Advertisement for orthosearch.org.uk
Results 1 - 7 of 7
Results per page:
Applied filters
The Bone & Joint Journal

Include Proceedings
Dates
Year From

Year To
The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 7 | Pages 889 - 892
1 Jul 2008
Al-Shawi A Badge R Bunker T

We have examined the accuracy of 143 consecutive ultrasound scans of patients who subsequently underwent shoulder arthroscopy for rotator-cuff disease. All the scans and subsequent surgery were performed by an orthopaedic surgeon using a portable ultrasound scanner in a one-stop clinic. There were 78 full thickness tears which we confirmed by surgery or MRI. Three moderate-size tears were assessed as partial-thickness at ultrasound scan (false negative) giving a sensitivity of 96.2%. One partially torn and two intact cuffs were over-diagnosed as small full-thickness tears by ultrasound scan (false positive) giving a specificity of 95.4%. This gave a positive predictive value of 96.2% and a negative predictive value of 95.4%. Estimation of tear size was more accurate for large and massive tears at 96.5% than for moderate (88.8%) and small tears (91.6%). These results are equivalent to those obtained by several studies undertaken by experienced radiologists.

We conclude that ultrasound imaging of the shoulder performed by a sufficiently-trained orthopaedic surgeon is a reliable time-saving practice to identify rotator-cuff integrity.


The Journal of Bone & Joint Surgery British Volume
Vol. 87-B, Issue 1 | Pages 137 - 137
1 Jan 2005
Bunker T


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 5 | Pages 677 - 683
1 Sep 1995
Bunker T Anthony P

Of 935 consecutive patients referred with shoulder pain, 50 fitted the criteria for primary frozen shoulder. Twelve patients who failed to improve after conservative treatment and manipulation had excision of the coracohumeral ligament and the rotator interval of the capsule. The specimens were examined histologically, using special stains for collagen. Immunocytochemistry was performed with monoclonal antibodies against leucocyte common antigen (LCA, CD45) and a macrophage/synovial antigen (PGMI, CD68) to assess the inflammatory component, and vimentin and smooth-muscle actin to evaluate fibroblasts and myofibroblasts. Our histological and immunocytochemical findings show that the pathological process is active fibroblastic proliferation, accompanied by some transformation to a smooth muscle phenotype (myofibroblasts). The fibroblasts lay down collagen which appears as a thick nodular band or fleshy mass. These appearances are very similar to those in Dupuytren's disease of the hand, with no inflammation and no synovial involvement. The contracture acts as a check-rein against external rotation, causing loss of both active and passive movement.


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 5 | Pages 684 - 686
1 Sep 1995
Bunker T Esler C

We prospectively studied 50 patients with the diagnosis of primary frozen shoulder. The serum lipid levels were measured in 43 of these patients and compared with those in 43 age-matched and sex-matched control subjects. The fasting serum triglyceride and cholesterol levels were significantly elevated in the frozen-shoulder group (cholesterol p < 0.01; triglyceride p < 0.02).


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 5 | Pages 810 - 815
1 Sep 1990
Gardner A Fox R Lawrence C Bunker T Ling R MacEachern A

Following the discovery of a powerful venous pump in the foot that is activated by weight-bearing independently of muscular action, a pneumatic impulse device was developed to actuate this pump artificially. In a multicentre international trial the device was shown to reduce post-traumatic and postoperative swelling; pain also was alleviated. Evidence is also presented that dangerously high compartment pressures may be reduced to acceptable levels and fasciotomy avoided. We present an explanation of the clinical effects of activation of the venous footpump, based on recent improved understanding of the physiology of the microcirculation. The hyperaemic response that follows the liberation of endothelial-derived relaxing factor (EDRF) by sudden changes of pressure after weight-bearing or impulse compression is particularly important.


The Journal of Bone & Joint Surgery British Volume
Vol. 70-B, Issue 1 | Pages 145 - 146
1 Jan 1988
MacNamee P Bunker T Scott T


The Journal of Bone & Joint Surgery British Volume
Vol. 69-B, Issue 4 | Pages 631 - 634
1 Aug 1987
Bunker T McNamee P Scott T

The results of a prospective multicentre study of the Herbert differential pitch bone screw used to treat 50 scaphoid fractures and non-unions are presented. All fresh fractures and four of the five fracture-dislocations united, an overall union rate of 92%. Although the technique is demanding, the Herbert screw can achieve excellent results in the management of scaphoid fractures.