Bentley European Instructional Lectures

Volume 9, 2009; 10th EFORT Congress, Vienna, Austria
1. Auflage 2009
ISBN: 978-3-642-00966-2
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, Band 9, 246 Seiten

Reihe: European Instructional Lectures

The 10th Congress of the European Federation of National Associations of Ort- paedics and Traumatology (EFORT) is the most important combined congress of the national societies in Europe. At present a total of 36 societies are members of this organisation. The major goal of EFORT is to bring current knowledge of diseases and trauma of the musculoskeletal system to all European surgeons and additionally to welcome colleagues from all over the world to join us in sharing our daily work experience. In the scienti? c programme the instructional lectures form a very basic and imp- tant part of the Congress. In Vienna a total of 25 sessions are included in the p- gramme. The authors come from all over Europe and they discuss topics from many different ? elds of trauma and orthopaedics. These lectures not only give the oppor- nity for us to be informed about various diseases, but they are also in? uenced by the authors’ experience based on the treatment philosophy in their own country – again an opportunity to widen the European horizon. They are aimed at both the general orthopaedic surgeons and the young residents and trainees who want to widen their knowledge in different topics of orthopaedic and trauma surgery. As the chairman of the Local Organising Committee I thank all the authors for providing their presentation for publication in this volume. I also address my special thanks to Professor George Bentley for organising this edition.

Autoren/Hrsg.

