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1. Prevalence, Characteristics, and Prognosis of Peripheral Arterial Disease in Patients With Diabetic Charcot Foot.

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, Orioli, Laura, Hammer, Frank, Vande Berg, Bruno, Putineanu, Dan Constantin, Maiter, Dominique, Vandeleene, Bernard, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, Orioli, Laura, Hammer, Frank, Vande Berg, Bruno, Putineanu, Dan Constantin, Maiter, Dominique, and Vandeleene, Bernard

Abstract

Charcot foot (CF) is a rare complication of diabetes associated with foot deformities and foot ulcers. Peripheral arterial disease (PAD) is a factor of poor prognosis in patients with diabetic foot ulcers (DFUs). However, PAD has infrequently been studied in CF. We aimed to determine the prevalence, the characteristics and the prognosis of PAD in a large group of patients with diabetic CF. We retrospectively compared 56 patients with diabetic CF to 116 patients with diabetic foot without CF. The prevalence of PAD in patients with CF was 66.1%. Compared to patients without CF, patients with CF had similar risks to have PAD (OR 0.98, 95%CI 0.50-1.94, p= .97) and neuro-ischemic DFUs (OR 1.19, 95%CI 0.57-2.49, p= .65), more risk to have lesions of distal arteries (OR 4.17, 95%CI 1.76-9.94, p= .001) and less risk to need revascularization (OR 0.14, 95%CI 0.06-0.36, p< .001). In patients with CF, PAD was strongly predicted by DFUs (OR 24.55, 95%CI 1.80-334.43, p= .016) and coronary artery disease (OR 17.11, 95%CI 1.75-167.43, p =.015). Survival rate and limb salvage rate in patients with CF were not worsened by PAD and by neuro-ischemic DFUs, respectively. In conclusion, we show that PAD should not be overlooked in patients with diabetic CF, especially in those having DFUs or coronary artery disease. PAD in patients with CF differed from that of patients without CF since it predominated in distal arteries and required less often revascularization.

Published
2022

2. Delayed healing — causes and treatment principles

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AO Trauma Course — Basic Principles of Fracture Management, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AO Trauma Course — Basic Principles of Fracture Management

Published
2022

3. The (soft-tissue) injury—a high priority consideration

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AO Trauma Course — Basic Principles of Fracture Management, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AO Trauma Course — Basic Principles of Fracture Management

Published
2022

4. Operative treatment of Humeral shaft fractures—which implant?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2022

5. Staged treatment of pilon fractures: the way to go?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2022

6. “AO and its Belgian connection”

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2022

7. Is Primary Pantalar Arthrodesys a Solution for Severe Non Reconstructible Tibial Pilon Fractures ?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Tribak, Karim, Manon, Julie, Cornu, Olivier, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Tribak, Karim, Manon, Julie, and Cornu, Olivier

Published
2022

8. Femur shaft nonunions: I treat with plates and bone grafting

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2022

9. Implant choice for Proximal Femoral Fractures, Augmentation ?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Sermon, An, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and Sermon, An

Published
2022

10. Chirurgie orthopédique et traumatologie: que retenir en 2021?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - SSS/IREC/MORF - Pôle de Morphologie, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de médecine interne générale, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Van Cauter, Maïté, Pirlot, Pierre, Guilmot, Pierre-Philippe, Thoreau, Loïc, Bonnelance, Maxime, Beckers, Gautier, Poilvache, Hervé, Morcillo, Daniel, Druez, Vincent, Dubuc, Jean-Emile, Irda, Nadia, Kaminski, Ludovic, Vandergugten, Simon, Sirbu, Alin, Tribak, Karim, Putineanu, Dan Constantin, Mathieu, David, Schubert, Thomas, Yombi, Jean Cyr, de Wouters d'Oplinter, Solange, Docquier, Pierre-Louis, Libouton, Xavier, Thienpont, Emmanuel, Banse, Xavier, Barbier, Olivier, Cornu, Olivier, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - SSS/IREC/MORF - Pôle de Morphologie, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de médecine interne générale, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Centre de malformations vasculaires congénitales, Van Cauter, Maïté, Pirlot, Pierre, Guilmot, Pierre-Philippe, Thoreau, Loïc, Bonnelance, Maxime, Beckers, Gautier, Poilvache, Hervé, Morcillo, Daniel, Druez, Vincent, Dubuc, Jean-Emile, Irda, Nadia, Kaminski, Ludovic, Vandergugten, Simon, Sirbu, Alin, Tribak, Karim, Putineanu, Dan Constantin, Mathieu, David, Schubert, Thomas, Yombi, Jean Cyr, de Wouters d'Oplinter, Solange, Docquier, Pierre-Louis, Libouton, Xavier, Thienpont, Emmanuel, Banse, Xavier, Barbier, Olivier, and Cornu, Olivier

