@article{ChopraBiehlSteinfattetal.2016,
  author    = {Chopra, Martin and Biehl, Marlene and Steinfatt, Tim and Brandl, Andreas and Kums, Juliane and Amich, Jorge and Vaeth, Martin and Kuen, Janina and Holtappels, Rafaela and Podlech, J{\"u}rgen and Mottok, Anja and Kraus, Sabrina and Jord{\´a}n-Garotte, Ana-Laura and B{\"a}uerlein, Carina A. and Brede, Christian and Ribechini, Eliana and Fick, Andrea and Seher, Axel and Polz, Johannes and Ottmueller, Katja J. and Baker, Jeannette and Nishikii, Hidekazu and Ritz, Miriam and Mattenheimer, Katharina and Schwinn, Stefanie and Winter, Thorsten and Sch{\"a}fer, Viktoria and Krappmann, Sven and Einsele, Hermann and M{\"u}ller, Thomas D. and Reddehase, Matthias J. and Lutz, Manfred B. and M{\"a}nnel, Daniela N. and Berberich-Siebelt, Friederike and Wajant, Harald and Beilhack, Andreas},
  title     = {Exogenous TNFR2 activation protects from acute GvHD via host T reg cell expansion},
  series = {Journal of Experimental Medicine},
  volume    = {213},
  journal   = {Journal of Experimental Medicine},
  number    = {9},
  doi       = {10.1084/jem.20151563},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-187640},
  pages     = {1881-1900},
  year      = {2016},
  abstract  = {Donor CD4\(^+\)Foxp3\(^+\) regulatory T cells (T reg cells) suppress graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HCT allo-HCT]). Current clinical study protocols rely on the ex vivo expansion of donor T reg cells and their infusion in high numbers. In this study, we present a novel strategy for inhibiting GvHD that is based on the in vivo expansion of recipient T reg cells before allo-HCT, exploiting the crucial role of tumor necrosis factor receptor 2 (TNFR2) in T reg cell biology. Expanding radiation-resistant host T reg cells in recipient mice using a mouse TNFR2-selective agonist before allo-HCT significantly prolonged survival and reduced GvHD severity in a TNFR2-and T reg cell-dependent manner. The beneficial effects of transplanted T cells against leukemia cells and infectious pathogens remained unaffected. A corresponding human TNFR2-specific agonist expanded human T reg cells in vitro. These observations indicate the potential of our strategy to protect allo-HCT patients from acute GvHD by expanding T reg cells via selective TNFR2 activation in vivo.},
  language  = {en}
}
@article{LadwigLederbogenAlbusetal.2014,
  author    = {Ladwig, Karl-Heinz and Lederbogen, Florian and Albus, Christian and Angermann, Christiane and Borggrefe, Martin and Fischer, Denise and Fritzsche, Kurt and Haass, Markus and Jordan, Jochen and J{\"u}nger, Jana and Kindermann, Ingrid and K{\"o}llner, Volker and Kuhn, Bernhard and Scherer, Martin and Seyfarth, Melchior and V{\"o}ller, Heinz and Waller, Christiane and Herrmann-Lingen, Christoph},
  title     = {Position paper on the importance of psychosocial factors in cardiology: Update 2013},
  series = {GMS German Medical Science},
  volume    = {12},
  journal   = {GMS German Medical Science},
  doi       = {10.3205/000194},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121196},
  year      = {2014},
  abstract  = {Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008. Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients. Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered. Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine.},
  language  = {en}
}
@article{ManchiaAdliAkulaetal.2013,
  author    = {Manchia, Mirko and Adli, Mazda and Akula, Nirmala and Arda, Raffaella and Aubry, Jean-Michel and Backlund, Lena and Banzato, Claudio E. M. and Baune, Bernhard T. and Bellivier, Frank and Bengesser, Susanne and Biernacka, Joanna M. and Brichant-Petitjean, Clara and Bui, Elise and Calkin, Cynthia V. and Cheng, Andrew Tai Ann and Chillotti, Caterina and Cichon, Sven and Clark, Scott and Czerski, Piotr M. and Dantas, Clarissa and Del Zompo, Maria and DePaulo, J. Raymond and Detera-Wadleigh, Sevilla D. and Etain, Bruno and Falkai, Peter and Fris{\´e}n, Louise and Frye, Mark A. and Fullerton, Jan and Gard, S{\´e}bastien and Garnham, Julie and Goes, Fernando S. and Grof, Paul and Gruber, Oliver and Hashimoto, Ryota and Hauser, Joanna and Heilbronner, Urs and Hoban, Rebecca and Hou, Liping and Jamain, St{\´e}phane and Kahn, Jean-Pierre and Kassem, Layla and Kato, Tadafumi and Kelsoe, John R. and Kittel-Schneider, Sarah and Kliwicki, Sebastian and Kuo, Po-Hsiu and Kusumi, Ichiro and Laje, Gonzalo and Lavebratt, Catharina and Leboyer, Marion and Leckband, Susan G. and L{\´o}pez Jaramillo, Carlos A. and Maj, Mario and Malafosse, Alain and Martinsson, Lina and Masui, Takuya and Mitchell, Philip B. and Mondimore, Frank and Monteleone, Palmiero and Nallet, Audrey and Neuner, Maria and Nov{\´a}k, Tom{\´a}s and O'Donovan, Claire and {\"O}sby, Urban and Ozaki, Norio and Perlis, Roy H. and Pfennig, Andrea and Potash, James B. and Reich-Erkelenz, Daniela and Reif, Andreas and Reininghaus, Eva and Richardson, Sara and Rouleau, Guy A. and Rybakowski, Janusz K. and Schalling, Martin and Schofield, Peter R. and Schubert, Oliver K. and Schweizer, Barbara and Seem{\"u}ller, Florian and Grigoroiu-Serbanescu, Maria and Severino, Giovanni and Seymour, Lisa R. and Slaney, Claire and Smoller, Jordan W. and Squassina, Alessio and Stamm, Thomas and Steele, Jo and Stopkova, Pavla and Tighe, Sarah K. and Tortorella, Alfonso and Turecki, Gustavo and Wray, Naomi R. and Wright, Adam and Zandi, Peter P. and Zilles, David and Bauer, Michael and Rietschel, Marcella and McMahon, Francis J. and Schulze, Thomas G. and Alda, Martin},
  title     = {Assessment of Response to Lithium Maintenance Treatment in Bipolar Disorder: A Consortium on Lithium Genetics (ConLiGen) Report},
  series = {PLoS ONE},
  volume    = {8},
  journal   = {PLoS ONE},
  number    = {6},
  doi       = {10.1371/journal.pone.0065636},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130938},
  pages     = {e65636},
  year      = {2013},
  abstract  = {Objective: The assessment of response to lithium maintenance treatment in bipolar disorder (BD) is complicated by variable length of treatment, unpredictable clinical course, and often inconsistent compliance. Prospective and retrospective methods of assessment of lithium response have been proposed in the literature. In this study we report the key phenotypic measures of the "Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder" scale currently used in the Consortium on Lithium Genetics (ConLiGen) study. Materials and Methods: Twenty-nine ConLiGen sites took part in a two-stage case-vignette rating procedure to examine inter-rater agreement [Kappa (\(\kappa\))] and reliability [intra-class correlation coefficient (ICC)] of lithium response. Annotated first-round vignettes and rating guidelines were circulated to expert research clinicians for training purposes between the two stages. Further, we analyzed the distributional properties of the treatment response scores available for 1,308 patients using mixture modeling. Results: Substantial and moderate agreement was shown across sites in the first and second sets of vignettes (\(\kappa\) = 0.66 and \(\kappa\) = 0.54, respectively), without significant improvement from training. However, definition of response using the A score as a quantitative trait and selecting cases with B criteria of 4 or less showed an improvement between the two stages (\(ICC_1 = 0.71\) and \(ICC_2 = 0.75\), respectively). Mixture modeling of score distribution indicated three subpopulations (full responders, partial responders, non responders). Conclusions: We identified two definitions of lithium response, one dichotomous and the other continuous, with moderate to substantial inter-rater agreement and reliability. Accurate phenotypic measurement of lithium response is crucial for the ongoing ConLiGen pharmacogenomic study.},
  language  = {en}
}
@article{BoelchRuecklFuchsetal.2018,
  author    = {Boelch, Sebastian P. and Rueckl, Kilian and Fuchs, Clara and Jordan, Martin and Knauer, Markus and Steinert, Andre and Rudert, Maximilian and Luedemann, Martin},
  title     = {Comparison of elution characteristics and compressive strength of biantibiotic-loaded PMMA bone cement for spacers: Copal\(^®\) spacem with gentamicin and vancomycin versus Palacos\(^®\) R+G with vancomycin},
  series = {BioMed Research International},
  volume    = {2018},
  journal   = {BioMed Research International},
  number    = {4323518},
  doi       = {10.1155/2018/4323518},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177435},
  year      = {2018},
