bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous fixation of acetabular fractures
Authors: Caviglia Horacio , Mejail Adrian , Landro Maria Eulalia , Vatani Nosratolah 
Published: May 2018

The objective of surgery for acetabular fractures is to achieve precise reduction to restore joint congruence, fix internal bone fragments, avoid displacement of the fracture and allow rapid rehabilitation. Open reduction and internal fixation is the benchmark method for displaced acetabular fractures, but open reductions can increase morbidity, causing neurovascular injury, blood loss, heterotopic bone formation, infection and poor wound healing. An anatomical reduction with a gap of 2 mm or less is a predictor of good joint function and reduced risk of post-traumatic osteoarthritis. The percutaneous approach is associated with fewer complications than open techniques, but acetabular geometry makes percutaneous screw insertion a challenging procedure. The percutaneous technique is recommended for non-displaced or slightly displaced fractures, and in obese, osteoporotic and elderly patients who cannot receive total joint arthroplasty. We recommend the use of intramedullary cannulated screws. Fracture reductions are achieved by manual traction of the affected bones. If some fracture displacement remains, accessory windows can be used to introduce a ball spike pusher, a hook or a Steinmann pin which can be used as a joystick to rotate the fracture. In this paper, we describe the accessory windows for the anterior column, the quadrilateral plate and the posterior column. We detail the position, direction and kind of screws used to stabilize the anterior and posterior columns.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170054
Bioceramics and bone healing
Authors: Ginebra Maria-Pau , Espanol Montserrat , Maazouz Yassine , Bergez Victor , Pastorino David 
Published: May 2018

Calcium phosphates have long been used as synthetic bone grafts. Recent studies have shown that the modulation of composition and textural properties, such as nano-, micro- and macro-porosity, is a powerful strategy to control and synchronize material resorption and bone formation. Biomimetic calcium phosphates, which closely mimic the composition and structure of bone mineral, can be produced using low-temperature processing routes, and offer the possibility to modulate the material properties to a larger extent than conventional high temperature sintering processes. Advanced technologies open up new possibilities in the design of bioceramics for bone regeneration; 3D-printing technologies, in combination with the development of hybrid materials with enhanced mechanical properties, supported by finite element modelling tools, are expected to enable the design and fabrication of mechanically competent patient-specific bone grafts. The association of ions, drugs and cells allows leveraging of the osteogenic potential of bioceramic scaffolds in compromised clinical situations, where the intrinsic bone regeneration potential is impaired. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170056
Stability in ankle fractures
Authors: Lampridis Vasileios , Gougoulias Nikolaos , Sakellariou Anthony 
Published: May 2018

Medial column (deltoid ligament) integrity is of key importance when considering the stability of isolated lateral malleolus ankle fractures. Weight-bearing radiographs are the best method of evaluating stability of isolated distal fibula fractures. Computed tomography (CT) scanning is mandatory for the assessment of complex ankle fractures, especially those involving the posterior malleolus. Most isolated trans-syndesmotic fibular fractures (Weber-B, SER, AO 44-B) are stable and can safely be treated non-operatively. Posterior malleolus fractures, regardless of size, should be considered for surgical fixation to restore stability, reduce the need for syndesmosis fixation, and improve contact pressure distribution. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170057
Trochlear dysplasia: imaging and treatment options
Authors: Batailler Cécile , Neyret Philippe 
Published: May 2018

Recurrent patellar dislocation is a disabling condition, which can lead to articular cartilage injuries, osteochondral fractures, recurrent instability, pain, decreased activity and patellofemoral osteoarthritis. Trochlear dysplasia represents an important component of patellar dislocation. Imaging provides an objective basis for the morphological abnormalities and thus allows determination of the surgical strategy according to the concept of ‘à la carte’ surgery. The main surgical techniques of trochleoplasty are the sulcus deepening trochleoplasty, the ‘Bereiter’ trochleoplasty and the recession trochleoplasty. At mid-term, all techniques have shown a postoperative improvement in clinical scores, with a low rate of recurrence of dislocation and a possible return to sport. But these techniques do not halt the progression of patellofemoral arthritis. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170058
Post-traumatic stiff elbow
Authors: Adolfsson Lars 
Published: May 2018

Post-traumatic and post-operative stiffness of the elbow joint is relatively common and may in pronounced cases markedly interfere with normal upper extremity function. Soft-tissue contractures and heterotopic bone formation are two major causes of limited movement. Extensive recent research has elucidated many of the pathways contributing to these conditions, but the exact mechanisms are still unknown. In the early phase of soft-tissue contractures conservative treatment may be valuable, but in longstanding cases operative treatment is often necessary. Several different options are available depending on the severity of the condition and the underlying offending structures. Surgical treatment may allow significant gains in movement but rarely complete restoration, and complications are not uncommon. The following presentation reviews the recent literature on pathomechanisms and treatment alternatives. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170062
Research methodology: how to maximize your research potential
Authors: Alves Cristina 
Published: May 2018

