[Medial end clavicle fractures: alternative osteosynthesis and brief review of the literature]. / Mediale Klavikulafraktur: alternative Osteosynthese und kurze Literaturübersicht.

Medial end clavicle fractures are rare injuries and typically treated conservatively. In contrast, displaced fractures have a higher incidence of delayed healing or non-union and might benefit from operative treatment. Thus, assessments of the stability and fracture morphology are essential for selection of the optimal treatment procedure. This article describes the diagnostics and surgical treatment of a displaced extra-articular fracture of the clavicle with a small medial fragment using an anatomically preformed radius plate.

[Intracerebral hemorrhage as the cause of low-flow priapism : A rare association]. / Intrazerebrale Blutung als Ursache eines Low-flow-Priapismus : Eine seltene Assoziation.

Priapism is a painful erection of the penis lasting for more than 4h and is independent of sexual stimulation. It represents a urological emergency and necessitates rapid treatment. Etiologically, approximately 20% are caused by drugs, 50% are a combination of hematological diseases (e.g. sickle cell anemia), leukemia, injections in the corpora cavernosa, paraneoplastic processes and neurological or infectious causes. Ultimately, 30% have an idiopathic origin. Priapism as a result of traumatic intracerebral hemorrhage has so far rarely been described. This article presents the case of a 48-year-old male patient who presented to the emergency department with a traumatic subarachnoid hemorrhage. During the hospital stay the patient suffered from low-flow priapism, which was initially punctured and ultimately operatively treated.

Osteoblast differentiation onto different biometals with an endoprosthetic surface topography in vitro.

In this in vitro study, we compared the cytocompatibility and osteoblast promoting potency on human bone marrow cell culture with three different alloys (surgical steel, CoCr, Ti6Al4V) and three different surface structures (polished, sandblasted, porous coated). These biometals were specifically chosen because of their current applications in clinical orthopedic practices. Human mononuclear bone marrow cells were cultivated onto the surface of the different biomaterials and stimulated by dexamethasone, L-ascorbic-acid-2-phoshpate and beta-glycerolphosphate over a 3-week period. Immunofluorescent stainings against several antigens (ALP, RANKL, osteopontin, collagen I), mRNA-expression of collagen (Col) I/II, BSP, osteopontin, osteocalcin, TRAP, light and scanning electron microscopy evaluation were used to evaluate cellular growth and osteoblast differentiation. For surface roughness and energy analysis of the specimen, roughness profile (Ra, Rz) and contact angle (CA) measurements were performed. We found differences between the different biometals and surface structures. Steel showed potential cytotoxic effects whereas CoCr and more Ti6Al4V showed an excellent cytocompatibility. There were no qualitative differences in mRNA expression between each of the tested biomaterials. In terms of antigen expression, a sandblasted Ti6Al4V surface showed enhanced osteoblastic differentiation. A porous-coated surface improved the osteoconductivity of CoCr when compared to a polished surface. In contrast to controls all cells cultivated with biometals induced a RANKL expression. Cells increased the implant roughness with the exception of sandblasted Ti6Al4V. Our data show that surface topography and physicochemical properties of biometals influence osteoblast differentiation in vitro.