Abstract

L’année 2021 nous permet d’éclairer l’impact des techniques mini-invasives en chirurgie d’arthroplastie de hanche, la poursuite des progrès dans l’arthroplastie du genou, la place de stratégies non conventionnelles dans le contrôle des infections d’implants et l’intérêt d’une nouvelle installation pour la réalisation des techniques d’arthroscopie de l’épaule. L’optimisation des techniques chirurgicales en arthroplastie de hanche permet d’identifier les patients pour lesquels un contrôle sanguin postopératoire s’avère nécessaire mais aussi, dès lors d’optimiser les patients avant l’intervention afin de réduire le risque d’anémie postopératoire et la nécessité d’une transfusion. Le bénéfice de l’arthroplastie du genou n’a jusqu’à présent pas égalé celui de la hanche. Néanmoins, le développement des stratégies de resurfaçage respectant l’anatomie individuelle du patient soutenu par la technologie moderne et particulièrement la robotisation et le recours aux implants sur mesures laisse augurer de progrès significatifs. L’infection constitue une complication redoutable de la chirurgie d’arthroplastie. Aux stratégies classiques viennent s’ajouter de nouvelles approches thérapeutiques comme la chirurgie deux temps en un et une meilleure définition de la place de l’antibiothérapie suppressive au long cours. Enfin, Il semble qu’une position optimale pour les patients qui bénéficient d’arthroscopies de l’épaule soit celle en décubitus dorsal, évitant les inconvénients des positions semi-assise et en décubitus latéral, la première étant associée à un risque anesthésique accru et la deuxième à des difficultés chirurgicales en cas de conversion vers une voie ouverte et un risque de lésion du plexus brachial., [2021 innovations in orthopedic surgery and traumatology] The year 2021 enabled us to shed light on the impact of minimally invasive techniques in hip arthroplasty surgery, continued progress in knee arthroplasty, place of unconventional strategies in the control of implant infections, and interest of a new surgical positioning for performing shoulder arthroscopy techniques. The optimization of surgical techniques in hip arthroplasty renders it now possible to identify those patients for whom a postoperative blood control proves necessary but also, therefore, for optimizing the patients before the intervention in order to reduce the risk of postoperative anemia and transfusion requirement. The benefit of knee replacement surgery has so far not matched that of hip replacement. Nevertheless, the development of resurfacing strategies respecting the individual anatomy of the patient, supported by modern technology and particularly robotization and using custom-made implants, augurs well for significant progress. Infection is a serious complication of arthroplasty surgery. To the classic strategies were added new therapeutic approaches, such as two-stage surgery in one stage and a better definition of the place of long-term suppressive antibiotic therapy. Finally, an optimal position for patients benefitting from shoulder arthroscopy is that in the supine position, avoiding the disadvantages of semi-sitting and lateral decubitus positions, with the first associated with increased anesthetic risks and the second with surgical difficulties in the event of conversion to an open approach, with a risk of injury to the brachial plexus.

Published
2022

11. IDF21-0337 Diabetic foot infection and its recurrence: a retrospective study from an academic center in Belgium

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/MBLG - Pôle de Microbiologie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de microbiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - (SLuc) Service de médecine interne et maladies infectieuses (MIMI), UCL - (SLuc) Département de pharmacie, Delcourt, Charlotte, Orioli, Laura, Maiter, Dominique, Briquet, Caroline, Rodriguez-Villalobos, Hector, Putineanu, Dan Constantin, Vandeleene, Bernard, Yombi, Jean Cyr, International Diabetes Federation (IDF) Virtual Congress 2021, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/MBLG - Pôle de Microbiologie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de microbiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - (SLuc) Service de médecine interne et maladies infectieuses (MIMI), UCL - (SLuc) Département de pharmacie, Delcourt, Charlotte, Orioli, Laura, Maiter, Dominique, Briquet, Caroline, Rodriguez-Villalobos, Hector, Putineanu, Dan Constantin, Vandeleene, Bernard, Yombi, Jean Cyr, and International Diabetes Federation (IDF) Virtual Congress 2021

Abstract

BACKGROUND: Diabetic foot infection (DFI) is a frequent and potentially both limb- and life-threatening complication of diabetic foot ulcer (DFU). [...]

Published
2022

12. Subtrochanteric fractures

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

13. Tibial Shaft fractures

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

14. Lisfranc Injuries

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

15. Review of the principles and new techniques : Summary and Q&A

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

16. Making a decision in Mangled extremity

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

17. Operative treatment of Humeral shaft fractures — which implant?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

18. Staged treatment of pilon fractures: the way to go?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Putineanu, Dan Constantin

Published
2021

19. Traumatic injuries of the distal tibiofibular syndesmosis.

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service des urgences, Cornu, Olivier, Manon, Julie, Tribak, Karim, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service des urgences, Cornu, Olivier, Manon, Julie, Tribak, Karim, and Putineanu, Dan Constantin

Abstract

AIM : The distal tibiofibular syndesmosis (DTFS) is frequently injured during ankle trauma. The sequelae can be significant, including chronic instability, early osteoarthritis and residual pain. The aim of this study is to summarize the current state knowledge about these injuries by answering four questions. HOW COMMON ARE SYNDESMOSIS INJURIES?: They frequently occur in the context of an ankle sprain (20-40% of cases) or during various types of ankle fractures (20-100% of cases). They cannot be ruled out based solely on fracture type and must be investigated when a fibular or posterior malleolar fracture is present. HOW ARE THEY DIAGNOSED?: Clinical examination and imaging are essential but do not provide a definitive diagnosis. Ultrasonography, CT scan and MRI have high sensitivity, but their static nature does not allow a treatment strategy to be defined. Dynamic radiographs must be taken, either with load or during a procedure. If instability is detected, stabilization is the general rule. HOW IS THE SYNDESMOSIS REDUCED AND STABILIZED?: In fracture cases, reduction is achieved by restoring the length and rotation of the distal fibular fragment, preferably during an open procedure. In sprain cases, reduction is not a problem unless there is ligament interposition. Tibiofibular fixation is done 1.5 to 3cm from the talocrural joint, while ensuring the reduction is perfect. WHAT OUTCOMES CAN BE EXPECTED?: The main complication-non-healing of the syndesmosis-is attributed to poor initial reduction. This or functional discomfort during weight bearing will require removal of the fixation hardware. In most cases, this allows functional recovery and correction of the inadequate reduction. Persistence of instability will require ligament reconstruction or fusion of the syndesmosis. Chronic instability can lead to ankle osteoarthritis. LEVEL OF EVIDENCE : V, expert opinion.

