International lower limb collaborative (INTELLECT) study: a multicentre, international retrospective audit of lower extremity open fractures

Trauma remains a major cause of mortality and disability across the world1, with a higher burden in developing nations2. Open lower extremity injuries are devastating events from a physical3, mental health4, and socioeconomic5 standpoint. The potential sequelae, including risk of chronic infection and amputation, can lead to delayed recovery and major disability6. This international study aimed to describe global disparities, timely intervention, guideline-directed care, and economic aspects of open lower limb injuries

Vampires in the village Žrnovo on the island of Korčula: following an archival document from the 18th century

Središnja tema rada usmjerena je na raščlambu spisa pohranjenog u Državnom arhivu u Mlecima (fond: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) koji se odnosi na događaj iz 1748. godine u korčulanskom selu Žrnovo, kada su mještani – vjerujući da su se pojavili vampiri – oskvrnuli nekoliko mjesnih grobova. U radu se podrobno iznose osnovni podaci iz spisa te rečeni događaj analizira u širem društvenom kontekstu i prate se lokalna vjerovanja.The main interest of this essay is the analysis of the document from the State Archive in Venice (file: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) which is connected with the episode from 1748 when the inhabitants of the village Žrnove on the island of Korčula in Croatia opened tombs on the local cemetery in the fear of the vampires treating. This essay try to show some social circumstances connected with this event as well as a local vernacular tradition concerning superstitions

ATYPICAL FEMORAL FRACTURES: CASE SERIES AND PROPOSAL OF AN ALGORITHM FOR MANAGEMENT

Objective: To purpose a practical tool for approaching atypical femoral fractures (AFF) considering the current evidences and experience of a multidisciplinary study group. Material and Methods: We examined a series of clinical cases with a diagnosis of AFF according with 2013 ASBMR criteria. After a consensus of our study group, we purposed an algorithm in order to improve the knowledge in terms of early diagnosis and conservative and surgical treatment. Results: From the analysis of 30 clinical cases of AFF (28 female and 2 male, mean aged 76.06 ± 6.56 years) our group debated on 4 main topics regarding the AFF: diagnosis, evaluation of bone turnover, treatment of the fractured femur, and management of the contralateral femur. These clinical issues represented the 4 steps of our proposed algorithm. Figure 1. AFF complicated by an intraoperative fracture and subsequent infection. A) Pre-operative X-ray showing an incomplete AFF in a very bowed femur; B) Reduction and synthesis of the intraoperative fracture using a locking plate; C) External fixation after removal of locking plate because of the development of an infection. Conclusions: A multidisciplinary approach is mandatory in order to face up the AFF. Based on our clinical experience, we proposed a practical guide for diagnosis and management of AFF. However, there is a lack of adequate evidences on treatment of AFF and further studies are needed. Osteoporos In

Management of atypical femoral fracture: A scoping review and comprehensive algorithm

Background: Atypical femoral fractures (AFF) are a rare type of femoral stress fracture recently described, potentially associated with prolonged bisphosphonate therapy. Evidence-based recommendations regarding diagnosis and management of these fractures are scarce. The purpose of this study is to propose an algorithm for the diagnosis and management of AFF. Methods: We performed a PubMed search of the last ten years using the keywords "atypical femoral fractures" and identified further articles through an evaluation of the publications cited in these articles. Relevant studies were included by agreement between researchers, depending on their specialization. Pertinent points of debate were discussed based on the available literature, allowing for consensus regarding the proposed management algorithm. Results: Using a systematic approach we performed a scoping review that included a total of 137 articles. Conclusions: A practical guide for diagnosis and management of AFF based on the current concepts is proposed. In spite of the impressive large volume of published literature available since AFF were initially identified, the level of evidence is mostly poor, in particular regarding treatment choice. Therefore, further studies are required

P845 ATYPICAL FEMORAL FRACTURES: CASE SERIES AND PROPOSAL OF AN ALGORITHM FOR MANAGEMENT

Objective: To purpose a practical tool for approaching atypical femoral fractures (AFF) considering the current evidences and experience of a multidisciplinary study group. Material and Methods: We examined a series of clinical cases with a diagnosis of AFF according with 2013 ASBMR criteria. After a consensus of our study group, we purposed an algorithm in order to improve the knowledge in terms of early diagnosis and conservative and surgical treatment. Results: From the analysis of 30 clinical cases of AFF (28 female and 2 male, mean aged 76.06 ± 6.56 years) our group debated on 4 main topics regarding the AFF: diagnosis, evaluation of bone turnover, treatment of the fractured femur, and management of the contralateral femur. These clinical issues represented the 4 steps of our proposed algorithm. Figure 1. AFF complicated by an intraoperative fracture and subsequent infection. A) Pre-operative X-ray showing an incomplete AFF in a very bowed femur; B) Reduction and synthesis of the intraoperative fracture using a locking plate; C) External fixation after removal of locking plate because of the development of an infection. Conclusions: A multidisciplinary approach is mandatory in order to face up the AFF. Based on our clinical experience, we proposed a practical guide for diagnosis and management of AFF. However, there is a lack of adequate evidences on treatment of AFF and further studies are needed. Osteoporos In

Management of atypical femoral fracture: A scoping review and comprehensive algorithm

Background: Atypical femoral fractures (AFF) are a rare type of femoral stress fracture recently described, potentially associated with prolonged bisphosphonate therapy. Evidence-based recommendations regarding diagnosis and management of these fractures are scarce. The purpose of this study is to propose an algorithm for the diagnosis and management of AFF. Methods: We performed a PubMed search of the last ten years using the keywords "atypical femoral fractures" and identified further articles through an evaluation of the publications cited in these articles. Relevant studies were included by agreement between researchers, depending on their specialization. Pertinent points of debate were discussed based on the available literature, allowing for consensus regarding the proposed management algorithm. Results: Using a systematic approach we performed a scoping review that included a total of 137 articles. Conclusions: A practical guide for diagnosis and management of AFF based on the current concepts is proposed. In spite of the impressive large volume of published literature available since AFF were initially identified, the level of evidence is mostly poor, in particular regarding treatment choice. Therefore, further studies are required