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Julie J. Willeumier, Yvette M. van der Linden, Michiel A.J. van de Sande, and P.D. Sander Dijkstra

probably present an even higher number. Due to constantly improving treatments, the duration of the palliative phase is prolonged. Longer survival unfortunately gives each patient more time to develop metastases. Bone metastases of the long bones may lead

Stijn E. W. Geraets, P. Koen Bos, and Johan van der Stok

develop bone metastases. 2 , 3 These bone metastases cause clinical symptoms that require treatment in more than half of these patients. 4 Clinical symptoms occurring due to long bone metastases include pain, with 10–25% of patients presenting

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

in terms of prosthetic integration, which allows for quicker return to physical activity. There are two major errors that an orthopedic surgeon can make in the management of long bone metastasis. Type 1 error is the use of load sharing implants

Elisa Pala, Alberto Procura, Giulia Trovarelli, Antonio Berizzi, and Pietro Ruggieri

Introduction Bones are a frequent location of metastases from carcinomas; the most common sites are the spine and pelvis, followed by the long bones, especially the proximal femur ( 1 ). All types of malignant tumors have the potential to

Miklós Szendrői, Imre Antal, Attila Szendrői, Áron Lazáry, and Péter Pál Varga

bones of the extremities. Metastatic diseases of the long bones Diagnostic algorithm Many authors 2 - 7 recommend rather similar diagnostic work-up protocols for potential metastatic diseases. These flow charts help orthopaedic surgeons

Maria Tennyson, Matija Krkovic, Mary Fortune, and Ali Abdulkarim

  • Various technical tips have been described on the placement of poller screws during intramedullary (IM) nailing; however studies reporting outcomes are limited. Overall there is no consistent conclusion about whether intramedullary nailing alone, or intramedullary nails augmented with poller screws is more advantageous.

  • We conducted a systematic review of PubMed, EMBASE, and Cochrane databases. Seventy-five records were identified, of which 13 met our inclusion criteria. In a systematic review we asked: (1) What is the proportion of nonunions with poller screw usage? (2) What is the proportion of malalignment, infection and secondary surgical procedures with poller screw usage? The overall outcome proportion across the studies was computed using the inverse variance method for pooling.

  • Thirteen studies with a total of 371 participants and 376 fractures were included. Mean follow-up time was 21.1 months. Mean age of included patients was 40.0 years. Seven studies had heterogenous populations of nonunions and acute fractures. Four studies included only acute fractures and two studies examined nonunions only.

  • The results of the present systematic review show a low complication rate of IM nailing augmented with poller screws in terms of nonunion (4%, CI: 0.03–0.07), coronal plane malunion (5%, CI: 0.03–0.08), deep (5%, CI: 0.03–0.11) and superficial (6%, CI: 0.03–0.11) infections, and secondary procedures (8%, CI: 0.04–0.18).

  • When compared with the existing literature our review suggests intramedullary nailing with poller screws has lower rates of nonunion and coronal malalignment when compared with nailing alone. Prospective randomized control trial is necessary to fully determine outcome benefits.

Cite this article: EFORT Open Rev 2020;5:189-203. DOI: 10.1302/2058-5241.5.190040

Yücel Ağırdil

Introduction The growth plate, also known as the physis, is the cartilaginous portion at the ends of long bones where longitudinal growth of the bone takes place. This region of bone is characterized by high metabolic activity and is under the

Abdel Rahim Elniel and Peter V. Giannoudis

Epidemiology Open fractures of the tibia are the most common open long bone fractures, with an annual incidence of 3.4 per 100 000. 1 , 2 The mean age of those who sustain open tibial fractures is 43.3 years, most frequently occurring in

Joaquim Soares do Brito, André Spranger, Paulo Almeida, José Portela, and Irene Barrientos-Ruiz

potential. 1 – 4 This tumour is commonly observed in the long bone epiphyseal-metaphyseal regions of young adults, with the most common age of onset being between 20 and 40 years old. The clinical symptoms are non-specific and may include local pain

Holger Keil, Nils Beisemann, Benedict Swartman, Sven Yves Vetter, Paul Alfred Grützner, and Jochen Franke

restriction that particularly applies in the management of shaft fractures of long bones, as the axis of the total bone can barely be visualized. Additionally, depending on the anatomical region, the soft tissues can absorb significant amounts of radiation. In