Scientific education and a clinical background allow orthopaedic surgeons to perform leading research. Several resources, skills and techniques may be developed to maximize their research potential. Surgeon-researchers should develop Specific, Measurable, Achievable, Realistic, and Time-defined (SMART) goals. It is critical to define a timeline – which can be 1 year, 3 years, 5 years – to re-evaluate goals and to plan and identify potential obstacles. Physician-scientists are a product of training, funding, resources, practice setting, context, environment, and infrastructure. Although orthopaedic surgery has difficulty in recruiting surgeon-scientists, these are essential for the promotion of advances in technologies and treatment, as they have unique abilities to raise questions from the bedside and the operating room. The most critical personal traits necessary to succeed as a surgeon-scientist are persistence, resilience, and passion for research. These traits may be innate or acquired through mentorship and from role models. Mentors can improve mentees’ research efficiency and help them to persevere. Clinical researchers and surgeon-scientists should focus their research interests and efforts in their areas of clinical expertise. For surgeon-researchers to succeed they must have passion for research, persistence in working toward a goal, collaboration/teamwork skills, resilience, research training/experience, a track record of publications, clear goals and expectations, and a defined research plan as well as being clinically excellent. A formal research degree is desirable. Having non-clinician scientists in the team brings added expertise and value. Funding and protected research time are important. To provide outstanding clinical care and improve the quality of the care delivered, surgeons must be leaders in innovation and research. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170065
Total hip arthroplasty
Authors: Karachalios Theofilos , Komnos George , Koutalos Antonios 
Published: May 2018

Total hip arthroplasty (THA) is a very satisfactory surgical procedure for end-stage hip disorders. Implant modifications, such as large femoral heads to improve stability, porous metals to enhance fixation and alternative bearings to improve wear, have been introduced over the last decade in order to decrease the rate of early and late failures. There is a changing pattern of THA failure modes. The relationship between failure modes and patient-related factors, and the time and type of revision are important for understanding and preventing short and late failure of implants. The early adoption of innovations in either technique or implant design may lead to an increased risk of early failure.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170068
Pelvic post-traumatic asymmetry
Authors: Cano-Luís Pedro , Giráldez-Sánchez Miguel Ángel , Andrés-Cano Pablo 
Published: May 2018

The most common cause of post-traumatic pelvic asymmetry is, by far, initial nonoperative treatment. Open reduction and internal fixation of unstable pelvic fractures are recommended to avoid pelvic nonunion or subsequent structural deformities. The most common symptom is pelvic pain. Pelvic instability is another symptom, as well as persistent urogenital problems and neurological sequelae. Preoperative evaluation of these patients requires careful clinical and functional assessment, in addition to a complete radiological study. Surgical treatment of pelvic fracture nonunions is technically demanding and has potentially serious complications. We have developed a new classification that modifies and completes Mears and Velyvis’s classification in which we highlight two types of post-traumatic sequelae with different clinical conditions and whose basic differentiating element is whether pelvic deformity is present or not. Based on this classification, we have established our strategy of surgical treatment. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170069.
Open fractures of the lower extremity
Authors: Elniel Abdel Rahim , Giannoudis Peter V. 
Published: May 2018

Open fractures of the lower extremity are the most common open long bone injuries, yet their management remains a topic of debate. This article discusses the basic tenets of management and the subsequent impact on clinical outcome. These include the rationale for initial debridement, antimicrobial cover, addressing the soft-tissue injury and definitive skeletal management. The classification of injury severity continues to be a useful tool in guiding treatment and predicting outcome and prognosis. The Gustilo-Anderson classification continues to be the mainstay, but the adoption of severity scores such as the Ganga Hospital score may provide additional predictive utility. Recent literature has challenged the perceived need for rapid debridement within 6 hours and the rationale for prolonged antibiotic therapy in the open fracture. The choice of definitive treatment must be decided against known efficacy and injury severity/type. Recent data demonstrate better outcomes with internal fixation methods in most open tibial fractures, but external fixation continues to be an appropriate choice in more severe injuries. The incidence of infection and non-union has decreased with new treatment approaches but continues to be a source of significant morbidity and mortality. Assessment of functional outcome using various measures has been prevalent in the literature, but there is limited consensus regarding the best measures to be used.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170072
3D printing and high tibial osteotomy
Authors: Jones Gareth G. , Jaere Martin , Clarke Susannah , Cobb Justin 
Published: May 2018

