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is a predictor of good joint function and reduced risk of post-traumatic osteoarthritis. Therefore, the surgeon should try to obtain reductions with zero displacement or up to 1 mm. The anatomical reduction and stable osteosynthesis of the acetabular
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should be discussed depending on the level of suffering and functional impairment. Repeated ’giving way’ may cause cartilaginous lesions and chronic hyperpression with the risk of the later development of patellofemoral osteoarthritis. The goal of surgery
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Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, Switzerland
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Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, Switzerland
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Introduction The surgical treatment of knee osteoarthritis (OA) has been constantly growing for more than two decades, with more than 10 billion dollars spent every year on knee replacements in the US alone. 1 Traditionally, total knee
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-button patients with less osteoarthritis 50 , 51 and with fewer complications and reoperations. 52 A recent meta-analysis on biomechanical comparison between fixation options shows superior strength for screw fixation but similar load and rotation to
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relative risk is only 1.7 in the second grade. 22 A higher incidence of hip osteoarthritis (OA) and implantation of total hip arthroplasty in the parents and grandparents of patients diagnosed with DDH in comparison with the general population has also
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Fractures of the lateral and the posterior processes of the talus are uncommon and frequently missed because of a low level of suspicion and difficulty in interpretation on plain radiographs. Missed fractures can lead to persistent pain and reduced function.
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Lateral process fractures are usually a consequence of forced dorsiflexion and inversion of fixed pronated foot. These are also commonly known as snowboarder’s fractures.
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The posterior process of the talus is composed of medial and lateral tubercles, separated by the groove for the flexor hallucis longus tendon.
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The usual mechanism of injury is forced hyperplantarflexion and inversion causing direct compression of the posterior talus, or an avulsion fracture caused by the posterior talofibular ligament. CT scans are helpful in cases of high clinical suspicion.
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There is a lack of consensus regarding optimal management of these fractures; however, management depends on the size, location and displacement of the fragment, the degree of cartilage damage and instability of the subtalar joint. Non-operative treatment includes immobilization and protected weight-bearing for six weeks. Surgical treatment includes open reduction and internal fixation or excision of the fragments, depending on the size.
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Fractures of the lateral and the posterior processes of the talus are uncommon but important injuries that may result in significant disability in cases of missed diagnosis or delayed or inadequate treatment. Early diagnosis and timely management of these fractures help to avoid long-term complications, including malunion, nonunion or severe subtalar joint osteoarthritis.
Cite this article: EFORT Open Rev 2018;3:85-92. DOI: 10.1302/2058-5241.3.170040
Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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osteoarthritis for its lubricating role for joint, although a consensus has not been reached. Studies have found its ability to downregulation of matrix metalloproteinases and cytokines through interleukin-1β-mediated expression ( 10 , 11 ), which is critical in
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patients with different underlying aetiologies (i.e. inflammatory arthritis from osteoarthritis); follow up less than 12 months. Two authors reviewed all abstracts for inclusion according to the above criteria, and where a study met all the criteria, or
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been identified”. 3 Another review studied twelve PROMs for the assessment of physical activities in osteoarthritis (OA) patients and concluded that there is “not enough evidence for any instrument to have adequate measurement properties”. 4
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footwear and the design and fitting of insoles. It can bring pain alleviation but no conservative treatment has the faculty to correct the deformity. Fig. 1 Indirect signs of first ray insufficiency include: a) osteoarthritis of the second tarso
