[Balloon kyphoplasty for recent vertebral fractures in the elderly]. / Ballonkyphoplastie frischer Wirbelkörperfrakturen bei alten Patienten.

BACKGROUND: An increasing life expectancy is often accompanied by a possible increase of vertebral fractures. If operative therapy is necessary, open procedures might be problematic for elderly patients. In this case, balloon kyphoplasty might be an alternative. METHODS: We present our prospective data of 30 patients with an average age of 72 years (range 65-82). The patients suffered from isolated thoracic and lumbar fractures (T6-L4) without neurological deficits and were operated on with balloon kyphoplasty. They were followed up an average of 13 months after surgery. RESULTS: Before surgery, the patients' average kyphotic angle was 12 degrees . After reduction with balloon kyphoplasty, this angle was significantly improved to 7 degrees , and at follow-up it was 8 degrees . Back pain, which was determined by a visual analogous scale, showed a significant reduction from 8.2 to 2.6 points at follow-up. No significant relationship between preoperative pain and improvement of the kyphotic angle could be found. Patients with a bad fracture reposition showed significantly more pain at follow-up. However, there was no difference between the reference group and the examined patients' quality of life regarding general health. CONCLUSION: Recent fractures of the thoracic or lumbar spine in elderly patients treated by balloon kyphoplasty showed good early results.

[Pseudoarthrosis of anterior pelvic ring fracture]. / Pseudarthrose nach vorderer Beckenringfraktur.

It is rare for there to be healing problems after anterior pelvic fractures. An internet search produced only a small number of hits. This paper recounts the course in two patients who experienced symptomatic nonunion of anterior pelvic fractures after stable osteosynthesis with locking plates. Stable internal fixation with locking plates eventually led to successful healing after both nonunion of the ischial ramus and nonunion of the transitional zone between the inferior pubic ramus and the ischial ramus, and also of nonunion of the superior pubic ramus, in both patients. The study demonstrates that it is possible to stabilise nonunion of the superior pubic ramus by internal fixation of the ischial ramus and of the transitional zone between the inferior pubic ramus and the ischial ramus with locking plates.