Proprioceptive elbow training reduces pain and improves function in painful lateral epicondylitis-a prospective trial.

BACKGROUND: In painful epicondylitis, previous studies reported deficiencies in elbow proprioception. In line, proprioceptive training of the lower limb has been reported substantial beneficial in a number of indications. Therefore, we have asked if a specified proprioceptive training using training devices that are capable of activating the deep musculature in the upper limb is able to reduce the symptoms of epicondylitis. MATERIALS AND METHODS: We included 71 patients with painful lateral epicondylitis > 3 months. INTERVENTIONS: Group A: Proprioceptive training intervention with a Flexibar® (9 min daily for 12 weeks). Group B: at least 40 min running or walking/week with the XCO® in addition to the proprioceptive training with the Flexibar® (9 min daily for 12 weeks), follow-up for 12 weeks. Primary end point: Pain on visual analogue scale (VAS, 0-10); secondary end points: DASH-Score (0 = very good, 100 = very poor), grip strength according to Jamar dynamometer (kg), vibration sensation measured with a 128 Hz tuning fork. RESULTS: The pain on VAS in group A was reduced significantly. 3.6 ± 2.0 to 2.4 ± 2.1 (-33%, p = 0.013), and from 3.7 ± 2.4 to 2.2 ± 1.9 (-41%, p = 0.004) in group B after 12 weeks. There was no significant difference between A and B (p = 0.899). In both groups, there was a significant improvement of the DASH-Score (A: 32 ± 15 to 14 ± 12, -56%, p < 0.001; B: 27 ± 12 to 12 ± 11, -55%, p = 0.001) without any difference between groups A and B (p = 0.339). Grip strength improvement in group A from 24 ± 12 to 33 ± 11 kg (+38%, p < 0.001), and from 29 ± 14 to 34 ± 11 kg (+15%, p < 0.001) in group B. In line, vibration sensation improved in both groups (A: 6.3 ± 0.6 to 6.5 ± 0.5, p = 0.0001; B: 6.3 ± 0.7 to 6.6 ± 0.5, p = 0.003). CONCLUSION: A 12-week proprioceptive training with the Flexibar® improves pain, quality of life, grip strength and vibration sensation in patients with painful lateral epicondylitis. LEVEL OF EVIDENCE: Ib, randomised clinical trial TRIAL REGISTRATION: German Clinical Trials Register, DRKS00024857 , registered on 25 March 2021-retrospectively registered, http://apps.who.int/trialsearch/.

[Biodegradable screw versus a press-fit bone plug fixation for ACL reconstruction: a prospective randomized study]. / Biodegradierbare Schraube vs. einer Press-fit-Verankerung für VKB-Rekonstruktionen : Eine prospektive randomisierte Studie.

BACKGROUND: Press-fit fixation of a tendon graft has been advocated in order to achieve tendon to bone healing. HYPOTHESIS: Fixation of a tendon graft with a porous bone scaffold limits bone tunnel enlargement compared with a biodegradable interference screw fixation. METHODS: Between 2005 and 2006, 20 patients (17 men, 3 women) were enrolled in this study for primary reconstruction of the ACL. Patients were randomized to either obtain graft fixation in the tibial tunnel by means of an interference screw (I) or a press-fit fixation with a porous bone cylinder (P). Three months after surgery, a CT scan of the knee was performed and tunnel enlargement was analysed in the coronal and sagittal planes for the proximal, middle and distal thirds of the tunnel. After 6 months, 1 and 2 years, International Knee Documentation Committee (IKDC), Tegner and Lysholm scores of both groups were compared. RESULTS: The bone tunnel enlargement was 106.9±10.9% for group P and 121.9±9.0% for group I (P<0.02) in the AP plane and 102.8±15.2% vs 121.5±10.1% in the coronal plane (P<0.01). IKDC, Tegner, and Lysholm scores improved in both groups from pre- to postoperative assessment without significant differences between the two groups. There was a trend to higher knee stability in group P after 3 months (0.6±1.4 mm vs 1.81±.5 mm, P=0.08). CONCLUSIONS: Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement. Press-fit fixation decreases the amount of proximal bone tunnel enlargement and improves bone to tendon contact.

[Preoperative perfusion analysis before total ankle arthroplasty]. / Präoperative Perfusionsuntersuchung vor Sprunggelenksersatzoperationen.

