Weichteil- und Knochendébridement im Rahmen offener Frakturen, um das Infektionsrisiko zu minimieren und einen primären Hautverschluss zu erreichen oder die Voraussetzung für eine zügige Weichteildeckung zu schaffen.

Purpose: To analyze the match between preoperatively determined implant size (2D templating) and intraoperatively used implant size in total knee arthroplasty (TKA). Also examined were the factors that might influence templating accuracy (gender, surgeon experience, obesity, etc.). Materials and methods: The study was retrospective and conducted in a specialized ENDOCERT arthroplasty center. Digital templating was done with the MediCAD software. If the planned and implanted TKA components (both femur and tibia) were the same size, the match was classified “exact.” A deviation of ± one size (at the femur or tibia or both) was classified “accurate.” A deviation of ± two or more sizes (at the femur or tibia or both) was classified “inaccurate.” Obesity, gender, implant type and surgeon experience were investigated for potential influence on templating accuracy. Chi-square tests and Cohen’s weighted kappa test were used for statistical analysis. Results: A total of 482 cases [33.6% male, 66.4% female, age 69 ± 11, body mass index (BMI) 30.3 ± 5.8] were included. When the femur and tibia were taken together, exact size match was observed in 34% (95% CI 29.9–38.3%) of cases, accurate size match in 57.5% (95% CI 53–61.8%) and inaccurate size match in 8.5% (95% CI 6.3–11.2%). Inaccurate size match prolonged operative time (p = 0.028). Regarding the factors potentially influencing templating accuracy, only gender had a significant influence, with templating being more accurate in men (p = 0.004). BMI had no influence on accuracy (p = 0.87). No effect on accuracy was observed for implant type and surgeon experience. Conclusions: The accuracy of 2D size templating in TKA is low, even in a specialized ENDOCERT arthroplasty center. The study findings challenge the usefulness of preoperative 2D size templating and highlight the importance of more reliable templating methods. Level of evidence: Level III (retrospective observational study).

Head and neck cancer (HNC) and its treatment can lead to various functional impairments. We developed and validated an instrument for rapid physician-rated assessment of basic functional outcomes in HNC patients. HNC-relevant functional domains were identified through a literature review and assigned to verbal ratings based on observable criteria. The instrument draft was subjected to systematic expert review to assess its face and content validity. Finally, the empirical validity, reliability, and responsiveness of the expert-adapted Functional Integrity in Head and Neck Cancer (HNC-FIT) scales were assessed in healthy controls and in HNC patients. A matrix of the 6 functional domains of oral food intake, respiration, speech, pain, mood, and neck and shoulder mobility was created, each with 5 verbal rating levels. Face and content validity levels of the HNC-FIT scales were judged to be adequate by 17 experts. In 37 control subjects, 24 patients with HNC before treatment, and in 60 HNC patients after treatment, the HNC-FIT ratings in the 3 groups behaved as expected and functional domains correlated closely with the outcome of corresponding scales of the EORTC-HN35-QoL questionnaire, indicating good construct and criterion validity. Interrater reliability (rICC) was ≥0.9 for all functional domains and retest reliability (rICC) was ≥0.93 for all domains except mood (rICC = 0.71). The treatment effect size (eta-square) as a measure of responsiveness was ≥0.15 (p < 0.01) for fall domains except for breathing and neck and shoulder mobility. The median HNC-FIT scale completion time was 1 min 17 s. The HNC-FIT scale is a rapid tool for physician-rated assessment of functional outcomes in HNC patients with good validity, reliability, and responsiveness.

Background: Nasal airway stenosis may lie anterior and/or posterior to the piriform aperture. We intended to compare the nasal airway anterior and posterior to the piriform aperture in patients with and without nasal obstruction. Methods: Segmented computed tomography cross-sectional areas of the nasal airway anterior (CT-CSA_ant) and posterior to the piriform aperture (at the level of the head of the inferior turbinate; CT-CSA_post) were compared between patients with nasal obstruction (cases) and trauma controls. CT-CSA were approximately perpendicular to the direction of the nasal airflow. Anterior to the piriform aperture, they were tilted about 30^o, 60^o and 90^o to the nasal floor. Posterior to the piriform aperture, they were tilted about 50^o, 80^o and 100^o to the nasal floor. In cases, we examined the Pearson’s correlation of active anterior rhinomanometry with CT-CSA_ant and CT-CSA_post. Results: Narrow and bilateral CT-CSA_post were similarly large between 56 cases and 56 controls (all p > 0.2). On the contrary, narrow and bilateral CT-CSA_ant were significantly smaller in cases than in controls (all p < 0.001). The ratio of the size of CT-CSA_ant−30 to that of CT-CSA_post−80 was significantly lower in cases (median: 0.84; lower to upper quartile: 0.55–1.13) than in controls (1.0; 0.88–1.16; Mann-Whitney U test; p = 0.006). Bilateral CT-CSA_ant correlated significantly with total inspiratory flow (all p < 0.026) in contrast to bilateral CT-CSA_post (all p > 0.056). Conclusions: The nasal airway anterior to the piriform aperture was smaller in patients with nasal obstruction due to skeletal nasal stenosis than that in controls. On the contrary, the nasal airway posterior to the piriform aperture was similarly large between patients with and without nasal obstruction. Furthermore, in patients with nasal obstruction, the anterior nasal airway was narrower compared to that located posterior to it. On the contrary, control patients’ anterior nasal airway was as large as the posterior one.

Accurately identifying residual biomechanical deficits following an anterior cruciate ligament injury is critical for effective rehabilitation and safe return to sport. This study aimed to determine which of four jump‐landing tasks demonstrated the greatest sensitivity in distinguishing individuals with a history of ACL injury from healthy controls. Forty‐three participants formed the ACL ( n = 21, 11 females) and the control group ( n = 22, 12 females). Three‐dimensional motion data (Vicon, 250 Hz) were recorded during a single‐leg hop, unilateral countermovement jump, unilateral crossover hop, and medial‐rotation hop before and after a fatigue‐inducing intervention (single‐leg squats and step‐ups). Logistic regression models to classify participants were built using 13 lower‐body, trunk, and pelvis joint angles at 50 ms after initial ground contact, angular changes in these angles between 50 and 80 ms, and principal components derived from these variables. Classification rates and individual classification outcomes were assessed. The results revealed that no single jump‐landing task consistently outperformed others in detecting ACL injury history. Classification outcomes were influenced by fatigue state and analytical approaches. Fatigue was found to enhance classification rates. Combining joint angles with their temporal changes improved classification rates compared to using joint angles alone. However, applying principal component analysis as a preprocessing step did not consistently enhance model performance. Overall, the study demonstrated that jump‐landing tasks, combined with a variety of analytical approaches, can effectively detect ACL injury history. Fatigue enhanced classification outcomes, suggesting that it amplifies differences between post‐injury and healthy movement characteristics.