  abstract  = {Purpose. Copal\(^®\) spacem is a new PMMA bone cement for fabricating spacers. This study compares elution of gentamicin, elution of vancomycin, and compressive strength of Copal\(^®\) spacem and of Palacos\(^®\) R+G at different vancomycin loadings in the powder of the cements. We hypothesized that antibiotic elution of Copal\(^®\) spacem is superior at comparable compressive strength. Methods. Compression test specimens were fabricated using Copal\(^®\) spacem manually loaded with 0.5 g gentamicin and additionally 2 g, 4 g, and 6 g of vancomycin per 40 g of cement powder (COP specimens) and using 0.5 g gentamicin premixed Palacos\(^®\) R+G manually loaded with 2 g, 4 g, and 6 g of vancomycin per 40 g of cement powder (PAL specimens). These specimens were used for determination of gentamicin and vancomycin elution (in fetal calf serum, at 22°C) and for determination of compressive strength both prior and following the elution tests. Results. Cumulative gentamicin concentrations (p < 0.005) and gentamicin concentration after 28 days (p ≤ 0.043) were significantly lower for COP specimens compared to PAL specimens. Cumulative vancomycin concentrations were significantly higher (p ≤ 0.043) for COP specimens after the second day. Vancomycin concentrations after 28 days were not significantly higher for the Copal specimens loaded with 2 g and 4 g of vancomycin. Compressive strength was not significantly different between COP specimens and PAL specimens before elution tests. Compressive strength after the elution tests was significantly lower (p = 0.005) for COP specimens loaded with 2 g of vancomycin. Conclusion. We could not demonstrate consistent superior antibiotic elution from Copal\(^®\) spacem compared to Palacos\(^®\) R+G for fabricating gentamicin and vancomycin loaded spacers. The results do not favor Copal\(^®\) spacem over Palacos\(^®\) R+G for the use as a gentamicin and vancomycin biantibiotic-loaded spacer.},
  language  = {en}
}
@article{JordanHoelscherDohtFehskeetal.2015,
  author    = {Jordan, Martin C. and Hoelscher-Doht, Stefanie and Fehske, Kai and Gilbert, Fabian and Jansen, Hendrik and Meffert, Rainer H.},
  title     = {Bunnell or cross-lock Bunnell suture for tendon repair? Defining the biomechanical role of suture pretension},
  series = {Journal of Orthopaedic Surgery and Research},
  volume    = {10},
  journal   = {Journal of Orthopaedic Surgery and Research},
  number    = {192},
  doi       = {10.1186/s13018-015-0331-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126262},
  year      = {2015},
  abstract  = {Background Suture pretension during tendon repair is supposed to increase the resistance to gap formation. However, its effects on the Bunnell suture technique are unknown. The purpose of this study was to determine the biomechanical effects of suture pretension on the Bunnell and cross-lock Bunnell techniques for tendon repair. Methods Eighty porcine hindlimb tendons were randomly assigned to four different tendon repair groups: those repaired with or without suture pretension using either a simple Bunnell or cross-lock Bunnell technique. Pretension was applied as a 10 \% shortening of the sutured tendon. After measuring the cross-sectional diameter at the repair site, static and cyclic biomechanical tests were conducted to evaluate the initial and 5-mm gap formation forces, elongation during cyclic loading, maximum tensile strength, and mode of failure. The suture failure mechanism was also separately assessed fluoroscopically in two tendons that were repaired with steel wire. Results Suture pretension was accompanied by a 10 to 15 \% increase in the tendon diameter at the repair site. Therefore, suture pretension with the Bunnell and cross-lock Bunnell repair techniques noticeably increased the resistance to initial gap formation and 5-mm gap formation. The tension-free cross-lock Bunnell repair demonstrated more resistance to initial and 5-mm gap formation, less elongation, and higher maximum tensile strength than the tension-free Bunnell repair technique. The only difference between the tensioned cross-lock Bunnell and tensioned Bunnell techniques was a larger resistance to 5-mm gap formation with the cross-lock Bunnell technique. Use of the simple instead of cross-lock suture configuration led to failure by suture cut out, as demonstrated fluoroscopically. Conclusion Based on these results, suture pretension decreases gapping and elongation after tendon repair, and those effects are stronger when using a cross-lock, rather than a regular Bunnell suture. However, pretension causes an unfavorable increase in the tendon diameter at the repair site, which may adversely affect wound healing.},
  language  = {en}
}
@article{BaeuerleinRiedelBakeretal.2013,
  author    = {B{\"a}uerlein, Carina A. and Riedel, Simone S. and Baker, Jeanette and Brede, Christian and Jord{\´a}n Garrote, Ana-Laura and Chopra, Martin and Ritz, Miriam and Beilhack, Georg F. and Schulz, Stephan and Zeiser, Robert and Schlegel, Paul G. and Einsele, Hermann and Negrin, Robert S. and Beilhack, Andreas},
  title     = {A diagnostic window for the treatment of acute graft-versus-host disease prior to visible clinical symptoms in a murine model},
  series = {BMC Medicine},
  journal   = {BMC Medicine},
  doi       = {10.1186/1741-7015-11-134},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96797},
  year      = {2013},
  abstract  = {Background Acute graft-versus-host disease (aGVHD) poses a major limitation for broader therapeutic application of allogeneic hematopoietic cell transplantation (allo-HCT). Early diagnosis of aGVHD remains difficult and is based on clinical symptoms and histopathological evaluation of tissue biopsies. Thus, current aGVHD diagnosis is limited to patients with established disease manifestation. Therefore, for improved disease prevention it is important to develop predictive assays to identify patients at risk of developing aGVHD. Here we address whether insights into the timing of the aGVHD initiation and effector phases could allow for the detection of migrating alloreactive T cells before clinical aGVHD onset to permit for efficient therapeutic intervention. Methods Murine major histocompatibility complex (MHC) mismatched and minor histocompatibility antigen (miHAg) mismatched allo-HCT models were employed to assess the spatiotemporal distribution of donor T cells with flow cytometry and in vivo bioluminescence imaging (BLI). Daily flow cytometry analysis of peripheral blood mononuclear cells allowed us to identify migrating alloreactive T cells based on homing receptor expression profiles. Results We identified a time period of 2 weeks of massive alloreactive donor T cell migration in the blood after miHAg mismatch allo-HCT before clinical aGVHD symptoms appeared. Alloreactive T cells upregulated α4β7 integrin and P-selectin ligand during this migration phase. Consequently, targeted preemptive treatment with rapamycin, starting at the earliest detection time of alloreactive donor T cells in the peripheral blood, prevented lethal aGVHD. Conclusions Based on this data we propose a critical time frame prior to the onset of aGVHD symptoms to identify alloreactive T cells in the peripheral blood for timely and effective therapeutic intervention.},
  language  = {en}
}
@article{ChopraLangSalzmannetal.2013,
  author    = {Chopra, Martin and Lang, Isabell and Salzmann, Steffen and Pachel, Christina and Kraus, Sabrina and B{\"a}uerlein, Carina A. and Brede, Christian and Jord{\´a}n Garrote, Ana-Laura and Mattenheimer, Katharina and Ritz, Miriam and Schwinn, Stefanie and Graf, Carolin and Sch{\"a}fer, Viktoria and Frantz, Stefan and Einsele, Hermann and Wajant, Harald and Beilhack, Andreas},
  title     = {Tumor Necrosis Factor Induces Tumor Promoting and Anti-Tumoral Effects on Pancreatic Cancer via TNFR1},
  series = {PLoS ONE},
  journal   = {PLoS ONE},
  doi       = {10.1371/journal.pone.0075737},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97246},
  year      = {2013},
  abstract  = {Multiple activities are ascribed to the cytokine tumor necrosis factor (TNF) in health and disease. In particular, TNF was shown to affect carcinogenesis in multiple ways. This cytokine acts via the activation of two cell surface receptors, TNFR1, which is associated with inflammation, and TNFR2, which was shown to cause anti-inflammatory signaling. We assessed the effects of TNF and its two receptors on the progression of pancreatic cancer by in vivo bioluminescence imaging in a syngeneic orthotopic tumor mouse model with Panc02 cells. Mice deficient for TNFR1 were unable to spontaneously reject Panc02 tumors and furthermore displayed enhanced tumor progression. In contrast, a fraction of wild type (37.5\%), TNF deficient (12.5\%), and TNFR2 deficient mice (22.2\%) were able to fully reject the tumor within two weeks. Pancreatic tumors in TNFR1 deficient mice displayed increased vascular density, enhanced infiltration of CD4+ T cells and CD4+ forkhead box P3 (FoxP3)+ regulatory T cells (Treg) but reduced numbers of CD8+ T cells. These alterations were further accompanied by transcriptional upregulation of IL4. Thus, TNF and TNFR1 are required in pancreatic ductal carcinoma to ensure optimal CD8+ T cell-mediated immunosurveillance and tumor rejection. Exogenous systemic administration of human TNF, however, which only interacts with murine TNFR1, accelerated tumor progression. This suggests that TNFR1 has basically the capability in the Panc02 model to trigger pro-and anti-tumoral effects but the spatiotemporal availability of TNF seems to determine finally the overall outcome.},
  language  = {en}
}
@article{SchmidtJordanHoelscherDohtetal.2014,
  author    = {Schmidt, Karsten and Jordan, Martin C. and H{\"o}lscher-Doht, Stefanie and Jakubietz, Michael G. and Jakubietz, Rafael G. and Meffert, Rainer H.},