Published
2021

20. Surgical treatment of lateral ankle instability. Does allograft tendon have a better functional result?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Gossing, Louis, Detrembleur, Christine, Puttemans, Thierry, Putineanu, Dan Constantin, Clairbois, Laurent, Ayong, Serge, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Gossing, Louis, Detrembleur, Christine, Puttemans, Thierry, Putineanu, Dan Constantin, Clairbois, Laurent, and Ayong, Serge

Abstract

Surgical treatment of lateral ankle instability can be performed with or without allograft. We compared these two technical options referring to patients’ functional, radiological and ultrasound data. Forty patients were surgically treated for lateral pain- ful instability of the ankle. Twenty patients underwent ligamentoplasty using the Broström-Gould technique and twenty underwent a ligamentoplasty by allograft tendon. Patients were matched in age and gender. The assessment was done at 2.5 years postoperatively by functional scores (Olerud & Molander, and Foot & Ankle Outcome), dynamic x-rays (focused on varus and anterior drawer stress tests) and ultrasound examination (focused on anterior talo-fibular and calcaneo-fibular ligaments). No significant difference was found between the two techniques for all scores. Functional scores were more than 75% and the com- plication rate was low (<10%). Regarding the surgical technique, the tendon allograft could not prove to be more beneficial.

Published
2020

21. Frequency and risk factors of complications after surgical treatment of ankle fractures : a retrospective study of 433 patients

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, and Cornu, Olivier

Abstract

Ankle fractures are frequently treated using surgical interventions, and are associated with a high rate of postoperative complications. We wonder if complications can be anticipated and correlated to patient demographics, lifestyle, fracture or surgery related factors. We retrospectively reviewed all medical reports of patients who underwent ankle fracture surgery between 2013 and 2017. We focused our risks factors analysis on 5 common complications : poor wound healing, surgical site infection, malunion, nonunion and chronic pain. Multivariate logistic regression was performed to analyze significant risk factors for these complications. We identified 433 patients. Complications were present in 26% of the cases. The most frequent complication was poor wound healing (10%) associated with deep surgical site infection in 6%. Malunion was found in 7% and nonunion in 3%. Seven percent of patients suffered from chronic pain. More severe fractures happened to be a risk factor for poor wound healing (p = 0,032) and malunion (p < 0,001). Open fractures had respectively 6 to 9 times more mal- (p = 0,012) and nonunion (p = 0,018). Overweight patients with alcohol abuse were doubling their chances of cutaneous (p = 0,030) and infectious (p = 0,040) complications, and tripling their risks of ankle fracture nonunion (p = 0,003). Female and patients operated at night (p = 0,045) seemed to be more at risk to develop chronic pain (p = 0,028). Complications of ankle fracture treatment are frequent and their risks increases with more complex and open fractures. This study brings new evidence concerning the combined effect of overweight and alcohol abuse on poor wound healing, surgical site infection and non-union.

Published
2020

22. INNOVATIONS 2019 EN CHIRURGIE ORTHOPÉDIQUE ET TRAUMATOLOGIE

Author

UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Libouton, Xavier, PIREAU, Nathalie, Vandergugten, Simon, CUNIN, Vincent, Dubuc, Jean-Emile, Mahaudens, Philippe, Irda, Nadia, VAN CAUTER, Maïté, Kaminski, Ludovic, Tribak, Karim, Putineanu, Dan Constantin, MATHIEU, David, MORCILLO, Daniel, THOREAU, Loïc, SIRBU, Alin, DRUEZ, Vincent, Schubert, Thomas, Yombi, Jean Cyr, Docquier, Pierre-Louis, Banse, Xavier, Thienpont, Emmanuel, Barbier, Olivier, Cornu, Olivier, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Libouton, Xavier, PIREAU, Nathalie, Vandergugten, Simon, CUNIN, Vincent, Dubuc, Jean-Emile, Mahaudens, Philippe, Irda, Nadia, VAN CAUTER, Maïté, Kaminski, Ludovic, Tribak, Karim, Putineanu, Dan Constantin, MATHIEU, David, MORCILLO, Daniel, THOREAU, Loïc, SIRBU, Alin, DRUEZ, Vincent, Schubert, Thomas, Yombi, Jean Cyr, Docquier, Pierre-Louis, Banse, Xavier, Thienpont, Emmanuel, Barbier, Olivier, and Cornu, Olivier

