European Federation of National Associations of Orthopaedics and Traumatology European Instructional Lectures Volume 12, 2012 European Federation of National Associations of Orthopaedics and Traumatology Committees and Task Forces EFORT Executive Committee Standing Committees EAR Committee Executive Board Prof. Dr. Nikolaus Böhler Prof. Dr. Pierre Hoffmeyer, President Education Committee Dr. Manuel Cassiano Neves, Vice President Prof. Dr. Maurilio Marcacci Ass. Prof. Dr. Per Kjaersgaard-Andersen, EA & L Committee Secretary General Prof. Dr. Wolfhart Puhl Prof. Dr. Miklós Szendröi, Immediate Finance Committee Past President Mr. Stephen R. Cannon Mr. Stephen R. Cannon, Treasurer Prof. Dr. Enric Cáceres Palou, Member Health Service Research Committee at Large Prof. Dr. Karsten Dreinhöfer Dr. George Macheras, Member at Large Portal Steering Committee Prof. Dr. Philippe Neyret, Member at Prof. Dr. Klaus-Peter Günther Large Publications Committee Co-Opted Members Prof. Dr. George Bentley Mr. John Albert Scientifi c Congress Committee Prof. Dr. Thierry Bégué Prof. Dr. Enric Cáceres Palou Prof. Dr. George Bentley, Past President Speciality Society Standing Committee Prof. Dr. Nikolaus Böhler, Past President Prof. Dr. Karsten Dreinhöfer Dr. George Macheras Prof. Dr. Klaus-Peter Günther Prof. Dr. Rüdiger Krauspe Prof. Dr. Norbert Haas Prof. Dr. Pierre Hoffmeyer Prof. Dr. Karl Knahr Prof. Dr. Rüdiger Krauspe Task Forces and Ad Hoc Committees Prof. Dr. Maurilio Marcacci Prof. Dr. Wolfhart Puhl, Past President Awards & Prizes Committee Prof. Dr. Nejat Hakki Sur Prof. Dr. George Bentley Prof. Dr. Karl-Göran Thorngren, Past Fora President Prof. Dr. Thierry Bégué Prof. Dr. Dieter C. Wirtz Travelling & Visiting Fellowships Scientifi c Coordination 13th EFORT Prof. Dr. Philippe Neyret Congress, Berlin 2012 Musculoskeletal Trauma Task Force Prof. Dr. Norbert Haas Chairman EFORT Foundation Committee Ass. Prof. Dr. Per Kjaersgaard-Andersen Prof. Dr. Karl-Göran Thorngren European Federation of National Associations of Orthopaedics and Traumatology European Instructional Lectures Volume 12, 2012 13th EFORT Congress, Berlin, Germany Edited by George Bentley Prof. George Bentley Royal National Orthopaedic Hospital Trust Brockley Hill HA 7 4LP, Stanmore Middlesex, UK EFORT Central Office Technoparkstrasse 1 8005 Zürich, Switzerland ISBN 978-3-642-27292-9 e-ISBN 978-3-642-27293-6 DOI 10.1007/978-3-642-27293-6 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2012933964 © EFORT 2012 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Foreword As representatives of the local organizing committee, it is an honour and a pleasure to present this Instructional Lecture Book for the 13th EFORT Congress, to be held in Berlin in 2012. In addition to the two main topics of the Congress – the WHO “Decade of Action for Road Safety” initiative and the EU’s “Active and Healthy Aging” declaration for the year 2012 – the instructional lectures build on the thematic highlights of our meeting. Several experts with great clinical and scientifi c experience present their philosophies for dealing with different issues and current debates in ortho- paedics and traumatology. In this sense, the Instructional Lecture Book pro- vides an excellent overview of current knowledge in musculoskeletal diseases and trauma care in Europe. Given that training is one of EFORT’s primary goals, the literature on the Instructional Lectures series will generally be handed out to all con- gress participants. It will therefore be possible to read and study all of the state-of-the-art presentations given during the Congress in detail when you are back home. As the local chairmen of the EFORT Congress 2012 in Berlin, we would like to express our gratitude to all of our lecturers for providing their presen- tations for publication in this volume. Our sincere thanks also go to Professor George Bentley, who has organized and edited the Instructional Lecture Book. In the awareness of that EFORT and all of its activities offers an unique platform for training, it is up to us to use it to optimize the treatment of all of our patients in Europe. Berlin, Germany Dieter C. Wirtz Karsten Dreinhöfer Chairmen LOC, Berlin v Preface This 12th volume of the EFORT European Instructional Lectures is a collection of all the Lectures to be presented at the 13th Congress in Berlin from 23rd to 25th of May 2012. As previously the topics were selected to refl ect some important aspects of current Orthopaedic and Traumatology philosophy and practice by a group of specialists who also represent the variety of expertise which is unique to Europe. Particular thanks go to the authors, not only for preparing and presenting their lectures but also for other activities such as paper reviewing and chairing of Symposia and Specialist sessions, participating in courses and demonstra- tions etc., which are vital for the rich totality of the Congress programme. Preparation of the volume has been by Gabriele Schroeder and her col- leagues in the Internationally-recognised Springer Company to whom we are very grateful. My personal thanks go to, particularly, Larissa Welti and the EFORT Central offi ce staff for their expert and unfailing support, as ever. This volume is dedicated to all those who have contributed to the ever- expanding educational and scientifi c development of EFORT, to bring it to be the greatest Orthopaedic and Traumatology fellowship in Europe. Stanmore, UK George Bentley Editor-in-Chief vii Contents Musculo-Skeletal Trauma The Spectrum of Polytrauma. A Pragmatic Approach for the Musculo-Skeletal Surgeon. . . . . . . . . . . . . . . . . . 3 Pierre Hoffmeyer and Robin Peter Proximal Femoral Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Christopher G. Moran and M. Gaden Acute Infections After Osteosynthesis. . . . . . . . . . . . . . . . . . . . . . . 25 Volkmar Heppert Musculo-Skeletal Tumours The Multi-modal Approach to Metastatic Disease. . . . . . . . . . . . . 35 Minna Laitinen, Maire Ratasvuo, and Toni-Karri Pakarinen How to Manage Osteolytic Lesions . . . . . . . . . . . . . . . . . . . . . . . . . 45 Jendrik Hardes Paediatrics Developmental Hip Dysplasia – A Problem Solved? . . . . . . . . . . . 61 Micheal K.D. Benson Spine Infections of the Spine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 José Guimarães Consciência, Rui Pinto, and T. Saldanha Multimodal Treatment of Back Pain . . . . . . . . . . . . . . . . . . . . . . . . 87 Hans Raimund Casser Upper Limb Proximal Humeral Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Martin Jaeger and N.P. Südkamp Pelvis and Hip Navigation and Hip Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Philippe Merloz ix