  title     = {Suture material for flexor tendon repair: 3-0 V-Loc versus 3-0 Stratafix in a biomechanical comparison ex vivo},
  doi       = {10.1186/s13018-014-0072-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110419},
  year      = {2014},
  abstract  = {Background Barbed suture material offers the possibility of knotless flexor tendon repair, as suggested in an increasing number of biomechanical studies. There are currently two different absorbable barbed suture products available, V-Loc™ and Stratafix™, and both have not been compared to each other with regard to flexor tendon repair. The purpose of this study was to evaluate both suture materials for primary stability under static and cyclic loading in a biomechanical ex vivo model. Methods Forty fresh porcine flexor digitorum profundus tendons were randomized in two groups. A four-strand modified Kessler suture technique was used to repair the tendon either with a 3-0 V-Loc™ or 3-0 Stratafix™ without a knot. Parameters of interest were mode of failure, 2-mm gap formation force, displacement, stiffness and maximum load under static and cyclic testing. Results The maximum load was 42.3 ± 7.2 for the Stratafix™ group and 50.7 ± 8.8 N for the V-Loc™ group. Thus, the ultimate tensile strength was significantly higher for V-Loc™ (p < 0.05). The 2-mm gap occurred at 24.8 ± 2.04 N in the Stratafix™ group in comparison to 26.5 ± 2.12 N in the V-Loc™ group (n.s.). Displacement was 2.65 ± 0.56 mm in the V-Loc™ group and 2.71 ± 0.59 mm in the Stratafix™ group (n.s.). Stiffness was 4.24 ± 0.68 (N/mm) in the V-Loc™ group and 3.85 ± 0.55 (N/mm) the Stratafix™ group (n.s.). Those measured differences were not significant. Conclusion V-Loc™ demonstrates a higher maximum load in tendon reconstruction. The differences in 2-mm gap formation force, displacement and stiffness were not significant. Hereby, the V-Loc™ has an advantage when used as unidirectional barbed suture for knotless flexor tendon repair.},
  language  = {en}
}
@phdthesis{Jordan2013,
  author    = {Jordan, Martin Cornelius},
  title     = {Biotechnologisch modifizierte Silikonimplantate in der Chirurgie - in vivo Untersuchungen zur Biokompatibilit{\"a}t einer Polydimethylsiloxan-Tetraethoxysilan-Halofuginon-Hybridoberfl{\"a}che},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-81213},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2013},
  abstract  = {Silikonprodukte werden erfolgreich im klinischen Alltag eingesetzt und haben sich in vielen Bereichen der Medizin als n{\"u}tzlich erwiesen. Trotz guter Biokompatibilit{\"a}t ist die Verwendung von medizinischen Materialien aus Silikon, besonders bei der dauerhaften Integration in den K{\"o}rper, mit Komplikationen verbunden. Die Brustrekonstruktion mit Silikonimplantaten ist ein Beispiel f{\"u}r den langfristigen Gewebeersatz mit einem Fremdmaterial. Der Organismus erkennt dabei das synthetische Polymer und reagiert mit einer fibr{\"o}sen Abkapselung. Dabei handelt es sich um eine physiologische Entz{\"u}ndungsreaktion mit Abgrenzung des Implantats durch Bestandteile der extrazellul{\"a}ren Matrix. Durch bisher nicht vollst{\"a}ndig gekl{\"a}rte pathophysiologische Abl{\"a}ufe kann es jedoch zu einer verst{\"a}rkten Auspr{\"a}gung dieser Kapselfibrose kommen, was mit Schmerzen und einer Deformierung sowie Zerst{\"o}rung des Implantats einhergehen kann. Als Konsequenz einer voll ausgepr{\"a}gten Kapselfibrose, der sogenannten Kapselkontraktur, bleibt dann meist nur eine operative Revision. Das Ziel dieser Arbeit war die Modifizierung herk{\"o}mmlicher Silikonimplantate, um die Biokompatibilit{\"a}t zu verbessern und die {\"u}berm{\"a}ßige Ausbildung einer periprothetischen Kapsel als h{\"a}ufigste revisionsbed{\"u}rftige Komplikation zu vermeiden. Daf{\"u}r wurde der antifibrotische Wirkstoff Halofuginon in einem nasschemischen Beschichtungsprozess auf eine Silikonoberfl{\"a}che gebunden und die Implantate in einem Tiermodell der Ratte untersucht. Es zeigte sich, dass Halofuginon den TGF-beta1-Signalweg durch Beeinflussung der intrazellul{\"a}ren Smad-Signalkaskade hemmt, wodurch es unter anderem zu einer spezifischen Hemmung der Kollagen-Typ-I-Expression kommt. Histologische, immunhistologische und molekularbiologische Untersuchungen nach einer Implantationsdauer von drei Monaten zeigten, dass eine Halofuginonbeschichtung die Kollagendichte, die Kapseldicke und die Anzahl an Fibroblasten und Entz{\"u}ndungszellen im Kapselgewebe vermindert. Zus{\"a}tzlich konnten weniger TGF-beta- und CD68-positive Zellen im Vergleich zur Kontrollgruppe nachgewiesen werden. Die Ergebnisse der Real-Time-PCR zeigten {\"u}bereinstimmend eine erniedrigte Expression f{\"u}r TGF-beta1, Kollagen-Typ-I, CTGF und CD68 und best{\"a}tigten die immunhistologische Auswertung. Dar{\"u}ber hinaus konnte eine verminderte Expression des MMP-2-Gens nachgewiesen werden, welches f{\"u}r die Steuerung der EZM-Ablagerung mitverantwortlich ist. Es kann belegt werden, dass eine Halofuginon freisetzende Silikonhybridoberfl{\"a}che effektiv und spezifisch die pathologische periprothetische Kapselbildung hemmt. Es sind jedoch weitere in-vivo-Studien zur {\"U}berpr{\"u}fung der Nachhaltigkeit und der Pharmakodynamik erforderlich, um die gewonnenen Erkenntnisse als Schritt in der Verbesserung der Biokompatibilit{\"a}t von Silikonimplantaten nutzen zu k{\"o}nnen.},
  subject      = {Silikon},
  language  = {de}
}
@article{DufnerKesslerJustetal.2022,
  author    = {Dufner, Vera and Kessler, Almuth Friederike and Just, Larissa and Hau, Peter and Bumes, Elisabeth and Pels, Hendrik Johannes and Grauer, Oliver Martin and Wiese, Bettina and L{\"o}hr, Mario and Jordan, Karin and Strik, Herwig},
  title     = {The emesis trial: depressive glioma patients are more affected by chemotherapy-induced nausea and vomiting},
  series = {Frontiers in Neurology},
  volume    = {13},
  journal   = {Frontiers in Neurology},
  issn      = {1664-2295},
  doi       = {10.3389/fneur.2022.773265},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262859},
  year      = {2022},
  abstract  = {Purpose Glioma patients face a limited life expectancy and at the same time, they suffer from afflicting symptoms and undesired effects of tumor treatment. Apart from bone marrow suppression, standard chemotherapy with temozolomide causes nausea, emesis and loss of appetite. In this pilot study, we investigated how chemotherapy-induced nausea and vomiting (CINV) affects the patients' levels of depression and their quality of life. Methods In this prospective observational multicentre study (n = 87), nausea, emesis and loss of appetite were evaluated with an expanded MASCC questionnaire, covering 10 days during the first and the second cycle of chemotherapy. Quality of life was assessed with the EORTC QLQ-C30 and BN 20 questionnaire and levels of depression with the PHQ-9 inventory before and after the first and second cycle of chemotherapy. Results CINV affected a minor part of patients. If present, it reached its maximum at day 3 and decreased to baseline level not before day 8. Levels of depression increased significantly after the first cycle of chemotherapy, but decreased during the further course of treatment. Patients with higher levels of depression were more severely affected by CINV and showed a lower quality of life through all time-points. Conclusion We conclude that symptoms of depression should be perceived in advance and treated in order to avoid more severe side effects of tumor treatment. Additionally, in affected patients, delayed nausea was most prominent, pointing toward an activation of the NK1 receptor. We conclude that long acting antiemetics are necessary totreat temozolomide-induced nausea.},
  language  = {en}
}
@article{HuflageFieberFaerberetal.2022,
  author    = {Huflage, Henner and Fieber, Tabea and F{\"a}rber, Christian and Knarr, Jonas and Veldhoen, Simon and Jordan, Martin C. and Gilbert, Fabian and Bley, Thorsten Alexander and Meffert, Rainer H. and Grunz, Jan-Peter and Schmalzl, Jonas},
  title     = {Interobserver reliability of scapula fracture classifications in intra- and extra-articular injury patterns},
  series = {BMC Musculoskeletal Disorders},
  volume    = {23},
  journal   = {BMC Musculoskeletal Disorders},
  number    = {1},
  doi       = {10.1186/s12891-022-05146-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299795},
  year      = {2022},