PURPOSE: Soft tissue management is of paramount importance in ankle surgery. As such, full thickness necrosis of the soft tissue envelope represents a severe complication following total ankle joint arthroplasty (TAA) potentially leading to implant exposure, infection and thus, substantially compromised patient outcomes. One of the main factors leading to soft tissue complications is an undetermined arterial perfusion of the lower leg or ankle joint. We report on clinical cases suffering soft tissue complications following TAA with the respective plastic surgical therapy regimen and present a simple algorithm for preoperative perfusion evaluation. METHODS: The medical records of 30 consecutive primary TAA patients were retrospectively reviewed after observing a higher than expected rate of severe soft tissue defects which have been referred to our plastic surgery department. RESULTS: 3 patients (10%, all females, age 63 ± 5 years; BMI 27 ± 3 kg/m2) presented with a soft tissue defect leading to angiography revealing one case of severe arterial obstruction. Wound closure could be reached in one case by conservative therapy consisting of regular dressing changes. In the further patients definite soft tissue reconstruction could only be performed by surgical intervention. One could be covered by split-thickness skin grafting and one by a microsurgical transplantation of a free latissimus dorsi flap. On the basis of these complications we established an easy algorithm for the preoperative evaluation of the arterial perfusion in the ankle region. First, (I) the pulses of the dorsal foot artery and posterior tibial artery should be examined. In the case of not palpable pulses (II) the ankle-brachial index should be performed. Values of <0.9 or >1.2 recommend (III) to perform angiography. In the case of stenosis or complete obstruction (IV) the arterial blood flow should be reconstituted by interventional radiological stenting or vascular surgical procedures. CONCLUSION: The identification of the arterial perfusion status of patients undergoing TAA using a straightforward clinical algorithm might overcome TAA-related soft tissue complications and improve patient-related outcome measures.

[Free latissimus dorsi flap transfer for reconstruction of soft tissue defects of the lower extremity]. / Freier Latissimus-dorsi-Transfer zur Rekonstruktion von Weichteildefekten der unteren Extremität.

OBJECTIVE: Sustainable and durable soft tissue coverage at the lower extremity following trauma, tumor resections, sequelae of radiation therapy or osteomyelitis using free latissimus dorsi muscle transfer is provided by a free latissimus dorsi muscle flap. INDICATIONS: Soft tissue defects at the lower extremity following trauma, tumor resections, and sequelae of radiation therapy or osteomyelitis. CONTRAINDICATIONS: Thoracotomy with incision of the latissimus dorsi muscle; a relative contraindication in wheelchair drivers as well as in overhead athletes due to potential diminished strength and shoulder proprioception following latissimus dorsi muscle transplantation. SURGICAL TECHNIQUE: Under general anesthesia the patient is positioned laterally, and a substantial and meticulous debridement of the defect is performed, as is the identification and preparation of the target vessel, which is preferentially the posterior tibial artery at the calf, or more proximally the popliteal or femoral artery from the medial side as well as concomitant veins/the great saphenous vein. A tailored latissimus dorsi musculocutaneous flap is harvested with subsequent microsurgical anastomosis to the target vessel with preferential end-to-side anastomosis of the artery and end-to-end anastomosis of one or two veins. POSTOPERATIVE MANAGEMENT: A 24-h intermediate care unit, clinical flap monitoring for at least 5-7 days, dangling of the flap using an elastic bandage for an initial 3  times 5 min starting on POD 7, compression stockings for at least 6 months subsequently. RESULTS: From 2001-2007 75 free latissimus dorsi flaps were performed (53 ± 17 years) for soft tissue coverage at the lower extremity. In 58% the target vessel was the posterior tibial artery, in 11% the femoral artery, in 8% the anterior tibial artery and in 8% the popliteal artery. In 15% an arteriovenous (AV) loop was applied. Overall free flap survival was 95%. We encountered four total flap losses, exclusively in complex reconstructions with AV-loop situations.

[Surgical decompression of the lower leg in painful diabetic polyneuropathy]. / Operative Nervendekompression an der unteren Extremität bei diabetischer Polyneuropathie.

