Die arthroskopische Arthrodese des oberen Sprunggelenks (OSG) führt bei OSG-Arthrose in geübten Händen zuverlässig zu einer Schmerzreduktion und Fusion des oberen Sprunggelenks. Sie ist der offenen Arthrodese in vielen Fällen durch eine schnellere Rehabilitation mit tendenziell besserem klinischem Outcome bei vergleichbaren radiologischen Ergebnissen überlegen. Allerdings bleibt das offene Verfahren der Goldstandard, wenn ein Knochenersatz, stärkere Achsenkorrektur oder eine rigidere Plattenfixierung notwendig ist. Die durch die Arthrodese entstehende funktionelle Einschränkung wird von angrenzenden Gelenken teilweise kompensiert. Diese Mehrbelastung wird als Ursache für die langfristig beobachtete vermehrte Arthrose des unteren Sprunggelenks (USG) und des Mittelfußes angesehen und kann zu persistierenden Beschwerden führen.
Abstract:Ulnarsided wrist pain represents one of the most common problems in hand surgery. Due to the close relationship between the ulnocarpal wrist compartiment, the distal radioulnar joint and its adjacent soft tissue structures numerous pathologies can be the cause for those symptoms. An exact understanding of the anatomic structures and their specific diagnostics is inevitable. The most common sources of ulnarsided wrist pain are instability or osteoarthrosis of the distal radioulnar joint and the ulnocarpal impaction syndrome. The pathologies were addressed with a broad audience during the third web symposium of the German-speaking Working Group for Hand Surgery (DAH) on the 3rd of December 2025. This article summarizes the key messages of the websymposium and provides a guideline for the diagnostics and stage-dependent therapy of the individual pathologies.
Reconstruction of bone defects is a key challenge in orthopaedic surgery. While autologous bone grafts are considered the gold standard, osseous allografts are increasingly used as an alternative as they allow for treatment of large bone defects. However, they may be associated with an increased risk of postoperative infections. This study aims to analyze the frequency of and risk factors for implant-associated infections after bone allograft transplantation. All patients who underwent reconstruction with bone allografts at a single orthopaedic and trauma unit between 2003 and 2023 were retrospectively included. Data on demographics, disease-associated parameters, risk factors at index surgery, and development of implant-associated infections during follow-up were documented. Potential risk factors for development of implant-associated infections during follow-up were investigated with logistic regression models. A total of 220 patients were included (46.8
