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from intravenous to oral antibiotic administration is currently a well-grounded practice. The growing clinical and microbiologic body of evidence on ‘high-risk’ children/neonates of acute osteoarticular infections warrants continual clinical extra
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Computed Tomography Research Group, University of Applied Sciences Upper Austria, Wels, Austria
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Extracorporeal shock wave therapy (ESWT) is a safe therapy and there are only a few side effects known (such as pain during ESWT and minor haematomata), but no severe complications are to be expected if it is performed as recommended.
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Contraindications are severe coagulopathy for high-energy ESWT, and ESWT with focus on the foetus or embryo and focus on severe infection.
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The effect mechanism of ESWT is still a component of diverse studies, but as far as we can summarize today, it is a similar process to a cascade triggered by mechano-transduction: mechanical energy causes changes in the cellular skeleton, which provokes a reaction of the cell core (for example release of mRNA) to influence diverse cell structures such as mitochondria, endoplasmic reticulum, intracellular vesicles, etc., so the enzymatic response leads to the improvement of the healing process.
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The usage of ESWT should be taught, to improve the outcome. Courses should be organized by national societies, since the legal framework conditions are different from one country to another.
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In this update the musculoskeletal indications are addressed (mainly bone and tendons): pseudoarthrosis, delayed fracture healing, bone marrow oedema and osteonecrosis in its early stages, insertional tendinopathies such as plantar fasciitis and Achilles tendon fasciitis, calcifying tendonitis of the rotator cuff, tennis elbow, and wound healing problems.
Cite this article: EFORT Open Rev 2020;5:584-592. DOI: 10.1302/2058-5241.5.190067
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Department of Orthopaedic Surgery, Amphia Hospital Breda, The Netherlands
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Introduction Septic arthritis is an acute infection of the joint that occurs most commonly in young children. The infection is mainly monoarticular, and is frequently localized in the knee and hip joints, while it is less frequent in the
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significant complications were those of failure, loosening or dislocation of implants. A number of other complications including fracture, infection, chronic regional pain syndrome, superficial radial nerve symptoms, tendon irritation, and heterotopic
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Clínica Alemana, Santiago, Chile
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43 9.7 54 92.5 26 Screw loosening Ballal 22 25 11.6 51 100 12.4 Plate and screw migration, deep infection, rebound Danino 23 206 12.5 362 93% femur 92% tibia 16 Infection, limited range motion knee
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of a generally accepted definition of consensus in the development of recommendations, we adopted the stepwise approach as implemented during the previous consensus initiative on periprosthetic joint infections. 6 The following levels of consensus
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Reduction Fractures can be reduced by closed or open means. 44 Open reduction has been related to a higher incidence of infection and stiffness. Closed reduction is a reliable technique for the majority of displaced fractures. Regarding extension
St George’s, University of London, London, UK
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University College London (UCL), London, UK
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St George’s, University of London, London, UK
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–71 pre-op, 32–91 post-op) 16 of 19 feet pain-free at last follow-up Not reported 19/19 feet pin infections 4 flat-top talus 4 temporary foot stiffness 8 toe flexion contracture needing PC release Recurrence of deformity in 2 pts (age 12 and 15
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anticoagulant drugs, are well known to predispose a fracture to delayed union or non-union. 9 – 13 In the case of open fractures, the delayed or non-union may be associated with infection and loss of vascularity. 14 Other authors have not found any
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-Mata 2013 9 Open 5 3 scar problems 1 paraesthesia None 6 Harrison 2013 8 Open 6 1 paraesthesia None 4 Barrera-Ochoa 2016 Open vs. mini-open 34 Open: 2 haematomas 1 cutaneous problem 1 superficial infection Mini
