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Proximal humeral fractures (PHF) also affect younger people who suffer such injuries due to high-velocity trauma but mainly involve people in the second half of life. In this age group PHF are the most frequent fractures following distal radius fractures. The majority of those affected in this age group are female but an increase in the male population has been observed. The existing classification systems show a lack of reproducibility and currently there is a lack of consensus with respect to the superiority of surgical treatment compared to conservative therapy as well as the superiority of one particular operative procedure. The greatest changes with respect to operative procedures can currently be observed in the field of prosthetic treatment. There is an increasing trend away from anatomical and towards inverse prostheses. The indications for inverse prostheses are increasingly directed towards younger people who are still in employment. This article gives a survey over current indications and therapeutic concepts for PHF with a focus on the operative treatment of comminuted fractures. [ABSTRACT FROM AUTHOR]

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Periprosthetic fractures after total knee arthroplasty continue to increase due to the demographic changes. Despite improvements of therapy morbidity and mortality rates up to 46% are still very high. Implant innovations offer better options for periprosthetic osteosynthesis and have led to good functional and radiographic outcome. Surgical therapy should be performed within 48 h, while emergency interventions remain the exception. Detailed preoperative planning and use of special implants and revision systems are essential. Management of these patients demands an interdisciplinary approach and should be performed in specialized centers. In the present article classifications, indications, techniques and results of periprosthetic osteosynthesis after total knee arthroplasty are presented. [ABSTRACT FROM AUTHOR]

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Due to the functional importance of the patella, accurate reduction and rigid fixation of patellar fractures are required. Tension band wiring has long been the standard treatment of these fractures, but there are several problems associated with this technique, e.g. loosening of the wires, fracture dislocation and poor outcome. Another possibility in the treatment of transverse patellar fractures is screw fixation. Although this technique ensures stable osteosynthesis, anatomical reduction is often problematic, especially in comminuted fractures. A good option in the treatment of (comminuted) patellar fractures is the newly designed locking patella plate, which combines anatomical reduction and stable osteosynthesis. In biomechanical tests the plate provided a more stable fixation of the patellar fracture and showed higher mechanical strength compared to classic tension band wiring. The first clinical applications achieved optimal fracture reduction. No complications have occurred to date following the use of the plate. Thus the patella plate represents a good option in the treatment of patellar fractures. [ABSTRACT FROM AUTHOR]

The biomechanical advantages of fixed angle locking plates resulted in a wide clinical use. The spectrum of indications ranges from complex periarticular fractures to metaphysial and diaphysial comminuted fractures, corrective osteotomies and to the application in periprosthetic fracture situations. The internal fixator principle provides particular advantages in the treatment of osteoporotic bone fractures as well as in the use as a bridging plate in wide multifragmentary diaphysial fractures as a form of elastic fixation with secondary fracture healing. Disadvantages of fixed angle locking plates are secondary screw perforations e.g. in proximal humeral fractures, the fixation of distractions, difficult implant removal (e.g. cold-welded screws) and higher implant costs. [ABSTRACT FROM AUTHOR]

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Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)