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radiological, clinical, and temporal criteria. Classically, these were considered ‘pseudarthrosis’ due to the abnormal motion identified in severe non-unions in long bones, developing a flexible fibrotic union or even a true neo-articulation at the fracture
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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
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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
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Department of Orthopaedics, Aarhus University Hospital, Palle Juul-Jensens Boulevard, Aarhus, Denmark
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describe swirling of the columns. Discussion Recent advances in epiphysiodesis techniques have opened the possibility of using guided growth to correct rotational deformities in long bones of growing children. This scoping review found a total of
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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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
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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
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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
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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.
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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.
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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.
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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).
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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
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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
West Hertfordshire Hospitals NHS Trust, London, United Kingdom
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James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, Norfolk, United Kingdom
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Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, Essex, United Kingdom
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School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Introduction Poller screws were named as a reference to ‘poller’, a term describing small metal bollards that block and direct traffic ( 1 ). Poller screws are a recently developed adjunct for intramedullary (IM) nailing of long bones and the
