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Michalis Panteli and Peter V. Giannoudis

-up, while ‘cure’ of the disease cannot be safely declared. Prompt diagnosis and aggressive management of chronic osteomyelitis are critical to the prognosis and final outcome. Treatment aims to achieve the resolution of the infection and restoration of

Tamer El-Sobky and Shady Mahmoud

, delayed diagnosis and consequent delay in institution of definitive treatment, late presentation, poor compliance with antibiotic regimes, high organism virulence and positive findings on joint ultrasound predict a poor long-term prognosis. 2 , 7 , 9

Josep Muñoz Vives, Jean-Christophe Bel, Arantxa Capel Agundez, Francisco Chana Rodríguez, José Palomo Traver, Morten Schultz-Larsen, and Theodoros Tosounidis

injuries of very different severity and prognosis. Type I injuries can involve the potentially harmful association of meniscal and ligamentary injuries, but Fraser type II fractures may cause such damage that meniscal and ligamentary integrity are almost

Philippe Hernigou, Victor Housset, Jacques Pariat, Arnaud Dubory, and Charles Henri Flouzat Lachaniette

surgery as patients and physicians are preparing for THA. The prognosis of patients with SCD has improved in recent times, and life expectancy has considerably increased. Therefore, improving quality of life by managing musculoskeletal complications

Xinhuan Lei, Jie Xiang, Hailan Yang, Hongya Bao, Zhong Zhu, and Hua Luo

Introduction Surgical site infection (SSI) is a rare and serious complication of total knee arthroplasty (TKA) that can cause a poor prognosis, reduce these patients’ quality of life, and significantly increase the financial burden. Therefore

Jonny K. Andersson

  • Injuries to the scapholunate joint are the most common cause of carpal instability.

  • An isolated injury to the scapholunate ligament may progress to abnormal joint mechanics and degenerative cartilage changes.

  • Treatment for scapholunate instability is aimed at arresting the degenerative process by restoring ligament continuity and normalising carpal kinematics.

  • Early arthroscopic diagnosis of scapholunate injury is mandatory for establishing the prognosis of the injury, as a proper ligament repair is recommended within four to six weeks after trauma.

  • In this review, anatomy, diagnosis and treatment of scapholunate ligament injury and carpal instability are discussed. Recommendations for treatment based on the stage and classification of injury and the degree of instability and arthritic changes are proposed.

Cite this article: EFORT Open Rev 2017;2:382–393. DOI: 10.1302/2058-5241.2.170016

Abdel Rahim Elniel and Peter V. Giannoudis

  • Open fractures of the lower extremity are the most common open long bone injuries, yet their management remains a topic of debate.

  • This article discusses the basic tenets of management and the subsequent impact on clinical outcome. These include the rationale for initial debridement, antimicrobial cover, addressing the soft-tissue injury and definitive skeletal management.

  • The classification of injury severity continues to be a useful tool in guiding treatment and predicting outcome and prognosis. The Gustilo-Anderson classification continues to be the mainstay, but the adoption of severity scores such as the Ganga Hospital score may provide additional predictive utility.

  • Recent literature has challenged the perceived need for rapid debridement within 6 hours and the rationale for prolonged antibiotic therapy in the open fracture. The choice of definitive treatment must be decided against known efficacy and injury severity/type.

  • Recent data demonstrate better outcomes with internal fixation methods in most open tibial fractures, but external fixation continues to be an appropriate choice in more severe injuries. The incidence of infection and non-union has decreased with new treatment approaches but continues to be a source of significant morbidity and mortality.

  • Assessment of functional outcome using various measures has been prevalent in the literature, but there is limited consensus regarding the best measures to be used.

Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170072

Robert Grimer, Michael Parry, and Steven James

reported no difference in outcomes between patients undergoing early re-excision (before 32 days, the median in his series) and after 32 days. 17 Funovics et al found that undergoing re-excision within 12 weeks of initial IE led to a better prognosis

Olga Savvidou, Olympia Papakonstantinou, Eleftheria Lakiotaki, Dimitra Melissaridou, Pinelopi Korkolopoulou, and Panayiotis J. Papagelopoulos

resection or as a palliative treatment. 33 The prognosis of EO is poor, compared to conventional osteosarcoma, with a five-year survival rate of 28%. Tumour size is the best predictor of outcome. 35 More than 80–90% of patients develop local

Catalin Cirstoiu, Bogdan Cretu, Sergiu Iordache, Mihnea Popa, Bogdan Serban, and Adrian Cursaru

metastases is to restore an optimal functional status. Palliative treatment is appropriate when we have a generalized metastatic disease, surgically unapproachable metastases, metastases with extensive locoregional extension, or patients with a poor prognosis