[Classification and treatment of patella fractures]. / Einteilung und Therapie der Patellafraktur.

Patella fractures are rare and account for approximately 1% of all fractures. They are classified regarding their localization (proximal, distal) and appearance. The aim of any treatment is reconstruction of the extensor mechanism and joint surface. If dislocation and cartilage steps are less than 2 mm, conservative treatment may be indicated. Operative treatment is only necessary if a dislocation is more than 2 mm or when the extensor mechanism is unstable. Depending on the shape of the fracture, tension band wiring, interfragmentary screw fixation and combinations are the main techniques. Because patellectomy has functionally the worst result it should be avoided. Sleeve fractures (children) need exact reconstruction of the joint surface. In elderly patients conservative treatment or surgical patella-enclosing wiring techniques for stabilization are the best options due to low bone quality.

Acute injuries in Taekwondo.

Although Taekwondo is becoming an increasingly popular sport, there is a lack of reliable epidemiologic data on Taekwondo injuries. To perform an epidemiologic study on the variety of types of injury in professional and amateur Taekwondo athletes and to find a relation between Taekwondo style, skill level, weight-class and warm-up routine and the occurrence of injuries, we analysed the injury data using a 7-page questionnaire from a total of 356 Taekwondo athletes who were randomly selected. Overall, we registered a total of 2,164 injuries in 356 athletes. Most traumas were contusions and sprains in the lower extremities. Professional Taekwondo athletes have an increased risk of injury in comparison to recreational athletes. Taekwondo style, weight class and tournament frequency have an influence on the athlete's injury profile. Warm-up routines were found to have a positive effect on injury rates. Overall, Taekwondo may be considered a rather benign activity, if injuries during Taekwondo tournaments can be avoided. If not, Taekwondo can result in serious musculoskeletal problems.

Upright MRI of the shoulder demonstrates labrum dynamics.

Conservative treatment of anterior shoulder luxation includes immobilization in internal rotation. This has been increasingly debated, but imaging techniques in supine position do not reflect the influence of gravity. To examine glenoid labrum dynamics, the shoulders of 15 healthy subjects were imaged in standing position at different (0, 15, 30) degrees of external rotation using the Upright MRI. The functional length of the anterior labrum was measured. Due to an increasing tension of the anterior capsule, functional labrum length increased the more, the more the humerus was externally rotated. The results underline the usefulness of the Upright MRI and support the concept of immobilization in the position of external rotation.

[Dynamic ultrasound examination of the shoulder of golf players]. / Dynamisch-sonographische Untersuchung der Schulter beim Golfspieler.

Although golf is becoming popular it can result in injury, usually from overuse and from poor technique. The shoulder is a commonly affected site, with the lead shoulder (or the left shoulder in the right-handed golfer) vulnerable to injury. With this study we tried to figure out any hyperlaxity of the lead shoulder using ultrasonography. 33 golf-players were investigated by questionnaire, clinical examination and dynamic ultrasonography. Neither clinically nor by using ultrasonography hyperlaxity of the shoulder was found. Nevertheless hyperlaxity followed by secondary impingement should be considered.

[Effect of rotation of the femoral and tibial components on patellofemoral malalignment in knee arthroplasty]. / Der Einfluss der Femur- und Tibiakomponentenrotation auf das patellofemorale Versagen beim künstlichen Kniegelenkersatz.

Patellofemoral complications are among the most common causes for revision surgery in total knee arthroplasty. So far no quantitative assessment has been made of the femoral and tibial malalignment or the positioning of the patellar component and the type of patellofemoral complication or failure. In particular, no comparative studies are available that include patients with and without patellofemoral failure in respect to the above-mentioned parameters when implant material, implant design, and fixation technique were identical. Between 1985 and 1992, 171 MG I total knee arthroplasties were performed. Since 1999, 20% of all the implanted MG I knee arthroplasties (all with metal-backed patellar component) had to be revised. Of those 34 patients, 18 were pair matched with 18 control patients based on the criteria of sex, body mass index, and age. The only difference in the control group was that they did not suffer any malfunction of the patellofemoral mechanism. To assess the patella component localization, conventional AP radiographs, patellar merchant view radiographs in 30 degrees, and CT scans were performed. This study has demonstrated a significant difference for the thickness of the patellar component and a trend regarding the rotational malalignment of the tibial component. Potential causes for the malrotation and guidelines to prevent rotational malalignment are discussed.