@article{JakubietzJakubietzSchmidtetal.2021,
  author    = {Jakubietz, Michael Georg and Jakubietz, Danni Felicitas and Schmidt, Karsten and Jakubietz, Rafael Gregor},
  title     = {Blepharoplastik bei asiatischen Augen},
  series = {Journal f{\"u}r {\"A}sthetische Chirurgie},
  volume    = {14},
  journal   = {Journal f{\"u}r {\"A}sthetische Chirurgie},
  number    = {4},
  issn      = {1867-4313},
  doi       = {10.1007/s12631-021-00276-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270189},
  pages     = {161-165},
  year      = {2021},
  abstract  = {Die operative Verj{\"u}ngung des Auges stellt einen der am h{\"a}ufigsten nachgefragten Eingriffe im {\"a}sthetischen Spektrum dar. Die multikulturelle Bev{\"o}lkerungsstruktur bedingt, dass auch „asiatisch" imponierende Augen behandelt werden. „Asiatische" Augen sind aber nicht nur bei Asiaten anzutreffen, sondern in unterschiedlicher Auspr{\"a}gung auch bei Patienten aus dem Nahen und Mittleren Osten. Das asiatische Auge stellt in Bezug auf Verj{\"u}ngungsm{\"o}glichkeiten eine eigene Entit{\"a}t dar. W{\"a}hrend die klassische „Korrektur" des asiatischen Auges eine etablierte und durch eine Vielzahl von verschiedenen Techniken mit vorhersehbaren Ergebnissen verbundene Methode ist, ist eine „verj{\"u}ngende" Blepharoplastik des asiatischen Auges komplexer zu bewerten [1, 3, 5, 10]. Die Operationsmethoden f{\"u}r das „asiatische" Auge sind f{\"u}r j{\"u}ngere Patienten intendiert, bei denen es {\"u}berwiegend um die Korrektur des Epikanthus geht. Diese Techniken ziehen eine gew{\"u}nschte Ver{\"a}nderung des periorbitalen Erscheinungsbildes nach sich, wobei das asiatische Aussehen teilweise zugunsten eines vermehrt „europ{\"a}ischen" Aussehens beeinflusst wird. Fraglich bleibt, ob eine Ver{\"a}nderung zu einem europ{\"a}ischen Aussehen hin auch bei einem alternden Patienten einer Verj{\"u}ngung gleichkommt. Prinzipiell imponiert ein derart operiertes asiatisches Auge „k{\"u}nstlich", eine Tatsache die bei alternden Patienten als noch st{\"o}render als der Alterungsprozess selbst empfunden werden d{\"u}rfte. Daher ist der Wunsch nach einer Verj{\"u}ngung ohne Verlust des typischen asiatischen Erscheinungsbildes des Auges chirurgisch nicht mit der klassischen Technik bei Europ{\"a}ern umzusetzen. W{\"a}hrend die Behandlung durch eine klassische Blepharoplastik ein unnat{\"u}rliches Aussehen zur Folge hat, kann unter Respektierung der asiatischen anatomischen Besonderheiten eine nat{\"u}rlich wirkende Verj{\"u}ngung erreicht werden.},
  language  = {en}
}
@article{JakubietzJakubietzHorchetal.2019,
  author    = {Jakubietz, Rafael G. and Jakubietz, Danni F. and Horch, Raymund E. and Gruenert, Joerg G. and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {The microvascular peroneal artery perforator flap as a "lifeboat" for pedicled flaps},
  series = {Plastic and Reconstructive Surgery - Global Open},
  volume    = {7},
  journal   = {Plastic and Reconstructive Surgery - Global Open},
  number    = {9},
  doi       = {10.1097/GOX.0000000000002396},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202233},
  pages     = {e2396},
  year      = {2019},
  abstract  = {Background: Pedicled perforator flaps have expanded reconstructive options in extremity reconstruction. Despite preoperative mapping, intraoperative findings may require microvascular tissue transfer when no adequate perforators can be found. The free peroneal artery perforator flap may serve as a reliable back-up plan in small defects. Methods: In 16 patients with small soft tissue defects on the upper and lower extremities, perforator-based propeller flaps were planned. The handheld Doppler device was used to localize potential perforators for a propeller flap in close proximity to the defect. Perforators of the proximal peroneal artery were also marked to allow conversion to microvascular tissue transfer. Results: In 6 cases, no adequate perforators were found intraoperatively. In 4 patients, the peroneal artery perforator flap was harvested and transferred. The pedicle length did not exceed 4 cm. No flap loss occurred. Conclusions: When no adequate perforator capable of nourishing a propeller flap can be found intraoperatively, the free peroneal artery flap is a good option to reconstruct small soft tissue defects in the distal extremities. The short vascular pedicle is less ideal in cases with a large zone of injury requiring a more distant site of anastomosis or when recipient vessels are located in deeper tissue planes.},
  language  = {en}
}
@article{JakubietzGruenertJakubietz2011,
  author    = {Jakubietz, Michael G. and Gruenert, Joerg G. and Jakubietz, Rafael G.},
  title     = {The use of beta-tricalcium phosphate bone graft substitute in dorsally plated, comminuted distal radius fractures},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-68829},
