Bipolar hemiarthroplasty(BPHA) for displaced intracapsular neck of femur fractures(DICNOF) is a controversial topic as conflicting evidence exists. The most common reason for revision to total hip arthroplasty(THA) from BPHA is acetabular erosion. In our study, we sought to quantify the direction of migration of the bipolar head within the first 3 years post-operatively. A proportional index in the horizontal and vertical planes of the pelvis were used to quantify migration. This method removed the need to account for magnification and rotation of the radiographs.Abstract
Introduction
Methods
The most challenging aspect in rotational deformity correction is translating the pre-operative plan to an accurate intra-operative correction. Landmarks away from the osteotomy site are typically employed at pre-operative planning and this can render inadequate correction. Our proposed technique of pre-operative planning using CT scan and leg length radiographs can translate to accurate intra-operative correction. A circle was superimposed at osteotomy site with its centre serving as the centre of correction of rotation. Medio-lateral distance at osteotomy site measured and used as diameter of the circle. Circumference of the circle was calculated by multiplying diameter with Pi and used in the below formula to obtain accurate de-rotation distance; Derotation distance = (Circumference/360) × correction value for desired ante-version The exact site of osteotomy was measured in theatre under C-arm and exposed. Derotation distance was marked on the surface of bone as point A and point B with a flexible ruler. Osteotomy performed with saw and derotation was done till point A and point B were co-linear. Derotation distance obtained using this technique is specific for the site of chosen osteotomy and implies a specific degree of correction for every millimeter derotated. Distal femur was the chosen site of osteotomy if there was associated patellar instability and proximal femur if there was no patellar instabilityIntroduction
Materials and Methods
Trigger finger is one of the most common problems presenting to hand clinics in the UK. Traumatic and compressive forces created through digital movement leads to thickening of the flexor tendon sheath. The most successful methods used to treat trigger finger are corticosteroid injection and surgical release. The ring, thumb and middle finger are the most frequently affected digits. The incidence of multiple digits being affected is between 20% and 24%, with a higher incidence in Diabetes Mellitus sufferers. We report a case of failed injection therapy in a patient with multiple trigger digits, review the literature and advocate the use of surgical release as a first line treatment option in those patients with multiply involved digits.
