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Introduction There is limited evidence on the indications of lateral extra-articular tenodesis (LET) in revision ACLR. The aim of this study was to evaluate the influence of the LET in patients with revision ACLR with preoperative low-grade anterior knee laxity. Methods Between 2013 and 2018, 78 patients who underwent revision ACLR with preoperative low-grade anterior knee laxity [≤ 5 mm side-to-side difference (SSD)] were included in the retrospective cohort study. An additional modified Lemaire tenodesis was performed in 23 patients during revision ACLR and patients were clinically examined with a minimum of 2 years after revision surgery. Postoperative failure of the revision ACLR was defined as SSD in Rolimeter® testing ≥ 5 mm or pivot-shift grade 2/3. Results In total, failure of the revision ACLR occurred in 11.5% (n = 9) of the cases at a mean follow-up of 28.7 ± 8.8 (24–67) months. Patients with an additional LET and revision ACLR did not show a significantly reduced failure rate (13% vs. 11%) or an improved clinical outcome according to the postoperative functional scores or pain in regards to patients with an isolated revision ACLR (Tegner 5.7 ± 1.3 vs. 5.9 ± 1.5, n.s.; IKDC 77.5 ± 16.2 vs. 80.1 ± 14.9, n.s., Lysholm 81.9 ± 14.2 vs. 83.8 ± 14.5, n.s.; VAS 1.9 ± 2.2 vs. 1.2 ± 1.7, n.s.). Conclusions An additional LET in patients with revision ACLR with low-grade anterior knee laxity does not influence patient-related outcomes or failure rates. Subjects with preoperative low-grade anterior knee laxity may not benefit from a LET in revision ACLR. Level of evidence III

Ziel der operativen Versorgung einer akuten Kniegelenkluxation (Schenck IV) ist die Wiederherstellung einer stabilen Bandfuhrung und einer physiologischen Kinematik des Kniegelenkes. Demonstration der Operationstechnik bei einem Patienten mit akuter Kniegelenkluxation (Schenck IV) mit Ruptur beider Kreuzbander und zusatzlich der medialen und lateralen peripheren Gelenkstabilisatoren. Kritische Weichteilverhaltnisse, kritische Gefassituation, (Risiko eines intraoperativen Gefasverschlusses). Beginn mit einer kurzen Arthroskopie zu Identifikation und Adressierung von Meniskusverletzungen und ggf. Platzierung der Zieldrahte fur die Ersatzplastik des vorderen Kreuzbandes (VKB). Im Anschluss anteromediale Arthrotomie und „ligament bracing“ des hinteren Kreuzbandes. Das VKB wird mit einer autologen Sehne rekonstruiert. Rekonstruktion der medialen und lateralen Bandkomplexe mit Nahtankersystemen und augmentierende posterolaterale Bandplastik nach Arciero. Teilbelastung mit 20 kg fur 6 Wochen. Stufenweise Freigabe der Beweglichkeit mithilfe einer Bewegungsorthese unter engmaschiger klinischer Kontrolle im Sinne der gefuhrten Arthrofibrose. Das Konzept des Ligament bracing des zentralen Pfeilers bei der akuten Kniegelenkluxation wurde bereits wissenschaftlich untersucht und erzielt gute bis sehr gute Ergebnisse. In einer vergleichenden Untersuchung des „VKB internal bracing“ gegenuber der VKB-Ersatzplastik im Rahmen der Akutversorgung einer Kniegelenkluxation zeigt sich ein Trend fur uberlegene Stabilitatsergebnisse im Rolimeter®-Test (Fa. Aircast, Freiburg, Deutschland) sowie in der Stressradiographie (Fa. TelosTM, Wolfersheim, Deutschland) 12 Monate nach der operativen Versorgung.