  abstract  = {Background Morphology and glenoid involvement determine the necessity of surgical management in scapula fractures. While being present in only a small share of patients with shoulder trauma, numerous classification systems have been in use over the years for categorization of scapula fractures. The purpose of this study was to evaluate the established AO/OTA classification in comparison to the classification system of Euler and R{\"u}edi (ER) with regard to interobserver reliability and confidence in clinical practice. Methods Based on CT imaging, 149 patients with scapula fractures were retrospectively categorized by two trauma surgeons and two radiologists using the classification systems of ER and AO/OTA. To measure the interrater reliability, Fleiss kappa (κ) was calculated independently for both fracture classifications. Rater confidence was stated subjectively on a five-point scale and compared with Wilcoxon signed rank tests. Additionally, we computed the intraclass correlation coefficient (ICC) based on absolute agreement in a two-way random effects model to assess the diagnostic confidence agreement between observers. Results In scapula fractures involving the glenoid fossa, interrater reliability was substantial (κ = 0.722; 95\% confidence interval [CI] 0.676-0.769) for the AO/OTA classification in contrast to moderate agreement (κ = 0.579; 95\% CI 0.525-0.634) for the ER classification system. Diagnostic confidence for intra-articular fracture patterns was superior using the AO/OTA classification compared to ER (p < 0.001) with higher confidence agreement (ICC: 0.882 versus 0.831). For extra-articular fractures, ER (κ = 0.817; 95\% CI 0.771-0.863) provided better interrater reliability compared to AO/OTA (κ = 0.734; 95\% CI 0.692-0.776) with higher diagnostic confidence (p < 0.001) and superior agreement between confidence ratings (ICC: 0.881 versus 0.912). Conclusions The AO/OTA classification is most suitable to categorize intra-articular scapula fractures with glenoid involvement, whereas the classification system of Euler and R{\"u}edi appears to be superior in extra-articular injury patterns with fractures involving only the scapula body, spine, acromion and coracoid process.},
  language  = {en}
}
@article{JordanJaeckleScheidtetal.2021,
  author    = {Jordan, Martin C. and J{\"a}ckle, Veronika and Scheidt, Sebastian and Gilbert, Fabian and H{\"o}lscher-Doht, Stefanie and Erg{\"u}n, S{\"u}leyman and Meffert, Rainer H. and Heintel, Timo M.},
  title     = {Trans-obturator cable fixation of open book pelvic injuries},
  series = {Scientific Reports},
  volume    = {11},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-021-92755-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261212},
  year      = {2021},
  abstract  = {Operative treatment of ruptured pubic symphysis by plating is often accompanied by complications. Trans-obturator cable fixation might be a more reliable technique; however, have not yet been tested for stabilization of ruptured pubic symphysis. This study compares symphyseal trans-obturator cable fixation versus plating through biomechanical testing and evaluates safety in a cadaver experiment. APC type II injuries were generated in synthetic pelvic models and subsequently separated into three different groups. The anterior pelvic ring was fixed using a four-hole steel plate in Group A, a stainless steel cable in Group B, and a titan band in Group C. Biomechanical testing was conducted by a single-leg-stance model using a material testing machine under physiological load levels. A cadaver study was carried out to analyze the trans-obturator surgical approach. Peak-to-peak displacement, total displacement, plastic deformation and stiffness revealed a tendency for higher stability for trans-obturator cable/band fixation but no statistical difference to plating was detected. The cadaver study revealed a safe zone for cable passage with sufficient distance to the obturator canal. Trans-obturator cable fixation has the potential to become an alternative for symphyseal fixation with less complications.},
  language  = {en}
}
@article{JordanJansenMeffertetal.2021,
  author    = {Jordan, Martin C. and Jansen, Hendrik and Meffert, Rainer H. and Heintel, Timo M.},
  title     = {Comparing porous tantalum fusion implants and iliac crest bone grafts for spondylodesis of thoracolumbar burst fractures: Prospectice Cohort study},
  series = {Scientific Reports},
  volume    = {11},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-021-96400-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261706},
  year      = {2021},
  abstract  = {The aim of this study was to compare two different techniques of performing one-level spondylodesis for thoracolumbar burst fractures using either an autologous iliac crest bone graft (ICBG) or a porous tantalum fusion implant (PTFI). In a prospective nonrandomized study, 44 patients (20 women, 24 men; average age 43.1 +/- 13.2 years) suffering from severe thoracolumbar burst fractures were treated with combined anterior-posterior stabilization. An ICBG was used in 21 cases, and a PTFI was used in the other 23 cases. A two-year clinical and radiographic follow-up was carried out. There were no statistically significant differences in age, sex, localization/classification of the fracture, or visual analog scale (VAS) before injury between the two groups. All 44 patients were followed up for an average period of 533 days (range 173-1567). The sagittal spinal profile was restored by an average of 11.1 degrees (ICBG) vs. 14.3 degrees (PTFI) (monosegmental Cobb angle). Loss of correction until the last follow-up tended to be higher in the patients treated with ICBG than in those treated with PTFI (mean: 2.8 degrees vs. 1.6 degrees). Furthermore, significantly better restoration of the sagittal profile was obtained with the PTFI than with the iliac bone graft at the long-term follow-up (mean: ICBG 7.8 degrees, PTFI 12.3 degrees; p < 0.005). Short-segment posterior instrumentation combined with anterior one-level spondylodesis using either an ICBG or a PTFI resulted in sufficient correction of posttraumatic segmental kyphosis. PTFI might be a good alternative for autologous bone grafting and prevent donor site morbidities.},
  language  = {en}
}
@article{SchmalzlFenwickReicheletal.2022,
  author    = {Schmalzl, Jonas and Fenwick, Annabel and Reichel, Thomas and Schmitz, Benedikt and Jordan, Martin and Meffert, Rainer and Plumhoff, Piet and Boehm, Dirk and Gilbert, Fabian},
  title     = {Anterior deltoid muscle tension quantified with shear wave ultrasound elastography correlates with pain level after reverse shoulder arthroplasty},
  series = {European Journal of Orthopaedic Surgery \& Traumatology},
  volume    = {32},
  journal   = {European Journal of Orthopaedic Surgery \& Traumatology},
  number    = {2},
  issn      = {1432-1068},
  doi       = {10.1007/s00590-021-02987-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-268441},
  pages     = {333-339},
  year      = {2022},
  abstract  = {Introduction Reverse shoulder arthroplasty (RSA) leads to medialization and distalization of the centre of rotation of the shoulder joint resulting in lengthening of the deltoid muscle. Shear wave ultrasound elastography (SWE) is a reliable method for quantifying tissue stiffness. The purpose of this study was to analyse if deltoid muscle tension after RSA correlates with the patients' pain level. We hypothesized that higher deltoid muscle tension would be associated with increased pain. Material and methods Eighteen patients treated with RSA were included. Constant score (CS) and pain level on the visual analogue scale (VAS) were analysed and SWE was performed on both shoulders. All three regions of the deltoid muscle were examined in resting position and under standardized isometric loading. Results Average patient age was 76 (range 64-84) years and average follow-up was 15 months (range 4-48). The average CS was 66 points (range 35-89) and the average pain level on the VAS was 1.8 (range 0.5-4.7). SWE revealed statistically significant higher muscle tension in the anterior and middle deltoid muscle region in patients after RSA compared to the contralateral non-operated side. There was a statistically significant correlation between pain level and anterior deltoid muscle tension. Conclusion SWE revealed increased tension in the anterior and middle portion of the deltoid muscle after RSA in a clinical setting. Increased tension of the anterior deltoid muscle portion significantly correlated with an increased pain level. SWE is a powerful, cost-effective, quick, dynamic, non-invasive, and radiation-free imaging technique to evaluate tissue elasticity in the shoulder with a wide range of applications.},
  language  = {en}
}
@article{JordanBroeerFischeretal.2022,
  author    = {Jordan, Martin C. and Br{\"o}er, David and Fischer, Christian and Heilig, Philipp and Gilbert, Fabian and H{\"o}lscher-Doht, Stefanie and Kalogirou, Charis and Popp, Kevin and Grunz, Jan-Peter and Huflage, Henner and Jakubietz, Rafael G. and Erg{\"u}n, S{\"u}leyman and Meffert, Rainer H.},
  title     = {Development and preclinical evaluation of a cable-clamp fixation device for a disrupted pubic symphysis},
  series = {Communications Medicine},
  volume    = {2},
  journal   = {Communications Medicine},
  number    = {1},
  doi       = {10.1038/s43856-022-00227-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299800},
  year      = {2022},
