Rehabilitation after musculoskeletal injury: European perspective.

Trauma is one of the main causes of death in younger people and ongoing disability worldwide. In Europe, while there is generally good organization of trauma reception and acute treatment, rehabilitation from major musculoskeletal injuries is less well defined and provided. This article documents the diverse approaches to rehabilitation after major injury in 6 European nations.

Orthopaedic trauma residency programs: Perspectives from different countries across the world.

The ability to manage the myriad of musculoskeletal conditions successfully requires multiple years of training. Access to and completion of orthopaedic surgical training entails an often grueling, highly regulated path to certification to practice. Although the world is more connected than ever, the question is whether the local certification criteria for medical specialists leads to a generic residency program and a similar training in all countries.

Ultrasound-Guided A1 Pulley Release Versus Classic Open Surgery for Trigger Digit: A Randomized Clinical Trial.

Objectives: We compared an ultra-minimally invasive ultrasound-guided percutaneous A1 pulley release and a classic open surgery for trigger digit.

Methods: We designed a single-center randomized control trial. All cases had clinical signs of primary grade III trigger digit.

Overview of fracture liaison services in the UK and Europe: standards, model of care, funding, and challenges.

Fragility fractures represent a growing global problem, including in the United Kingdom and European countries. Reports demonstrate the benefits of national guidance and organized fragility fracture programs through fracture liaison services to deliver care to patients who sustain these injuries. The challenge of assembling multidisciplinary teams, providing routine screening of appropriate patients, and monitoring therapies where there is a known compliance problem, remains an obstacle to the success of fragility fracture treatment programs to all.

Ultra-minimally Invasive Sonographically-guided Trigger Digit Release: An External Pilot Study.

Objectives: The most common surgical option for releasing the first annular pulley in trigger digit (TD) is classic open surgery followed by blind percutaneous release. However, they have been related to major complications and incomplete releases, respectively. Intrasheath sonographically-guided first annular pulley release has recently been shown to be safe and effective in every digit.

Homemade 3D mirror imaging models utility for surgical treatment of complex fractures of scapula.

The treatment of complex articular scapular fractures requires obtaining an anatomic reduction. The experience of the surgeon and the surgical skills needed are still the most important aspect in this surgical field. 3D printed models at a 1:1 scale provides tactile and visual experience.

International trauma care: initial European approaches during the COVID 19 pandemic.

The world was not prepared for the global of pandemic in early 2020 with the arrival of COVID 19. Europe has some of the most developed health care systems in the world and this article explains the initial response to the pandemic from an orthopaedic and trauma viewpoint from 8 nations. Italy reported the first cluster in February, which then rapidly spread around the continent, requiring a rapid reorganization of services.

Hip fracture systems-European experience.

European countries have established health care systems but are struggling with the increasing rise of fragility fractures in their aging population. In trying to address this significant burden, countries are establishing national guidelines and standards, focusing on hip fractures, which represent the significant cost for this patient group. This has evolved with the establishment of national audits and guidelines.

Thromboprophylaxis Management in Surgical Patients: The Efficacy of a Protocol in the Electronic Prescription Program.

Background And Objective: Venous thromboembolism (VTE) continues to be a problem in surgical patients, but thromboprophylactic measures are not always implemented. This study aimed to evaluate thromboprophylaxis practice in surgical patients at our institution by assessing appropriateness during admission and discharge; 60-day clinical outcomes are analyzed, and finally further interventions are discussed for continued improvement.

Methods: A cross-sectional, observational study was conducted in patients undergoing orthopedic and abdominal surgical procedures.

Ultrasound-guided supra-acetabular pelvic external fixator (US-SA FIX).

Background: Between the different options in pelvic external fixation, the supra-acetabular pin placement is considered the best option by many authors. The aim of this study is to describe the surgical technique of the ultrasound-guided supra-acetabular pelvic external fixator (US-SA FIX).

Surgical Technique: Description of the steps to perform the US-SA FIX technique.