Bentley, George

Inhaltsverzeichnis

1;Foreword;6
2;Preface;7
3;Contents;8
4;Contributors;10
5;Part I General Orthopaedics;13
5.1;Current Status of Arthroplasty Registers in Europe;14
5.1.1;Introduction;14
5.1.2;Historical Review and Methods;14
5.1.3;Basic Requirements for the Development and Activities of a National Arthroplasty Register;15
5.1.4;Registers in Orthopaedics;17
5.1.5;Basic Principles in Interpreting Register Data of Other Countries;17
5.1.6;Benefits the Individual Surgeon Can Derive from Registers;18
5.1.7;Discussion;19
5.1.8;Acknowledgements;20
5.1.9;References;20
5.2;National Registration of Hip Fractures in Sweden;22
5.2.1;Development of the National Registration RIKSHÖFT;22
5.2.2;Hip Fracture Demographics;23
5.2.3;National Data 2007;23
5.2.4;Motivation;28
5.2.5;Performance;28
5.2.6;Computing and Feed Back;28
5.2.7;Funding;28
5.2.8;References;28
5.3;Current Status of Articular Cartilage Repair;30
5.3.1;Introduction;30
5.3.2;Arthroscopic Debridement;30
5.3.3;Reparative Techniques;31
5.3.4;Restorative Techniques;31
5.3.5;Treatment Selection;33
5.3.6;Future Developments;34
5.3.7;Conclusions;34
5.3.8;References;35
5.4;Thromboprophylaxis After Major Orthopaedic Surgery: State of the Art;39
5.4.1;Introduction;39
5.4.2;Venous Thromboembolism After Major Orthopaedic Surgery;39
5.4.3;Guideline Recommendations;40
5.4.4;Current Options for Thromboprophylaxis;40
5.4.5;New Developments in Prophylaxis: Targeted Anticoagulants;41
5.4.6;References;45
6;Part II Paediatrics;49
6.1;DDH: Diagnosis and Treatment Strategies;50
6.1.1;Introduction;50
6.1.2;Method;50
6.1.3;Results;52
6.1.4;Conclusion and Recommendation;54
6.1.5;Acknowledgments;55
6.1.6;References;55
6.2;Slipped Capital Femoral Epiphysis;56
6.2.1;Introduction;56
6.2.2;Classi. cation;56
6.2.3;Clinical Signs and Symptoms;57
6.2.4;Complications;61
6.2.5;After-Treatment;62
6.2.6;Prognosis;62
6.2.7;Summary;65
6.2.8;References;66
6.3;Major Joint Contractures in Children;70
6.3.1;Make the Diagnosis;70
6.3.2;Planning Treatment;71
6.3.3;Physiotherapy;71
6.3.4;Splints and Orthotics;71
6.3.5;Tone-Reducing Medication;72
6.3.6;Soft Tissue Releases;72
6.3.7;Correction of Limb Alignment;72
6.3.8;Arthrodesis;73
6.3.9;Arthroplasty;73
6.3.10;Decision Making;73
7;Part III Trauma;74
7.1;Damage-Control Orthopaedic Surgery in Polytrauma: In. uence on the Clinical Course and Its Pathogenetic Background;75
7.1.1;Decision Making for the Treatment of Major Fractures: Evidence for the Bene. ts of Tapered Treatment Evidence for the Bene. ts of Tapered Treatment;75
7.1.2;Pathogenesis of Organ Failure Following Trauma Induced by Multiple Fractures, Soft-Tissue Damage and Acute Haemorrhage;77
7.1.3;Interaction Between Acute Surgery After Trauma and the Pathophysiological Responses Induced by Trauma;78
7.1.4;Factors for Grading Patient Assessment;79
7.1.5;Summary;80
7.1.6;References;81
7.2;Fractures and Non-Unions of the Clavicle;83
7.2.1;Surgical Anatomy and Classi. cation;83
7.2.2;Up-Date on Conservative Treatment for Mid-Clavicular Fractures;84
7.2.3;Modalities of Plate Fixation of Mid-Clavicular Fractures;85
7.2.4;Intra-Medullary Fixation;85
7.2.5;Results of Operative Treatment;85
7.2.6;Indications for Surgery in Mid-Clavicular Fractures;85
7.2.7;Mal-Union of Midshaft Clavicle Fractures;86
7.2.8;Non-Union of Mid-Clavicle Fractures;86
7.2.9;Fractures of the Lateral Third of the Clavicule;86
7.2.10;Conclusions;87
7.2.11;References;87
7.3;Proximal Humeral Fractures;89
7.3.1;Introduction;89
7.3.2;Epidemiology;89
7.3.3;Imaging Studies;89
7.3.4;Classi. cations Systems;91
7.3.5;Current Trends of Treatment;92
7.3.6;Conclusions;95
7.3.7;References;96
7.4;Fixation of Intertrochanteric Femoral Fractures;98
7.4.1;Introduction;98
7.4.2;Treatment Methods;98
7.4.3;Discussion;99
7.4.4;Conclusions;102
7.4.5;References;102
7.5;Surgical Management of Distal Tibial Fractures in Adults;104
7.5.1;Introduction;104
7.5.2;Classification;104
7.5.3;Soft Tissue Injuries;106
7.5.4;Initial Management;107
7.5.5;De. nitive Management;108
7.5.6;Surgical Techniques;109
7.5.7;Intra-Articular Fractures, AO 43-B;112
7.5.8;Intra-Articular Fractures, AO 43-C;115