High tibial osteotomy (HTO) is a relatively conservative surgical option in the management of medial knee pain. Thus far, the outcomes have been variable, and apparently worse than the arthroplasty alternatives when judged using conventional metrics, owing in large part to uncertainty around the extent of the correction planned and achieved. This review paper introduces the concept of detailed 3D planning of the procedure, and describes the 3D printing technology that enables the plan to be performed. The different ways that the osteotomy can be undertaken, and the varying guide designs that enable accurate registration are discussed and described. The system accuracy is reported. In keeping with other assistive technologies, 3D printing enables the surgeon to achieve a preoperative plan with a degree of accuracy that is not possible using conventional instruments. With the advent of low dose CT, it has been possible to confirm that the procedure has been undertaken accurately too. HTO is the ‘ultimate’ personal intervention: the amount of correction needed for optimal offloading is not yet completely understood. For the athletic person with early medial joint line overload who still runs and enjoys life, HTO using 3D printing is an attractive option. The clinical effectiveness remains unproven. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170075.
Safe management of acute cervical spine injuries
Authors: Schleicher Philipp , Pingel Andreas , Kandziora Frank 
Published: May 2018

Cervical spine injuries are frequent and often caused by a blunt trauma mechanism. They can have severe consequences, with a high mortality rate and a high rate of neurological lesions. Diagnosis is a three-step process: 1) risk assessment according to the history and clinical features, guided by a clinical decision rule such as the Canadian C-Spine rule; 2) imaging if needed; 3) classification of the injury according to different classification systems in the different regions of the cervical spine. The urgency of treatment is dependent on the presence of a neurological lesion and/or instability. The treatment strategy depends on the morphological criteria as defined by the classification. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170076
3D printing and unicompartmental knee arthroplasty
Authors: Jones Gareth G. , Clarke Susannah , Jaere Martin , Cobb Justin 
Published: May 2018

In suitable patients, unicompartmental knee arthroplasty (UKA) offers a number of advantages compared with total knee arthroplasty. However, the procedure is technically demanding, with a small tolerance for error. Assistive technology has the potential to improve the accuracy of implant positioning. This review paper describes the concept of detailed UKA planning in 3D, and the 3D printing technology that enables a plan to be delivered intraoperatively using patient-specific instrumentation (PSI). The varying guide designs that enable accurate registration are discussed and described. The system accuracy is reported. Future studies need to ascertain whether accuracy for low-volume surgeons can be delivered in the operating theatre using PSI, and reflected in improved patient reported outcome measures, and lower revision rates. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180001
Ischaemia, healing and outcomes in proximal humeral fractures
Authors: Lambert Simon M. 
Published: May 2018

Interfragmental ischaemia is a prerequisite for the initiation of the inflammatory and immunological response to fracturing of bone. Intrafragmental ischaemia is inevitable: the extent of the initial ischaemic insult does not, however, directly relate to the outcome for healing of the fracture zones and avascular necrosis of the humeral head. The survival of distal regions of fragments with critical perfusion may be the result of a type of inosculation (blood vessel contact), which establishes reperfusion before either revascularization or neo-angiogenesis has occurred. Periosteum has a poorly defined role in fracture healing in the proximal humerus. The metaphyseal periosteal perfusion may have a profound effect, as yet undefined, on the healing of most metaphyseal fractures of the proximal humerus, and may be disturbed further by inadvertent surgical manipulation. The metaphysis can be considered as a ‘torus’ or ring of bone, its surface covered by periosteum antero- and posterolaterally, through which the tuberosity segments gain perfusion and capsular reflections antero- and posteromedially, through which the humeral head (articular) fragment gains perfusion. The torus is broken in relatively simple primary patterns: a fracture line at the upper surface of the torus is an anatomical ‘neck’ fracture; a fracture line at the lower surface of the torus is the surgical ‘neck’ fracture. Secondary fragmentation (through compression and/or distraction) of the torus itself creates complexity for analysis (classification), alters the capacity and outcome for healing (by variable interruption of the fragmental blood supply) and influences interfragmental stability.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180005
Minimizing Restraint and Seclusion in Schools: A Response to Beaudoin and Moore
Authors: Walker Virginia L. , Pinkelman Sarah E. 
Published: May 2018