  year      = {2011},
  abstract  = {Background: Intraarticular distal radius fractures can be treated with many methods. While internal fixation with angle stable implants has become increasingly popular, the use of bone graft substitutes has also been recommended to address comminution zones and thus increase stability. Whether a combination of both methods will improve clinical outcomes was the purpose of the study Methods: The study was thus conducted as a prospective randomized clinical trial. 39 patients with unilateral, intraarticular fractures of the distal radius were included and randomized to 2 groups, one being treated with internal fixation only, while the second group received an additional bone graft substitute. Results: There was no statistical significance between both groups in functional and radiological results. The occurrence of complications did also not show statistical significance. Conclusions: No advantage of additional granular bone graft substitutes could be seen in this study. Granular bone graft substitutes do not seem to provide extra stability if dorsal angle stable implants are used. Dorsal plates have considerable complication rates such as extensor tendon ruptures and development of CRPS.},
  subject      = {Medizin},
  language  = {en}
}
@article{JakubietzGruenertJakubietz2012,
  author    = {Jakubietz, Michael G. and Gruenert, Joerg G. and Jakubietz, Rafael G.},
  title     = {Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term?},
  series = {Journal of Orthopedic Surgery and Research},
  volume    = {7},
  journal   = {Journal of Orthopedic Surgery and Research},
  number    = {8},
  doi       = {10.1186/1749-799X-7-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-133987},
  year      = {2012},
  abstract  = {Background: Current surgical approaches to the distal radius include dorsal and palmar plate fixation. While palmar plates have gained widespread popularity, few reports have provided data on long term clinical outcomes in comparison. This paper reports the result of a randomised clinical study comparing dorsal Pi plates and palmar, angle-stable plates for treatment of comminuted, intraarticular fractures of the distal radius over the course of twelve months. Methods: 42 patients with unilateral, intraarticular fractures of the distal radius were included and randomised to 2 groups, 22 were treated with a palmar plate, 20 received a dorsal Pi-plate. Results were evaluated after 6 weeks, 3, 6 and 12 months postoperatively focussing on functional recovery as well as radiological results. Results: The palmar plate group demonstrated significantly better results regarding range of motion and grip strength over the course of 12 months. While a comparable increase in function was observed in both groups, the better results from the early postoperative period in the palmar plate group prevailed over the whole course. Radiological results showed a significantly increased palmar tilt and carpal sag in dorsal plates, with other radiological parameters being comparable. Pain levels were decreased in dorsal plates after hardware removal and failed to show significant differences after 12 months. However, complications such as tendon ruptures were more frequent in the dorsal plate group. Conclusions: Functional advantage of palmar plates gained within the first 6 weeks prevails over the course of a year. Both groups demonstrate further gradual increase of function after 6 months, although dorsal plates did not catch up completely. Improved early postoperative function seems to be the cornerstone for the best possible results. Patients with dorsal plates benefit from hardware removal more than palmar plates in terms of reduction of pain levels. The advantage of palmar plates is a faster functional recovery with lower complication rates. This is especially important in the elderly population. Radiological results did not show a superiority of palmar plates over dorsal plates.},
  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}
}
@article{SchmidtJakubietzGilbertetal.2021,
  author    = {Schmidt, Karsten and Jakubietz, Michael Georg and Gilbert, Fabian and Fenwick, Annabel and Meffert, Reiner Heribert and Jakubietz, Rafael Gregor},
  title     = {Muscle cuff in distal pedicled adipofascial sural artery flaps: a retrospective case control study},
  series = {PRS Global Open},
  volume    = {9},
  journal   = {PRS Global Open},
  number    = {3},
  doi       = {10.1097/GOX.0000000000003464},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259875},
  year      = {2021},
