@phdthesis{Brede2006, author = {Brede, Alexander Elmar Hans Oskar}, title = {Ganganalyse des oberen Sprunggelenks rheumaerkrankter Kinder mittels mobiler Videoaufnahme}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-16437}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2006}, abstract = {Ziel unserer Arbeit war es, von Rheuma betroffene Kinder und Jugendliche auf Ver{\"a}nderungen in ihrem Gangbild zu untersuchen. Gefilmt wurden Probanden im Normalgang, Zehenspitzen- und Fersengang mit einer digitalen Videokamera auf einem mobilen Stativ. Die Probanden wurden nach Schwerdegrad des Rheumas anhand der Ergebnisse der klinischen Untersuchung, nach Geschlecht und nach Alter in verschiedene Gruppen sortiert und untereinander verglichen. Es wurde herausgefunden, dass Patienten mit rheumatisch affektiertem oberen Sprunggelenk in der Plantarflexion geringere Winkelwerte in der Plantarflexion, dagegen h{\"o}here Winkelwerte in der Dorsalextension aufweisen als Patienten ohne Sprunggelenksbeteiligung. Viele Faktoren wie unter anderem morphologische und strukturelle Ver{\"a}nderungen des Bewegungsapparates wurden verantwortliche gemacht. Außerem wurden Trends f{\"u}r ein alters- und geschlechstsspezifisches Gangbild - allerdings nur bei Patienten ohne Sprunggelenksaffektion - erkannt.}, language = {de} } @article{JordanHufnagelMcDonoghetal.2022, author = {Jordan, Martin C. and Hufnagel, Lukas and McDonogh, Miriam and Paul, Mila M. and Schmalzl, Jonas and Kupczyk, Eva and Jansen, Hendrik and Heilig, Philipp and Meffert, Rainer H. and Hoelscher-Doht, Stefanie}, title = {Surgical fixation of calcaneal beak fractures — biomechanical analysis of different osteosynthesis techniques}, series = {Frontiers in Bioengineering and Biotechnology}, volume = {10}, journal = {Frontiers in Bioengineering and Biotechnology}, issn = {2296-4185}, doi = {10.3389/fbioe.2022.896790}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-282792}, year = {2022}, abstract = {The calcaneal beak fracture is a rare avulsion fracture of the tuber calcanei characterized by a solid bony fragment at the Achilles tendon insertion. Treatment usually requires osteosynthesis. However, lack of biomechanical understanding of the ideal fixation technique persists. A beak fracture was simulated in synthetic bones and assigned to five different groups of fixation: A) 6.5-mm partial threaded cannulated screws, B) 4.0-mm partial threaded cannulated screws, C) 5.0-mm headless cannulated compression screws, D) 2.3-mm locking plate, and E) 2.8-mm locking plate. Different traction force levels were applied through an Achilles tendon surrogate in a material-testing machine on all stabilized synthetic bones. Outcome measures were peak-to-peak displacement, total displacement, plastic deformation, stiffness, visual-fracture-line displacement, and mode of implant failure. The 2.3- and 2.8-mm plating groups showed a high drop-out rate at 100 N tension force and failed under higher tension levels of 200 N. The fracture fixation using 4.0-mm partial threaded screws showed a significantly higher repair strength and was able to withhold cyclic loading up to 300 N. The lowest peak-to-peak displacement and the highest load-to-failure and stiffness were provided by fracture fixation using 6.5-mm partial threaded cannulated screws or 5.0-mm headless cannulated compression screws. As anticipated, large 6.5-mm screw diameters provide the best biomechanical fixation. Surprisingly, the 5.0-mm headless cannulated compression screws yield reliable stability despite the absent screw head and washer. When such large screws cannot be applied, 4.0-mm screws also allow reasonable fixation strength. Plate fixation should be implemented with precaution and in combination with a restrictive postoperative motion protocol. Finally, clinical cases about the surgical application and recovery are included.}, language = {en} } @phdthesis{Kreische2007, author = {Kreische, Gunda}, title = {Stabilisierung zur Verletzungspr{\"a}vention am Sprunggelenk - eine Metaanalyse}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-25229}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2007}, abstract = {In der vorliegenden Arbeit sollte im Rahmen einer Metaanalyse die Effektivit{\"a}t der verschiedenen pr{\"a}ventiven Stabilisierungshilfen auf das Sprunggelenk bewertet werden. Dazu wurde in den medizinischen Datenbanken Medline und Pubmed nach relevanten Studien recherchiert. Nach der Literaturselektion entsprechend festgelegter Auswahlkriterien konnten 44 Studien im Zeitraum von 1962 bis 2005 in die Bewertung einfließen. Diese wurden der Evidenzhierarchie nach der Cochrane Collaboration zugeordnet. Entsprechend der Evidenzst{\"a}rken und der kritischen Beurteilung der externen und internen Validit{\"a}t wurden die einzelnen Stabilisierungshilfen bewertet. Dabei zeigt sich, dass {\"a}ltere, weit verbreitete und langzeiterprobte Maßnahmen wie der adh{\"a}sive Tape- Verband innovativeren und ausbauf{\"a}higen Methoden wie dem propriozeptiven Training weichen. In diesem sensomotorischen Bereich konnten {\"u}bereinstimmend positive und gr{\"o}ßtenteils signifikante Ergebnisse ermittelt werden. Auch die Anwendung semirigider und rigider Orthesen zeigte bei der Mehrzahl der Studien einen signifikanten Supinationsschutz. Der pr{\"a}ventive Effekt von (Schn{\"u}r-) Bandagen {\"a}ußerte sich vornehmlich in der Verbesserung der propriozeptiven F{\"a}higkeiten vor allem instabiler Sprunggelenke. Beim Tape-Verband steht die initiale signifikante Supinationsrestriktion im Vordergrund, was unter anderem mit den Materialeigenschaften sowie vielf{\"a}ltigen und eingeschr{\"a}nkt reproduzierbaren Techniken begr{\"u}ndet wird. Die Untersuchungen zu Schuhen unterschiedlicher Schafth{\"o}hen konnten keine {\"u}bereinstimmend signifikanten Ergebnisse liefern.