Segond's fracture: a biomechanical cadaveric study using navigation

Background Segond’s fracture is a well-recognised radiological sign of an anterior cruciate ligament (ACL) tear. While previous studies evaluated the role of the anterolateral ligament (ALL) and complex injuries on rotational stability of the knee, there are no studies on the biomechanical effect of Segond’s fracture in an ACL deficient knee. The aim of this study was to evaluate the effect of a Segond’s fracture on knee rotation stability as evaluated by a navigation system in an ACL deficient knee. Materials and methods Three different conditions were tested on seven knee specimens: intact knee, ACL deficient knee and ACL deficient knee with Segond’s fracture. Static and dynamic measurements of anterior tibial translation (ATT) and axial tibial rotation (ATR) were recorded by the navigation system (2.2 OrthoPilot ACL navigation system B. Braun Aesculap, Tuttlingen, Germany). Results Static measurements at 30 showed that the mean ATT at 30 of knee flexion was 5.1 ± 2.7 mm in the ACL intact condition, 14.3 ± 3.1 mm after ACL cut (P = 0.005), and 15.2 ± 3.6 mm after Segond’s fracture (P = 0.08). The mean ATR at 30 of knee flexion was 20.7 ± 4.8 in the ACL intact condition, 26.9 ± 4.1 in the ACL deficient knee (P[0.05) and 30.9 ± 3.8 after Segond’s fracture (P = 0.005). Dynamic measurements during the pivot-shift showed that the mean ATT was 7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in the ACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in the ACL deficient knee with Segond’s fracture (P = 0.07). The mean ATR was 9.6 ± 1.8 in the intact knee, 12.3 ± 2.3 in the ACL deficient knee (P[0.05) and 19.1 ± 3.1 in the ACL deficient knee with Segond’s lesion (P = 0.016). Conclusion An isolated lesion of the ACL only affects ATT during static and dynamic measurements, while the addition of Segond’s fracture has a significant effect on ATR in both static and dynamic execution of the pivot-shift test, as evaluated with the aid of navigation

What is the Other of Europe?

Peer reviewe

The future of sovereignty in multilevel governance Europe: a constructivist reading

Multilevel governance presents a depiction of contemporary structures in EU Europe as consisting of overlapping authorities and competing competencies. By focusing on emerging non-anarchical structures in the international system, hence moving beyond the conventional hierarchy/anarchy dichotomy to distinguish domestic and international arenas, this seems a radical transformation of the familiar Westphalian system and to undermine state sovereignty. Paradoxically, however, the principle of sovereignty proves to be resilient despite its alleged empirical decline. This article argues that social constructivism can explain the paradox, by considering sovereign statehood as a process-dependent institutional fact, and by showing that multilevel governance can feed into this process

Progressive realism and the EU’s international actorness: towards a grand strategy?

The EU lacks a coherent strategy to guide its international actions.This is a problem that has been amply discussed in both academic and policy-making circles, but that remains to be fully addressed. The December 2013 European Council recognised the issue, and the EU High Representative Federica Mogherini is in charge of a strategic review that will lead to a global strategy by June 2016. Most arguments in favour of a grand strategy rely on utilitarian arguments that highlight the EU’s potential for a more efficient foreign policy. By linking a progressive realist approach to the importance of an EU grand strategy, this article intends to demonstrate the normative need for such a guiding document. As it will be argued, a grand strategy is a necessary step in the consolidation of the EU as a pluralist postnational polity that has in the fulfilment of its citizens’ interests its raison d’être

Governing differentiation : on standardisation as political steering

The introduction of Luhmann’s System Theory to International Relations has been long overdue. In the last few years, articles by Donnelly (2012) and Buzan and Albert (2010) have started to discuss the application of the concept of differentiation to International Relations theory, and an edited book by Albert et al. (2010) has examined how systemic thought can reinvigorate the study of world politics. This article welcomes and continues these developments by proposing a Luhmannian reinterpretation of the evolution and functioning of governance via standards. The article argues that standardisation — involving the proliferation of standards but also of standardised instruments such as rankings, indicators and benchmarks — can be understood as a mechanism of political steering in a growingly differentiated (world) society. By considering standardisation as a systemic adaptation of the political system to a multifunctional environment, this article contests conventional economistic and power-based explanations where the ‘standardisation turn’ in global governance is a mere consequence of neoliberal globalisation, power struggles among states or some type of hegemonic logic. In this manner, the article suggests that Luhmann’s Systems Theory can provide a more encompassing framework to understand the operation of standards as an extension of politics beyond territory, and to frame the challenges of governing an increasingly complex world

Welche Macht darf es denn Sein? Tracing ‘Power’ in German Foreign Policy Discourse

The relationship between ‘Germany’ and ‘power’ remains a sensitive issue. While observers tend to agree that Germany has regained the status of the most powerful country in Europe, there is debate whether that is to be welcomed or whether that is a problem. Underpinning this debate are views, both within Germany and amongst its neighbours, regarding the kind of power Germany has, or should (not) have. Against this backdrop, the article reviews the dominant role conceptions used in the expert discourse on German foreign policy since the Cold War that depict Germany as a particular type of ‘power’. Specifically, we sketch the evolution of three prominent conceptions (constrained power, civilian power, hegemonic power) and the recent emergence of a new one (shaping power). The article discusses how these labels have emerged to give meaning to Germany’s position in international relations, points to their normative and political function, and to the limited ability of such role images to tell us much about how Germany actually exercises power