  abstract  = {Background Traumatic separation of the pubic symphysis can destabilize the pelvis and require surgical fixation to reduce symphyseal gapping. The traditional approach involves open reduction and the implantation of a steel symphyseal plate (SP) on the pubic bone to hold the reposition. Despite its widespread use, SP-fixation is often associated with implant failure caused by screw loosening or breakage. Methods To address the need for a more reliable surgical intervention, we developed and tested two titanium cable-clamp implants. The cable served as tensioning device while the clamp secured the cable to the bone. The first implant design included a steel cable anterior to the pubic symphysis to simplify its placement outside the pelvis, and the second design included a cable encircling the pubic symphysis to stabilize the anterior pelvic ring. Using highly reproducible synthetic bone models and a limited number of cadaver specimens, we performed a comprehensive biomechanical study of implant stability and evaluated surgical feasibility. Results We were able to demonstrate that the cable-clamp implants provide stability equivalent to that of a traditional SP-fixation but without the same risks of implant failure. We also provide detailed ex vivo evaluations of the safety and feasibility of a trans-obturator surgical approach required for those kind of fixation. Conclusion We propose that the developed cable-clamp fixation devices may be of clinical value in treating pubic symphysis separation.},
  language  = {en}
}
@article{JansenHeintelJordanetal.2019,
  author    = {Jansen, Hendrik and Heintel, Timo M. and Jordan, Martin and Meffert, Rainer H. and Frey, Soenke P.},
  title     = {Survived traumatic hemipelvectomy with salvage of the limb in a 14  months old toddler},
  series = {Trauma Case Reports},
  volume    = {22},
  journal   = {Trauma Case Reports},
  doi       = {10.1016/j.tcr.2019.100220},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202207},
  pages     = {100220},
  year      = {2019},
  abstract  = {We report on a 14 months old toddler who sustained a traumatic hemipelvectomy by being crushed between a car and a stone wall. After stabilization in the resuscitation room he was treated operatively by laparotomy, osteosynthesis of the pelvic ring, reconstruction of the both external iliac vessels and the urethra and reposition of the testicles. After 66 days he was discharged into rehabilitation. Implants were removed after eight months. 20 months after the injury, the leg was plegic, initial radiological signs of femoral head necrosis showed up but the infant was able to walk with an orthesis and a walker. Up to our knowledge, this is the youngest patient described in the literature with a survived traumatic hemipelvectomy and salvaged limb.},
  language  = {en}
}
@article{JordanZimmermannGhoetal.2016,
  author    = {Jordan, Martin C. and Zimmermann, Christina and Gho, Sheridan A. and Frey, S{\"o}nke P. and Blunk, Torsten and Meffert, Rainer H. and Hoelscher-Doht, Stefanie},
  title     = {Biomechanical analysis of different osteosyntheses and the combination with bone substitute in tibial head depression fractures},
  series = {BMC Musculoskeletal Disorders},
  volume    = {17},
  journal   = {BMC Musculoskeletal Disorders},
  number    = {287},
  doi       = {10.1186/s12891-016-1118-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-161201},
  year      = {2016},
  abstract  = {Background Tibial head depression fractures demand a high level of fracture stabilization to prevent a secondary loss of reduction after surgery. Elderly individuals are at an increased risk of developing these fractures, and biomechanical investigations of the fractures are rare. Therefore, the aim of this study was to systematically analyze different types of osteosyntheses in combination with two commonly used bone substitutes. Methods Lateral tibial head depression fractures were created in synthetic bones. After reduction, the fractures were stabilized with eight different treatment options of osteosynthesis alone or in combination with a bone substitute. Two screws, 4 screws and a lateral buttress plate were investigated. As a bone substitute, two common clinically used calcium phosphate cements, Norian® Drillable and ChronOS™ Inject, were applied. Displacement of the articular fracture fragment (mm) during cyclic loading, stiffness (N/mm) and maximum load (N) in Load-to-Failure tests were measured. Results The three different osteosyntheses (Group 1: 2 screws, group 2: 4 screws, group 3: plate) alone revealed a significantly higher displacement compared to the control group (Group 7: ChronOS™ Inject only) (Group 1, 7 [p < 0.01]; group 2, 7 [p = 0.04]; group 3, 7 [p < 0.01]). However, the osteosyntheses in combination with bone substitute exhibited no differences in displacement compared to the control group. The buttress plate demonstrated a higher normalized maximum load than the 2 and 4 screw osteosynthesis. Comparing the two different bone substitutes to each other, ChronOS™ inject had a significantly higher stiffness and lower displacement than Norian® Drillable. Conclusions The highest biomechanical stability under maximal loading was provided by a buttress plate osteosynthesis. A bone substitute, such as the biomechanically favorable ChronOS™ Inject, is essential to reduce the displacement under lower loading.},
  language  = {en}
}
@article{JordanJovicGilbertetal.2020,
  author    = {Jordan, Martin C. and Jovic, Sebastian and Gilbert, Fabian and Kunz, Andreas and Ertl, Maximilian and Strobl, Ute and Jakubietz, Rafael G. and Jakubietz, Michael G. and Meffert, Rainer H. and Fuchs, Konrad F.},
  title     = {Qualit{\"a}tssteigerung der Abrechnungspr{\"u}fung durch Smartphone-basierte Fotodokumentation in der Unfall-, Hand-, und Plastischen Chirurgie},
  series = {Der Unfallchirurg},
  volume    = {124},
  journal   = {Der Unfallchirurg},
  issn      = {0177-5537},
  doi       = {10.1007/s00113-020-00866-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232415},
  pages     = {366-372},
  year      = {2020},
  abstract  = {Hintergrund Die Fotodokumentation von offenen Frakturen, Wunden, Dekubitalulzera, Tumoren oder Infektionen ist ein wichtiger Bestandteil der digitalen Patientenakte. Bisher ist unklar, welchen Stellenwert diese Fotodokumentation bei der Abrechnungspr{\"u}fung durch den Medizinischen Dienst der Krankenkassen (MDK) hat. Fragestellung Kann eine Smartphone-basierte Fotodokumentation die Verteidigung von erl{\"o}srelevanten Diagnosen und Prozeduren sowie der Verweildauer verbessern? Material und Methoden Ausstattung der Mitarbeiter mit digitalen Endger{\"a}ten (Smartphone/Tablet) in den Bereichen Notaufnahme, Schockraum, OP, Sprechstunden sowie auf den Stationen. Retrospektive Auswertung der Abrechnungspr{\"u}fung im Jahr 2019 und Identifikation aller Fallbesprechungen, in denen die Fotodokumentation eine Erl{\"o}sver{\"a}nderung bewirkt hat. Ergebnisse Von insgesamt 372 Fallbesprechungen half die Fotodokumentation in 27 F{\"a}llen (7,2 \%) zur Best{\"a}tigung eines Operationen- und Prozedurenschl{\"u}ssels (OPS) (n = 5; 1,3 \%), einer Hauptdiagnose (n = 10; 2,7 \%), einer Nebendiagnose (n = 3; 0,8 \%) oder der Krankenhausverweildauer (n = 9; 2,4 \%). Pro oben genanntem Fall mit Fotodokumentation ergab sich eine durchschnittliche Erl{\"o}ssteigerung von 2119 €. Inklusive Aufwandpauschale f{\"u}r die Verhandlungen wurde somit ein Gesamtbetrag von 65.328 € verteidigt. Diskussion Der Einsatz einer Smartphone-basierten Fotodokumentation kann die Qualit{\"a}t der Dokumentation verbessern und Erl{\"o}seinbußen bei der Abrechnungspr{\"u}fung verhindern. Die Implementierung digitaler Endger{\"a}te mit entsprechender Software ist ein wichtiger Teil des digitalen Strukturwandels in Kliniken.},
  language  = {de}
}
@article{HeiligFaerberPauletal.2022,
  author    = {Heilig, Philipp and Faerber, Lars-Christopher and Paul, Mila M. and Kupczyk, Eva and Meffert, Rainer H. and Jordan, Martin C. and Hoelscher-Doht, Stefanie},
  title     = {Plate osteosynthesis combined with bone cement provides the highest stability for tibial head depression fractures under high loading conditions},
  series = {Scientific Reports},
  volume    = {12},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-022-19107-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299782},
  year      = {2022},
  abstract  = {Older patients sustaining tibial head depression fractures often cannot follow the post-operative rehabilitation protocols with partial weight-bearing of the affected limb, leading to osteosynthesis failure, cartilage step-off and arthritis development. Therefore, the aim of this study was to analyse the biomechanical performance of different types of osteosyntheses alone and in combination with bone cement simulating cyclically high loading conditions of tibial head depression fractures. Lateral tibial head depression fractures (AO: 41-B2.2; Schatzker type III) were created in synthetic bones and stabilized using three different osteosyntheses alone and in combination with a commonly used bone cement (chronOS™): 2 screws, 4 screws in the jail technique and a lateral angle-stable buttress plate. After fixation, the lateral tibial plateau was axially loaded in two, from each other independent testing series: In the first test protocol, 5000 cycles with 500 N and in the end load-to-failure tests were performed. In the second test protocol, the cyclic loading was increased to 1000 N. Parameters of interest were the displacement of the articular fracture fragment, the stiffness and the maximum load. The osteosyntheses revealed a higher stiffness in combination with bone cement compared to the same type of osteosynthesis alone (e.g., 500 N level: 2 screws 383 ± 43 N/mm vs. 2 screws + chronOs 520 ± 108 N/mm, increase by 36\%, p < 0.01; 4 screws 368 ± 97 N/mm vs. 4 screws + chronOS 516 ± 109 N/mm, increase by 40\%, p < 0.01; plate: 509 ± 73 N/mm vs. plate + chronOs 792 ± 150 N/mm, increase by 56\%, p < 0.01). Bone cement reduced the displacement of the plate significantly (500 N level: plate: 8.9 ± 2.8 mm vs. plate + chronOs: 3.1 ± 1.4 mm, reduction by 65\%, p < 0.01; 1000 N level: 16.9 ± 3.6 mm vs 5.6 ± 1.3 mm, reduction by 67\%, p < 0.01). Thus, the highest stiffness and lowest displacement values were found when using the plate with bone cement in both loading conditions (500 N level: 2 screws + chronOs 3.7 ± 1.3 mm, 4 screws + chronOs 6.2 ± 2.4 mm; 1000 N level: 2 screws + chronOs 6.5 ± 1.2 mm, 4 screws + chronOs 5.7 ± 0.8 mm). From a biomechanical perspective, plate osteosynthesis of tibial head depression fractures should always be combined with bone cement, provides higher stability than 2-screw and 4-screw fixation and is a valid treatment option in cases where extraordinary stability is required.},