Abstract

L’année 2019 nous amène à évoquer trois thématiques : l’apport de l’imagerie 3D dans la planification des arthroplasties de l’épaule, la reconstruction articulaire du coude par greffe ostéoarticulaire taillée en miroir et enfin la chirurgie de la scoliose par modulation de croissance, sans fusion vertébrale. La pathologie de l’épaule est une des plus fréquentes du système locomoteur, touchant environ la moitié de la population. L’arthrose gléno-humérale, quelle que soit son étiologie, peut justifier le recours à un remplacement prothétique. Le devenir de ces implants n’atteint cependant pas le taux de survie des implants prothétiques de la hanche et du genou. La sévérité des pertes osseuses, particulièrement au niveau de la glène de l’omoplate, et la difficulté d’orienter avec précision les implants rend compte pour une bonne part d’échecs fréquents et trop précoces. La planification de la chirurgie à l’aide d’un logiciel de planification à partir de reconstructions 3D scanner permet d’anticiper ces problèmes et d’établir une stratégie chirurgicale adaptée. Le devenir des arthroplasties du coude dans le temps reste limité, particulièrement chez le sujet jeune et actif. L’utilisation d’une reconstruction ostéochondrale permet de postposer le recours à l’arthroplastie de plusieurs années. Cette chirurgie difficile par la nécessité d’une congruence articulaire parfaite est actuellement rendue possible par l’usage d’une planification en miroir à partir de l’articulation saine et la sélection de l’allogreffe la plus appropriée sur base de l’imagerie scanner. La chirurgie est rendue possible par la mise à disposition du chirurgien de guides de coupe pour l’articulation lésée et l’allogreffe, assurant la correction avec exactitude, conformément à la planification préopératoire. La scoliose atteint principalement une population jeune et tend à s’aggraver avec la croissance. Jusqu’à présent, la chirurgie visait à rétablir l’équilibre sagital du rachis en bloquant les segment, The year 2019 has provided us three major themes: the contribution of 3D imaging in the planning of shoulder replacements, joint reconstruction of the elbow by mirrored osteoarticular graft, and finally scoliosis surgery by modulation of growth, without vertebral fusion. Shoulder disease is one of the most common conditions involving the musculoskeletal system, affecting about half of the patients with musculoskeletal complaints. Gleno-humeral osteoarthritis, whatever its etiology, may justify prosthetic replacement. However, the fate of these implants does not attain the survival rates of prosthetic hip and knee implants. The severity of bone loss, particularly within the scapula, and the difficulty of precisely orientating implants both account for a large part of common and too early failures. Planning surgery using planning software from 3D reconstruction scans can anticipate these problems and enable us to establish an appropriate surgical strategy. The fate of elbow replacements remains limited over time, especially in the young and active subject. Using osteochondral reconstruction allows us to postpone arthroplasty for several years. The need for perfect joint congruence is currently made possible via mirror planning from the healthy joint and selection of the most appropriate allograft based on scanner imaging. Surgery is made possible by the surgeon's provision of cutting guides for the injured joint and allograft, ensuring accurate correction, in accordance with preoperative planning. Scoliosis mainly affects a young population, tending to worsen with growth. Until now, surgery has been aimed at restoring the spine’s sagittal balance by fusion of the bony segments to prevent further deformation. This strategy has implemented constraints on the spine segments left free of instrumentation and bone fusion with potentially secondary discoradicular pathologies at these levels. The concept of using residual spine growth to correct deformation has recently been

Published
2020

23. Predictors of mechanical complications after intramedullary nailing of tibial fractures.

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service des urgences, Manon, Julie, Detrembleur, Christine, Van de Veyver, Simon, Tribak, Karim, Cornu, Olivier, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service des urgences, Manon, Julie, Detrembleur, Christine, Van de Veyver, Simon, Tribak, Karim, Cornu, Olivier, and Putineanu, Dan Constantin

Abstract

INTRODUCTION: Intramedullary (IM) nailing is the gold standard treatment for tibial shaft fractures, but can be associated with various mechanical complications, including delayed union. HYPOTHESIS: We believe that complications do not occur randomly, but in certain conditions that contribute to their development. Risk factors likely to predict delayed union can be identified to support prevention. MATERIALS AND METHODS: A cohort of 171 fractures treated by IM nailing between 2005 and 2015 was reviewed retrospectively. Independent variables included intrinsic, patient-related factors and extrinsic factors such as those related to the fracture or surgery. A multiple logistic regression model was used to determine which factors can predict each type of complication. RESULTS: Delayed union occurred in 22.8% of patients. Smoking and high-energy trauma were risk factors. Hardware breakage was significantly reduced (p<0.05) when the nail diameter was greater than 10mm. A nail diameter/reamer diameter ratio outside the recommended limits (0.80-0.99) was more likely to be associated with screw failure. Diabetes is a risk factor for hardware migration, which itself is associated with other complications. DISCUSSION: Nonunion is the most common complication after IM nailing of tibial shaft fractures. Smoking cessation after a fracture is necessary in our opinion, even if the literature is ambivalent on this aspect and stopping to smoke once the fracture occurs may not be sufficient to prevent a poor outcome. Use of a nail diameter/reamer diameter between 0.80 and 0.99 favors union and prevents hardware breakage. Hardware migration in a diabetic patient may be a warning sign of other types of complications. LEVEL OF EVIDENCE: Retrospective cohort study. Level IV.

