Patients (2.7M in EU) with positive cancer prognosis frequently develop metastases (≈1M) in their remaining lifetime. In 30-70% cases, metastases affect the spine, reducing the strength of the affected vertebrae. Fractures occur in ≈30% patients. Clinicians must choose between leaving the patient exposed to a high fracture risk (with dramatic consequences) and operating to stabilise the spine (exposing patients to unnecessary surgeries). Currently, surgeons rely on their sole experience. This often results in to under- or over-treatment. The standard-of-care are scoring systems (e.g. Spine Instability Neoplastic Score) based on medical images, with little consideration of the spine biomechanics, and of the structure of the vertebrae involved. Such scoring systems fail to provide clear indications in ≈60% patients. The HEU-funded METASTRA project is implemented by biomechanicians, modellers, clinicians, experts in verification, validation, uncertainty quantification and certification from 15 partners across Europe. METASTRA aims to improve the stratification of patients with vertebral metastases evaluating their risk of fracture by developing dedicated reliable computational models based on Explainable Artificial Intelligence (AI) and on personalised Physiology-based biomechanical (VPH) models.Introduction
Method
The treatment of clavicle fractures remains controversial. Although most clavicle fractures can be treated successfully nonoperatively, no consensus exists for the complete range of lesions. A systematic literature review was performed to summarize and compare the results of different treatments. A Pubmed search on ‘clavicle’ and ‘fracture’ was performed and relevant papers collected. Predefined inclusion/exclusion criteria had to be met and parameters were extracted. The articles were regrouped according to fracture location: midshaft; lateral; or location not specified. Main parameters were: Edinburgh classification; treatment type; complications; pseudarthrosis; cosmetic satisfaction and pain.Introduction
Material and Methods
