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fractures . Journal of Neurosurgery 1990 72 889 – 893 . ( https://doi.org/10.3171/jns.1990.72.6.0889 ) 19. König MA Jehan S Boszczyk AA & Boszczyk BM . Surgical management of U-shaped sacral fractures: a systematic review of current treatment
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surgical management of extremity bone sarcomas is based mainly on endoprosthetic reconstructive procedures that take advantage of the modular systems, offering immediate mechanical support and functional recovery. Despite this trend, there is still an
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Orthopedic Department, Spine Unit, Hotel Dieu de France Hospital, Beirut, Lebanon
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there is no wedging of the apical vertebras. If surgical management is considered, flexibility of this deformity should be assessed and the patient is positioned placing a bolster under the thoracic spine to have a hyperextension lateral
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treatment of proximal ulna fractures still remains a challenge for the orthopaedic surgeon. The aim of this review article is to illustrate the proper surgical management of these complex injuries using modern osteosynthetic implants and novel techniques
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. 47 Most patients with a degenerative tear do well with conservative treatment, and no differences with surgical management have been reported at one-year follow-up in well-designed studies. 43 , 45 , 46 , 48 – 50 This is probably due to the
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania
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Bone metastases are difficult to treat surgically, necessitating a multidisciplinary approach that must be applied to each patient depending on the specifics of their case.
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The main indications for surgical treatment are a lack of response to chemotherapy, radiation therapy, hormone therapy, immunotherapy, and bisphosphonates which is defined by persistent pain or tumor progression; the risk of imminent pathological bone fracture; and surgical treatment for single bone metastases.
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An important aspect of choosing the right treatment for these patients is accurately estimating life expectancy. Improved chemotherapy, postoperative radiation therapy, and sustainable reconstructive modalities will increase the patient’s life expectancy.
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The surgeon should select the best surgical strategy based on the primary tumor and its characteristics, the presence of single or multiple metastases, age, anatomical location, and the functional resources of the patient.
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Preventive osteosynthesis, osteosynthesis to stabilize a fracture, resections, and reconstructions are the main surgical options for bone metastases.
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Resection and reconstruction with a modular prosthesis remain the generally approved surgical option to restore functionality, increase the quality of life, and increase life expectancy.
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Preoperative embolization is necessary, especially in the case of metastases of renal or thyroid origin. This procedure is extremely important to avoid complications, with a major impact on survival rates.
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There are three main patterns of complex elbow instability: posterolateral (terrible triad), varus posteromedial (anteromedial coronoid fracture with lateral collateral ligament complex disruption), and trans-olecranon fracture dislocations.
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Radial head fractures, in the setting of complex elbow instability, often require internal fixation or arthroplasty; the outcome of radial head replacement is dictated by adequate selection of the head diameter, correct restoration of radial length, and proper alignment and tracking.
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Small coronoid fractures can be ignored. Larger coronoid fractures, especially those involving the anteromedial facet, require fixation or graft reconstruction, particularly in the presence of incongruity.
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The lateral collateral ligament complex should be repaired whenever disrupted. Medial collateral ligament disruptions seem to heal reliably without surgical repair provided all other involved structures are addressed.
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The most common mistakes in the management of trans-olecranon fracture dislocations are suboptimal fixation, lack of fixation of coronoid fragments, and lack of restoration of the natural dorsal angulation of the ulna.
Cite this article: Sanchez-Sotelo J, Morrey M. Complex elbow instability. EFORT Open Rev 2016;1:183-190.
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to 80 years, typically following low-energy trauma. 7 The objectives of this article are to review the evaluation of patients presenting with HSF, delineate the relative indications of conservative and surgical management, summarize treatment
Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Thessaloniki, Greece
Centre of Orthopaedics and Regenerative Medicine (CORE) – Centre of Interdisciplinary Research and Innovation (CIRI) – Aristotle University Thessaloniki, Greece
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Gennimatas General Hospital, Cholargos, Athens, Greece
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superior HHS and pain scores during the first 12 months. 55 Although SWT was considered beneficial for the management of GTPS, the information for the control group was unclear. Surgical treatment Surgical management is indicated for full
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will focus on the management of high-energy, axial compression injuries. Initial management The surgical management of pilon fractures is technically demanding and requires accurate pre-operative planning. The pre-operative plan should include a
