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Book ; Thesis: Histomorphometrie des spongiösen Knochens im proximalen Säuglingsfemur

Bungartz, Matthias

1999

Author's details	vorgelegt von Matthias Bungartz
Language	German
Size	64 S. : Ill., graph. Darst.
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Aachen, Techn. Hochsch., Diss., 1999
HBZ-ID	HT011157061
Database	Catalogue ZB MED Medicine, Health

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Article: Minimally Invasive Internal Fixation of Femoral Shaft Fractures-A Biomechanical Study with a Disruptive Technique.

Layher, Frank / Matziolis, Georg / Kayhan, Leos N / Bungartz, Matthias / Brinkmann, Olaf

Life (Basel, Switzerland)

2021 Volume 11, Issue 11

Abstract: 1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted ... ...

Abstract	(1) Background: In polytrauma patients, femur fractures are usually stabilised by external fixation for damage control, later being treated with definitive plate or nail osteosynthesis. Screw/rod systems established in spinal surgery might be inserted for internal fixation, providing sufficient fracture stability that subsequent intervention is unnecessary. This was to be investigated biomechanically. (2) Methods: The unilaterally applied spinal internal fixator (IF) was subjected to load and deformation analysis on artificial femurs with 32-A3 fracture according to AO classification. Distance of screws to fracture and rod to cortical bone were analysed as parameters influenced surgically as stiffness and deformation of the treated fracture. In addition, the stability of another construct with a second screw/rod system was determined. The axial load in stance phase during walking was simulated. The results were compared against an established fixed-angle plate osteosynthesis (IP). (3) Results: There were no implant failures in the form of fractures, avulsions or deformations. All unilateral IF combinations were inferior to IP in terms of stability and stiffness. The bilateral construct with two screw/rod systems achieved biomechanical properties comparable to IP. 4) Conclusion: Biomechanically, a biplanar screw/rod system is suitable for definitive fracture stabilisation of the femur, despite a damage control approach.
Language	English
Publishing date	2021-11-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life11111254
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Article ; Online: Biodegradable cement augmentation of gamma nail osteosynthesis reduces migration in pertrochanteric fractures, a biomechanical in vitro study.

Bungartz, Matthias / Matziolis, Georg / Layher, Frank / Horbert, Victoria / Maslaris, Alexander / Brinkmann, Olaf

Clinical biomechanics (Bristol, Avon)

2021 Volume 84, Page(s) 105327

Abstract: Background: Cut-out of gamma nail often results from poor primary bone stability, suboptimal reduction (varus) and excentric placement of the head element which may lead to "instability" and frequently requires revision. Various studies have shown that ... ...

Abstract	Background: Cut-out of gamma nail often results from poor primary bone stability, suboptimal reduction (varus) and excentric placement of the head element which may lead to "instability" and frequently requires revision. Various studies have shown that augmentation with polymethylmethacrylate cement increases the primary stability of osteosynthesis. However, it has not yet been widely used in fracture treatment due to certain disadvantages, e.g., the lack of osteointegration, the formation of an interface membrane or the presence of toxic monomers. Few studies show that biodegradable bone cements increase the stability of osteosynthesis in different anatomical regions and therefore could be an alternative to polymethylmethacrylate cement in the treatment of pertrochanteric fractures. Methods: Two biomechanical situations were simulated using 24 Sawbones (simple and multifragmentary pertrochanteric fractures; AO-classification 31-A1 and 31-A2. Both groups were stabilized using the Gamma3® nailing system with and without biodegradable bone cement. Sawbones underwent the same cyclic loading test, simulating 10.000 gait cycles loading the bones with three times body weight. Migration was determined by comparing computed tomography scans recorded before and after the mechanical testing. The three-dimensional migration of the lag screw was calculated, and the rotation of the head around the longitudinal axis was determined. Findings: Biodegradable cement reduced migration by approximately 35% in 31-A1 fractures (25.4% in 31-A2 fractures) and the rotation of the head around the lag screw by approximately 37% in 31-A1 fractures (17.8%, 31-A2). Interpretation: Use of biodegradable bone cement improved the primary stability of gamma nail osteosynthesis in the biomechanical model.
MeSH term(s)	Biomechanical Phenomena ; Bone Cements/therapeutic use ; Femoral Fractures ; Fracture Fixation, Internal ; Fracture Fixation, Intramedullary ; Humans
Chemical Substances	Bone Cements
Language	English
Publishing date	2021-03-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632747-3
ISSN	1879-1271 ; 0268-0033
ISSN (online)	1879-1271
ISSN	0268-0033
DOI	10.1016/j.clinbiomech.2021.105327
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Article ; Online: A novel method for intraoperative osseomechanical strength measurements: a biomechanical ex vivo evaluation on proximal femora.