Published
2019

24. Clinical and demographic profile of admitted victims in a tertiary hospital after the 2015 earthquake in Nepal

Author

UCL - SSS/IRSS - Institut de recherche santé et société, UCL - SSH/IACS - Institute of Analysis of Change in Contemporary and Historical Societies, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Centre du cancer, Rodrigues Leal Moitinho De Almeida, Maria, van Loenhout, Joris, Thapa, Sunil Singh, Kumar, K. C., Schlüter, Benjamin-Samuel, Singh, Ravikant, Banse, Xavier, Putineanu, Dan Constantin, Mahara, Deepak Prakash, Guha-Sapir, Debarati, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - SSH/IACS - Institute of Analysis of Change in Contemporary and Historical Societies, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Centre du cancer, Rodrigues Leal Moitinho De Almeida, Maria, van Loenhout, Joris, Thapa, Sunil Singh, Kumar, K. C., Schlüter, Benjamin-Samuel, Singh, Ravikant, Banse, Xavier, Putineanu, Dan Constantin, Mahara, Deepak Prakash, and Guha-Sapir, Debarati

Abstract

BACKGROUND: In 2015, an earthquake killing 9,000 and injuring 22,000 people hit Nepal. The Tribhuvan University Teaching Hospital (TUTH), a reference tertiary hospital, was operational immediately after the earthquake. We studied the profile of earthquake victims admitted in TUTH and assessed what factors could influence hospital length of stay. METHODS: An earthquake victim dataset was created based on patient records, with information on sex, age, date of admission and discharge, diagnosis, and surgical intervention. We performed an initial descriptive overview of the earthquake victims followed by a time-to-event analysis to compare length of hospital stay in different groups, using log rank test and cox regression to calculate Hazard Ratios. RESULTS: There were in total 501 admitted victims, with the peak of admissions occurring on the fifth day after the earthquake. About 89% had injury as main diagnosis, mostly in lower limbs, and 66% of all injuries were fractures. Nearly 69% of all patients underwent surgery. The median length of hospital stay was 10 days. Lower limb and trunk injuries had longer hospital stays than injuries in the head and neck (HR = 0.68, p = 0.009, and HR = 0.62 p = 0.005, respectively). Plastic surgeries had longer hospital stays than orthopaedic surgeries (HR = 0.57 p = 0.006). Having a crush injury and undergoing an amputation also increased time to discharge (HR = 0.57, p = 0.013, and HR = 0.65 p = 0.045 respectively). CONCLUSIONS: Hospital stay was particularly long in this sample in comparison to other studies on earthquake victims, indirectly indicating the high burden TUTH had to bear to treat these patients. To strengthen resilience, tertiary hospitals should have preparedness plans to cope with a large influx of injured patients after a large-scale disaster, in particular for the initial days when there is limited external aid.

Published
2019

25. Primary tibio-talar-calcaneal arthrodesys with intramedullary nailing of severely non—reconstructible tibial pilon fractures

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, XVIIIth Orthopedic and Trauma National Congress, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and XVIIIth Orthopedic and Trauma National Congress

Published
2019

26. The operating room. How to fix it? The upper limb

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Belgian Orthopaedic Trauma Association National Congress - The polytraumatized Patient - From the spot to the Rehabilitation, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and Belgian Orthopaedic Trauma Association National Congress - The polytraumatized Patient - From the spot to the Rehabilitation

Published
2019

27. Tarsectomy and Ilizarov external fixation for treatment of extensive osteomyelitis and chronic ulcer of midfoot with Charcot arthropathy

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, XVIIIth Orthopedic and Trauma National Congress, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and XVIIIth Orthopedic and Trauma National Congress

Published
2019

28. The osteoporotic shoulder, leave it, fix it or replace it?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AOTrauma Symposium - Tips & Tricks in Geriatric Fracture Surgery, Learning from Errors, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AOTrauma Symposium - Tips & Tricks in Geriatric Fracture Surgery, Learning from Errors

Published
2019

29. Non-union in Subtrochanteric region

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AOTrauma Seminar—Fractures arround the hip, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AOTrauma Seminar—Fractures arround the hip

Published
2019

30. La prise en charge des traumatismes de la ceinture scapulaire

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Tribak, Karim, Pireau, Nathalie, Putineanu, Dan Constantin, BOTA (Belgian Orthopaedic Trauma Association) Casuistic Joint, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Tribak, Karim, Pireau, Nathalie, Putineanu, Dan Constantin, and BOTA (Belgian Orthopaedic Trauma Association) Casuistic Joint

Published
2019

31. Cases discussion

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Putineanu, Dan Constantin, BOTA (Belgian Orthopaedic Trauma Association) Casuistic Joint, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Putineanu, Dan Constantin, and BOTA (Belgian Orthopaedic Trauma Association) Casuistic Joint

Published
2019

32. Risk factors of complications after surgical treatment of ankle fractures

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, and 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS)

Abstract

Category: Fracture-related Infection - Poster 30

Published
2019

33. Tarsectomy and Ilizarov external fixation for the treatment of chronic ulcer and extensive osteomyelitis of the midfoot with Charcot neuroarthropathy

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, Remy, Stéphanie, Cornu, Olivier, Vandeleene, Bernard, Yombi, Jean Cyr, Orioli, Laura, Putineanu, Dan Constantin, 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service d'endocrinologie et de nutrition, Remy, Stéphanie, Cornu, Olivier, Vandeleene, Bernard, Yombi, Jean Cyr, Orioli, Laura, Putineanu, Dan Constantin, and 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS)

Abstract

Category: Diabetic - Poster 57

Published
2019

34. Could we predict infection after intramedullary nailing of tibial shaft fracture?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, Putineanu, Dan Constantin, Tribak, Karim, Van de Veyver, Simon, Cornu, Olivier, 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, Putineanu, Dan Constantin, Tribak, Karim, Van de Veyver, Simon, Cornu, Olivier, and 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS)

