Background and objectives: Electromobility has become increasingly popular. In 2001, Segway personal transporters (Segway) were established for tourists, and e-scooters have been in use since their approval in 2019. The aim of this study was to analyze and compare the types of injuries directly related to the use of Segways and e-scooters, respectively, in a German city and to phrase potential safety advice. Materials and Methods: All patients presenting to our emergency department after Segway incidents were retrospectively analyzed and compared with the prospectively collected cohort of patients following e-scooter incidents. Presented injuries were analyzed by body region and injury severity score (ISS). Epidemiological data were collected. Results: Overall, 171 patients were enrolled. The Segway group included 56 patients (mean age 48 years), and the e-scooter group consisted of 115 patients (mean age 33.9 years). Head injuries (HI) occurred in 34% in the Segway group compared to 52% in the e-scooter group. The ISS was approximately equal for both groups (mean ISS Segway group: 6.9/e-scooter group: 5.6). Conclusions: Since the e-scooter group presented a high number of HI along with a higher likelihood and greater severity of HI, mandatory use of helmets is suggested.

(1) Background: As age in western populations is rising, so too are fractures, e.g., of the distal fibula. The aim of this study was to find out whether a novel, minimally invasive intramedullary osteosynthesis technique for the treatment of distal fibula fractures in elderly patients results in not only a reduction of postoperative complications, but also a shorter hospitalization time, an improved clinical outcome, and preserved autonomy in geriatric trauma patients. (2) Methods: In this prospective study, the results following surgical treatment for distal fibula fractures in geriatric patients after using DePuy Synthes^® one-third semitubular plate (Group I) or a minimally invasive intramedullary photodynamic Bone StabilizationSystem (IlluminOss^®) (Group II) were compared at 6 weeks, 12 weeks, 6 months, and 1 year after initial treatment. (3) Results: Significant improvement regarding clinical outcome was shown in Group II 6 and 12 weeks after surgery. (4) Conclusions: Our study results demonstrate that the use of this new intramedullary stabilization system in combination with an immediate postoperative weight bearing seems to be a safe and stable treatment option for ankle fractures in geriatric patients, especially in the early stages of recovery.

Anterior shoulder dislocation is a prevalent clinical issue, with high recurrence rates after initial dislocation. Stability of the shoulder joint is maintained by the interplay of static and dynamic stabilizers, including the glenoid and humeral head morphology. Glenoid morphology has been identified as particularly influential in joint stability, and thus the evaluation of glenoid bone loss is crucial in managing shoulder dislocations. This study aimed to investigate the differences in glenoid morphologies between on-track and off-track lesions postdislocation. This retrospective case-control study included patients who presented with shoulder dislocation at a level 1 trauma center from 2011 to 2020. Patients with anterior shoulder dislocation, complete computed tomography imaging, visible bone loss, and those aged 18 years or more were included. Radiographic parameters were assessed using a certified picture achieving and communication system workstation. The groups were divided into on-track or off-track lesions and their glenoid version, glenoid concavity, and the morphometrical-based bony shoulder stability ratio (BSSR) were compared. Two hundred twelve patients (70% male and mean age of 50 years) were included and no significant difference was found between the on-track and off-track groups in terms of demographics or injury mechanism. Significant differences were noted in the glenoid defect (1.28 mm vs. 4.67 mm, P = .001), glenoid concavity/depth (1.7 mm vs. 1.3 mm, P = .001), the BSSR (40% vs. 33%, P = .001), and glenoid retroversion (4.4 vs. 2.9°, P = .009). Glenoid morphology has become an increasing focus in the treatment of anterior shoulder dislocation. Patients with an off-track lesion appear to have not only greater glenoid loss and a larger Hill-Sachs but also a flatter glenoid with less retroversion. This also appears to lead to a lower BSSR.

Background: Shoulder dislocation is the most common major joint dislocation, with anterior dislocations accounting for 95% of cases. Accurate assessment of bony lesions, such as glenoid bone loss (GBL) and Hill-Sachs lesions, is critical for treatment planning. While computed tomography (CT) is the gold standard for evaluating bony parameters, magnetic resonance imaging (MRI) may serve as a viable alternative, offering no radiation exposure. This study aims to compare the reliability of conventional 2D (two- Dimensional)-MRI with 2D-CT in measuring bony parameters and classifying lesions as on- or off-track. It was hypothesized that there is no difference in evaluation between MRI and conventional CT scans. Methods: A retrospective case-control study was conducted on 61 patients (mean age 45 ± 19 years) with anterior shoulder dislocations who underwent both CT and MRI imaging. Radiographic measurements, including glenoid diameter, glenoid defect (in width), Hill-Sachs lesion and bony bridge, were obtained independently from CT and MRI scans. Patients were categorized as on- or off-track based on the glenoid track and Hill-Sachs index. Statistical analyses included correlation tests, Bland-Altman plots, interrater agreement (intraclass correlation coefficient), and sensitivity and specificity analyses for lesion classification. Results: MRI showed good agreement with CT across most parameters, with mean differences of less than 1 mm for glenoid defect, glenoid diameter, and Hill-Sachs lesions. Correlation coefficients ranged from 0.62 (bony bridge) to 0.93 (glenoid defect). Bland-Altman plots revealed good agreement for glenoid parameters but higher variance for the Hill-Sachs lesion and bony bridge. MRI correctly classified 89% of on-track lesions (sensitivity) and 76% of off-track lesions (specificity). Interrater agreement was excellent for glenoid defect measurements (ICC = 0.962) and lower for the bony bridge (ICC = 0.848). Conclusion: Conventional MRI demonstrates high reliability in measuring bony parameters and good accuracy in classifying on- and off-track lesions compared to CT. MRI is a viable alternative for preoperative evaluation, particularly in cases with minor bony defects. However, in indeterminate defects, a CT scan is recommended to ensure accurate measurements, classification and treatment planning. Level of evidence: Level III.