Maslaris, Alexander / Brinkmann, Olaf / Layher, Frank / Matziolis, Georg / Bungartz, Matthias

Archives of orthopaedic and trauma surgery

2019 Volume 140, Issue 6, Page(s) 727–734

Abstract: Introduction: The increasing number of geriatric traumatology cases has intensified the need to reliably and objectively evaluate local bone quality, the latter poses a decisive factor for the choice of an optimal approach to treat osteoporotic ... ...

Abstract	Introduction: The increasing number of geriatric traumatology cases has intensified the need to reliably and objectively evaluate local bone quality, the latter poses a decisive factor for the choice of an optimal approach to treat osteoporotic fractures. Osteodensitometry imaging techniques are not routinely available in acute operative settings, nor do they provide objective information on local bone properties specifically needed for the prognosis of implant stability. Materials and methods: This study sought to verify ex vivo the feasibility and sensitivity of a novel method for the determination of local bone strength in the acute operative setting (intraoperative osseomechanical strength measurement; IOSM) that is based on the principle of material displacement resistance against the force of a rotary indenter. Samples consisted of human femoral heads obtained after total hip replacement. Comparisons were made with results obtained via conventional dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (qCT). Results: Regression analyses of the results showed a highly significant correlation between the IOSM and the control methods (r = 0.61 and r = 0.56; p < 0.01), indicating that this new approach qualifies as a reliable tool for the intraoperative evaluation of the intrinsic local bone strength. Conclusions: The intraoperative integration of this method may support surgeon on taking proper decisions in terms of optimal surgical approaches and prevention of complications inherent to osteoporotic bone.
MeSH term(s)	Absorptiometry, Photon ; Biomechanical Phenomena/physiology ; Feasibility Studies ; Femur/physiopathology ; Femur/surgery ; Humans ; Intraoperative Period ; Orthopedic Procedures/methods ; Tomography, X-Ray Computed
Language	English
Publishing date	2019-11-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-019-03284-7
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Article: Feasibility Analysis of a Novel Method for the Estimation of Local Bone Mechanical Properties: A Preliminary Investigation of Different Pressure Rod Designs on Synthetic Cancellous Bone Models.

Maslaris, Alexander / Bungartz, Matthias / Layher, Frank / Zippelius, Timo / Matziolis, Georg / Brinkmann, Olaf

The archives of bone and joint surgery

2020 Volume 9, Issue 2, Page(s) 203–210

Abstract: Background: Whilst traumatology around elderly population becomes more and more popular nowadays, the knowledge of local bone quality prior to osteosynthesis is of paramount importance. Assessment of the local bone mechanical properties provides ... ...

Abstract	Background: Whilst traumatology around elderly population becomes more and more popular nowadays, the knowledge of local bone quality prior to osteosynthesis is of paramount importance. Assessment of the local bone mechanical properties provides essential information related to implant stability and can support treatment strategies in a timely manner. In the acute setting, dual-energy X-ray absorptiometry and quantitative computer tomography cannot be used routinely, and up till now no known intraoperative methods have been established. Methods: A novel technique was developed to determine the local bone strength. A feasibility and sensitivity analysis were performed on synthetic cancellous bone models of various densities [including osteoporotic ranges (0.12 - 0.48g/cm Results: The Intraoperative Osseomechanical Strength Measurement (IOSM) method revealed high sensitivity for the evaluation of local density on synthetic bone material. Among the indenter designs tested, the one with 40° sharp apex and 5 mm diameter reflected accurately the density changes of the synthetic bones. It was also associated with less invasiveness posing no risk for the primary implant stability of the osteosynthesis that may follow. Conclusion: The IOSM method using the indicated indenter design on synthetic cancellous models appears to be a minimal invasive technique with high accuracy in identifying different bone densities . Further studies on human bone material are now focused on the evaluation of the IOSM sensitivity compared to the gold standards (Dual-energy X-ray absorptiometry and quantitative computer tomography).
Language	English
Publishing date	2020-01-13
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2782053-1
ISSN	2345-461X ; 2345-4644
ISSN (online)	2345-461X
ISSN	2345-4644
DOI	10.22038/abjs.2020.47854.2365
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Article: [No title information]