OBJECTIVE: Surgical decompression of nerves of the lower leg should facilitate swelling-related pressure in diabetic polyneuropathic similar to carpal and cubital tunnel syndrome. Pain reduction, reduced need for pain medication, improved pedal sensitivity, improved balance and proprioception, and potential prevention of ulcerations and amputations are the objectives of the operation. INDICATIONS: Diabetic polyneuropathy with positive Hoffmann-Tinel sign over the tarsal tunnel and an ankle-brachial index >0.7. CONTRAINDICATIONS: No Hoffmann-Tinel sign over the tarsal tunnel, no pain, no sensibility disorders, ankle-brachial index <0.7, body weight >140 kg. Relative contraindication: venous stasis and postthromobitic syndrome. SURGICAL TECHNIQUE: Under general or spinal anesthesia, tourniquet, decompression of nerves of the lower leg in three locations: (1) common peroneal nerve at the fibula head with incision of the peroneus longus muscle, (2) tarsal tunnel with its four tunnels: (a) tibial nerve in the tarsal tunnel, (b) medial plantar nerve in the medial plantar tunnel, (c) lateral plantar nerve in the lateral plantar tunnel, (d) Rr. calcaneare in the calcaneal tunnel, (3) dorsum of the foot with decompression of the peroneus profundus nerve with excision of the extensor hallucis brevis muscle. POSTOPERATIVE MANAGEMENT: No weight bearing for up to 3 weeks, suture removal after 3 weeks, water aerobics starting postoperative week 4. RESULTS: A total of 12 patients (64±9 years) were operated and were followed up for 12±6 months. Procedure time was 83±27 min. Pain reduction on a visual analogue scale improved from 7.1±1.2 preoperatively to 3.3±2.4 postoperatively. Balance improved on a Likert scale (1=best, 6=worst) from 5±1 to 2±1, while sensory impairment improved from 5±2 to 3±1. There were no ulcerations or amputations. Two secondary wound healing problems at the ankle and one lower leg venous thrombosis 2 weeks following discharge were managed conservatively.

[Postdoctoral qualification regulations of medical faculties in German universities. A comparison of 1998 and 2010]. / Habilitationsordnungen medizinischer Fakultäten an deutschen Hochschulen. Ein Vergleich von 1998 und 2010.

BACKGROUND: In Germany, Austria and Switzerland the "Habilitation" (postgraduate qualification) is currently the highest ranked university degree which qualifies candidates to perform high ranking autonomous research and teach the specific subject at university level. Although it is legally not an academic degree, the habilitation is a mandatory qualification for the later appointment and employment as a professor. The habilitation process is a complex assessment of diverse prerequisites which differ highly in terms of uniformity among the medical faculties in Germany. METHODS: In order to re-evaluate these prerequisites and to find out if there might be more conformity for candidates all habilitation requirements were analyzed for 12 primary outcome measures according to Nagelschmidt and rated with a specific scoring system (Nagelschmidt score). RESULTS: The overall scoring for habilitation requirements increased from 15.2±5.1 points in 1998 to 21.9±4.0 points in 2010 (95% confidence interval 20.6-23.3, p<0.001, mainly due to increased requirements in terms of publications, teaching and mandatory board certification. No correlation was found between the number of habilitation degrees per faculty and the overall Nagelschmidt score (y=-0.0545x+26.021, r(2)=0,00028). CONCLUSION: The requirements for habilitation have substantially increased by 44% from 1998 to 2010 in Germany. This is mainly based on higher requirements in terms of publications, teaching and board certification.

Free flap microcirculatory monitoring correlates to free flap temperature assessment.

INTRODUCTION: Salvage rates of free flaps have been reported to be inversely related to the time interval between the onset of ischaemia and its clinical recognition. Consecutively, monitoring of free flaps remains of major importance. The aim of this study was to analyse the correlation of postoperative free flap microcirculation and free flap skin temperature as a potential tool of postoperative flap monitoring. HYPOTHESIS: Free flap skin temperature correlates to free flap capillary microcirculation. METHODS: Fifty-four free flaps were prospectively monitored during the study. Postoperative flap monitoring was performed using a regular digital infrared surface thermometer (Medisana FTD, Germany) simultaneously to microcirculatory assessment using combined Laser-Doppler and photospectrometry (Oxygen-to-see, Lea Medizintechnik, Germany). RESULTS: Mean microcirculatory blood flow was 105±35 arbitrary units (AU). Mean temperature was 34.9±2.2 °C. We found a significant correlation between free flap temperature and free flap capillary blood flow (Pearson correlation r=0.48; p<0.001) and postcapillary venous filling pressure (r=-0.32; p=0.021) in 54 free flaps. A 1 °C less free flap temperature was associated with a decrease of the mean microcirculatory capillary blood flow by 37 relative units. CONCLUSION: Our study demonstrates free flap skin temperature related to capillary microcirculation. Our primary hypothesis was confirmed. We postulate an acute temperature drop of 3 °C at the centre of the skin island as indicative of arterial thrombosis, whereas a 1-2 °C uniform temperature drop of the flap is indicative of venous compromise. Consecutively, free flap skin temperature assessment might be a reliable and inexpensive adjunct monitoring method in plastic reconstructive surgery to improve patients' safety.