Abstract

Category: Fracture-related Infection - Poster 23

Published
2019

35. Beside infection, do not forget to manage peripheral arterial dis¬ease in diabetic Charcot foot

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine interne générale, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - SSS/IONS/NEUR - Clinical Neuroscience, Orioli, Laura, Hammer, Frank, Vande Berg, Bruno, Putineanu, Dan Constantin, Maiter, Dominique, Yombi, Jean Cyr, Cornu, Olivier, Vandeleene, Bernard, 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS), UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine interne générale, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - SSS/IONS/NEUR - Clinical Neuroscience, Orioli, Laura, Hammer, Frank, Vande Berg, Bruno, Putineanu, Dan Constantin, Maiter, Dominique, Yombi, Jean Cyr, Cornu, Olivier, Vandeleene, Bernard, and 38th Annual Meeting of the European Bone and Joint Infection Society (EBJIS)

Abstract

AIM: Our study aimed to analyze 1) the prevalence of peripheral arterial disease (PAD) and infec¬tion in diabetic patients with and without Charcot foot (CF), 2) the characteristics of PAD in these 2 groups, 3) the prognosis of patients with CF and PAD and/or infection. METHOD: We retrospectively reviewed the medical and radiological records of 172 hospitalized pa¬tients in our diabetic foot unit between 2010 and 2014. These patients were identified using the ICD-9-CM. The CF group and the diabetic foot (DF) group included 56 and 116 patients, respectively. All statistical analyses were performed using SPSS 25.0.01. A p <0.05 was considered as statistically significant. RESULTS: In the CF group, the prevalence of PAD and infection reached 66.1% and 67.9%, respec¬tively. Diabetic foot ulcers (DFUs) were neuroischemic, infected or both in 69.5%, 80% and 57.7% of cases, respectively. No significant difference was found with the DF group. PAD in the CF group affected the infrapopliteal arteries alone more often (59.4% vs 26.7%, p 0.005) and neuroischemic DFUs needed less often revascularization (34.4% vs 78.7%, p <0.001). Endovascular revasculariza¬tion was feasible in 77.8% of cases in the CF group, without significant difference with the DF group. Independent predictors of PAD in CF were DFUs (OR 24.5, CI 1.8-334.4, p 0.016) and coronary artery disease (OR 17.1, CI 1.7-167.4, p 0.016). Both patients’ survival and limb salvage were not affected by PAD, neuroischemic DFUs and infected neuroischemic DFUs in the CF group. CONCLUSIONS: In agreement with current literature, our study showed that infection is often asso¬ciated with DFUs1, both in DF and CF. However, our study demonstrated that beside infection, PAD is associated with CF more often than previously thought2. As a consequence, DFUs in CF are most often neuroischemic. However, our study did not show worse outcomes in patients with CF and PAD or neuroischemic DFUs. This probably results from a less severe PAD in

Published
2019

36. Mode de vie du patient et survenue de complications postopératoires après fracture de cheville : analyse rétrospective de 433 dossiers

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, 94ème Congrès de la SOFCOT (Société Française de Chirurgie Orthopédique & Traumatologique), UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cammas, Claire, Ancion, Amaury, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, and 94ème Congrès de la SOFCOT (Société Française de Chirurgie Orthopédique & Traumatologique)

Abstract

INTRODUCTION : Les fractures de la cheville traitées chirurgicalement sont fréquentes. Cependant, les complications ne sont pas rares, et les problèmes cutanés et infectieux non négligeables. Le but de l’étude est d’en évaluer l’incidence et les facteurs de risque, en particulier ceux relatifs au mode de vie du patient. MÉTHODES : Dans un seul centre, 433 dossiers de patients opérés de fracture de cheville entre 2013-2017 ont été analysés rétrospectivement. Le suivi moyen était de 1 an. Les données démographiques, les comorbidités, la consommation de tabac et alcool, les caractéristiques chirurgicales et les complications ont été recueillies. Les dossiers incomplets, les fractures extra-malléolaires du tibia et les suivis de moins de 30 jours ont été exclus. Une régression logistique multivariée a été réalisée afin de mettre en exergue les facteurs de risque significatifs (p < 0,05). RÉSULTATS : 26% des patients ont développé une ou plusieurs complications. La plus fréquente était une mauvaise cicatrisation des plaies opératoires (10%), dont 14% nécessitant une couverture par lambeau local. Une infection du site opératoire est survenue dans 6% des cas. Les cal vicieux et douleurs chroniques ont représenté 7%, et les pseudarthroses 3%. Selon notre étude, les patients en surpoids avec une surconsommation d’alcool doubleraient leurs risques de complications cutanées (p = 0,030) et infectieuses (p = 0,040), et tripleraient leurs risques de pseudarthrose (p = 0,003). Les fractures ouvertes seraient également plus à risque de pseudarthrose (p = 0,018, RR = 9,4) et les plus complexes [tri malléolaires et Maisonneuve] auraient un risque majoré de cal vicieux (p < 0,001, RR= 2,6). Les femmes (p = 0,028, RR = 8,3) et patients opérés la nuit (p = 0,045, RR = 1,7) développeraient plus fréquemment des douleurs chroniques. DISCUSSION : L’incidence des complications étudiées semblent s’accorder avec celles décrites dans la littérature. L’obésité et l’alcool ont été décrits comme h

Published
2019

37. Low haemoglobin at admission is associated with mortality after hip fractures in elderly patients.

Author

UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service de soins intensifs, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de gériatrie, UCL - (SLuc) Service de médecine interne générale, Yombi, Jean Cyr, Putineanu, Dan Constantin, Cornu, Olivier, Lavand'homme, Patricia, Cornette, Pascale, Castanares Zapatero, Diego, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service de soins intensifs, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de gériatrie, UCL - (SLuc) Service de médecine interne générale, Yombi, Jean Cyr, Putineanu, Dan Constantin, Cornu, Olivier, Lavand'homme, Patricia, Cornette, Pascale, and Castanares Zapatero, Diego