}, subject = {Sprunggelenkverletzung}, language = {de} } @article{LuetkensGrunzKunzetal.2023, author = {Luetkens, Karsten Sebastian and Grunz, Jan-Peter and Kunz, Andreas Steven and Huflage, Henner and Weißenberger, Manuel and Hartung, Viktor and Patzer, Theresa Sophie and Gruschwitz, Philipp and Erg{\"u}n, S{\"u}leyman and Bley, Thorsten Alexander and Feldle, Philipp}, title = {Ultra-high-resolution photon-counting detector CT arthrography of the ankle: a feasibility study}, series = {Diagnostics}, volume = {13}, journal = {Diagnostics}, number = {13}, issn = {2075-4418}, doi = {10.3390/diagnostics13132201}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-362622}, year = {2023}, abstract = {This study was designed to investigate the image quality of ultra-high-resolution ankle arthrography employing a photon-counting detector CT. Bilateral arthrograms were acquired in four cadaveric specimens with full-dose (10 mGy) and low-dose (3 mGy) scan protocols. Three convolution kernels with different spatial frequencies were utilized for image reconstruction (ρ\(_{50}\); Br98: 39.0, Br84: 22.6, Br76: 16.5 lp/cm). Seven radiologists subjectively assessed the image quality regarding the depiction of bone, hyaline cartilage, and ligaments. An additional quantitative assessment comprised the measurement of noise and the computation of contrast-to-noise ratios (CNR). While an optimal depiction of bone tissue was achieved with the ultra-sharp Br98 kernel (S ≤ 0.043), the visualization of cartilage improved with lower modulation transfer functions at each dose level (p ≤ 0.014). The interrater reliability ranged from good to excellent for all assessed tissues (intraclass correlation coefficient ≥ 0.805). The noise levels in subcutaneous fat decreased with reduced spatial frequency (p \< 0.001). Notably, the low-dose Br76 matched the CNR of the full-dose Br84 (p 0.999) and superseded Br98 (p \< 0.001) in all tissues. Based on the reported results, a photon-counting detector CT arthrography of the ankle with an ultra-high-resolution collimation offers stellar image quality and tissue assessability, improving the evaluation of miniscule anatomical structures. While bone depiction was superior in combination with an ultra-sharp convolution kernel, soft tissue evaluation benefited from employing a lower spatial frequency.}, language = {en} } @article{SzymskiAchenbachSiebentrittetal.2021, author = {Szymski, Dominik and Achenbach, Leonard and Siebentritt, Martin and Simoni, Karola and Kuner, Norbert and Pfeifer, Christian and Krutsch, Werner and Alt, Volker and Meffert, Rainer and Fehske, Kai}, title = {Injury epidemiology of 626 athletes in surfing, wind surfing and kite surfing}, series = {Open Access Journal of Sports Medicine}, volume = {12}, journal = {Open Access Journal of Sports Medicine}, doi = {10.2147/OAJSM.S316642}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261545}, pages = {99-107}, year = {2021}, abstract = {Introduction/Background Surfing, wind surfing and kite surfing enjoy a growing popularity with a large number of athletes worldwide. The aim of this study was to identify and compare the injury profiles and compare the injury profiles of these three extreme water sports. Materials and Methods These data for this retrospective cohort study were collected through an online standardised questionnaire during the 2017-18 season. The questionnaire included questions about anthropometry, skill level, injury diagnosis, injury mechanism, environmental conditions and training regimes. Results The 626 athletes included reported 2584 injuries. On average, each athlete sustained 4.12 injuries during the season. The most frequent injury location was in the lower extremity, in particular the foot, with 49 (16.4\%) injuries in surfing, 344 (18.3\%) in wind surfing and 79 (19.7\%) in kite surfing. Surfing demonstrated a particularly high rate of head injuries (n = 37; 12.4\%). Other frequent injury types were skin lesions (up to 42.1\%) and contusions (up to 40.5\%). The most common injury across all surfing sports was skin lesions of the foot (wind surfing: 11.7\%; kite surfing: 13.2\%; surfing: 12.7\%). In surfing, skin lesions of the head were frequently observed (n = 24; 8.0\%). In surfing, a 'too large wave' (n = 18; 24.7\%) was main cause of the injury, while in wind surfing (n = 189; 34.5\%) and kite surfing (n = 65; 36.7\%) 'own incompetence' led to the most injuries. Conclusion This unique study compares injury epidemiology and mechanism in the three most popular surfing sports: wind surfing, kite surfing and surfing. Overall, injuries were sustained mainly in the lower extremity, while surfing also demonstrated a high rate of head injuries.}, language = {en} }