  abstract  = {Background: Amputation after open tibial fracture occurs in 3\% of cases. The rate increases when flap reconstruction is required. The standard care involves microsurgical tissue transfer although the pedicled reverse sural artery adipofascial flap (PRSAF) is a local alternative in patients endangered by a prolonged operative time. Incorporation of a gastrocnemius muscle cuff in this flap can be used to fill dead space and increase healing potential. Literature shows superior survival rates for both PRSAF and inclusion of a muscle cuff in comparison with the cutaneous version. The aim of the study was to compare the outcome of the PRSAF and the musculoadipofascial version (PRSMAF). We hypothesize that the PRSMAF provides similar lap viability and flap-related complication rates as does the adipofascial version. The muscle component may reduce the long-term osteomyelitis rate. Methods: Patients were evaluated retrospectively after reconstruction with either PRSAF or PRSMAF. Preoperative osteomyelitis, flap survival, complications and osteomyelitis clearance were analyzed. Results: The study shows preliminary results supporting the potential use of the PRSMAF. We compare either 23 PRSMAF or 20 PRSAF flaps. We found no statistically significant differences in flap survival or in complication rate. Conclusions: Although the anatomical situation may sometimes dictate the use of a free flap, a technically less-complicated option may in some cases offer a viable alternative. This study shows that the PRSMAF can serve as an alternative for complex bone defects in the limb, though it does not provide statistical improvement to the PRSAF.},
  language  = {en}
}
@article{SchmidtJakubietzGilbertetal.2019,
  author    = {Schmidt, Karsten and Jakubietz, Michael Gregor and Gilbert, Fabian and Hausknecht, Franca and Meffert, Rainer Heribert and Jakubietz, Rafael Gregor},
  title     = {Quality of life after flap reconstruction of the distal lower extremity: is there a difference between a pedicled suralis flap and a free anterior lateral thigh flap?},
  series = {Plastic and Reconstructive Surgery - Global Open},
  volume    = {7},
  journal   = {Plastic and Reconstructive Surgery - Global Open},
  number    = {4},
  doi       = {10.1097/GOX.0000000000002114},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-203940},
  pages     = {e2114},
  year      = {2019},
  abstract  = {Background: Flap reconstruction of the distal lower extremity is challenging. Especially, the concept of perforator surgery has increased available surgical options. Although results are generally judged in terms of objective facts, patients-perceived quality of life has largely remained unexamined. The aim of the study was to compare quality of life after lower extremity reconstruction with pedicled and free flaps. Methods: Patients were evaluated retrospectively after reconstruction of defects of the distal lower extremity either with distally based adipofascial sural flap (pedicled reverse sural flap) or an anterior lateral thigh (ALT) flap. A specific questionnaire was developed to measure the patient's quality of life, based on short form health survey-12, Dresden Body Image Score-35, Patient Health Questionnaire-4, and XSMFA questionnaires with additional specific questions. Furthermore, results, secondary surgeries, and complications were analyzed. Results: Thirty-seven patients with reconstruction of lower limb defects treated with a pedicled reverse sural flap and 34 patients treated with an ALT flap were included in the study. There was no statistical significant difference in the overall satisfaction with the procedure in the long-term follow-up between both groups, but patients with ALT showed a higher satisfaction with the treatment in the initial postoperative period. Both groups demonstrated approximately similar results in the long term for self-acceptance and vitality. Conclusions: Although anatomic situation may dictate flap choice coverage with free flaps, a less-complicated flap is by no means regarded as an inferior treatment option in patient's estimation. Despite the intuitive speculation that patients with more advanced reconstruction methods should have better function and subsequently higher quality of life, this assumption was clearly not supported by data in this study.},
  language  = {en}
}
@article{JakubietzSchmidtBernuthetal.2019,
  author    = {Jakubietz, Rafael G. and Schmidt, Karsten and Bernuth, Silvia and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Evaluation of the intraoperative blood flow of pedicled perforator flaps using indocyanine green-fluorescence angiography},
  series = {Plastic and Reconstructive Surgery - Global Open},
  volume    = {7},
  journal   = {Plastic and Reconstructive Surgery - Global Open},
  number    = {9},
  doi       = {10.1097/GOX.0000000000002462},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202625},
  pages     = {e2462},
  year      = {2019},