Abstract
Increasing efforts have been made in the field of special education to identify positive, evidence-based practices (EBPs) to meet the needs of students who engage in problem behavior, with a major goal being to eliminate or limit the use of reactive measures such as restraint and seclusion (Snell & Walker, 2014). Various stakeholders, including families and self-advocates, have voiced concerns about the dangers of restraint and seclusion and the lack of protection afforded to students who engage in severe problem behavior. In the previous article in this issue of Intellectual and Developmental Disabilities, Beaudoin and Moore (2018) echo these concerns in their account of a family's experience with restraint as told from the perspective of a father whose son was subjected to restraint, resulting in a number of adverse short- and long-term consequences that affected the entire family. In response to Beaudoin and Moore, we provide readers with a brief review of the current status of restraint and seclusion in school settings and evidence-based strategies that can be used to address severe problem behavior and reduce the need for restraint and seclusion. For readers interested in exploring restraint and seclusion in greater depth, we suggest recent work by Trader and colleagues (2017). We also have outlined guidelines for behavior support planning that should be considered by various stakeholders as educators work toward establishing safe and supportive school environments that address a wide range of student behavioral needs.
Assessing the Confidence of Australian Mental Health Practitioners in Delivering Therapy to People With Intellectual Disability
Authors: Hronis Anastasia , Roberts Lynette , Kneebone Ian 
Published: May 2018

Abstract
Research supports the use of psychological therapies among people with mild to moderate intellectual disability (ID). One barrier to people with ID accessing psychological treatments is the confidence of mental health practitioners. This article explores the confidence of Australian clinicians in providing therapy to people with ID. One hundred and fifty-two psychologists and counselors in Australia completed a survey exploring self-reported confidence when working with clients who have ID and mental health difficulties. Clinicians were most confident with generic counseling skills, but less confident with elements of assessments and interventions. The use of treatment protocols was endorsed as helpful particularly among those with low confidence. This highlights the need for dissemination of treatment guides and training to help increase clinician confidence.
Supporting Women at the Time of Abortion: A Mixed‐Methods Study of Male Partner Experiences and Perspectives
Authors: Nguyen Brian T. , Hebert Luciana E. , Newton Sara L. , Gilliam Melissa L. 
Published: May 2018

AbstractCONTEXTAlthough men are commonly viewed as unaware, uninvolved and even obstructive regarding their partner's abortion access, those who accompany women to an abortion appointment may be more supportive. A better understanding of men's motivations could inform clinic policies regarding their involvement.METHODSIn 2015–2016, data were collected from male partners of women seeking an abortion at two clinics in a large Midwestern city. Twenty‐nine interviews were conducted to explore how men wanted to be involved in the abortion and why they accompanied their partners. Thematic content analysis was used to examine these data, and emergent themes informed a survey, completed by 210 men, that focused on perceptions about and reasons for accompaniment. Descriptive statistics were calculated for the survey data.RESULTSFour in 10 interviewees were aged 25–34, as were half of survey respondents. Overall, most had at least some college education and were in long‐term or committed relationships. Interviewees described providing primarily instrumental (e.g., transportation and financial) and emotional (e.g., companionship and reassurance) support during the abortion process. While 57% of survey respondents would not have chosen to terminate the pregnancy if the decision had been their own, all wanted to support their partners. Notably, 70% viewed the appointment as an opportunity to receive contraceptive counseling.CONCLUSIONSPositive narratives regarding men's support for the abortion decisions of their partners provide a counterpoint to commonly held negative narratives. Future research should explore how supportive men who accompany partners at the time of an abortion may improve women's abortion experiences.
Zasady dynamiki misyjnej według św. Pawła (refleksja misjonarza)
Authors: KROEGER JAMES H. 
Published: May 2018

Saint Paul, apostle par excellence, tirelessly labored to spread the Gospel, particularly in the Gentile world. His missionary travels and encounter with diverse peoples, cultures, and religions form the matrix or context of his missionary methods. A comprehensive examination of Paul’s writings yields much mission wisdom and insight shaped by his apostolic experience and dynamic faith. This presentation suggests ten “mission principles”-derived from Paul’s profound reflection and “applied” to missionary engagement today.
Światowa Organizacja Zdrowia i opieka medyczna sprawowana przez instytucje religijne w 30 lat po deklaracji w Ałma Ata
Authors: PAWŁOWSKI ZBIGNIEW 
Published: May 2018

Considerable changes, concerning the scope of the completion of the basic health care for all, which was offered originally in year 2000 are developing in very close relation to the missionary medical care centers. One of the most common issues is the idea of the basic health care for all. Another important question is linked to the role and future of medical centers run by religious institutions. Following matter is the necessary reorganization of the work of medical centers led by religious institutions. It is essential but have to be projected from the new global perspective. Finally going back to the main subject, the article presents the declaration published recently by the World Health Organization (WHO) on the collaboration with medical centers, guided by Faith-Based Organizations (FBO).