Purpose Given that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing. Methods In a retrospective multicenter cohort study, 122 TPF of 121 patients were analyzed with respect to radiological and clinical outcomes (Rasmussen) with a mean follow-up of 35.7 ± 24.9 months. The risk factor assessment included bone metabolism-affecting comorbidities and medication. Results The findings showed that 95.9% of the patients reported a good-to-excellent clinical outcome, and 97.4% reported a good-to-excellent radiological outcome. Logistic regression revealed that potentially impaired bone metabolism (IBM) was an independent risk factor for the clinical (p = 0.016) but not the radiological outcome (Table 4). Patients with 41-type B fractures and a potential IBM had a seven times higher risk to present a fair-to-poor clinical outcome [OR 7.45, 95 CI (4.30, 12.92)]. The most common objective impairment was a limited range of motion in 16.4% of the patients, especially in 41-type C fractures (p = 0.06). The individual failure analysis additionally identified surgery-related options for improvement. Conclusion This study demonstrated that potential IBM was an independent risk factor for a poor-to-fair clinical outcome.

Purpose The outcome of a tibial plateau fracture (TPF) depends on the fracture reduction achieved and the extent of soft-tissue lesions, including lesions in the ligaments, cartilage, and menisci. Sub-optimal treatment can result in poor knee function and osteoarthritis. Preoperative planning is primarily based on conventional X-ray and computed tomography (CT), which are unsuitable for diagnosing soft-tissue lesions. Magnetic resonance imaging (MRI) is not routinely performed. To date, no literature exists that clearly states the indications for preoperative MRI. This systematic review aimed to determine the frequency of soft-tissue lesions in TPFs, the association between fracture type and soft-tissue lesions, and the types of cases for which MRI is indicated. Methods A systematic review of the literature was based on articles located in PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL), supplemented by searching the included articles’ reference lists and the ePublication lists of leading orthopedic and trauma journals. Results A total of 1138 studies were retrieved. Of these, 18 met the eligibility criteria and included a total of 877 patients. The proportion of total soft-tissue lesions was 93.0%. The proportions of soft-tissue lesions were as follows: medial collateral ligament 20.7%, lateral collateral ligament 22.9%, anterior cruciate ligament 36.8%, posterior cruciate ligament 14.8%, lateral meniscus 48.9%, and medial meniscus 24.5%. A weak association was found between increasing frequency of LCL and ACL lesions and an increase in fracture type according to Schatzker's classification. No standard algorithm for MRI scans of TPFs was found. Conclusion At least one ligament or meniscal lesion is present in 93.0% of TPF cases. More studies with higher levels of evidence are needed to find out in which particular cases MRI adds value. However, MRI is recommended, at least in young patients and cases of high-energy trauma.

Multiligamentäre Kniegelenkverletzungen sind glücklicherweise sehr selten. Doch wenn es dazu kommt, stellen sie für den behandelnden Arzt wegen der geringen Inzidenz, der möglichen Begleitverletzungen und der unterschiedlichen Unfallmechanismen eine erhebliche diagnostische Herausforderung dar.

Malreduction after tibial plateau fractures mainly occurs due to insufficient visualization of the articular surface. In 85% of all C-type fractures an involvement of the posterolateral-central segment is observed, which is the main region of malreduction. The choice of the approach is determined (1) by the articular area which needs to be visualized and (2) the positioning of the fixation material. For simple lateral plateau fractures without involvement of the posterolateral-central segment an anterolateral standard approach in supine position with a lateral plating is the treatment of choice in most cases. For complex fractures the surgeon has to consider, that the articular surface of the lateral plateau only can be completely visualized by extended approaches in supine, lateral and prone position. Anterolateral and lateral plating can also be performed in supine, lateral and prone position. A direct fixation of the posterolateral-central segment by a plate or a screw from posterior can be only achieved in prone or lateral position, not supine. The posterolateral approach includes the use of two windows for direct visualization of the fracture. If visualization is insufficient the approach can be extended by lateral epicondylar osteotomy which allows exposure of at least 83% of the lateral articular surface. Additional central subluxation of the lateral meniscus allows to expose almost 100% of the articular surface. The concept of stepwise extension of the approach is helpful and should be individually performed as needed to achieve anatomic reduction and stable fixation of tibial plateau fractures.