  abstract  = {Background: Although indocyanine-green fluorescence angiography (ICG-FA) has been established as a useful tool to assess perfusion in free tissue transfer, only few studies have applied this modality to pedicled perforator flaps. As both volume and reach of pedicled perforator flaps are limited and tip necrosis often equals complete flap failure, ICG-FA may help to detect hypoperfusion in pedicled flaps. Methods: In 5 patients, soft tissue reconstruction was achieved with pedicled perforator flaps. ICG-FA was utilized intraoperatively to visualize flap perfusion. Results: Three pedicled anterolateral thigh flap flaps and 2 propeller flaps were transferred. ICG-FA detected hypoperfusion in 2 flaps. No flap loss occurred; in 2 cases, prolonged wound healing was encountered. Conclusions: ICG-FA confirmed clinical findings and reliably detected tissue areas with hypoperfusion. A clear cut-off point between nonvital tissue and such that stabilized in the following clinical course could not be found. ICG-FA is a promising technology which could also be used in pedicled perforator flaps.},
  language  = {en}
}
@article{JakubietzJakubietzMeffertetal.2017,
  author    = {Jakubietz, Michael G. and Jakubietz, Rafael G. and Meffert, Rainer H. and Schmidt, Karsten and Zahn, Robert K.},
  title     = {Biomechanical properties of first dorsal extensor compartment regarding adequacy as a bone-ligament-bone graft},
  series = {Plastic and Reconstructive Surgery Global Open},
  volume    = {5},
  journal   = {Plastic and Reconstructive Surgery Global Open},
  number    = {7},
  doi       = {10.1097/GOX.0000000000001397},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158851},
  pages     = {e1397},
  year      = {2017},
  abstract  = {Background: Bone-ligament-bone grafts for reconstruction of the scapholunate ligament are a valuable tool to prevent disease progression to carpal collapse. Locally available grafts do not require an additional donor site. The first extensor compartment was evaluated biomechanically regarding its possible use as an autograft. Methods: Twelve native fresh-frozen, human cadaver specimens were tested by applying axial tension in a Zwick Roell machine. Load to failure, transplant elongation, and bony avulsion were recorded. The load to failure was quantitated in newtons (N) and the displacement in length (millimeters). Parameters were set at distinct points as start of tension, 1 mm stretch and 1.5 mm dissociation, failure and complete tear, and were evaluated under magnified visual control. Although actual failure occurred at higher tension, functional failure was defined at a stretch of 1.5 mm. Results: Mean load at 1 mm elongation was 44.1 ± 28 N and at 1.5 mm elongation 57.5 ± 42 N. Failure occurred at 111 ± 83.1 N. No avulsion of the bony insertion was observed. Half the transplants failed in the central part of the ligament, while the rest failed near the insertion but not at the insertion itself. Analysis of tension strength displayed a wide range from 3.8 to 83.7 N/mm at a mean of 33.4 ± 28.4 N/mm. Conclusions: The biomechanical tensile properties of the first dorsal extensor compartment are similar to those of the dorsal part of the scapholunate ligament. A transplant with a larger bone stock and a longer ligament may display an advantage, as insertion is possible in the dorsal, easily accessible part of the carpal bones rather than in the ar{\^e}te-like region adjacent to the insertion of the scapholunate ligament. In this study, 1.5 mm lengthening of the bone-ligament-bone transplant was defined as clinical failure, as such elongation will cause severe gapping and is considered as failure of the transplant.},
  language  = {en}
}
@article{GilbertJakubietzMeffertetal.2018,
  author    = {Gilbert, Fabian and Jakubietz, Rafael G. and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Does distal radio-ulnar joint configuration affect postoperative functional results after ulnar shortening osteotomy?},
  series = {PRS Global Open},
  volume    = {6},
  journal   = {PRS Global Open},
  number    = {4},
  doi       = {10.1097/GOX.0000000000001760},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176265},
  pages     = {e1760},
  year      = {2018},
  abstract  = {Background: Reverse oblique distal radio-ulnar joint (DRUJ) configuration is assumed to show inferior postoperative results in ulnar-shortening osteotomy due to osteoarthritis, as the joint force pressure in the DRUJ may be increased. An evaluation and comparison of the postoperative functional results with regard to clinical and radiographic signs of arthritis among different DRUJ configurations was carried out retrospectively. Methods: Sixty-two patients after ulnar shortening osteotomy were included. The minimum follow-up was 5 years. Preoperative x-rays were assessed for the DRUJ configuration according to the Tolat classification, whereas postoperative radiographs were evaluated with regard to signs of osteoarthritis using the