[Certified breast centers in Germany : How much is plastic surgery involved?]. / Zertifizierte Brustzentren in Deutschland : Beteiligung der Plastischen Chirurgie.

INTRODUCTION: This study was designed to assess the degree of cooperation between plastic surgeons and gynecologists in certified breast centers in Germany. The rate of breast reconstruction after mastectomy remains low at 8-13%. In certified breast centers plastic surgeons are often not members of the team. METHODS: A total of 220 hospitals affiliated to the West German Breast Center (WBC) were contacted in 2007 and 80 breast centers and hospitals returned the questionnaire. This study is based on the data of approximately 24,000 patients. RESULTS: At the time of the investigation 60 out of the 80 hospitals (75%) were certified breast centers. Many different criteria have been applied for certified breast centers: the state of Nordrhein-Westfalen, the DKG/DGS (German Cancer Society/German Society of Senology), EUSOMA and others. In 8 hospitals (10%) a plastic surgeon was part of the team in the breast center. Most breast centers (44 out of 80) function with 3-4 attending specialists for breast surgery. DISCUSSION: The cooperation between gynecologists and plastic surgeons within a breast center can be strengthened. A microsurgical breast augmentation is not the ideal solution for every patient with a mastectomy but every patient has the right to obtain complete information about the whole spectrum of breast reconstruction including microsurgical free flap reconstruction.

[Systematic review about eccentric training in chronic patella tendinopathy]. / Systematische Literaturanalyse über exzentrisches Training bei chronischer Patellatendinopathie: Gibt es einen Standard?

BACKGROUND: Eccentric training has become a popular treatment for patellar tendinopathy. Aim of this review is to display different exercise prescriptions for patellar tendinopathy, to help clinicians make appropriate choices and identify areas needing further research. OBJECTIVES: Is eccentric training as a conservative treatment in chronic patellar tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? STUDY DESIGN: Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines [Preferred Reporting Items for Systematic Reviews and Meta-Analyses]. DATA SOURCE: National library of Medicine [NLM] between the years 1950 and 2010. STUDY ELIGIBILITY CRITERIA: Prospective randomised controlled trials (RCT). PARTICIPANTS: 7 articles with a total of 165 patients and in which eccentric training was one of the interventions, all published after 2000, were included. The median cohort study size was 20 subjects with a range from 15 to 35 subjects. Median follow-up duration was 12 weeks with a range from 4 to 12 weeks. RESULTS: Encouraging results, but variable study quality, with small numbers or short follow-up periods. The content of the different training programmes varied, but most were home-based programmes with twice daily training for 12 weeks. A number of potentially significant differences were identified in the eccentric programmes used: drop squats or slow eccentric movement, squatting on a 25° decline board or level ground, exercising into tendon pain or short of pain, loading the eccentric phase only or both phases, and progressing with speed then loading or simply loading. LIMITATIONS: A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. CONCLUSION: Most studies suggest that eccentric training may have a positive effect, but our ability to recommend a specific protocol is limited. The studies available indicate that the treatment programme should include a 25° decline board and should be performed with some level of discomfort, and that athletes should be removed from sports activity. However, these aspects need further study. Because of the heterogeneous outcome variables (ordinal scale, VAS, VISA-P) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Patellar tendinopathy.

[Systematic review about eccentric training in chronic achilles tendinopathy]. / Systematische Literaturanalyse über exzentrisches Training bei chronischer Mid-portion-Achillestendinopathie: Gibt es einen Standard?