7.5.9;Conclusion;117
7.5.10;References;117
8;Part IV Upper Limb and Hand;120
8.1;The Distal Radio-Ulnar Joint: Functional Anatomy, Biomechanics, Instability and Management;121
8.1.1;Functional Anatomy;121
8.1.2;Biomechanics;122
8.1.3;Injuries of the DRUJ: Pathophysiology;123
8.1.4;Treatment Options;125
8.1.5;References;128
8.2;Distal Radius Fractures: Evolution in the Treatment Standard of Care 2009;131
8.2.1;Introduction;131
8.2.2;Epidemiology;131
8.2.3;Results and How to Measure Them;132
8.2.4;Treatment Alternatives;134
8.2.5;Open Surgery;135
8.2.6;Bone Grafts and Bone Cements;135
8.2.7;The Future;137
8.2.8;A Treatment Protocol;139
8.2.9;Conclusions;139
8.2.10;References;139
8.2.11;Dupuytren’s Contracture;143
8.2.12;Introduction;143
8.3;Structures, Properties and Function of the Palmar Aponeurosis and Related Tissues;143
8.3.1;How Does the Palmar Aponeurosis Function in Non-Human Primates?;145
8.3.2;Considerations Concerning the Plantar Aponeurosis;146
8.3.3;The Mechanical Properties of the Palmar Aponeurosis;146
8.3.4;The Clinical and Natural Course of Dupuytren’s Disease;147
8.3.5;Plantar Duypuytren’s Disease;148
8.3.6;Complications;156
9;Part V Spine;159
9.1;Low Back Pain;160
9.1.1;Strategies and Management;160
9.1.2;Diagnostic Strategies History;160
9.1.3;Physical Examination;160
9.1.4;Imaging;161
9.1.5;Natural History;161
9.1.6;Therapy;161
9.1.7;Surgical Treatment;163
9.1.8;Conclusion and Future Perspectives;163
9.1.9;Reference;163
10;Part VI Hip;165
10.1;Total Hip Arthroplasty: A Comparison of Current Approaches;166
10.1.1;Introduction;166
10.1.2;Differences;166
10.1.3;Non-Union;168
10.1.4;Nerve Palsy and Neuralgia;168
10.1.5;Trendelenburg Sign and Gait;170
10.1.6;Gait and Limp;170
10.1.7;Trochanteric Pain;171
10.1.8;Dislocation;171
10.1.9;Infection;173
10.1.10;Outcome;173
10.1.11;Leg Length;173
10.1.12;Heterotopic Ossification;173
10.1.13;Patient Preference;173
10.1.14;Minimally-Invasive Modifications;174
10.1.15;Comparison Between Normal and Minimally-Invasive Technique in the Same Approach;174
10.1.16;Comparison Between Normal and Minimally-Invasive Technique in Different Approaches;175
10.1.17;Discussion;175
10.1.18;Conclusions;176
10.1.19;References;176
10.2;Chapter How to Do a Cemented Total Hip Arthroplasty;179
10.2.1;Introduction;179
10.2.2;Clinical Outcome;182
10.2.3;The Current Cementing Technique;186
10.2.4;Conclusions;188
10.2.5;References;188
10.3;How to Do a Cementless Hip Arthroplasty;191
10.3.1;Introduction;191
10.3.2;Implant Selection;191
10.3.3;Implant Survival;203
10.3.4;References;204
11;Part VII Knee;205
11.1;How to Treat a Meniscal Lesion?;206
11.1.1;Biomechanics of the Menisci and the Sequelae of Meniscectomies;206
11.1.2;Meniscal Repair;207
11.1.3;Meniscal Replacement;208
11.1.4;The In. uence of Associated Lesions on the Treatment of Meniscal Tear;209
11.1.5;Conclusion;210
11.1.6;Acknowledgements;211
11.1.7;References;211
11.2;Soft-Tissue Balance in Total Knee Arthroplasty;213
11.2.1;Biomechanics of Total Knee Arthroplasty;213
11.2.2;Aims of Total Knee Arthroplasty;214
11.2.3;Genu Recurvatum;214
11.2.4;Fixed Flexion and Restoration of Joint-Line;214
11.2.5;Soft-Tissue Balance in the Varus Knee with or without Fixed Flexion;215
11.2.6;Tibial Defect in a Varus Knee;217
11.2.7;Soft-Tissue Balance in the Valgus Knee with or without Fixed Flexion;217
11.2.8;Summary;218
11.2.9;References;218
11.3;Revision Total Knee Arthroplasty with Bone Loss;219
11.3.1;Introduction;219
11.3.2;Classification;219
11.3.3;Mobile-Bearing Revisions;220
11.3.4;Treatment Options for Bone Loss;220
11.3.5;Conclusion;222
11.3.6;References;222
12;Part VIII Foot and Ankle;224
12.1;Ankle Arthritis;225
12.1.1;Definition;225
12.1.2;Epidemiology and Aetiology;225
12.1.3;Pathophysiology;225
12.1.4;Clinical Presentation and Functional Limitation;226
12.1.5;Radiological Presentation;227
12.1.6;Conservative Treatment;228
12.1.7;Surgical Treatment;228
12.1.8;Conclusion and Perspectives;233
12.1.9;References;233
12.2;Hallux Rigidus: Arthroplasty or Not?;236
12.2.1;Introduction;236
12.2.2;Arthrodesis;236
12.2.3;Arthroplasty;237
12.2.4;Discussion;240
12.2.5;Reference;241