Background: The genitourinary system is not as commonly affected as many other organ systems in severely injured patients. Although a delayed and missed diagnosis of genitourinary injuries (GUIs) can severely compromise long-term outcomes, these injuries are frequently overlooked. Therefore, we present a scoring system designed to assist emergency physicians in diagnosing GUIs in severely injured patients. Methods: The data were obtained from the TraumaRegister DGU^® from the years 2015–2021. All severely injured patients (ISS ≥ 16) ≥16 years of age and treated in Germany, Austria, or Switzerland were included in this study. We excluded patients who were transferred out early (48 h), and all patients with isolated traumatic brain injury. After the univariate analysis of the relevant predictive factors, we developed a scoring system using a binary logistic regression model. Results: A total of 70,467 patients were included in this study, of which 4760 (6.8%) sustained a GUI. Male patients (OR: 1.31, 95% CI [1.22, 1.41]) injured in motorcycle accidents (OR: 1.70, 95% CI [1.55, 1.87]), who were under 60 years of age (OR: 1.59, 95% CI [1.49, 1.71]) and had sustained injuries in multiple body regions (OR: 6.63, 95% CI [5.88, 7.47]), and suffered severe pelvic girdle injuries (OR: 2.58, 95% CI [2.29, 2.91]) had the highest odds of sustaining a GUI. With these predictive factors combined, a novel scoring system, the GUIPP score, was developed. It showed good validity, with an AUC of 0.722 (95% CI [0.71; 0.73]). Conclusion: Predicting GUI in severely injured patients remains a challenge for treating physicians, but is extremely important to prevent poor outcomes for affected patients. The GUIPP score can be utilized to initiate appropriate diagnostic steps early on in order to reduce the delayed and missed diagnosis of GUI, with scores ≥ 9 points making GUIs very likely.

Posterior shoulder dislocation (PSD) is less common than anterior dislocation (ASD) but is increasingly recognized. Understanding the osseous characteristics of PSD is essential for guiding management. However, direct comparative radiographic analyses between PSD and ASD remain limited. The purpose of this study was to perform a matched-pair radiographic comparison of acromial, glenoidal, and (reverse) Hill-Sachs lesion morphology between patients with first-time traumatic PSD and ASD, and to identify osseous features that may predispose to posterior shoulder instability. In this retrospective single-center study, 24 patients (24 shoulders) with cross-sectional imaging (computed tomography [CT] or magnetic resonance imaging [MRI]) following first-time traumatic PSD between 2011 and 2020 were included and matched 1:1 by sex, age, and laterality to 24 patients with first-time traumatic anterior shoulder dislocation. Two independent raters performed standardized radiological measurements on CT/MRI, assessing the following parameters: posterior acromial height (PAH), posterior acromial coverage (PAC), anterior acromial coverage (AAC), and total acromial coverage (TAC), acromial tilt (AT), glenoid bone loss (GBL, glenoid offset, glenoid retroversion, glenoid depth, scapular neck angle, defect size, width and depth of Hill-Sachs lesion (HSL)/reverse Hill-Sachs lesion (rHSL). PAH was greater in PSD than ASD (22.5 mm vs. 15.9 mm, p < 0.001). The PAC was lower in PSD (58.7° vs. 68.0°, p < 0.001), while AAC was higher (4.9° vs. -3.0°, p = 0.0015). No statistically significant difference was found for TAC. The AT was greater in PSD (65.5° vs. 55.2°, p < 0.001). The GBL was smaller in PSD than ASD (8.1% vs. 12.2%, p = 0.0073). Glenoid offset and neck angle showed no statistically significant differences. Retroversion was higher in PSD (8.0° vs. 3.3°, p < 0.001), and glenoid depth was greater (2.0 mm vs. 1.2 mm, p = 0.0053). The rHSL width was smaller in PSD than HSL width in ASD (13.0 mm vs. 17.0 mm, p = 0.037), while lesion depth and surface area did not differ. PSD is associated with distinct alterations in bony shoulder anatomy including a higher, flatter acromion resulting in reduced posterior containment of the humeral head, increased glenoid retroversion, less GBL, and deeper glenoid concavity compared with ASD. Retrospective matched-pair cohort study, 3.