Eine Fehlstellung nach Tibiaplateaufraktur tritt meist aufgrund einer unzureichenden Visualisierung der intraartikularen Oberflache auf. In 85 % aller Typ-„C“-Tibiaplateaufrakturen konnte eine Beteiligung des posterolateral-zentralen Segments beobachtet werden, dieses stellt gleichzeitig die Region mit den meisten postoperativen Fehlpositionen dar. Die Wahl des Zuganges wird durch die frakturierten Segmente des Tibiaplateaus und die gewunschte Position des Osteosynthesematerials bestimmt. Bei einfachen lateralen Frakturen des Tibiaplateaus ohne Beteiligung des posterolateral-zentralen Segments ist in den meisten Fallen ein anterolateraler Standardzugang in Ruckenlage mit einer lateralen Plattenosteosynthese die Behandlung der Wahl. Bei komplexeren Frakturen muss der Chirurg berucksichtigen, dass die Gelenkflache des lateralen Plateaus erst durch Erweiterung der Zugange in Rucken‑, Seiten- oder Bauchlage vollstandig dargestellt werden kann. Die anterolaterale und laterale Plattenosteosynthese kann in Rucken‑, Seiten- oder Bauchlage durchgefuhrt werden. Eine direkte Fixierung des posterolateral-zentralen Segments mit einer Platte oder Schraube von posterior sollte jedoch nur in Bauch- oder Seitenlage, nicht aber in Ruckenlage erfolgen. Der posterolaterale Zugang beinhaltet die Verwendung von zwei chirurgischen Fenstern zur direkten Visualisierung der Fraktur. Bei unzureichender Darstellung sollte der Zugang durch eine laterale Epikondylenosteotomie erweitert werden, wodurch die Moglichkeit besteht, mindestens 83 % der lateralen Gelenkflache einzusehen. Wenn zusatzlich ein dorsales, kapsulares Release des lateralen Meniskus durchgefuhrt wird, kann der laterale Meniskus zentral subluxiert und so fast 100 % der lateralen Gelenkflache eingesehen werden.

ZusammenfassungTibiaplateaufrakturen stellen im klinischen Alltag eine vergleichsweise seltene Verletzung dar. Aufgrund des heterogenen Patientenkollektivs, des divergierenden Traumamechanismus und der Vielzahl an möglichen weichteiligen Begleitverletzungen ist die adäquate Diagnostik und bedarfsgerechte Behandlung weiterhin eine große Herausforderung im klinischen Alltag. Neben der konventionellen Röntgenaufnahme in zwei Ebenen hat sich die Computertomographie (CT) mit zusätzlicher 3‑D-Rekonstruktion als probates und reliables diagnostisches Werkzeug im Alltag vieler Kliniken etabliert. Die so angefertigten Befunde zeigen dem Chirurgen mit hoher Genauigkeit die Frakturmorphologie und lassen Rückschlüsse auf Begleitverletzungen zu. Die Diagnostik der weichteiligen Begleitverletzungen erfolgt aktuell u. a. im Rahmen der klinischen Untersuchung, dem chirurgischen Befund sowie der intraoperativen Arthroskopie. Mit der Magnetresonanztomographie (MRT) steht eine Technik zur Verfügung, welche die diagnostische Lücke zwischen der CT-Bildgebung und dem intraoperativen Befund schließen kann. Mit hoher Sensitivität kann eine adäquate präoperative Diagnostik der weichteiligen Begleitverletzungen erfolgen und so entscheidenden Einfluss nicht nur auf die Frakturklassifikation, sondern vor allem auf das operative Vorgehen nehmen. Neben der klinischen Verfügbarkeit und (noch) hohen Kosten im Vergleich zur CT stellt vor allem die fehlende Erfahrung mit präoperativ angefertigten MRT-Befunden eine große Herausforderung in der umfassenden Anwendung dieses diagnostischen Tools bei der Behandlung von Tibiaplateaufrakturen dar.

