Experimentalists are overwhelmed by high-throughput data and there is an urgent need to condense information into simple hypotheses. For example, large amounts of microarray and deep sequencing data are becoming available, describing a variety of experimental conditions such as gene knockout and knockdown, the effect of interventions, and the differences between tissues and cell lines.

Introduction: Palmar plate fixation of the distal radius fracture involves dissecting the pronator quadratus (PQ). This is regardless of whether the approach is radial or ulnar to the flexor carpi radialis (FCR) tendon. It is not yet clear whether and to what extent this dissection leads to a functional loss of pronation or pronation strength. The aim of this study was to investigate the functional recovery of pronation and pronation strength after dissection of the PQ without suturing. Materials and methods: From October 2010 to November 2011, patients aged over 65 with fracture were prospectively enrolled in this study. Fracture stabilisation was performed via the FCR approach without suturing the PQ. Follow-up examinations took place 8 weeks and 12 months postoperatively, and pronation and supination strength were analysed by means of an especially developed measuring device. Results: 212 patients were initially screened and 107 were enrolled. The range of motion compared to the healthy opposite side was Ext/Flex 75/66% 8 weeks postoperatively. Pronation was 97% with a pronation strength of 59%. After 1 year, the scores improved to Ext/Flex 83/80%. Pronation recovered to 99% and pronation strength to 78%. Conclusion: The present study can show a recovery of pronation as well as pronation strength in a large patient population. At the same time, the pronation strength is still significantly lower 1 year after the operation than on the opposing healthy side. As the pronation strength recovers as the grip strength and is at all times on a par with the supination strength, we believe that we can continue to refrain from re-fixating the pronator quadratus.

Introduction: Given the significant therapeutic gap for osteoporosis, this study aims to investigate the most common osteoporosis-related fracture. The analysis will also consider patients’ serum vitamin D levels and the indications for basic osteoporosis diagnostic tests and osteoporosis therapy prior to fracture. Materials and methods: This prospective clinical trial included patients with distal radius fractures who underwent surgery at our hospital between 1 April 2021 and 7 April 2022. Blood samples were taken from all participants and existing risk factors for osteoporosis were recorded. In addition, the indication for a guideline-based osteoporosis diagnosis was assessed and the risk of another future fracture with FRAX^® was calculated. This information was used to decide whether there was an indication for specific osteoporosis therapy. Results: A diagnosis gap of 53% and a treatment gap of 84% were identified among the 102 patients investigated. The patients’ ages ranged from 46 to 91 years, with an average vitamin D level of 57 nmol/l, which was below the recommended level of 75 nmol/l. It was noted on a monthly basis that the vitamin D level (without substitution) never exceeded the recommended value of 75 nmol/l in any month. Three-quarters of patients had indications for a baseline osteoporosis diagnosis, yet less than 50% received one. According to FRAX^® data, 57% of patients had indications for specific osteoporosis treatment before experiencing the fracture. Conclusion: Even without a previous distal radius fracture, many patients are in need of osteoporosis diagnosis or treatment. Our research suggests that patients with distal radius fractures should have their vitamin D levels checked via a blood test and be evaluated for osteoporosis. As endogenous vitamin D levels are often inadequate, year-round vitamin D supplementation should be considered for the prevention of osteomalacia and as a basis for the treatment of osteoporosis. German clinical trial register ID: DRKS00028085.

Purpose: One of the key challenges trauma centres are currently facing is the management of polytraumata in an ageing population. The aim of this study is to assess the extent to which demographic changes are reflected in the trauma bay population and the impact on geriatric polytrauma patient outcomes. Methods: This is a retrospective single-centre cohort study of a level one trauma centre in Germany. The data were collected from the DGU TraumaRegister. All patients exhibiting vital signs who were primarily admitted to the trauma bay were included in the study. Patient characteristics were compared for years 2011 and 2021. Polytrauma was defined as ISS > 15, and patients aged 65 and over were assigned to the geriatric group. Results: The study included 214 patients. During the study period, there was a significant increase in the mean age of patients (from 47.7 to 55.9 years) and in the proportion of geriatric patients (from 30.37 to 40.51%). Injury severity, as measured by the Injury Severity Score (ISS), also increased significantly. In the entire patient population, the proportion of patients discharged to their place of residence decreased, while the hospital mortality (2011: 9.63%; 2021: 21.52%) increased. Conclusions: The ageing trauma bay population presents new challenges for medical staff, because polypharmacy, multiple comorbidities and frailty become more significant in an ageing population. Enhanced interdisciplinary management, particularly between trauma and geriatric specialists, may mitigate rising mortality rates. Geriatric trauma centres or at least more geriatric expertise might be required to improve the treatment and outcome in this changing population.

Summary Since ankle fractures are common fractures in the lower limb, it is worth exploring their potential association with osteoporosis. As part of the research, patients with ankle fractures were screened for osteoporosis to assess its potential for identifying patients with osteoporosis (osteoporosis cases). Consequently, screening should be included as part of fracture management. Ankle fractures are part of the orthopaedic surgeon’s daily routine. They are the most common lower limb fractures in the elderly. The absence of an age peak, such as that seen in distal radius fractures, makes it difficult to distinguish between fractures that are likely to be related to osteoporosis and those that are not. The DVO (German Osteological Association) guideline, published in 2017, mainly mentions exceptions for osteoporotic fractures, such as ankle fractures. This study examined patients with ankle fractures to assess whether this fracture type can be used for identifying osteoporosis. Purpose Considering the fact that ankle fractures are the most prevalent fractures in the lower extremity, it is worth investigating what proportion of these fractures are related to osteoporosis. As part of the research, patients with ankle fractures underwent screening for osteoporosis to determine its potential utility in identifying patients with osteoporosis. Method The present study included all patients aged 45 or older with ankle fractures that occurred within a period of 24 months. Participants were asked about their osteoporosis risk factors. The Fracture Risk Assessment Tool® was used to assess eligibility for treatment. The information from the questionnaire was used to determine whether there was an indication for diagnostic testing for osteoporosis according to the DVO guideline. It was also recorded whether, based on the risk factors assessed, the patient had an indication for osteoporosis therapy. Results A total of 131 patients were enrolled. The average age was 65 years. Osteoporosis screening was necessary for 61 percent. Based on age, 85% of patients aged 60 years or older were recommended for osteoporosis screening. Fifty-five percent of the patients aged 61 years and above had an indication for a specific therapy. The treatment gap in patients requiring specific therapy was 97%. Conclusion Screening should be provided and conducted as part of fracture management due to the substantial number of patients who require screening. Ankle fractures could help to close the existing treatment gap of 78–80% in Germany. Trial registration ClinicalTrials.gov Identifier: DRKS00028085.