TY  - JOUR
A1  - Jordan, Martin C.
A1  - Bittrich, Leonie A.
A1  - Fehske, Kai
A1  - Meffert, Rainer H.
A1  - Jansen, Hendrik
T1  - A rare case of Hoffa fracture combined with lateral patellar dislocation
JF  - Trauma Case Reports
N2  - 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.
KW  - dislocation
KW  - femur
KW  - fracture
KW  - Hoffa
KW  - MPFL
KW  - patella
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158315
VL  - 9
ER  - 
TY  - JOUR
A1  - Jordan, Martin C.
A1  - Jäckle, Veronika
A1  - Scheidt, Sebastian
A1  - Eden, Lars
A1  - Gilbert, Fabian
A1  - Heintel, Timo M.
A1  - Jansen, Hendrik
A1  - Meffert, Rainer H.
T1  - Ergebnisse nach Plattenstabilisierung der Symphysensprengung
JF  - Der Unfallchirurg
N2  - 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 über einen Untersuchungszeitraum von 24 Monaten.

Ergebnisse
Es waren 56 Patienten männlich, 8 weiblich und das mittlere Alter betrug 44 Jahre (SD ± 17). Unfälle im Straßenverkehr waren der führende Grund für 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 stationäre Verweildauer 29 Tage (pos. Korrelation p ≤ 0,001). Im Verlauf war eine radiologische Implantatlockerung bei 52 Patienten nachweisbar. Therapierelevante Komplikationen gab es in 14 Fällen. Hierbei war das Implantatversagen (n = 8) der Hauptgrund für eine operative Revision.

Diskussion
Obwohl die radiologische Implantatlockerung häufig beobachtet wird, ist sie nur selten Grund für einen Revisionseingriff. Kommt es hingegen zum vollständigen Implantatversagen, tritt dies meist innerhalb der ersten postoperativen Wochen auf und ist revisionsbedürftig. Eine frühzeitige Abklärung durch Röntgenbildgebung sollte bei Verdacht erfolgen.
N2  - Background
Separation of the pubic symphysis with corresponding diastasis can be stabilized by symphyseal plating.

Objective
Which pelvic injuries are stabilized with symphyseal plating and what is their outcome?

Material and methods
A retrospective evaluation of 64 patients who underwent symphyseal plating over a period of 24 months was conducted.

Results
Of the patients 56 were male and 8 female with a mean age of 44 years (SD ± 17 years). The main cause of the pelvic injuries were traffic accidents. The distribution according to the AO fracture classification was 14 × B1, 10 × B2, 5 × B3, 23 × C1, 9 × C2 and 3 × C3 injuries. The distribution according to the Young and Burgess classification showed 9 × APC I, 18 × APC II, 13 × APC III, 9 × LC I, 3 × LC II, 2 × LC III and 10 × VS injuries. The mean Injury Severity Score (ISS) was 32 (SD ± 17) and the mean inpatient stay was 29 days (SD ± 16 days; positive correlation p ≤ 0.001). Radiological implant loosening occurred in 52 patients. 14 patients required treatment for severe complications. The leading reason for revision surgery was implant failure (n = 8).

Conclusion
These observations suggest that radiological signs of implant loosening are commonly observed but rarely the reason for revision surgery. Complete implant failures, however; occur mainly within the first postoperative weeks and require early revision. A timely clarification by additional X-ray imaging should be carried out if this is suspected.
KW  - Beckenring
KW  - Beckenfraktur
KW  - AO
KW  - Fixation
KW  - Trauma
KW  - pelvic ring
KW  - pelciv fracture
KW  - AO
KW  - fixation
KW  - trauma
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232447
SN  - 0177-5537
VL  - 123
ER  - 
TY  - JOUR
A1  - Westbury, Sarah K
A1  - Turro, Ernest
A1  - Greene, Daniel
A1  - Lentaigne, Claire
A1  - Kelly, Anne M
A1  - Bariana, Tadbir K
A1  - Simeoni, Ilenia
A1  - Pillois, Xavier
A1  - Attwood, Antony
A1  - Austin, Steve
A1  - Jansen, Sjoert BG
A1  - Bakchoul, Tamam
A1  - Crisp-Hihn, Abi
A1  - Erber, Wendy N
A1  - Favier, Rémi
A1  - Foad, Nicola
A1  - Gattens, Michael
A1  - Jolley, Jennifer D
A1  - Liesner, Ri
A1  - Meacham, Stuart
A1  - Millar, Carolyn M
A1  - Nurden, Alan T
A1  - Peerlinck, Kathelijne
A1  - Perry, David J
A1  - Poudel, Pawan
A1  - Schulman, Sol
A1  - Schulze, Harald
A1  - Stephens, Jonathan C
A1  - Furie, Bruce
A1  - Robinson, Peter N
A1  - van Geet, Chris
A1  - Rendon, Augusto
A1  - Gomez, Keith
A1  - Laffan, Michael A
A1  - Lambert, Michele P
A1  - Nurden, Paquita
A1  - Ouwehand, Willem H
A1  - Richardson, Sylvia
A1  - Mumford, Andrew D
A1  - Freson, Kathleen
T1  - Human phenotype ontology annotation and cluster analysis to unravel genetic defects in 707 cases with unexplained bleeding and platelet disorders
JF  - Genome Medicine
N2  - Background: 
Heritable bleeding and platelet disorders (BPD) are heterogeneous and frequently have an unknown genetic basis. The BRIDGE-BPD study aims to discover new causal genes for BPD by high throughput sequencing using cluster analyses based on improved and standardised deep, multi-system phenotyping of cases. 
Methods: 
We report a new approach in which the clinical and laboratory characteristics of BPD cases are annotated with adapted Human Phenotype Ontology (HPO) terms. Cluster analyses are then used to characterise groups of cases with similar HPO terms and variants in the same genes. Results: 
We show that 60% of index cases with heritable BPD enrolled at 10 European or US centres were annotated with HPO terms indicating abnormalities in organ systems other than blood or blood-forming tissues, particularly the nervous system. Cases within pedigrees clustered closely together on the bases of their HPO-coded phenotypes, as did cases sharing several clinically suspected syndromic disorders. Cases subsequently found to harbour variants in ACTN1 also clustered closely, even though diagnosis of this recently described disorder was not possible using only the clinical and laboratory data available to the enrolling clinician. 
Conclusions: 
These findings validate our novel HPO-based phenotype clustering methodology for known BPD, thus providing a new discovery tool for BPD of unknown genetic basis. This approach will also be relevant for other rare diseases with significant genetic heterogeneity.
KW  - disease
KW  - thrombocytopenia
KW  - guidelines
KW  - complex
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-143329
VL  - 7
IS  - 36
ER  -