Introduction ACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated. Materials and methods One hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al. Results In 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039). Conclusion In the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

Background:Concomitant lesion of the medial collateral ligament (MCL) is associated with a greater risk of anterior cruciate ligament (ACL) graft failure.Purpose:The aim of this study was to compare two medial stabilization techniques in patients with revision ACL reconstruction (ACLR) and concomitant chronic medial knee instability.Study Design:Cohort study; Level of evidence, 3.Methods:In a retrospective study, we included 53 patients with revision ACLR and chronic grade 2 medial knee instability to compare medial surgical techniques (MCL reconstruction [n = 17] vs repair [n = 36]). Postoperative failure of the revision ACLR (primary aim) was defined as side-to-side difference in Rolimeter testing ≥5 mm or pivot-shift grade ≥2. Clinical parameters and postoperative functional scores (secondary aim) were evaluated with a mean ± SD follow-up of 28.8 ± 9 months (range, 24-69 months).Results:Revision ACLR was performed in 53 patients with additional grade 2 medial instability (men, n = 33; women, n = 20; mean age, 31.3 ± 12 years). Failure occurred in 5.9% (n = 1) in the MCL reconstruction group, whereas 36.1% (n = 13) of patients with MCL repair showed a failed revision ACLR ( P = .02). In the postoperative assessment, the anterior side-to-side difference in Rolimeter testing was significantly reduced (1.5 ± 1.9 mm vs 2.9 ± 2.3 mm; P = .037), and medial knee instability occurred significantly less (18% vs 50%; P = .025) in the MCL reconstruction group than in the MCL repair group. In the logistic regression, patients showed a 9-times elevated risk of failure when an MCL repair was performed ( P = .043). Patient-reported outcomes were increased in the MCL reconstruction group as compared with MCL repair, but only the Lysholm score showed a significant difference (Tegner, 5.6 ± 1.9 vs 5.3 ± 1.6; International Knee Documentation Committee, 80.3 ± 16.6 vs 73.6 ± 16.4; Lysholm, 82.9 ± 13.6 vs 75.1 ± 21.1 [ P = .047]).Conclusion:MCL reconstruction led to lower failure rates in patients with combined revision ACLR and chronic medial instability as compared with MCL repair. MCL reconstruction was superior to MCL repair, as lower postoperative anterior instability, an increased Lysholm score, and less medial instability were present after revision ACLR. MCL repair was associated with a 9-times greater risk of failure.

Introduction For successful intramedullary implant placement at the femur, such as nailing in unstable proximal femur fractures, the use of an implant that at least reaches or exceeds the femoral isthmus and yields sufficient thickness is recommended. A number of complications after intramedullary femoral nailing have been reported, particularly in Asians. To understand the anatomical features of the proximal femur and their ethnic differences, we aimed to accurately calculate the femoral isthmus dimensions and proximal distance of Asians and Caucasians. Methods In total, 1189 Asian and Caucasian segmented 3D CT data sets of femurs were analyzed. The individual femoral isthmus diameter was precisely computed to investigate whether gender, femur length, age, ethnicity or body mass index have an influence on isthmus diameters. Results The mean isthmus diameter of all femurs was 10.71 ± 2.2 mm. A significantly larger diameter was found in Asians when compared to Caucasians (p p r2 = 0.299). With every year of life, the isthmus showed a widening of 0.08 mm in women. A Matched Pair Analysis of 150 female femurs showed a significant difference between isthmus diameter in Asian and Caucasian femurs (p = 0.05). In 50% of the cases the isthmus was found in a range of 2.4 cm between 16.9 and 19.3 cm distal to the tip of the greater trochanter. The female Asian femur differs from Caucasians as it is wider at the isthmus. Conclusions In absolute values, the proximal isthmus distance did not show much variation but is more proximal in Asians. The detailed data presented may be helpful in the development of future implant designs. The length and thickness of future standard implants may be considered based on the findings.