3D surgical printing for preoperative planning of trabecular augments in acetabular fracture sequel.

We describe the methodical and possibilities of 3D surgical printing in preoperative planning for a total hip arthroplasty in acetabular deformity after acetabular fractures, showing a case of a 43-year-old with posttraumatic arthritis after both column fracture of the left acetabulum that was treated non operatively, supporting the do it yourself mode.

Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

Introduction: Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy.

The floating knee: a review on ipsilateral femoral and tibial fractures.

In 1975, Blake and McBryde established the concept of 'floating knee' to describe ipsilateral fractures of the femur and tibia. This combination is much more than a bone lesion; the mechanism is usually a high-energy trauma in a patient with multiple injuries and a myriad of other lesions.After initial evaluation patients should be categorised, and only stable patients should undergo immediate reduction and internal fixation with the rest receiving external fixation.

Ultra-Minimally Invasive Ultrasound-Guided Carpal Tunnel Release: A Randomized Clinical Trial.

Objectives: The purpose of this study was to compare the outcomes of 1-mm ultra-minimally invasive ultrasound-guided carpal tunnel release and 2-cm blind mini-open carpal tunnel release.

Methods: We conducted a single-center individual parallel-group controlled-superiority randomized control trial in an ambulatory office-based setting at a third-level referral hospital. Eligible participants had clinical signs of primary carpal tunnel syndrome and positive electrodiagnostic test results and were followed for 12 months.

3D Surgical Printing Cutting Guides for Open-Wedge High Tibial Osteotomy: Do It Yourself.

Opening wedge osteotomy has recently gained popularity, thanks to the recent implementation of locking plates, which have shown equivalent stability with greater reproducibility, accuracy, and longevity than the closing wedge techniques and a lower prosthetic conversion rate. We present a new "do-it-yourself" cutting guides system for tibial opening osteotomy. Using a conventional computed tomography digital image, a positioning guide and wedge spacers were printed in three dimensions (3D) for implementing the osteotomy and obtaining the planned correction.

Methods and Guidelines for Venous Thromboembolism Prevention in Polytrauma Patients with Pelvic and Acetabular Fractures.

Sequential compression devices and chemical prophylaxis are the standard venous thromboembolism (VTE) prevention for trauma patients with acetabular and pelvic fractures. Current chemical pharmacological contemplates the use of heparins or fondaparinux. Other anticoagulants include coumarins and aspirin, however these oral agents can be challenging to administer and may need monitoring.

Cup-cage construct for acute fractures of the acetabulum, re-defining indications.

Acetabular fractures in the elderly are challenging injuries. The use of a trabecular metal acetabular cage was investigated as the treatment option in a series of elderly patients with acetabular fractures. At a 2-year follow up, 6 elderly patients were found to have mimimum pain, increased function, and increased scores using the Merle d'Aubigné and Postel system modified by Charnley.

Tantalum cones in revision total knee arthroplasty. A promising short-term result with 29 cones in 21 patients.

Twenty-nine porous tantalum metaphyseal cones were implanted in 21 patients (14 women and 7 men) during revision TKA. The average age at the time of the procedure was 73.3 years.

Stoppa approach, an alternative for total hip arthroplasty in an intra-pelvic cup.

Removal of an acetabular prosthesis that has migrated into the pelvis can be hazardous. We describe the preoperative planning and the surgical procedure for removing a severely displaced acetabular component in one patient and outline our recommendation for the use of Stoppa approach because it has advantages of simple dissection, a low complication rate, and may help in preventing life-threatening problems.

Sonographically guided intrasheath percutaneous release of the first annular pulley for trigger digits, part 2: randomized comparative study of the economic impact of 3 surgical models.

Objectives: Trigger digit surgery can be performed by an open approach using classic open surgery, by a wide-awake approach, or by sonographically guided first annular pulley release in day surgery and office-based ambulatory settings. Our goal was to perform a turnover and economic analysis of 3 surgical models.

Methods: Two studies were conducted.