Biasca, Nicola / Brinkmann, Olaf / Bungartz, Matthias / Orasch, Christina

Praxis

2017 Volume 106, Issue 21, Page(s) 1157–1167

Title translation	Aktuelle Diagnose- und Therapiestrategie bei Gelenksprothesen-Infektionen.
Language	German
Publishing date	2017
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	209026-0
ISSN	1661-8165 ; 1661-8157 ; 0369-8394
ISSN (online)	1661-8165
ISSN	1661-8157 ; 0369-8394
DOI	10.1024/1661-8157/a002813
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Article: Multifragmentary dislocated humeral head fracture-A case report of a successful head preserving treatment strategy despite delayed presentation.

Bungartz, Matthias / Matziolis, Georg / Rohe, Sebastian / Brinkmann, Olaf

International journal of surgery case reports

2016 Volume 29, Page(s) 63–66

Abstract: Introduction: Head preserving, delayed osteosynthesis five days after a luxated, multifragmentary humeral head fracture is rarely seen and a challenge for the surgeon.: Presentation of case: This case history describes the case of a 69-year-old ... ...

Abstract	Introduction: Head preserving, delayed osteosynthesis five days after a luxated, multifragmentary humeral head fracture is rarely seen and a challenge for the surgeon. Presentation of case: This case history describes the case of a 69-year-old female with delayed head preserving treatment of a dislocated multifragmentary humeral head fracture using intramedullary nailing, avoiding a primary trauma arthroplasty after strict refusal of the patient despite poor prognosis and high risk of avascular humeral head necrosis. Discussion: The treatment of the humeral head fracture is still a matter of debate, the "golden standard" does not exist, especially in the deferred luxated situation. With the use of modern implants head preserving treatment is reasonable and possible. It should therefore always be taken into account as an alternative for arthroplasty. Conclusion: Excellent postoperative outcome can be achieved by joint reconstruction eliminating the possible side effects of shoulder endoprosthesis.
Language	English
Publishing date	2016-10-29
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2016.10.064
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Conference proceedings: Reliabilitätsanalyse sechs anerkannten CT-Torsionsmesstechniken nach geschlossener Nagelosteosynthese stabiler (A1) und instabiler (A2) pertrochantärer Femurfrakturen

Maslaris, Alexander / Brinkmann, Olaf / Lindemann, Chris / Liodakis, Emmanouil / Zippelius, Timo / Matziolis, Georg / Bungartz, Matthias

2021 , Page(s) AB27–883

Event/congress	Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2021); Berlin; ; Berufsverband für Orthopädie und Unfallchirurgie; 2021
Keywords	Medizin, Gesundheit ; Torsionsdiagnostik ; Torsionsdeformitäten ; Nagelosteosynthese des Femurs ; Reliabilität
Publishing date	2021-10-26
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/21dkou097
Database	German Medical Science

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Article ; Online: Sagittal profile has a significant impact on the explantability of well-fixed cemented stems in revision knee arthroplasty: a biomechanical comparison study of five established knee implant models.

Maslaris, Alexander / Layher, Frank / Bungartz, Matthias / Zippelius, Timo / Liodakis, Emmanouil / Brinkmann, Olaf / Matziolis, Georg

Archives of orthopaedic and trauma surgery

2019 Volume 139, Issue 7, Page(s) 991–998

Abstract: Background: Easy revisability is gaining increasingly in importance. The removal of well-fixed cemented stems is very demanding and is often associated with increased operative morbidity. Implant design may be here a decisive impact factor, and the best ...

