Background.
We present the results of a technique of
Aim: The addition of the Trochanteric Support Plate (TSP) to the
Objectives: To compare the biomechanical properties of lag screw insertion in a laboratory model. Two blades, the Synthes
Aims:
Aims:
Background: To determine patients clinical and haematological characteristics that could affect the use of blood and infection incidence with hip fractures (HF) treated with a
Introduction:
The placement of the guide wire in the
Background. The advantages of treatment by open reduction and internal fixation for intertrochanteric fractures of the proximal femur have been well known for several decades. Failure of fixation can result in revision surgery, prolonged inpatient stay and has major socio-economic consequences. There are many new devices on the market to help deal with this problem. Expandable hip screw (EHS) is one such device, which is an expanding bolt that may offer superior fixation in osteoporotic bone compared to the standard
Background. Hip fractures affect 1.6 million people globally per annum, associated with significant morbidity and mortality. A large proportion are extracapsular neck of femur fractures, treated with the
Background. Hip fractures cause significant morbidity and mortality, affecting 70,000 people in the UK each year. The
Background. Training within surgery is changing from the traditional Halstedian apprenticeship model. There is need for objective assessment of trainees, especially their technical skills, to ensure they are safe to practice and to highlight areas for development. In addition, due to working time restrictions in both the UK and the US, theatre time is being limited for trainees, reducing their opportunities to learn such technical skills. Simulation is one adjunct to training that can be utilised to both assess trainees objectively, and provide a platform for trainees to develop their skills in a safe and controlled environment. The insertion of a
Introduction: Many patients admitted to acute fracture units with femoral neck fractures are frail and elderly, dehydrated and malnourished, often with associated medical conditions. Surgery may be delayed for investigation, prolonged management and inadequate review of their medical problems, leading to clinical deterioration with poor outcome. Local anaesthetic techniques have been described for intracapsular fractures. We describe a technique effective for the treatment of the more difficult extracapsular type. Aims: To provide a safe and effective technique using local anaesthetic and sedation, for the insertion of a
A tip-apex distance (TAD) greater than 25 mm is a strong predictor of screw cut-out in patients with intertrochanteric femoral fracture treated with a
Introduction: The use of intramedullary nailing (IMHS) has increased at the expense of the
Increasing incidence of osteoporosis, obesity and an aging population have led to an increase in low energy hip fractures in the elderly. Perceived lower blood loss and lower surgical time, media coverage of minimal invasive surgery and patient expectations unsurprisingly have led to a trend towards intramedullary devices for fixation of extracapsular hip fractures. This is contrary to the Cochrane review of random controlled trials of intramedullary vs extramedullary implants which continues recommends the use of a sliding hip screw (SHS) over other devices. Furthermore, despite published literature of minimally invasive surgery (MIS) of SHS citing benefits such as reduced soft tissue trauma, smaller scar, faster recovery, reduced blood loss, reduced analgesia needs; the uptake of these approaches has been poor. We describe a novel technique one which remains minimally invasive, that not only has a simple learning curve but easily reproducible results. All patients who underwent MIS SHS fixation of extracapsular fractures were included in this study. Technique is shown in Figure 1. We collated data on all intertrochanteric hip fractures that were treated by a single surgeon series during period Jan 2014 to July 2015. Data was collected from electronic patient records and radiographs from Picture Archiving and Communication System (PACS). Surgical time, fluoroscopy time, blood loss, surgical incision length, post-operative transfusion, Tip Apex Distance (TAD) were analyzed. There were 10 patients in this study. All fractures were Orthopaedic Trauma Association (OTA) type A1 or A2. Median surgical time was 36 minutes (25–54). Mean fluoroscopy time was similar to standard incision sliding hip screw fixation. Blood loss estimation with MIS SHS can be undertaken safely and expeditiously for extracapsular hip fractures.
Introduction. The use of the
Introduction: While recent guidelines for the treatment of such fractures do not recommend load-bearing devices, there is little evidence actually condemning them, and there is still a lack of literature on the reconstruction nails now generally used. Aim: To evaluate the clinical outcome of pathological (metastatic) proximal femoral fractures treated by either a long Gamma nail, an AO nail with a spiral blade plate (AO-SBP), or a
Background: A radiological audit of the local use of the