Abstract

AIMS: Low haemoglobin (Hb) at admission has been identified as a risk factor for mortality for elderly patients with hip fractures in some studies. However, this remains controversial. This study aims to analyze the association between Hb level at admission and mortality in elderly patients with hip fracture undergoing surgery. PATIENTS AND METHODS: All consecutive patients (prospective database) admitted with hip fracture operated in a tertiary hospital between 2012 and 2016 were analyzed. We collected patient characteristics, time to surgery, duration and type of surgery, comorbidities, Hb at admission, nadir of Hb after surgery, the use and amount of red blood cells (RBCs) transfusion products, postoperative complications, and death. The main outcome measures were mortality at 30 days, 90 days, 180 days, and one year after surgery. RESULTS: We included 829 patients; the mean age was 81 years (sd 11). Mortality at 30 days, 90 days, 180 days, and one year was 5.7%, 12.3%, 18.1%, and 23.5%, respectively. The highest mortality was observed in patients aged over 80 years (162/557, 29%) and in male patients (85/267, 32%). Survival at 90 days, 180 days, and one year after surgery was significantly lower in patients with a Hb level below 120 g/l at admission. In multivariate analysis, Hb level below 120 g/l at admission was found to be an independent factor associated with mortality (adjusted hazard ratio (aHR) 1.68 (95% confidence interval (CI) 1.22 to 2.31); p = 0.001), along with age (aHR 1.06 (95% CI 1.04 to 1.06); p < 0.001), male sex (aHR 2.19 (95% CI 1.61 to 2.96); p < 0.001), and need for RBC transfusions (aHR 1.10 (95% CI 1.02 to 1.19); p = 0.01). CONCLUSION: Our results suggest that low Hb at admission along with age and RBC transfusions is significantly associated with short- and long-term mortality after hip fracture surgery, independently of comorbidity confounders. Further studies should be performed to understand how preoperative Hb could be taken into acc

Published
2019

38. Delayed healing—causes and treatment principles

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AOTrauma Course—Basic Principles of Fracture Management, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AOTrauma Course—Basic Principles of Fracture Management

Published
2019

39. Special circumstances – a case based presentation

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Orthopaedica Belgica 2019 Congress : Complications in Orthopaedics and Traumatology, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and Orthopaedica Belgica 2019 Congress : Complications in Orthopaedics and Traumatology

Published
2019

40. Unusual proximal fragment migration of an os peroneum fracture with associated peroneus longus tendon injury-a tree often hides a forest.

Author

UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Tawk, Sammy, Lecouvet, Frédéric, Putineanu, Dan Constantin, Acid, Souad, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Tawk, Sammy, Lecouvet, Frédéric, Putineanu, Dan Constantin, and Acid, Souad

Abstract

We report the case of a 55-year-old male patient who presented to the emergency department after sustaining a right ankle trauma. Swelling and tenderness of the lateral aspect of the right ankle were present on physical examination without evidence of motor or sensory deficit. Ankle radiographs were performed and showed two bony fragments, the first located postero-inferiorly to the cuboid bone while the second was adjacent to the tip of the lateral malleolus. The diagnosis of an os peroneum fracture was made with high suspicion of an associated peroneus longus tendon rupture. Computed tomography (CT) and magnetic resonance imaging (MRI) of the right ankle confirmed the diagnosis of a subtotal retracted tendinous rupture. Successful surgical repair of the injured tendon was performed. This article illustrates the imaging findings of an os peroneum fracture with its associated tendinous injury and reviews the literature.

Published
2019

41. Scapula fracture

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, Orthopaedica Belgica Congress 2018 : "The orthopaedic patient : Who cares?", UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and Orthopaedica Belgica Congress 2018 : "The orthopaedic patient : Who cares?"

Published
2018

42. Can we assess healing of surgically treated long bone fractures on radiograph?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Perlepe, Vasiliki, Omoumi, Patrick, Larbi, Ahmed, Putineanu, Dan Constantin, Dubuc, Jean-Emile, Schubert, Thomas, Vande Berg, Bruno, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Perlepe, Vasiliki, Omoumi, Patrick, Larbi, Ahmed, Putineanu, Dan Constantin, Dubuc, Jean-Emile, Schubert, Thomas, and Vande Berg, Bruno

Abstract

PURPOSE: To determine the frequency and causes for limitations in the radiographic evaluation of surgically treated long bone fractures. MATERIALS AND METHODS: Six readers separately scored 140 sets of antero-posterior (AP) and lateral radiographs of surgically treated long bone fractures, using a radiographic union score (RUS). We determined the rate of assessability of the fracture edges at each of the four cortical segments (n=560) seen tangentially on the two radiographs and the causes for non-assessability. The rate of feasibility of the RUS (more than two fracture edges assessable per fracture) was determined and compared according to different parameters. RESULTS: Fracture edges were visible in 71% to 81% of the 560 cortical segments. Metal hardware superimposition was the most frequent cause for non-assessability (79-95%). RUS values could be calculated in 58% to 75% of fractures. Scoring was statistically significantly less frequently calculable in plated (31-56%) than in nailed fractures (90-97%), in distal (47-61%) than in proximal (78-89%) bones and in upper (27-49%) than in lower (76-91%) limb bones (P≤0.01). CONCLUSIONS: The type of stabilization hardware is the main limiting factor in the radiographic assessment of surgically treated long bone fractures. Scoring was feasible in only 31% to 56% of plated fractures.

