Cryopreservation is a well-established method for bone storage. However, the ideal timing of mechanical testing after sacrificing the experimental animals is still under discussion and of significant importance to the presentation of accurate results. Therefore, the aim of this study was to investigate and compare different cryopreservation durations to native murine bone and whether there was an influence on mechanical bone testing. For this study the tibias of 57 female C57BL/6 mice—18-weeks of age—were harvested and randomly allocated to one of four groups with varying storage times: (1) frozen at −80 °C for 3 months, (2) frozen at −80 °C for 6 months, (3) frozen at −80 °C for 12 months and (4) native group. The native group was immediately tested after harvesting. The comparison of the mean strength and load to failure rates demonstrated a significant difference between the storage groups compared to the native control (p = 0.007). However, there was no difference in the strength and the load to failure values of bones of all storage groups when compared against each other. Once cryopreservation at −80 °C is performed, no differences of mechanical bone properties are seen up to 12 months of storage. When actual in vivo data is of close interest, immediate testing should be considered and is preferred. If comparison of groups is required and long-time storage is necessary, cryopreservation seems to be an accurate method at present.
Background: The management of intra-articular displaced calcaneal fractures remains controversial. Both minimally invasive technique (MIT) and open reduction internal fixation (ORIF) are commonly employed, but there is no clear consensus on the optimal approach. Open surgical techniques carry a higher risk of wound complications, whereas percutaneous methods may offer less precise fracture reduction, while conservative therapy (CT) shows higher functional complications. The aim of this retrospective study was to compare the radiological and functional outcomes of three treatment methods for calcaneal fractures. Methods: Patients admitted to two level-one trauma centers between 2013 and 2023 were analyzed. Clinical and radiological parameters and scores were collected. The outcome measures were assessed using Böhler’s and Gissane’s angles. The clinical results were compared using the Visual Analogue Scale (VAS), the American Orthopaedic Foot and Ankle Society Hindfoot Score (AOFAS), the Maryland Foot Score (MFS), and the Parker Mobility Score (PMS) at the 12-month follow-up. Results: A total of 236 patients with 256 calcaneal fractures were analyzed. Among them, 175 men and 61 women were included. The mean patient age was 46.3 (min-max) years. In total, 130 patients were treated operatively (minimally invasive technique or ORIF), and 106 were treated conservatively. Böhler’s and Gissane’s angles at follow-up were significantly higher within the operated group. Complications occurred more frequently in the surgical treatment group than in the conservative treatment group, especially deep infections within ORIF (p < 0.001). MFS and VAS yielded better results for surgical treatment. Conclusions: Based on the results of this study, surgical treatment is preferable to conservative treatment due to better anatomical reduction and a slightly better functional outcome. One-year results for all three methods were comparable, showing good clinical and functional results with the surgical groups.
Background and Objectives: The adequate therapy of thoracolumbar fractures in the elderly population is still controversially discussed. The aim of this study was to evaluate and compare the results of conservatively and surgically treated younger (≤60a) and elderly patients (>60a) with fractures of L1. Materials and Methods: Patients (231) with isolated L1 fractures were included and treated at the University Clinic of Orthopedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna, during the observation period of 2012–2018. Results: Conservative treatment led to a significant increase in the vertebral and bi-segmental kyphosis angle in both age groups (young vertebral: p = 0.007; young bi-segmental: p = 0.044; old vertebral: p = 0.0001; old bis-segmental: p = 0.0001). A significant reduction in the vertebral angle in both age groups was achieved after operative treatment (young: p = 0.003, old: p = 0.007). The bi-segmental angle did not significantly improve after surgery in both age groups (≤60a: p = 0.07; >60a: p = 1.0). Conclusions: The study shows that conservative treatment does not seem to be sufficient for a correction of radiological parameters in young and elderly patients. In contrast, operative treatment led to a significant improvement of the vertebral kyphosis angle, without changing the bi-segmental kyphosis angle. These results suggest a greater benefit from operative treatment in patients ≤ 60a than in older patients.
Background/Objectives: Traumatic spinal fractures are common injuries, and a proportion of these cases require surgical stabilization using various operative systems. This study aimed to analyze the epidemiology of surgical site infections (SSIs) following exclusively trauma-related spinal surgery and to identify potential risk factors for their occurrence, as there is a lack of studies focusing on non-elective trauma-related spinal surgeries and SSI in the literature. Methods: This retrospective single-center analysis examined 710 patients with traumatic spinal injuries treated surgically between 2012 and 2022 at the Level I Trauma Center at the Department of Orthopedics and Trauma Surgery of the University Hospital Wiener Neustadt, Austria. To investigate SSI risk factors, comparative statistical analyses and logistic regression were used, with a level of statistical significance of α = 0.05. Results: In total, 28 cases (with an incidence of 3.94%) developed SSI, and these cases were characterized by a significantly higher body weight/BMI, longer operative times, and more stabilized segments and implanted hardware. They were also more likely to have undergone open surgery, laminectomy in combination with dorsal stabilization, intensive care treatment, or to present with neurological deficits or ankylosing spondylitis. SSIs occurred most frequently in the thoracolumbar and cervicothoracic junctions, and were predominantly caused by Staphylococcus epidermidis, Staphylococcus aureus, and Cutibacterium acnes. As independent risk factors, a higher BMI (OR = 1.188) and the use of cross-connectors (OR = 4.948) were identified, whereas other initially significant variables did not remain significant after adjustment. Conclusions: There are surgery-related and potentially modifiable variables and non-modifiable patient-related risk factors for the occurrence of SSI. Patients with SSIs stayed an average of 25.3 days in hospital and had a mortality rate of 17.9%.