Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
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Department of Trauma and Orthopaedic Surgery, Hospital Nostra Senyora de Meritxell, Andorra
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Universidad de Valladolid, Valladolid, Spain
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Universidad Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
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, disuse osteopenia and fracture remodelling ( 5 ). Despite the proposed algorithms and classifications, the decision-making process is still unclear and there is lack of systematization and consensus. In addition, not only are these fractures treated by
King’s Global Health Partnerships, School of Life Course and Population Sciences, King’s College London, London, UK
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Department of Orthopaedics, University of the Philippines, Philippine General Hospital Manila, The Phillipines
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complexity of managing FRI well, experts came together to discuss definitions and management principles. The International Consensus Meeting (ICM) Orthopaedic Trauma Work Group and the International Fracture Related Infection Consensus Group were born out of
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-economic constraints depend on healthcare systems. The objective of this review is to describe the current management of meniscus pathology based on current literature and on the ESSKA Meniscus Consensus Project, 8 which was presented in 2016. We will
Ludwig Maximilians University Munich, Department of Orthopaedic and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany
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Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK
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Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
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Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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of the 1 st EFORT European Consensus on ‘Medical and Scientific Research Requirements for the Clinical Introduction of Artificial Joint Arthroplasty Devices’ were foremost to focus on patient safety through performance requirements for medical
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of the ankle. 2 Some of these patients will develop chronic ankle instability (CAI), making this situation an important and frequent condition. 1 Anatomy Consensus The lateral ankle ligament has three bundles: anterior talo
Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.
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Nonunions are a relevant economic burden affecting about 1.9% of all fractures. Rather than specifying a certain time frame, a nonunion is better defined as a fracture that will not heal without further intervention.
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Successful fracture healing depends on local biology, biomechanics and a variety of systemic factors. All components can principally be decisive and determine the classification of atrophic, oligotrophic or hypertrophic nonunions. Treatment prioritizes mechanics before biology.
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The degree of motion between fracture parts is the key for healing and is described by strain theory. If the change of length at a given load is > 10%, fibrous tissue and not bone is formed. Therefore, simple fractures require absolute and complex fractures relative stability.
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The main characteristics of a nonunion are pain while weight bearing, and persistent fracture lines on X-ray.
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Treatment concepts such as ‘mechanobiology’ or the ‘diamond concept’ determine the applied osteosynthesis considering soft tissue, local biology and stability. Fine wire circular external fixation is considered the only form of true biologic fixation due to its ability to eliminate parasitic motions while maintaining load-dependent axial stiffness. Nailing provides intramedullary stability and biology via reaming. Plates are successful when complex fractures turn into simple nonunions demanding absolute stability. Despite available alternatives, autograft is the gold standard for providing osteoinductive and osteoconductive stimuli.
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The infected nonunion remains a challenge. Bacteria, especially staphylococcus species, have developed mechanisms to survive such as biofilm formation, inactive forms and internalization. Therefore, radical debridement and specific antibiotics are necessary prior to reconstruction.
Cite this article: EFORT Open Rev 2020;5:46-57. DOI: 10.1302/2058-5241.5.190037
IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy
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Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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Fondazione Livio Sciutto Onlus, Campus Savona – Università degli Studi di Genova, Savona, Italy
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Introduction Total hip arthroplasty (THA) is one of the most frequent and successful surgeries performed in the orthopedic field, nevertheless, a clear consensus on post-surgical management still lacks ( 1 ). The need to define a clear
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behaviours, as well as the variety of joints involved, is difficult to establish an absolute standard for treatment. 8 The current consensus for treating a diffuse tenosynovial giant-cell tumour of the knee is surgical resection of the lesional tissue
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render the nerve susceptible to subluxation or neo-compression. There is no consensus on the management of cubital tunnel, and the aim of this article is to provide a guide to management based on our clinical experience of treating failed surgery
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years ago, a non-consensus between units existed regarding the anticoagulation chemical VTE prophylaxis pre-operatively. But they advocated the start of Heparin (UFH or LWMH) 6-12 hours after surgery for 4 weeks, the early mobilization of the frail