  language  = {en}
}
@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}
}
@article{HeiligSandnerJordanetal.2021,
  author    = {Heilig, Philipp and Sandner, Phoebe and Jordan, Martin Cornelius and Jakubietz, Rafael Gregor and Meffert, Rainer Heribert and Gbureck, Uwe and Hoelscher-Doht, Stefanie},
  title     = {Experimental drillable magnesium phosphate cement is a promising alternative to conventional bone cements},
  series = {Materials},
  volume    = {14},
  journal   = {Materials},
  number    = {8},
  issn      = {1996-1944},
  doi       = {10.3390/ma14081925},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236633},
  year      = {2021},
  abstract  = {Clinically used mineral bone cements lack high strength values, absorbability and drillability. Therefore, magnesium phosphate cements have recently received increasing attention as they unify a high mechanical performance with presumed degradation in vivo. To obtain a drillable cement formulation, farringtonite (Mg\(_3\)(PO\(_4\))\(_2\)) and magnesium oxide (MgO) were modified with the setting retardant phytic acid (C\(_6\)H\(_{18}\)O\(_{24}\)P\(_6\)). In a pre-testing series, 13 different compositions of magnesium phosphate cements were analyzed concentrating on the clinical demands for application. Of these 13 composites, two cement formulations with different phytic acid content (22.5 wt\% and 25 wt\%) were identified to meet clinical demands. Both formulations were evaluated in terms of setting time, injectability, compressive strength, screw pullout tests and biomechanical tests in a clinically relevant fracture model. The cements were used as bone filler of a metaphyseal bone defect alone, and in combination with screws drilled through the cement. Both formulations achieved a setting time of 5 min 30 s and an injectability of 100\%. Compressive strength was shown to be ~12-13 MPa and the overall displacement of the reduced fracture was <2 mm with and without screws. Maximum load until reduced fracture failure was ~2600 N for the cements only and ~3800 N for the combination with screws. Two new compositions of magnesium phosphate cements revealed high strength in clinically relevant biomechanical test set-ups and add clinically desired characteristics to its strength such as injectability and drillability.},
  language  = {en}
}
@article{FuchsHeiligMcDonoghetal.2020,
  author    = {Fuchs, Konrad F. and Heilig, Philipp and McDonogh, Miriam and Boelch, Sebastian and Gbureck, Uwe and Meffert, Rainer H. and Hoelscher-Doht, Stefanie and Jordan, Martin C.},
  title     = {Cement-augmented screw fixation for calcaneal fracture treatment: a biomechanical study comparing two injectable bone substitutes},
  series = {Journal of Orthopaedic Surgery and Research},
  volume    = {15},
  journal   = {Journal of Orthopaedic Surgery and Research},
  doi       = {10.1186/s13018-020-02009-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230336},
  year      = {2020},
  abstract  = {Background The role of cement-augmented screw fixation for calcaneal fracture treatment remains unclear. Therefore, this study was performed to biomechanically analyze screw osteosynthesis by reinforcement with either a calcium phosphate (CP)-based or polymethylmethacrylate (PMMA)-based injectable bone cement. Methods A calcaneal fracture (Sanders type IIA) including a central cancellous bone defect was generated in 27 synthetic bones, and the specimens were assigned to 3 groups. The first group was fixed with four screws (3.5 mm and 6.5 mm), the second group with screws and CP-based cement (Graftys (R) QuickSet; Graftys, Aix-en-Provence, France), and the third group with screws and PMMA-based cement (Traumacem (TM) V+; DePuy Synthes, Warsaw, IN, USA). Biomechanical testing was conducted to analyze peak-to-peak displacement, total displacement, and stiffness in following a standardized protocol. Results The peak-to-peak displacement under a 200-N load was not significantly different among the groups; however, peak-to-peak displacement under a 600- and 1000-N load as well as total displacement exhibited better stability in PMMA-augmented screw osteosynthesis compared to screw fixation without augmentation. The stiffness of the construct was increased by both CP- and PMMA-based cements. Conclusion Addition of an injectable bone cement to screw osteosynthesis is able to increase fixation strength in a biomechanical calcaneal fracture model with synthetic bones. In such cases, PMMA-based cements are more effective than CP-based cements because of their inherently higher compressive strength. However, whether this high strength is required in the clinical setting for early weight-bearing remains controversial, and the non-degradable properties of PMMA might cause difficulties during subsequent interventions in younger patients.},
  language  = {en}
}
@article{JordanBittrichFehskeetal.2017,
  author    = {Jordan, Martin C. and Bittrich, Leonie A. and Fehske, Kai and Meffert, Rainer H. and Jansen, Hendrik},
  title     = {A rare case of Hoffa fracture combined with lateral patellar dislocation},
  series = {Trauma Case Reports},
  volume    = {9},
  journal   = {Trauma Case Reports},
  doi       = {10.1016/j.tcr.2017.05.001},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158315},
  pages     = {13-16},
  year      = {2017},
  abstract  = {The coronal unicondylar fracture of the distal femur (AO 33-B3) is a rare intraarticular injury within the weight bearing area of the knee, initially described by Albert Hoffa in 1904. We report an unusual combination of a Hoffa fracture with lateral patellar dislocation in a young adult. Our patient sustained the injury by a sudden twist of his leg during sports. He presented clinically with knee swelling, dislocation of the patella, and localized tenderness; unable to bare weight. After plane radiograph confirmed the injury, manual reduction of the patella was done by hyperextension of the knee and medialward pressure. Afterwards, a CT scan and MRI were conducted. The injury was surgically treated with lag-screws, locking-plate and MPFL-reconstruction.},
  language  = {en}
}
@article{FuchsEdenGilbertetal.2021,
  author    = {Fuchs, Konrad F. and Eden, Lars and Gilbert, Fabian and Bernuth, Silvia and Wurmb, Thomas and Meffert, Rainer H. and Jordan, Martin C.},
  title     = {F{\"u}hrt eine COVID-19-bedingte Ausgangsbeschr{\"a}nkung zu einer Reduktion schwer verletzter Patienten an einem {\"u}berregionalen Traumazentrum?},
  series = {Der Unfallchirurg},
  volume    = {124},
  journal   = {Der Unfallchirurg},
  number    = {5},
  doi       = {10.1007/s00113-020-00924-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265268},
  pages     = {352-357},
  year      = {2021},
  abstract  = {Hintergrund Intensiv- und Beatmungskapazit{\"a}ten sind f{\"u}r die Behandlung COVID-19-erkrankter Patienten essenziell. Unabh{\"a}ngig davon beanspruchen auch schwer verletzte Patienten h{\"a}ufig Intensiv- und Beatmungskapazit{\"a}ten. Daraus ergibt sich folgende Fragestellung: F{\"u}hrt eine Ausgangsbeschr{\"a}nkung zu einer Reduktion schwer verletzter Patienten, und kann hierdurch mit frei werdenden Intensivkapazit{\"a}ten gerechnet werden? Material und Methoden Es erfolgte eine retrospektive Auswertung schwer verletzter Patienten mit einem Injury Severity Score (ISS) ≥16 zwischen dem 17.03.2020 und 30.04.2020 (landesweiter Shutdown) an einem {\"u}berregionalen Traumazentrum. Erfasst wurden der Unfallmechanismus, ISS, Versicherungstr{\"a}ger (BG vs. GKV/PKV), ob es sich um einen dokumentierten Suizidversuch handelte, und ob eine operative Intervention innerhalb der ersten 24 h erforderlich war. Als Kontrollgruppe wurden die Daten des gleichen Zeitraums der Jahre 2018 und 2019 ausgewertet. Ergebnisse Es konnte keine wesentliche Ver{\"a}nderung bez{\"u}glich der Anzahl an schwer verletzten Patienten festgestellt werden (2018 n = 30, 2019 n = 23, 2020 n = 27). Es zeigten sich insgesamt keine deutlichen Ver{\"a}nderungen der absoluten Zahlen bez{\"u}glich der Intensivpflichtigkeit in den ersten 24 h und der Beatmungspflichtigkeit beim Verlassen des Schockraums. Die Anzahl an Patienten, die eine Operation innerhalb der ersten 24 h nach Eintreffen im Schockraum ben{\"o}tigten, war 2020 sogar leicht erh{\"o}ht, jedoch nicht statistisch signifikant. Der durchschnittliche ISS blieb konstant. Bez{\"u}glich der Unfallursache zeigte sich 2020 kein Motorradfahrer, der einen nicht berufsgenossenschaftlich versicherten Unfall erlitt (2018 n = 5, 2019 n = 4, 2020 n = 0). Es wurde 2020 ein erh{\"o}hter Anteil an Arbeitsunf{\"a}llen mit einem ISS ≥16 festgestellt (2018: 10 \%, 2019: 26,1 \%, 2020: 44,4 \%). Diskussion Eine Ausgangsbeschr{\"a}nkung f{\"u}hrte zu keiner Reduktion verletzter- und intensivpflichtiger Patienten am untersuchten Zentrum. Auch unter einer landesweiten Ausgangsbeschr{\"a}nkung muss f{\"u}r dieses Patientenkollektiv eine ausreichende Menge an Intensiv- und OP-Kapazit{\"a}ten vorgehalten werden. Die Best{\"a}tigung dieser Ergebnisse durch Auswertung nationaler Register steht noch aus.},