Kallgren-Lawrence-Score. Functional results were evaluated using the disabilities of the arm, shoulder and hand (DASH) and Mayo Wrist Score and measuring range of motion and grip strength. Results: Significantly better functional results were found in patients with parallel configuration of the DRUJ (Tolat type 1 configuration) with regard to DASH score, grip strength, and supination compared with nonparallel configurations. In the Tolat type 1, configurated DRUJ mean DASH score was 9 compared with 18 in the Tolat type 2 and 3 groups. Apart from supination, no differences were observed in range of motion among groups. Conclusion: Although long-term postoperative range of motion failed to display statistically significant differences between DRUJ configurations except for supination, better results regarding grip strength and DASH scores were seen in a parallel-aligned DRUJ configuration. Although onset of osteoarthritis does not seem to become apparent within the observation period, nonparallel aligned configuration predisposes to inferior results.},
  language  = {en}
}
@article{JakubietzNickelNeshkovaetal.2017,
  author    = {Jakubietz, Rafael G. and Nickel, Aljoscha and Neshkova, Iva and Schmidt, Karsten and Gilbert, Fabian and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Long-term patency of twisted vascular pedicles in perforator-based propeller flaps},
  series = {Plastic and Reconstructive Surgery Global Open},
  volume    = {5},
  journal   = {Plastic and Reconstructive Surgery Global Open},
  number    = {10},
  doi       = {10.1097/GOX.0000000000001544},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158870},
  pages     = {e1544},
  year      = {2017},
  abstract  = {Background: Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is relevant. The aim of this study was a long-term evaluation of the patency of vascular pedicle of propeller flaps. Methods: In a retrospective clinical study, 22 patients who underwent soft-tissue reconstruction with a propeller flap were evaluated after 43 months. A Doppler probe was used to locate and evaluate the patency of the vascular pedicle of the flap. Results: The flaps were used in the lower extremity in 19 cases, on the trunk in 3 cases. All flaps had healed. In all patients, an intact vascular pedicle could be found. Flap size, source vessel, or infection could therefore not be linked to an increased risk of pedicle loss. Conclusions: The vascular pedicle of propeller flaps remains patent in the long term. This allows reelevation and undermining of the flap. We therefore recommend protecting the pedicle in all secondary cases to prevent later flap loss.},
  language  = {en}
}
@article{JakubietzJakubietzMeffertetal.2017,
  author    = {Jakubietz, Rafael G. and Jakubietz, Michael G. and Meffert, Rainer H. and Schmidt, Karsten},
  title     = {Multiple-level replantation in elderly patients: risk versus benefit},
  series = {Plastic and Reconstructive Surgery Global Open},
  volume    = {5},
  journal   = {Plastic and Reconstructive Surgery Global Open},
  number    = {4},
  doi       = {10.1097/GOX.0000000000001313},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158443},
  pages     = {e1313},
  year      = {2017},
  abstract  = {Multiple-level amputations of the upper extremity represent a surgical challenge generally only attempted in young patients. This case demonstrates a successful replantation in an elderly woman. The postoperative course was complicated by disseminated intravascular coagulopathy most likely due to inadequate resuscitation. Hand trauma is often underestimated in its general severity. Upper extremity amputations need to be handled similar to polytraumatized patients.},
  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{HuflageKarstenKunzetal.2021,
  author    = {Huflage, Henner and Karsten, Sebastian and Kunz, Andreas Steven and Conrads, Nora and Jakubietz, Rafael Gregor and Jakubietz, Michael Georg and Pennig, Lenhard and Goertz, Lukas and Bley, Thorsten Alexander and Schmitt, Rainer and Grunz, Jan-Peter},
  title     = {Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography},
  series = {European Radiology},
  volume    = {31},
  journal   = {European Radiology},
  number    = {12},
  issn      = {1432-1084},
  doi       = {10.1007/s00330-021-08024-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266512},
  pages     = {9399-9407},
  year      = {2021},