BACKGROUND: Throughout the recent decade, eccentric training has become a widely accepted therapy option in the conservative treatment of chronic Achilles tendinopathy. Nevertheless, current recommendations are missing regarding dosage and duration of eccentric training as well as standardized training protocols. OBJECTIVES: Is eccentric training as a conservative treatment in chronic Achilles tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? STUDY DESIGN: Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). DATA SOURCE: National library of Medicine (NLM) between the years 1950 and 2010. STUDY ELIGIBILITY CRITERIA: Prospective randomised controlled trials (RCT). PARTICIPANTS: 8 RCTs included 416 subjects with a median number of 42 subjects and a range of 17 to 116 subjects per trial. Median follow-up duration was 12 weeks with a range from 12 to 54 weeks. RESULTS: 124 papers met the eligibility criteria in the NLM, whereas only eight randomised controlled trials were included in this review after screening titles, abstracts and full texts. All included trials demonstrated an improvement in pain after performing equivalent training protocols of eccentric training in chronic Achilles tendinopathy. LIMITATIONS: A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. CONCLUSION: In spite of different compliance, effects of eccentric training in conservative treatment of chronic mid-portion-Achilles tendinopathy are promising. Because of the heterogeneous outcome variables (ordinal scale, VAS, FAOS, AOFAS, VISA-A) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Achilles tendinopathy.

[Conservative treatment of Achilles tendinopathy]. / Konservative Behandlung der Achillestendinopathie.

Hind foot tendinopathies mainly involve the Achilles tendon. Color and Power-Doppler ultrasound visualizes pathological neovessels in painful tendons, which are associated with pain mediating nerve fibres. These neovessels are characterized by an increased capillary blood flow at the point of pain. Painful eccentric training can significantly reduce pain and improve function in Achilles tendinopathy (evidence level Ib). Shock wave therapy in combination with eccentric training is superior to eccentric training alone (evidence level Ib). Long-term results suggest a collagen induction and reduced pain following topical application of glyceryl trinitrate (NO) (evidence level Ib). Color and Power-Doppler-guided sclerosing therapy using polidocanol reduces pain, improves function and may lead to tendon remodeling (evidence level Ib). Pain-restricted sport up to a visual analogue scale (VAS) score 5/10 during therapy is recommended (evidence level Ib). Cryotherapy sessions of 3-times 10 min of reduce pain and capillary blood flow (evidence level Ib). The role of proprioceptive training in tendinopathy has to be determined in future trials (evidence level II). Anecdotical treatment of hindfoot tendinopathies has been replaced by evidence-based recommendations.

Is UV radiation beneficial in postburn wound healing?

Currently strict ultraviolet (UV) light avoidance strategies and utilizing sunblock containing products are generally advocated during the reepithelialization process as well as after wound closure. These recommendations are guided by a common appreciation of UV radiation as a predominant cause of skin cancer development. It is possible however that the currently accepted practice of near continuous UV protection abrogates the normal cutaneous response to injury, with melanocyte redistribution and pigmentation creating hypopigmented scars. We hypothesize that judicious UV exposure might in fact be beneficial for wound healing and skin homeostasis. UV light should be investigated as a potential modulator of keratinocyte-melanocyte cross-talk in wound healing. In vitro studies will have to prove whether UV radiation induced melanocyte activation might have a stimulatory paracrine effect on keratinocyte proliferation which could beneficially affect wound healing. We further hypothesize that UV exposure to wounds might stimulate and restore normal melanocyte distribution and melanin content in reepithelialized wounds preventing hypopigmentation. Furthermore, exposure of reepithelialized wounds to UV light might exert a photo protective effect in the skin by the production of melanin. This in turn may protect the epidermis from UV-induced damage and carcinogenesis. It is therefore proposed that moderate UV exposure should be commenced early in the healing process of cutaneous wounds. At present, current practice and literature do not support the notion that UV-sun block is necessary in postburn scar management. Burn scars do not seem to exert an enhanced risk for melanomagenesis, the occurrence of which has only very rarely been reported in burn scars. Different mutations in susceptibility genes or in genes involved in the control of the cell cycle or maintenance of cellular integrity which are UV radiation independent are involved in the initiation and promotion steps of skin cancer.

[The reconstructive sequence in the 21st century. A reconstructive clockwork]. / Die rekonstruktive Sequenz des 21. Jahrhunderts. Ein rekonstruktives Uhrwerk.

