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Background: Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome. Method: Selective review of the literature. Results: Ankle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complica - tions, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term. Conclusion: With properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low. [ABSTRACT FROM AUTHOR]

Zusammenfassung: Hintergrund: BMX Freestyle entwickelte sich in den 1970er Jahren als unabhängige Fun-sportart. Heute werden Wettkämpfe in 4 Hauptdisziplinen veranstaltet, welche sich in ihrem spezifischen Risikoprofil unterscheiden. Material und Methoden: In einer Online-Umfrage wurden die Starter der BMXMasters® 2011 zu ihren Trainingsgewohnheiten und Verletzungen während eines Jahreszeitraumes befragt. Ergebnisse: Ergebnisse: Alle befragten Sportler (n=28) erlitten während eines Jahreszeitraums Verletzungen oder einen Überlastungsschaden. Am häufigsten traten Hautverletzungen und Prellungen (100%) auf, gefolgt von Distorsionen (32%). Schwerere Verletzungen wie Frakturen (14%) oder Luxationen (7%) waren eher selten. Schlussfolgerung: BMX Freestyle ist eine risikoreiche Sportart mit großer Anzahl von leichteren Verletzungen. Ernsthafte Verletzungen treten vergleichsweise selten auf. Evidenzeben: V; Fallserie [Copyright &y& Elsevier]

Summary: Background & aims: : We hypothesize that wound closure in trauma patients with disorders in wound healing is accelerated by supplementation of antioxidant micronutrients and glutamine. Methods: In a randomized, double-blind, placebo-controlled trial, 20 trauma patients with disorders in wound healing were orally supplemented with antioxidant micronutrients (ascorbic acid, α-tocopherol, β-carotene, zinc, selenium) and glutamine (verum) or they received isoenergetic amounts of maltodextrine (placebo) for 14 days. Plasma/serum levels of micronutrients, glutamine, and vascular endothelial growth factor-A (VEGF-A) were determined before and after supplementation. In the wound, several parameters of microcirculation were measured. Time from study entry to wound closure was recorded. Results: Micronutrients in plasma/serum did not change except for selenium which increased in the verum group (1.1 ± 0.2 vs. 1.4 ± 0.2 μmol/l; P = 0.009). Glutamine decreased only in the placebo group (562 ± 68 vs. 526 ± 55 μmol/l; P = 0.047). The prevalence of hypovitaminoses and the concentration of VEGF-A did not change. Considering microcirculation, only O2-saturation decreased in the placebo group (56.7 ± 23.4 vs. 44.0 ± 24.0 [arbitrary units]; P = 0.043). Wound closure occurred more rapidly in the verum than in the placebo group (35 ± 22 vs. 70 ± 35 d; P = 0.01). Conclusions: Time to wound closure can be shortened by oral antioxidant and glutamine containing supplements in trauma patients with disorders in wound healing. [Copyright &y& Elsevier]

Summary: The goal of this study was to determine functional results of hemiarthroplasty for 3- and 4-part proximal humeral fractures in elderly patients and to analyze factors affecting the outcome. Thirty-eight consecutive shoulders were treated with hemiarthroplasty after proximal humeral fracture. Two groups of patients with different health status were classified. Group I consisted of patients with 2 or less comorbidities and a maximum of 2 medications at the time of injury. Patients in group II had 3 or more comorbidities with a minimum of 3 medications at the time of injury. The mean of the absolute Constant score in group I was 41, compared to 27 in group II (P < .05). Furthermore, compliance of the patient and regular physiotherapy proved to be important prognostic factors. If primary hemiarthroplasty is not likely to be successful with a low functional score, this surgical procedure should be reconsidered especially in patients with more than three comorbidities. [Copyright &y& Elsevier]