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The Bone & Joint Journal
Vol. 100-B, Issue 12 | Pages 1609 - 1617
1 Dec 2018
Malhas AM Granville-Chapman J Robinson PM Brookes-Fazakerley S Walton M Monga P Bale S Trail I

Aims

We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross glenoid bone deficiency.

Patients and Methods

A prospective cohort study of the first 45 shoulder arthroplasties using the SMR Axioma Trabecular Titanium (TT) metal-backed glenoid with autologous bone graft. Between May 2013 and December 2014, 45 shoulder arthroplasties were carried out in 44 patients with a mean age of 64 years (35 to 89). The indications were 23 complex primary arthroplasties, 12 to revise a hemiarthroplasty or resurfacing, five for aseptic loosening of the glenoid, and five for infection.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_17 | Pages 33 - 33
1 Nov 2014
Brookes-Fazakerley S Howard N Harvey D Platt S Jackson G
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Introduction:

Diabetic ulcer superficial swab cultures have a low specificity for guiding antibiotic treatment. Some studies have recently re-assessed and advocated the role of superficial swabs. We have performed an analysis of microbiology results in patients with infected diabetic ulcers to further appraise the need for using deep tissue cultures as a guide for antimicrobial treatment.

Methods:

We reviewed 23 consecutive diabetic patients in 2013. All patients underwent investigation and treatment by the Orthopaedic department for deep, intractable diabetic ulceration. Microbiology culture results from superficial swabs were compared to deep tissue and bone biopsies.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 584 - 584
1 Oct 2010
Brookes-Fazakerley S Atkinson C Walker C
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Closure with interrupted mattress sutures is useful where careful skin apposition is required following hindfoot surgery. However, suture removal can be technically difficult and painful. Modification with an additional suture loop creates a “traction loop suture”. We hypothesise this technique makes suture removal quicker and reduced tension placed on sutures during their removal reduces pain.

37 patients undergoing elective hindfoot surgery took part in a prospective clinical trial comparing traditional interrupted sutures with traction loop sutures. Each patient underwent half of each wound sutured with both types. Sutures were removed at 2 weeks and pain levels were determined during removal using the 10 cm visual analogue pain scale. Duration of time taken for each type of suture removal was measured. Wound complications were recorded at 2 and 6 weeks post-operative.

Results demonstrated traction loop sutures were 43% less painful to remove per wound than normal interrupted sutures (mean difference 1.06; standard deviation 1.56; 95% confidence interval 0.50 to 1.62; p-value 0.001). Traction loop sutures were also 31% quicker to remove per wound (mean difference 15.72 seconds; standard deviation 19.98; confidence interval 8.51 to 22.93; p-value < 0.001). At 2 weeks, 1 normally sutured wound suffered dehiscence. At 6 weeks, no complications were noted in either group.

Our results demonstrate that traction loop sutures provide a quick and simple means of reducing patients’ pain and time during suture removal. Traction loop suturing technique could be applied to other surgical specialities where interrupted suture closure is indicated.