Mathes and Nahai introduced the conventional reconstructive ladder in 1982 to address tissue defects starting with primary and secondary closure of wounds followed by autologous skin grafting. Regional and local pedicled flaps, tissue expansion and free tissue transfer were further steps. Despite enormous achievements and refinements in these techniques, clinical situations and problems occur beyond the scope of these conventional reconstructive measures. Composite tissue allotransplantation (CTA) of partial faces or of unilateral or bilateral forearms and upper arms, are a novel part of transplantation medicine. The initially reported clinical results are encouraging, especially in light of the initial clinical reports of organ transplantation. However, short and long term problems such as potential tumor induction by immunosuppression and chronic rejection must be taken into consideration. Given the fact that patients receiving CTA have already undergone various reconstructive procedures before, patients often gain tremendous improvement in the quality of life. Robots such as the Da Vinci system for surgeons and the Penelope assistant robot have found their way into the surgical routine. While even microsurgical anastomosis has been accomplished using the Da Vinci system, the total amount of time and resources spent is beyond being practical at present. Regeneration and tissue engineering are of distinct interest in reconstructive surgery. Adipose-derived stem cell transfer is able not only to improve contour defects by volume effects, but also to improve the quality of the overlying skin. Therefore we would propose that these novel techniques, CTA, robotics, regeneration and tissue engineering should be considered as potential future integral cogs in the reconstructive mechanism for the 21st century with the patient being at the centre of the reconstructive efforts.

[Current perspective and limitations of autologous fat transplantation--"consensus meeting" of the German Society of Plastic, Reconstructive and Aesthetic Surgeons at Hannover; September 2009]. / Möglichkeiten und Grenzen der autologen Fetttransplantation--"Consensus Meeting" der DGPRAC in Hannover, September 2009.

One hundred years after the first description of autologous fat transplantation, this technique is receiving renewed attention. Initially, critically reviewed by plastic surgery societies, particularly those in the United States, the transfer of autologous fat was recently addressed at the September 2009 annual meeting of the German Society of Plastic Reconstructive and Aesthetic Surgeons in Hannover. In this consensus meeting, the panel reviewed both the current status of autologous fat transfer as well as established data concerning this evolving practice. In Germany, autologous fat transplantation is regulated by the Law on Tissue Transfer and Processing (Gewebegesetz). In an effort to facilitate future comparisons it is mandatory to describe harvesting, processing and reinjection techniques in detail. The consensus panel concluded that fat should be harvested using low vacuum settings and then transplanted in thin layers (Evidence V). Quantification of transplanted fat can best be performed by MRI (Evidence level III). Limited clinical studies are available with only some reaching a level of evidence II. At present, risk associated with autologous fat transplantation is considered to be minor. Tumor induction by autologous fat grafting is not proven. New techniques like stem cell enriched fat grafts may offer new promise for the Plastic and Reconstructive Surgeon.

MRI-based breast volumetry-evaluation of three different software solutions.

As lipofilling of the female breast is becoming more popular in plastic surgery, the use of MRI to assess breast volume has been employed to control postoperative results. Therefore, we sought to evaluate the accuracy of magnetic resonance imaging (MRI)-based breast volumetry software tools by comparing the measurements of silicone implant augmented breasts with the actual implant volume specified by the manufacturer. MRI-based volume analysis was performed in eight bilaterally augmented patients (46 ± 9 years) with three different software programs (Brainlab© I plan 2.6 neuronavigation software; mass analysis, version 5.3, Medis©; and OsiriX© v.3.0.2. 32-bit). The implant volumes analysed by the BrainLab© software had a mean deviation of 2.2 ± 1.7% (r = 0.99) relative to the implanted prosthesis. OsiriX© software analysis resulted in a mean deviation of 2.8 ± 3.0% (r = 0.99) and the Medis© software had a mean deviation of 3.1 ± 3.0% (r = 0.99). Overall, the volumes of all analysed breast implants correlated very well with the real implant volumes. Processing time was 10 min per breast with each system and 30 s (OsiriX©) to 5 min (BrainLab© and Medis©) per silicone implant. MRI-based volumetry is a powerful tool to calculate both native breast and silicone implant volume in situ. All software solutions performed well and the measurements were close to the actual implant sizes. The use of MRI breast volumetry may be helpful in: (1) planning reconstructive and aesthetic surgery of asymmetric breasts, (2) calculating implant size in patients with missing documentation of a previously implanted device and (3) assessing post-operative results objectively.