Introduction: Recently, a novel extended approach for comminuted lateral tibial plateau fractures was introduced. It includes a lateral epicondyle osteotomy and meniscus subluxation allowing for an almost complete overview of the lateral tibial plateau. First clinical results are presented. Hypotheses: We hypothesized, that a superior visualization using the novel approach in demanding cases leads to improved radiologic and clinical outcomes. Methods: A consecutive case series of ten in which the approach was used was followed prospectively. The cases were classified using the “10-segment classification” and the “AO classification”. To evaluate the clinical and radiological results, the Rasmussen score was applied. Results: Excellent to good clinical and radiological results were encountered after a median follow-up of 8,6 (IQR 4,3) months. The clinical score amounted to a median of 25 (IQR 2,8) and the radiological score a median of 17 (IQR 2,0). Conclusion: The early results after the treatment of demanding cased with a high degree of joint comminution presented are promising with excellent to good results, only. At the same time, despite an extended surgical procedure, no complications were encountered in the cohort. As suggested by the authors before, tibial plateau fractures should be managed using a stepwise approach with extension of the approach as individually required.

Purpose Anatomic reduction in tibial plateau fractures remains to be demanding. For further visualisation of and approach to the joint surface an extended lateral approach using a lateral femoral epicondyle osteotomy and subluxation of the lateral meniscus was recently described. First clinical and radiographic mid-term results of this technique are presented in this feasibility study. Method Ten complex tibial plateau fractures treated with extended lateral approach and lateral meniscal subluxation were prospectively analysed. Clinical and radiographic results were objectified according to the Rasmussen scores. Results After a median follow-up of 8.6 (IQR 4.3) months good to excellent clinical and radiographic results were noted. The clinical Rasmussen Score showed a median of 25 (IQR 2.8) and radiographic a median of 17 (IQR 2.0) points. Conclusion Good to excellent clinical and radiological scores were obtained after using an extended lateral approach with lateral femoral epicondyle osteotomy and central meniscus subluxation. No approach specific complications could be observed.

The primary purpose of the study was to gain insight into geometric changes of the patellar height (PH) and posterior tibial slope (PTS) after a biplanar ascending medial open-wedge high tibial osteotomy (HTO) compared to biplanar descending medial open-wedge HTO in patients with genu varum. Sixty-four patients (mean age 45.2 ± 8.7 years, females n = 24, males n = 40) with varus malalignment and medial gonarthrosis were retrospectively studied. Patients received either a biplanar ascending or descending medial open-wedge HTO. Radiographic analysis included the assessment of standing total leg axis, PH, and PTS prior to and after surgery. In the ascending HTO group, PH decreased significantly by 4.0% (p = 0.037, Caton–Deschamps index) after an average leg axis valgus-producing correction of 7.1° ± 2.8°. In the descending HTO group, with an average leg axis correction of 7.0° ± 3.7°, there were no significant PH changes. There were no significant differences between the ascending and descending HTO groups regarding PTS or leg axis. The mean post-operative leg axis between ascending (1.6° ± 1.9°) and descending HTO (1.9° ± 2.4°) was not significantly different. Compared to the biplanar ascending medial open-wedge HTO, the descending HTO did not influence patella height or increase the posterior tibial slope. In order to respect patellofemoral and slope-related knee kinematics, a biplanar descending medial open-wedge HTO has proven useful to control patella height and posterior tibial slope. These findings underscore the importance of the preoperative patella height assessment in the osteotomy planning and subsequent choice of the biplanar osteotomy direction. IV.

Soft-tissue sarcomas (STS) are a rare subtype of soft-tissue mass and are frequently misinterpreted as benign lesions. Magnetic resonance imaging (MRI) is the primary recommended type of diagnostics. To assess the quality of primary radiology reports, we investigated whether recommended MRI report elements were included in compliance with European Society of Musculoskeletal Radiology (ESSR) guidelines. A total of 1107 patients were evaluated retrospectively, and 126 radiological reports on patients with malignant STS were assessed for ESSR quality criteria. One or more required sequences or planes were missing in 67% of the reports. In all 126 cases, the report recognized the mass as anomalous (100%). Sixty-eight percent of the reports mentioned signs of malignancy. The majority of reports (n = 109, 87%) articulated a suspected diagnosis, 32 of which showed a mismatch with the final diagnosis (25%). Thirty-two percent of the reports had a misinterpretation of the masses as benign. Benign misinterpretations were more common in masses smaller than 5 cm (65% vs. 27%). Thirty percent of the reports suggested tissue biopsy and 6% recommended referral to a sarcoma center. MRI reports showed frequent deviations from ESSR guidelines, and protocol guidelines were not routinely met. Deviations from standard protocol and reporting guidelines could put patients at risk for inadequate therapy.