Published
2018

43. Could we predict infection after intramedullary nailing of tibial shaft fracture

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, Van den Veyver, Simon, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, 19th EFORT Congress 2018, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, Van den Veyver, Simon, Tribak, Karim, Putineanu, Dan Constantin, Cornu, Olivier, and 19th EFORT Congress 2018

Published
2018

44. Ankle malunion and arthritis

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, AOTrauma Course—Basics on Foot and Ankle Reconstruction, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Putineanu, Dan Constantin, and AOTrauma Course—Basics on Foot and Ankle Reconstruction

Published
2018

45. Can infection be predicted after intramedullary nailing of tibial shaft fractures?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, vandeveyver, simon, Tribak, Karim, Cornu, Olivier, Putineanu, Dan Constantin, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Manon, Julie, Detrembleur, Christine, vandeveyver, simon, Tribak, Karim, Cornu, Olivier, and Putineanu, Dan Constantin

Abstract

Despite the progress in tibial fracture care, some patients contract infection following intramedullary nailing. We analyzed which risk factors could predict infection in 171 tibial fractures. The independent variables included age, gender, body mass index, and comorbidities, along with external factors of fracture pattern, nailing settings, and treatment processing time. A multiple logistic regression was used to identify infection risk factors. The risk of infection significantly increased according to the open grading, the fractures’ classification, time until antibiotic administration, and time until nailing. Gustilo type I fractures presented a higher rate of infection than expected, explained by a longer delay before surgery. The probabilistic equation allows infection prediction with high sensitivity and specificity. In total, we showed that no antibiotics’ prescription in emergency service and a transverse fracture pattern were predictors of infection. An infection risk score can be computed, aiding surgeons in decision making. Outcomes could improve keeping these observations in mind.

Published
2018

46. Complications des fractures du tibia traitées par enclouage

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, Cornu, Olivier, Manon, Julie, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, 16ème AOLF, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, Cornu, Olivier, Manon, Julie, Detrembleur, Christine, Tribak, Karim, Putineanu, Dan Constantin, and 16ème AOLF

Published
2018

47. Complications des ostéosynthèses des fractures diaphysaires de l’humérus

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Fossati, Alexandre, Tribak, Karim, Putineanu, Dan Constantin, 16ème AOLF, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Fossati, Alexandre, Tribak, Karim, Putineanu, Dan Constantin, and 16ème AOLF

Published
2018

48. Complications des ostéosynthèses des fractures de la clavicule

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Miri, Othmane, Tribak, Karim, Putineanu, Dan Constantin, 16ème AOLF, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cornu, Olivier, Miri, Othmane, Tribak, Karim, Putineanu, Dan Constantin, and 16ème AOLF

Published
2018

49. Can infection be predicted after intramedullary nailing of tibial shaft fractures?

Author

UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, Manon, Julie, Detrembleur, Christine, Van den Veyver, Simon, Tribak, Karim, Cornu, Olivier, Putineanu, Dan Constantin, 19th European Congress of Trauma & Emergency Surgery (ESTES), UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, UCL - (SLuc) Service de médecine physique et de réadaptation motrice, Manon, Julie, Detrembleur, Christine, Van den Veyver, Simon, Tribak, Karim, Cornu, Olivier, Putineanu, Dan Constantin, and 19th European Congress of Trauma & Emergency Surgery (ESTES)

Published
2018

50. Value of a radiographic score for the assessment of healing of nailed femoral and tibial shaft fractures: A retrospective preliminary study.

Author

UCL - SSH/LIDAM/SMCS - Support en méthodologie et calcul statistique (plate-forme technologique), UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Perlepe, Vasiliki, Cerato, Andréa, Putineanu, Dan Constantin, Bugli, Céline, Heynen, Guy, Omoumi, Patrick, Vande Berg, Bruno, UCL - SSH/LIDAM/SMCS - Support en méthodologie et calcul statistique (plate-forme technologique), UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, Perlepe, Vasiliki, Cerato, Andréa, Putineanu, Dan Constantin, Bugli, Céline, Heynen, Guy, Omoumi, Patrick, and Vande Berg, Bruno

Abstract

OBJECTIVES: To assess the value of a radiographic score for the detection of delayed union in nailed fractures. METHODS: The modified radiographic union score (mRUS) values were determined by three separate radiologists on 259 radiographic sets of 58 nailed tibial or femoral fractures obtained at different timepoints after fracture (mean of 4.5 radiographic sets per fracture). A surgeon determined fracture outcome (normal or delayed union) at a mean of 192days after injury. Mean radiographic scores obtained at different timepoints after fracture were compared between fractures with normal or abnormal healing at follow-up. RESULTS: The mean score values increased significantly over time for fractures with normal healing for all readers (p<0.001). The mean score values determined 11-14 weeks after injury were higher in fractures with normal healing than in fractures with delayed union at follow-up (p<0.05). Scoring of radiographs obtained at about 3 months after injury or later enabled detection of fractures with delayed union with a sensitivity of 0.63-0.77 and a specificity of 1.0 (area under curve: 0.77- 0.88). CONCLUSIONS: The mRUS score can contribute to the detection of delayed union at a delay of about 3 months after injury in nailed shaft fractures.

Published
2018

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