  abstract  = {Objectives Triangular fibrocartilage complex (TFCC) injuries frequently cause ulnar-sided wrist pain and can induce distal radioulnar joint instability. With its complex three-dimensional structure, diagnosis of TFCC lesions remains a challenging task even in MR arthrograms. The aim of this study was to assess the added diagnostic value of radial reformatting of isotropic 3D MRI datasets compared to standard planes after direct arthrography of the wrist. Methods Ninety-three patients underwent wrist MRI after fluoroscopy-guided multi-compartment arthrography. Two radiologists collectively analyzed two datasets of each MR arthrogram for TFCC injuries, with one set containing standard reconstructions of a 3D thin-slice sequence in axial, coronal and sagittal orientation, while the other set comprised an additional radial plane view with the rotating center positioned at the ulnar styloid. Surgical reports (whenever available) or radiological reports combined with clinical follow-up served as a standard of reference. In addition, diagnostic confidence and assessability of the central disc and ulnar-sided insertions were subjectively evaluated. Results Injuries of the articular disc, styloid and foveal ulnar attachment were present in 20 (23.7\%), 10 (10.8\%) and 9 (9.7\%) patients. Additional radial planes increased diagnostic accuracy for lesions of the styloid (0.83 vs. 0.90; p = 0.016) and foveal (0.86 vs. 0.94; p = 0.039) insertion, whereas no improvement was identified for alterations of the central cartilage disc. Readers' confidence (p < 0.001) and assessability of the ulnar-sided insertions (p < 0.001) were superior with ancillary radial reformatting. Conclusions Access to the radial plane view of isotropic 3D sequences in MR arthrography improves diagnostic accuracy and confidence for ulnar-sided TFCC lesions.},
  language  = {en}
}
@article{JakubietzSchmidtHolzapfeletal.2020,
  author    = {Jakubietz, Rafael G. and Schmidt, Karsten and Holzapfel, Boris M. and Meffert, Rainer H. and Jakubietz, Michael G.},
  title     = {Pedicled perforator flaps for mid-tibial soft tissue reconstruction in medically compromised patients},
  series = {JPRAS Open},
  volume    = {24},
  journal   = {JPRAS Open},
  doi       = {10.1016/j.jpra.2020.02.002},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229473},
  pages     = {47-55},
  year      = {2020},
  abstract  = {Background: The soft tissue of the central pretibial area is difficult to reconstruct often requiring free tissue transfer. Especially medi- cally compromised patients are not ideal candidates for free tissue transfer and may benefit from expeditiously harvested local flaps with limited donor site morbidity. As muscle flaps are rare, pedi- cled flaps based on lateral perforators represent an alternative as the arc of rotation can often be limited to 90 °. Material and Methods: A retrospective analysis of patient data was conducted to identify patients over the age of 60 years with comor- bidities that underwent pretibial soft tissue reconstruction with a single-pedicle perforator flap. Patient demographics, size and cause of the defect, flap dimension, arc of rotation and complications were recorded. Results: Five patients with an average age of 71.4 years were in- cluded. The arc of rotation was 69 °, all flaps healed. There were two recurrences of osteomyelitis. Conclusion: Lateral perforators originating from the anterior tib- ial artery or peroneal artery are adequate source vessels for single pedicled perforator flaps even in medically compromised patients. A perforator located proximal to the defect allows limiting the arcof rotation to less than 90 °, which increases the safety of the flap. Patients benefit from a simple procedure without a microvascular anastomosis and a donor site confined to one extremity},
  language  = {en}
}
@article{JakubietzMeffertSchmidtetal.2017,
  author    = {Jakubietz, Michael G. and Meffert, Rainer H. and Schmidt, Karsten and Gruenert, Joerg G. and Jakubietz, Rafael G.},
  title     = {Acute A4 Pulley Reconstruction with a First Extensor Compartment Onlay Graft},
  series = {Plastic and Reconstructive Surgery Global Open},
  volume    = {5},
  journal   = {Plastic and Reconstructive Surgery Global Open},
  number    = {6},
  doi       = {10.1097/GOX.0000000000001361},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158057},
  pages     = {e1361},
  year      = {2017},
  abstract  = {Background: The integrity of the flexor tendon pulley apparatus is crucial for unimpaired function of the digits. Although secondary reconstruction is an established procedure in multi-pulley injuries, acute reconstruction of isolated, closed pulley ruptures is a rare occurrence. There are 3 factors influencing the functional outcome of a reconstruction: gapping distance between tendon and bone (E-space), bulkiness of the reconstruction, and stability. As direct repair is rarely done, grafts are used to reinforce the pulley. An advantage of the first extensor retinaculum graft is the synovial coating providing the possibility to be used both as a direct graft with synovial coating or as an onlay graft after removal of the synovia when the native synovial layer is present. Methods: A graft from the first dorsal extensor compartment is used as an onlay graft to reinforce the sutured A4 pulley. This technique allows reconstruction of the original dimensions of the pulley system while stability is ensured by anchoring the onlay graft to the bony insertions of the pulley. Results: Anatomical reconstruction can be achieved with this method. The measured E-space remained 0 mm throughout the recovery, while the graft incorporated as a slim reinforcement of the pulley, displaying no bulkiness. Conclusions: The ideal reconstruction should provide synovial coating and sufficient strength with minimal bulk. Early reconstruction using an onlay graft offers these options. The native synovial lining is preserved and the graft is used to reinforce the pulley.