The quasibinary section of the intermetallic phases MAl4 and MGa4 with M=Sr and Ba have been characterised by means of X-ray diffraction (XRD) studies and differential thermal analysis. The binary phases show complete miscibility and form solid solutions M(Al1−xGax)4 with M=Sr and Ba. These structures crystallise in the BaAl4 structure type with four- and five-bonded Al and/or Ga atoms (denoted as Al(4b), Al(5b), Ga(4b), and Ga(5b), respectively) that form a polyanionic Al/Ga sublattice. Solid state 27Al NMR spectroscopic analysis and quantum mechanical (QM) calculations were applied to study the bonding of the Al centres and the influence of Al/Ga substitution, especially in the regimes with low degrees of substitution. M(Al1−xGax)4 with M=Sr and Ba and 0.925≤x≤0.975 can be described as a matrix of the binary majority compound in which a low amount of the Ga atoms has been substituted by Al atoms. In good agreement with the QM calculations, 27Al NMR investigations and single crystal XRD studies prove a preferred occupancy of Al(4b) for these substitution regimes. Furthermore, two different local Al environments were found, namely isolated Al(4b1) atoms and Al(4b2), due to the formation of Al(4b)–Al(4b) pairs besides isolated Al(4b) atoms within the polyanionic sublattice. QM calculations of the electric field gradient (EFG) using superlattice structures under periodic boundary conditions are in good agreement with the NMR spectroscopic results.

The gold-rich intermetallic compounds Sr2Au6Zn3, Eu2Au6Zn3, Sr2Au6Ga3, and Eu2Au6Ga3were synthesized from the elements in sealed tantalum ampoules in induction or muffle furnaces. The europium compounds are reported for the first time and their structures were refined from single crystal X-ray diffractometer data: Sr2Au6Zn3type,R3̅c,a= 837.7(1),c= 2184.5(4) pm,wR2 = 0.0293, 572F2values for Eu2Au6.04Zn2.96anda= 838.1(2),c= 2191.7(5) pm,wR2 = 0.0443, 513F2values for Eu2Au6.07Ga2.93with 20 variables per refinement. The structures consist of a three-dimensional gold network with a 6R stacking sequence, similar to the respective diamond polytype. The cavities of the network are filled in a ratio of 2:1 by strontium (europium) atoms and Ga3(Zn3) triangles in an ordered manner. Sr2Au6Zn3and Sr2Au6Ga3are diamagnetic with room temperature susceptibilities of –3.5 × 10−4emu mol–1. Temperature dependent susceptibility and151Eu Mössbauer spectroscopic measurements show a stable divalent ground state for both europium compounds. Eu2Au6Zn3and Eu2Au6Ga3order antiferromagnetically below Néel temperatures of 16.3 and 12.1 K, respectively. Anisotropic electrical conductivity of Sr2Au6Ga3is proven by an alignment of the crystallites in the magnetic field. Orientation-dependent69;71Ga NMR experiments combined with quantum mechanical calculations (QM) give evidence for a highly anisotropic charge distribution of the Ga atoms.

The quasibinary section of the intermetallic phases MAl

C 3 -symmetric ligands carrying a rigid triaminoguanidinium backbone are important building blocks for the preparation of supramolecular coordination cages as tetrahedra or trigonal bipyramides. Coordination of Eu(III)- or Gd(III)-ions leads to 1,2,4-triazole formation, which has been reported only rarely. Using Pd(II)-complexes as a model system, this triazole formation could be analyzed in more detail. The preparation of Pd(II)-coordination compounds can be easily done under stoichiometric control. These complexes could be transformed into 1,2,4-triazoles using O2 or H2O2 as an oxidation reagent. The steric demand of the PR3-coligand seems to play a key role in the cyclisation reaction.