Abstract	Background: Easy revisability is gaining increasingly in importance. The removal of well-fixed cemented stems is very demanding and is often associated with increased operative morbidity. Implant design may be here a decisive impact factor, and the best way to ascertain it is experimentally. Aim of this study is to assess different cemented stems of established knee revision implants in regard to their removal capability. Methods: Based on their sagittal profile, five stem extensions from known manufacturers were divided in conical, conical-cylindrical and cylindrical designs. The pedicles were also characterized in respect to their cross section, diameter and surface roughness. The cemented stems were dismounted six times each in a reproducible biomechanical setup. The explantation energy required was determined and statistical analyzed. Results: The conical shaft needed significantly the slightest explantation energy with 19.2 joules (p = 0.004). There was a strong negative linear correlation between conicity proportion and explantation energy of the cemented stems (R Conclusion: The longitudinal stem profile may have a primary impact on the explantability of well-fixed cemented shafts with conical designs showing superiority. Cross-sectional profile and surface roughness had here a less decisive influence on the explantability. Surgeons can choose proper implants and removal techniques depending on potential implant-associated revision risks and re-revisions to be expected.
MeSH term(s)	Arthroplasty, Replacement, Knee/adverse effects ; Arthroplasty, Replacement, Knee/instrumentation ; Arthroplasty, Replacement, Knee/methods ; Biomechanical Phenomena ; Cross-Sectional Studies ; Device Removal/methods ; Equipment Failure Analysis ; Humans ; Knee Joint/physiopathology ; Knee Joint/surgery ; Knee Prosthesis/adverse effects ; Knee Prosthesis/classification ; Materials Testing ; Prosthesis Design/adverse effects ; Prosthesis Design/methods ; Reoperation/methods
Language	English
Publishing date	2019-03-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-019-03160-4
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Article ; Online: Reliability analysis of CT torsion assessment after closed cephalomedullary nailing of trochanteric femoral fractures. A comparison study of six established methods.

Maslaris, Alexander / Brinkmann, Olaf / Lindemann, Chris / Layher, Frank / Pateronis, Konstantinos / Liodakis, Emmanouil / Zippelius, Timo / Matziolis, Georg / Bungartz, Matthias

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

2020 Volume 27, Issue 1, Page(s) 146–152

Abstract: Background: Posttraumatic maltorsion and implant failure after closed reduction of proximal femoral fractures remain a cause of concern. Although the reproducibility of torsion measuring techniques on CT for femoral shaft fractures has been thoroughly ... ...

Abstract	Background: Posttraumatic maltorsion and implant failure after closed reduction of proximal femoral fractures remain a cause of concern. Although the reproducibility of torsion measuring techniques on CT for femoral shaft fractures has been thoroughly analyzed, little is known about the trochanteric fractures. Apart from the well-known CT limitations, posttraumatic alteration of bony landmarks makes torsional assessment even more challenging. Main goal of this study was to examine the reliability of different CT techniques on trochanteric femoral fractures after closed nail fixation. Secondary goal was to see whether the measurements within the examined population were influenced by the fracture type and patient age or BMI. Methods: 20 cases (AO.31-A1 or -A2) were retrospectively examined. Six established CT techniques for torsional assessment were performed from three different investigators twice at different time points. The intraclass correlation coefficient (ICC for 95% CI) was used to analyze the interobserver and intraobserver reliability. Results: The Hernandez method (0.986) followed by the Jend method (0.982) by a mean difference of <1° showed the highest reliability. Although increasing fracture complexity from A1 to A2 led to an overall worsening of the measurement precision, the Hernandez and Jend techniques revealed a very good consistency. Within the examined population, age and BMI had no impact on the precision of the measurements. Conclusions: The Hernandez and Jend methods represent reliable alternatives for torsional assessment of trochanteric femur fractures treated with closed nail fixation when compared to the other measurement techniques here involved. Documentation of the torsion measuring method used in each case constitutes an essential element of the radiological reports.
MeSH term(s)	Bone Nails ; Femoral Fractures/diagnostic imaging ; Femoral Fractures/surgery ; Hip Fractures/diagnostic imaging ; Hip Fractures/surgery ; Humans ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-12-10
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1314243-4
ISSN	1436-2023 ; 0949-2658
ISSN (online)	1436-2023
ISSN	0949-2658
DOI	10.1016/j.jos.2020.10.022
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