal fixation with nailing in pertrochanteric femur fractures is a standard operative approach. It is suitable as a "beginner's" procedure, that is quickly and easily performed. Only complex, multifragmented or markedly displaced or long-segment fractures need to be treated by staff physicians. Mortality is not affected by the surgeon's experience, but rather by comorbidity and from the preoperative duration.

Percutaneous suture of the Achilles tendon with the Dresden instruments is a standardised and cost-effective surgical procedure. It is suitable as a "beginner's" procedure that can be performed quickly, safely, and cost-effectively.

For over 10 years, kyphoplasty has been established for the treatment of painful osteoporotic vertebral compression fractures. Its effectiveness has been substantiated in multiple clinical studies. Not only is prompt pain reduction achieved, but according to a new, large, long-term study, long-term survival is also increased. Balloon kyphoplasty was performed for 564 patients from 1 January 2008 until 31 July 2011. In all cases, pain was rated more than 6/10 points, and recent fracture was evident on cross-sectional imaging (CT or MRT) performed to supplement spine x-rays. Average patient age was 75.3 years; 71.3% of patients were female. Treated fracture levels ranged from Th3 to L5. A single level was treated in 372 cases, with two levels treated simultaneously in 128 cases, three levels in 48 cases, and four levels in 22 cases. Average operative time for all patients was 36 min. Eight different surgeons performed the procedures. Average convalescence time was 8 days which decreased progressively over the years. Pain was reduced from 8 preoperative to 2.4 points postoperative in the visual analogue scale. Six major complications (1.06%) occurred. Kyphoplasty is a good procedure to treat painful osteoporotic fractures from the lumbar to thoracic spine. Major complications occur seldom after kyphoplasty; however, they must be considered and clarified.

Endoprosthesis placement for displaced femoral neck fractures is a common, safe procedure. However, patients are old and have comorbidities. Despite recent decreases in hospital mortality, the risk of death remains more than twice as high within one year than that for uninjured patients of the same age.