  language  = {de}
}
@article{BaeuerleinQureischiMokhtarietal.2021,
  author    = {B{\"a}uerlein, Carina A. and Qureischi, Musga and Mokhtari, Zeinab and Tabares, Paula and Brede, Christian and Jord{\´a}n Garrote, Ana-Laura and Riedel, Simone S. and Chopra, Martin and Reu, Simone and Mottok, Anja and Arellano-Viera, Estibaliz and Graf, Carolin and Kurzwart, Miriam and Schmiedgen, Katharina and Einsele, Hermann and W{\"o}lfl, Matthias and Schlegel, Paul-Gerhardt and Beilhack, Andreas},
  title     = {A T-Cell Surface Marker Panel Predicts Murine Acute Graft-Versus-Host Disease},
  series = {Frontiers in Immunology},
  volume    = {11},
  journal   = {Frontiers in Immunology},
  issn      = {1664-3224},
  doi       = {10.3389/fimmu.2020.593321},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-224290},
  year      = {2021},
  abstract  = {Acute graft-versus-host disease (aGvHD) is a severe and often life-threatening complication of allogeneic hematopoietic cell transplantation (allo-HCT). AGvHD is mediated by alloreactive donor T-cells targeting predominantly the gastrointestinal tract, liver, and skin. Recent work in mice and patients undergoing allo-HCT showed that alloreactive T-cells can be identified by the expression of α4β7 integrin on T-cells even before manifestation of an aGvHD. Here, we investigated whether the detection of a combination of the expression of T-cell surface markers on peripheral blood (PB) CD8\(^+\) T-cells would improve the ability to predict aGvHD. To this end, we employed two independent preclinical models of minor histocompatibility antigen mismatched allo-HCT following myeloablative conditioning. Expression profiles of integrins, selectins, chemokine receptors, and activation markers of PB donor T-cells were measured with multiparameter flow cytometry at multiple time points before the onset of clinical aGvHD symptoms. In both allo-HCT models, we demonstrated a significant upregulation of α4β7 integrin, CD162E, CD162P, and conversely, a downregulation of CD62L on donor T-cells, which could be correlated with the development of aGvHD. Other surface markers, such as CD25, CD69, and CC-chemokine receptors were not found to be predictive markers. Based on these preclinical data from mouse models, we propose a surface marker panel on peripheral blood T-cells after allo-HCT combining α4β7 integrin with CD62L, CD162E, and CD162P (cutaneous lymphocyte antigens, CLA, in humans) to identify patients at risk for developing aGvHD early after allo-HCT.},
  language  = {en}
}
@article{JordanJaeckleScheidtetal.2020,
  author    = {Jordan, Martin C. and J{\"a}ckle, Veronika and Scheidt, Sebastian and Eden, Lars and Gilbert, Fabian and Heintel, Timo M. and Jansen, Hendrik and Meffert, Rainer H.},
  title     = {Ergebnisse nach Plattenstabilisierung der Symphysensprengung},
  series = {Der Unfallchirurg},
  volume    = {123},
  journal   = {Der Unfallchirurg},
  issn      = {0177-5537},
  doi       = {10.1007/s00113-020-00804-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232447},
  pages     = {870-878},
  year      = {2020},
  abstract  = {Hintergrund Die Symphysensprengung mit entsprechender Diastase kann durch eine Symphysenplatte stabilisiert werden. Fragestellung Welche Beckenverletzungen werden mit einer Symphysenplatte stabilisiert und wie ist das Outcome? Material und Methoden Retrospektive Auswertung von 64 Patienten {\"u}ber einen Untersuchungszeitraum von 24 Monaten. Ergebnisse Es waren 56 Patienten m{\"a}nnlich, 8 weiblich und das mittlere Alter betrug 44 Jahre (SD ± 17). Unf{\"a}lle im Straßenverkehr waren der f{\"u}hrende Grund f{\"u}r die Beckenverletzung. Die Verteilung nach AO-Klassifikation zeigte sich wie folgt: 14-mal B1-, 10-mal B2-, 5‑mal B3-, 23-mal C1-, 9‑mal C2- und 3‑mal C3-Verletzungen. Die Verteilung nach Young und Burgess ergab: 9‑mal APC-I-, 18-mal APC-II-, 13-mal APC-III-, 9‑mal LC-I-, 3‑mal LC-II-, 2‑mal LC-III- und 10-mal VS-Verletzungen. Der mittlere Injury Severity Score (ISS) betrug 32 und die mittlere station{\"a}re Verweildauer 29 Tage (pos. Korrelation p ≤ 0,001). Im Verlauf war eine radiologische Implantatlockerung bei 52 Patienten nachweisbar. Therapierelevante Komplikationen gab es in 14 F{\"a}llen. Hierbei war das Implantatversagen (n = 8) der Hauptgrund f{\"u}r eine operative Revision. Diskussion Obwohl die radiologische Implantatlockerung h{\"a}ufig beobachtet wird, ist sie nur selten Grund f{\"u}r einen Revisionseingriff. Kommt es hingegen zum vollst{\"a}ndigen Implantatversagen, tritt dies meist innerhalb der ersten postoperativen Wochen auf und ist revisionsbed{\"u}rftig. Eine fr{\"u}hzeitige Abkl{\"a}rung durch R{\"o}ntgenbildgebung sollte bei Verdacht erfolgen.},
  language  = {de}
}
@article{FuchsEdenGilbertetal.2021,
  author    = {Fuchs, Konrad F. and Eden, Lars and Gilbert, Fabian and Bernuth, Silvia and Wurmb, Thomas and Meffert, Rainer H. and Jordan, Martin C.},
  title     = {F{\"u}hrt eine COVID-19 bedingte Ausgangsbeschr{\"a}nkung zu einer Reduktion schwerverletzter Patienten an einem {\"u}berregionalen Traumazentrum?},
  series = {Der Unfallchirurg},
  volume    = {124},
  journal   = {Der Unfallchirurg},
  issn      = {0177-5537},
  doi       = {10.1007/s00113-020-00924-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232547},
  pages     = {352-357},
  year      = {2021},
  abstract  = {Hintergrund Intensiv- und Beatmungskapazit{\"a}ten sind f{\"u}r die Behandlung COVID-19-erkrankter Patienten essenziell. Unabh{\"a}ngig davon beanspruchen auch schwer verletzte Patienten h{\"a}ufig Intensiv- und Beatmungskapazit{\"a}ten. Daraus ergibt sich folgende Fragestellung: F{\"u}hrt eine Ausgangsbeschr{\"a}nkung zu einer Reduktion schwer verletzter Patienten, und kann hierdurch mit frei werdenden Intensivkapazit{\"a}ten gerechnet werden? Material und Methoden Es erfolgte eine retrospektive Auswertung schwer verletzter Patienten mit einem Injury Severity Score (ISS) ≥16 zwischen dem 17.03.2020 und 30.04.2020 (landesweiter Shutdown) an einem {\"u}berregionalen Traumazentrum. Erfasst wurden der Unfallmechanismus, ISS, Versicherungstr{\"a}ger (BG vs. GKV/PKV), ob es sich um einen dokumentierten Suizidversuch handelte, und ob eine operative Intervention innerhalb der ersten 24 h erforderlich war. Als Kontrollgruppe wurden die Daten des gleichen Zeitraums der Jahre 2018 und 2019 ausgewertet. Ergebnisse Es konnte keine wesentliche Ver{\"a}nderung bez{\"u}glich der Anzahl an schwer verletzten Patienten festgestellt werden (2018 n = 30, 2019 n = 23, 2020 n = 27). Es zeigten sich insgesamt keine deutlichen Ver{\"a}nderungen der absoluten Zahlen bez{\"u}glich der Intensivpflichtigkeit in den ersten 24 h und der Beatmungspflichtigkeit beim Verlassen des Schockraums. Die Anzahl an Patienten, die eine Operation innerhalb der ersten 24 h nach Eintreffen im Schockraum ben{\"o}tigten, war 2020 sogar leicht erh{\"o}ht, jedoch nicht statistisch signifikant. Der durchschnittliche ISS blieb konstant. Bez{\"u}glich der Unfallursache zeigte sich 2020 kein Motorradfahrer, der einen nicht berufsgenossenschaftlich versicherten Unfall erlitt (2018 n = 5, 2019 n = 4, 2020 n = 0). Es wurde 2020 ein erh{\"o}hter Anteil an Arbeitsunf{\"a}llen mit einem ISS ≥16 festgestellt (2018: 10 \%, 2019: 26,1 \%, 2020: 44,4 \%). Diskussion Eine Ausgangsbeschr{\"a}nkung f{\"u}hrte zu keiner Reduktion verletzter- und intensivpflichtiger Patienten am untersuchten Zentrum. Auch unter einer landesweiten Ausgangsbeschr{\"a}nkung muss f{\"u}r dieses Patientenkollektiv eine ausreichende Menge an Intensiv- und OP-Kapazit{\"a}ten vorgehalten werden. Die Best{\"a}tigung dieser Ergebnisse durch Auswertung nationaler Register steht noch aus.},
  language  = {de}
}
@article{KippnichDuempertSchorscheretal.2022,
  author    = {Kippnich, Maximilian and Duempert, Maximilian and Schorscher, Nora and Jordan, Martin C. and Kunz, Andreas S. and Meybohm, Patrick and Wurmb, Thomas},
  title     = {Simultaneous treatment of trauma patients in a dual room trauma suite with integrated movable sliding gantry CT system: an observational study},
  series = {Scientific Reports},
  volume    = {12},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-022-20491-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299695},
