Despite advances in surgical and antibiotic therapies the treatment of chronic osteomyelitis remains complex and is often associated with a significant financial burden to the National Health Service. The aim of this review was to identify the different types of single-stage procedures being performed for this condition as well as to evaluate their effectiveness. Ovid Medline and Embase databases were searched for articles on the treatment of chronic osteomyelitis over the last 20 years. 3511 journal abstracts were screened by 3 independent reviewers. Following the exclusion of paediatric subjects, animal models, non-bacterial osteomyelitis and patients undergoing multiple surgical procedures we identified 13 studies reported in English with a minimum follow up of 12 months. Following a quality assessment of each study, data extraction was performed and the results analysed.Aim
Method
To investigate the biomechanical behaviours of the TL-Hex & Taylor Spatial Frame (TSF) Hexapod external fixators, with comparison to traditional ring-fixator constructs. Standardised four-ring TL-Hex and TSF constructs, as well as matched ilizarov threaded-rod constructs for each set of components, were tested alone and mounted with an acrylic bone model with simulated fracture gap using fine-wires. Load-deformation properties for each construct and mode of loading were calculated and analysed statistically using ANOVA.Aim
Methods
Hip arthroscopy is performed in a number of specialist centres throughout the UK with good results, no work has been published on the outcomes of hip arthroscopy in the District General Hospital setting. The early results from our prospective observational study show good outcomes in patients with femoro-acetabular impingement (FAI) and labral pathologies. To date we have follow-up data on 46 patients who have undergone hip arthroscopy with a mean follow-up period of 23 weeks. Of these patients 14 were male (30%) and 32 were female (70%) with a mean age of 36 years (16 to 62). Analysis of the data has shown a mean improvement in the Modified Harris Hip Score from 46.89 pre-operatively to 59.50 post-operatively (p<0.01) and a mean improvement in the Non-arthritic Hip Score from 47.38 pre-operatively to 66.74 post operatively (p<0.01). One of the patients has since undergone a total hip arthroplasty. There was one episode of minor wound infection treated successfully with oral antibiotics. There are been no cases of nerve injury or venous-thromboembolism. Our results demonstrate that hip arthroscopy can be provided safely in the DGH setting with good early functional outcomes.
The aim of this study is to evaluate the role of low intensity pulsed ultrasound, Exogen in the treatment of delayed and non unions. Methodology: We conducted a retrospective study of 292 patients who has had Exogen treatment for delayed and non union from 2005 to 2009. Patient's age, sex, associated co morbidities, smoking history, medications, type of fractures (open/closed), infection and site of fractures were sought for. 271 patients' data (228 delayed and 43 non unions) were available during the study with mean age of 53.5 yrs. Exogen therapy was initiated at 3–4 months for delayed unions and 6–12 months for non unions in 61 tibia (15 open); 31 femur (2 open); 20 scaphoid; 38 5th metatarsal; 31 ankle (2 open); 17 ulna (1 open); 15 radius (3 open); 29 humerus (2 open); 16 clavicles; 6 olecranon; 4 pilon (2 open) and 2 metacarpal fractures. Union was achieved in 196 patients (72.3%) of which 11 (5.6%) were smokers. In 73 (26.9 %) patients union was not achieved of which 53 (72 %) were smokers. The mean healing timing after application of Exogen was 16 weeks for delayed union and 26.6 weeks for non union. 5 (31.2%) pt out of 16 in the DM group went into non union.Purpose of study
Discussion
A systematic review of the available literature comparing the outcomes of radiofrequency denervation to sham procedure in treating chronic low back pain caused by lumber zygapophysial joint pathology. Medline and EMBASE databases were searched for English language articles from 2005 to July 2010. Articles were considered for review if they satisfied the inclusion criteria: Randomised Controlled Trials(RCT) comparing radiofrequency neurotomy(RFN) to a ‘placebo’ procedure in patients with chronic low back pain caused by facet joint osteoarthritis. Adult patients of both sexes above 17 years of age who complained of continuous low back pain for more than 6 months with focal tenderness over the facet joints. Outcome measures of interest are pain improvement, physical activity, analgesic use, quality of life variables, range of motion of the lumbar spine and hip movement. Critical appraisal of the selected studies was carried out using the CASP appraisal tool for RCT.Aims
Methods
