Identification of novel therapeutics to accelerate acute fracture healing remains critical. A prostaglandin EP-2 receptor agonist (CP-533,536) has demonstrated acceleration of fracture healing in preclinical models. The objective of this study is to assess the efficacy of a single dose of CP-533,536 in subjects with a closed fracture of the tibial shaft using radiographic measurements compared to placebo treatment. In a phase II randomised, blinded, placebo-controlled trial, the efficacy of a single local injection of three doses of CP-533,536 (0.5mg, 1.5mg and 15mg) was compared to a placebo and a standard of care arm in patients with closed tibial shaft fractures. The tibial fractures were treated with reamed inter-locked intramedullary nails. Patients were followed at two week intervals to six months with a final evaluation at one year. Fracture healing was independently adjudicated by a radiologist panel and an orthopaedic surgeon panel.Background
Methods
Humeral non-union may present a challenging problem. The instability from the un-united fracture leads to pain, disability and significant morbidity. The incidence of humeral shaft non-union as a complication of both operative and non-operative treatment is approximately 8% to 12%. This retrospective study reviews the results of surgical treatment of humeral fracture non-union performed by a single surgeon with a consistent surgical protocol. We present a retrospective analysis of a series of 51 consecutive cases of humeral fracture non-union treated in our limb reconstruction centre. Data were collected on mechanism of injury, associated co-morbidities, smoking, use of NSAIDs and treatment before referral. Patients were followed up to clinical and radiological union.Introduction
Material and Method
Deciding how to allocate scarce surgical resources is a worldwide issue. These decisions are difficult when considering procedures aimed primarily at improving functional quality of life, such as lower extremity joint replacement (LEJR) surgery, and procedures perceived as life preserving which also have impacts on physical function, such as coronary artery bypass graft (CABG) surgery. Comparing functional outcomes of these two procedures may provide further evidence to guide resource allocation decisions. We compared patient-reported functional outcomes following CABG and LEJR surgery using standardised, validated outcome metrics. A retrospective review of prospectively collected pre- and post-operative health related quality of life (SF-36) measures were conducted from 105 patients undergoing elective CABG and 105 elective LEJR surgery patients. Patients were matched based on gender and age.Background
Methods
We present the results of cementless total hip arthroplasty using anatomically adapted stem and hemispherical cup with a fully coated Spongiosa metal surface, first introduced in 1982, which aims to achieve a surface structure approaching that of human cancellous bone. This implant is still being used in clinical practice with minor modifications. The aim of the study is to determine the long-term outcomes of spongiosa-I metal surface hip arthroplasty over minimum of twenty years follow-up.Background
Aim
For correction of cubitus varus deformity many types of osteotomies and fixation methods have been described, but besides technical difficulties, they have limitations such as non-union, stiffness of the elbow joint and neurovascular injury. The prominence of the lateral condyle can also give rise to a poor cosmetic result. To overcome these problems, we reviewed the results of simple dome osteotomy with fixation by cross pins. From 2003 to 2007, eleven children with cubitus varus deformity having full range of movements and good elbow function had surgery. The average age was 9.2 years (range, 7 to 13) and M:F ratio was 4:1. Through a posterior triceps splitting approach a dome-shaped osteotomy is fashioned, the distal part of humerus is aligned as planned and then fixation by cross pinning is achieved. Patients were followed for two years. Pre-operative and post-operative humeral-elbow angles, ranges of motion and lateral prominence indices were compared. The results were evaluated according to the modified criteria of Oppenheim et al.Background
Methods
Evaluating the success of a treatment has changed. Currently, the emphasis is on patient-rated outcome scores rather than surgeon recording of outcome measures. Functional outcome and patient satisfaction following Dupuytren's disease surgery is poorly quantified in the literature. This study aimed to assess subjective patient hand function, disability and satisfaction using a PEM score and its correlation with residual contracture. Percutaneous Needle Fasciotomy (PNF) is performed in our outpatient clinic to treat Dupuytren's contracture at MCP joints. A validated patient completed questionnaire (PEM) was used to record patient demographics, side of surgery, finger involved, time since surgery, residual symptoms, disability, subjective hand function and satisfaction. The questionnaire was posted to all patients who had PNF over the study period (n=68) along with a stamped addressed envelope and participant information sheet.Introduction
Methods