  year      = {2022},
  abstract  = {The trauma center of the University Hospital Wuerzburg has developed an advanced trauma pathway based on a dual-room trauma suite with an integrated movable sliding gantry CT-system. This enables simultaneous CT-diagnostics and treatment of two trauma patients. The focus of this study was to investigate the quality of the concept based on defined outcome criteria in this specific setting (time from arrival to initiation of CT scan: tCT; time from arrival to initiation of emergency surgery: tES). We analyzed all trauma patients admitted to the hospital's trauma suite from 1st May 2019 through 29th April 2020. Two subgroups were defined: trauma patients, who were treated without a second trauma patient present (group 1) and patients, who were treated simultaneously with another trauma patient (group 2). Simultaneous treatment was defined as parallel arrival within a period of 20 min. Of 423 included trauma patients, 46 patients (10.9\%) were treated simultaneously. Car accidents were the predominant trauma mechanism in this group (19.6\% vs. 47.8\%, p < 0.05). Prehospital life-saving procedures were performed with comparable frequency in both groups (intubation 43.5\% vs. 39\%, p = 0.572); pleural drainage 3.2\% vs. 2.2\%, p = 0.708; cardiopulmonary resuscitation 5\% vs. 2.2\%, p = 0.387). At hospital admission, patients in group 2 suffered significantly more pain (E-problem according to Advanced Trauma Life Support principles©; 29.2\% vs. 45.7\%, p < 0.05). There were no significant differences in the clinical treatment (emergency procedures, vasopressor and coagulant therapy, and transfusion of red blood cells). tCT was 6 (4-10) minutes (median and IQR) in group 1 and 8 (5-15.5) minutes in group 2 (p = 0.280). tES was 90 (78-106) minutes in group 1 and 99 (97-108) minutes in group 2 (p = 0.081). The simultaneous treatment of two trauma patients in a dual-room trauma suite with an integrated movable sliding gantry CT-system requires a medical, organizational, and technical concept adapted to this special setting. Despite the oftentimes serious and life-threatening injuries, optimal diagnostic and therapeutic procedures can be guaranteed for two simultaneous trauma patients at an individual medical level in consistent quality.},
  language  = {en}
}
@article{HabartaJordanMeffertetal.,
  author    = {Habarta, Johanna and Jordan, Martin and Meffert, Rainer and Huflage, Henner and Schmalzl, Jonas},
  title     = {Surgical management of a traumatic elbow dislocation with disruption of the brachial artery. Case report},
  series = {Obere Extremit{\"a}t},
  volume    = {17},
  journal   = {Obere Extremit{\"a}t},
  number    = {4},
  issn      = {1862-6599},
  doi       = {10.1007/s11678-022-00686-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323972},
  pages     = {267-271},
  abstract  = {Background Dislocations of the elbow are the second most common dislocations of humeral joints following the shoulder. Besides numerous possible concomitant injuries of the collateral ligaments or the extensor or flexor apparatus, an accompanying disruption of the brachial artery is a rare occurrence. In the following, such a case is presented and discussed. Method A 70-year-old woman sustained a closed posterior elbow dislocation with accompanying disruption of the brachial artery due to a fall in a domestic environment. Pulselessness of the radial artery led to a computed tomography angiography being performed, which confirmed the diagnosis. Direct operative vascular reconstruction with a vein insert was carried out. Due to strong swelling of the soft tissue, other examinations of the elbow could not be performed initially. A redislocation a few days later led to an operative stabilization of the elbow joint. Results The final consultation 4 months postoperatively showed a stable, centered elbow joint and a normal perfusion of the affected arm. The elbow function was good with a range of motion of 0/0/110° of extension/flexion. Conclusion An elbow dislocation is a complex injury. An accurate clinical examination of possible concomitant injuries is important and should be repeated in the first few days after the occurrence. Vascular reconstruction should be performed immediately. In the case of persistent joint instability, an operative stabilization is indicated and may be supported by a hinged external fixator.},
  language  = {en}
}
@article{LuekeHallerUtpateletal.2022,
  author    = {L{\"u}ke, Florian and Haller, Florian and Utpatel, Kirsten and Krebs, Markus and Meidenbauer, Norbert and Scheiter, Alexander and Spoerl, Silvia and Heudobler, Daniel and Sparrer, Daniela and Kaiser, Ulrich and Keil, Felix and Schubart, Christoph and T{\"o}gel, Lars and Einhell, Sabine and Dietmaier, Wolfgang and Huss, Ralf and Dintner, Sebastian and Sommer, Sebastian and Jordan, Frank and Goebeler, Maria-Elisabeth and Metz, Michaela and Haake, Diana and Scheytt, Mithun and Gerhard-Hartmann, Elena and Maurus, Katja and Br{\"a}ndlein, Stephanie and Rosenwald, Andreas and Hartmann, Arndt and M{\"a}rkl, Bruno and Einsele, Hermann and Mackensen, Andreas and Herr, Wolfgang and Kunzmann, Volker and Bargou, Ralf and Beckmann, Matthias W. and Pukrop, Tobias and Trepel, Martin and Evert, Matthias and Claus, Rainer and Kerscher, Alexander},
  title     = {Identification of disparities in personalized cancer care — a joint approach of the German WERA consortium},
  series = {Cancers},
  volume    = {14},
  journal   = {Cancers},
  number    = {20},
  issn      = {2072-6694},
  doi       = {10.3390/cancers14205040},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-290311},
  year      = {2022},
  abstract  = {(1) Background: molecular tumor boards (MTBs) are crucial instruments for discussing and allocating targeted therapies to suitable cancer patients based on genetic findings. Currently, limited evidence is available regarding the regional impact and the outreach component of MTBs; (2) Methods: we analyzed MTB patient data from four neighboring Bavarian tertiary care oncology centers in W{\"u}rzburg, Erlangen, Regensburg, and Augsburg, together constituting the WERA Alliance. Absolute patient numbers and regional distribution across the WERA-wide catchment area were weighted with local population densities; (3) Results: the highest MTB patient numbers were found close to the four cancer centers. However, peaks in absolute patient numbers were also detected in more distant and rural areas. Moreover, weighting absolute numbers with local population density allowed for identifying so-called white spots—regions within our catchment that were relatively underrepresented in WERA MTBs; (4) Conclusions: investigating patient data from four neighboring cancer centers, we comprehensively assessed the regional impact of our MTBs. The results confirmed the success of existing collaborative structures with our regional partners. Additionally, our results help identifying potential white spots in providing precision oncology and help establishing a joint WERA-wide outreach strategy.},
  language  = {en}
}
@article{PaulMiedenLeferingetal.2023,
  author    = {Paul, Mila M. and Mieden, Hannah J. and Lefering, Rolf and Kupczyk, Eva K. and Jordan, Martin C. and Gilbert, Fabian and Meffert, Rainer H. and Sir{\´e}n, Anna-Leena and Hoelscher-Doht, Stefanie},
  title     = {Impact of a femoral fracture on outcome after traumatic brain injury — a matched-pair analysis of the TraumaRegister DGU\(^®\)},
  series = {Journal of Clinical Medicine},
  volume    = {12},
  journal   = {Journal of Clinical Medicine},
  number    = {11},
  issn      = {2077-0383},
  doi       = {10.3390/jcm12113802},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319363},
  year      = {2023},
  abstract  = {Traumatic brain injury (TBI) is the leading cause of death and disability in polytrauma and is often accompanied by concomitant injuries. We conducted a retrospective matched-pair analysis of data from a 10-year period from the multicenter database TraumaRegister DGU\(^®\) to analyze the impact of a concomitant femoral fracture on the outcome of TBI patients. A total of 4508 patients with moderate to critical TBI were included and matched by severity of TBI, American Society of Anesthesiologists (ASA) risk classification, initial Glasgow Coma Scale (GCS), age, and sex. Patients who suffered combined TBI and femoral fracture showed increased mortality and worse outcome at the time of discharge, a higher chance of multi-organ failure, and a rate of neurosurgical intervention. Especially those with moderate TBI showed enhanced in-hospital mortality when presenting with a concomitant femoral fracture (p = 0.037). The choice of fracture treatment (damage control orthopedics vs. early total care) did not impact mortality. In summary, patients with combined TBI and femoral fracture have higher mortality, more in-hospital complications, an increased need for neurosurgical intervention, and inferior outcome compared to patients with TBI solely. More investigations are needed to decipher the pathophysiological consequences of a long-bone fracture on the outcome after TBI.},
  language  = {en}
}