Komplikationen nach osteosynthetischer Versorgung von Azetabulumfrakturen

Schwabe, Philipp; Wichlas, Florian; Druschel, Claudia; Jacobs, C; Haas, Norbert; Schaser, Klaus‐Dieter; Märdian, Sven

doi:10.1007/s00132-013-2121-1

Cited by 8 publications

(2 citation statements)

References 44 publications

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“…To our knowledge there have been no studies on early PWB and its complications during rehabilitation from (peri)-or intra-articular fractures of the pelvis and lower extremities treated with internal fixation. Recent literature has reported composite postoperative complication rates of up to 37% (range 0.7-37%) (21)(22)(23)(24)(25)(26)(27)(28)(29)(30). A comparison of our complication data with published data based on applying the current guidelines shows comparable rates of complication for all our groups treated with the PWB protocol (21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Discussionsupporting

confidence: 54%

A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities

Meys¹,

Kalmet²,

Sanduleanu³

et al. 2019

J Rehabil Med

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Aftercare in surgically treated trauma patients with fractures of the pelvis and lower extremities has remained largely unchanged during the past 60 years. To optimize rapid clinical recovery and the restoration of function and functionality, permissive weight-bearing has been designed as a new aftercare mobilization regime, within the upper boundary of the therapeutic bandwidth, yet safe enough to avoid overloading. The aim of the present paper is to describe a comprehensive protocol for permissive weight-bearing during allied health therapy and to report on both the time to full weight-bearing and the number of complications in patients with surgically treated fractures of the pelvis and lower extremities who undergo permissive weight-bearing. Objective: To optimize rapid clinical recovery and restoration of function and functionality, permissive weight-bearing has been designed as a new aftercare mobilization regimen, within the upper boundary of the therapeutic bandwidth, yet safe enough to avoid overloading. The aim of the present paper is to describe a comprehensive protocol for permissive weight-bearing during allied health therapy and to report on the time to full weight-bearing, as well as the number of complications, in patients with surgically treated fractures of the pelvis and lower extremities undergoing permissive weight-bearing. Patients and methods: This study included surgically treated trauma patients with (peri)-or intra-articular fractures of the pelvis and lower extremities. A standardized permissive weight-bearing protocol was used for all patients. Time to full weight-bearing and number of complications were recorded. Results: This study included 150 patients, 69% male, with a median age of 48 years (interquartile range (IQR) 33.0, 57.0). The median time to full weight bearing was 12.0 weeks (IQR 6.8, 19.2). The complication rate during rehabilitation was 10%. Conclusion: The permissive weight-bearing protocol, as described, might be beneficial and has potential to be implemented in trauma patients with surgically treated (peri)-or intra-articular fractures of the pelvis and lower extremities.

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Section: Discussionsupporting

confidence: 54%

A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities

Meys¹,

Kalmet²,

Sanduleanu³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

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“…It is located near important structures such as the femoral artery, femoral vein, femoral nerve, spermatic cord/round ligament of the uterus, pudendal neurovascular bundle, and bladder. Improper operation can cause damage to these vital tissues [ 15 ]. Although the classification of acetabular fractures does not fully include QLP fractures, from the aspect of the 3-column classification, some of them belong to the anterior column, some belong to the posterior column, and some belong to the roof column.…”

Section: Discussionmentioning

confidence: 99%

Quadrilateral plate classification program of acetabular fractures based on three-column classification: a three-dimensional fracture mapping study

Wang,

Jiang,

Wang

et al. 2024

J Orthop Surg Res

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Background A new classification system for acetabular fractures has been proposed in recent years, which is called the 3-column classification. However, this system does not provide information regarding quadrilateral plate fractures. To address this issue, we utilized three-dimensional (3D) fracture line mapping and heat map to analyze the link between the 3-column classification and quadrilateral plate fractures. Methods We collected CT scan data from 177 patients who had been diagnosed with acetabular fractures. Additionally, we utilized a CT scan of a healthy adult to generate a standard acetabular model. We utilized the collected CT data of the fracture to create a 3D model and subsequently reduced it. We then matched each acetabular fracture model with the standard acetabular model and mapped all of the fracture lines to the standard model. 3D fracture lines and heat maps were created by overlapping all fracture lines. Fracture characteristics were then summarized using these maps. Results This study analyzed a total of 221 acetabular fractures. The most frequently observed fracture type, based on the three-column classification, was A1.2, which corresponds to fractures of the anterior column. In contrast, the least common type of fracture was A4, which represents fractures of the central wall. It was noted that quadrilateral plate fractures were frequently observed in fractures classified as type B and C according to the three-column classification. Conclusions Among the three-column classification, the QLP fractures are commonly observed in type B and C. It is important to carefully identify these fractures during the diagnostic process. Therefore, based on the three-column classification, we have amalgamated quadrilateral plate fractures and formulated a classification program for acetabular fractures.

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Effectiveness of permissive weight bearing in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities: a prospective comparative multicenter cohort study

Kalmet,

Maduro,

Verstappen

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose The aim of the present study was to investigate the effectiveness of a novel approach involving permissive weight bearing (PWB) in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities. Methods Prospective comparative multicenter cohort study in one level 1 trauma center and five level 2 trauma centers. Surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities were included. Permissive weight bearing (PWB) in comparison to restricted weight bearing (RWB) was assessed over a 26-week post-surgery follow-up period. Patients’ self-perceived outcome levels regarding activities of daily living (ADL), quality of life (QoL), pain and weight bearing compliance were used. Results This study included 106 trauma patients (N = 53 in both the PWB and RWB groups). Significantly better ADL and QoL were found in the PWB group compared to the RWB group at 2-, 6-, 12- and 26-weeks post-surgery. There were no significant differences in postoperative complication rates between the PWB and RWB groups. Conclusion PWB is effective and is associated with a significantly reduced time to full weight bearing, and a significantly better outcome regarding ADL and QoL compared to patients who followed RWB regimen. Moreover, no significant differences in complication rates were found between the PWB and RWB groups. Level of evidence Level II. Registration This study is registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.

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Komplikationen nach osteosynthetischer Versorgung von Azetabulumfrakturen

Cited by 8 publications

References 44 publications

A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities

A protocol for permissive weight-bearing during allied health therapy in surgically treated fractures of the pelvis and lower extremities

Quadrilateral plate classification program of acetabular fractures based on three-column classification: a three-dimensional fracture mapping study

Effectiveness of permissive weight bearing in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities: a prospective comparative multicenter cohort study

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