},
  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{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{WallstabeBussemerGroeberBeckeretal.2020,
  author    = {Wallstabe, Julia and Bussemer, Lydia and Groeber-Becker, Florian and Freund, Lukas and Alb, Mirian and Dragan, Mariola and Waaga-Gasser, Ana Maria and Jakubietz, Rafael and Kneitz, Hermann and Rosenwald, Andreas and Rebhan, Silke and Walles, Heike and Mielke, Stephan},
  title     = {Inflammation-Induced Tissue Damage Mimicking GvHD in Human Skin Models as Test Platform for Immunotherapeutics},
  series = {ALTEX},
  volume    = {37},
  journal   = {ALTEX},
  number    = {3},
  doi       = {10.14573/altex.1907181},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229974},
  pages     = {429-440},
  year      = {2020},
  abstract  = {Due to the rapidly increasing development and use of cellular products, there is a rising demand for non-animal-based test platforms to predict, study and treat undesired immunity. Here, we generated human organotypic skin models from human biopsies by isolating and expanding keratinocytes, fibroblasts and microvascular endothelial cells and seeding these components on a collagen matrix or a biological vascularized scaffold matrix in a bioreactor. We then were able to induce inflammation-mediated tissue damage by adding pre-stimulated, mismatched allogeneic lymphocytes and/or inflammatory cytokine-containing supernatants histomorphologically mimicking severe graft versus host disease (GvHD) of the skin. This could be prevented by the addition of immunosuppressants to the models. Consequently, these models harbor a promising potential to serve as a test platform for the prediction, prevention and treatment of GvHD. They also allow functional studies of immune effectors and suppressors including but not limited to allodepleted lymphocytes, gamma-delta T cells, regulatory T cells and mesenchymal stromal cells, which would otherwise be limited to animal models. Thus, the current test platform, developed with the limitation that no professional antigen presenting cells are in place, could greatly reduce animal testing for investigation of novel immune therapies.},
  language  = {en}
}
@article{BernuthVaterFuchsetal.2023,
  author    = {Bernuth, Silvia and Vater, Adrian and Fuchs, Konrad F. and Meffert, Rainer H. and Jakubietz, Rafael G.},
  title     = {Perfusion changes in perforator-based propeller flaps},
  series = {Journal of Reconstructive Microsurgery Open},
  volume    = {8},
  journal   = {Journal of Reconstructive Microsurgery Open},
  number    = {1},
  issn      = {2377-0813},
  doi       = {10.1055/a-2086-4988},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350491},
  pages     = {e45-e50},
  year      = {2023},
  abstract  = {Background  To cover soft tissue defects, the perforator-based propeller flap offers the option to rotate healthy tissue into complex wounds. By rotating the flap, the perforator is torqued. As a result, perfusion changes are possible. Methods  A retrospective data analysis of patients was done, who received a propeller flap to cover soft tissue defects of the lower extremity as well as a peri- and postoperative perfusion monitoring with a laser-Doppler-spectrophotometry system. Additionally, patient-specific data were collected. Results  Seven patients were identified. Four patients experienced early complications, two epidermolysis of the distal flap areas, three wound healing disorders, and one partial flap necrosis. Intraoperative perfusion monitoring showed a decline of blood flow after incision of the flap, especially at distal flap site. In case of complications, there were prolonged blood flow declines up to the first postoperative day. Conclusion  Torqueing the perforator by rotating the flap can cause an impairment in inflow and outflow. If the impairment is prolonged, perfusion-associated complications are possible. The identification of a viable perforator is particularly important. In addition, a conservative postoperative mobilization is necessary to compensate for the impaired and adapting outflow.},
  language  = {en}
}