The aim of this study was to perform a systematic review of the literature on Gustilo-Anderson (GA) type IIIB open
Abstract. Objectives. The need to accurately forecast the injury burden has never been higher. With an aging, ever expanding trauma population and less than half of the beds available compared to 1990, the National Health Service (NHS) is stretched to breaking point1,2. Resultantly, we aimed to determine whether it is possible to predict the proportionality of injuries treated operatively within orthopaedic departments based on their number of Neck of Femur fracture (NOF) patients reported both in our study and the National Hip Fracture Database (NHFD). Methods. We utilised the ORthopaedic trauma hospital outcomes - Patient operative delays (ORTHOPOD) dataset of 22,585 trauma patients across the four countries of the United Kingdom (UK) admitted to 83 hospitals between 22/08/22 – 16/10/22. This dataset had two arms: arm one was assessing the caseload and theatre capacity, arm two assessed the patient, injury and management demographics. Results. Our results complied with the data reported to the NHFD in over 80% of cases for both the 2022 and five-year average reported numbers. More operations were performed for elderly hip fractures alone than for the combined totals of the next four most common fractures: ankle, distal radius,
The need to accurately forecast the injury burden has never been higher. With an aging, ever expanding trauma population and less than half of the beds available compared to 1990, the National Health Service (NHS) is stretched to breaking point. 1,2. . We utilised a dataset of 22,585 trauma patients across the four countries of the United Kingdom (UK) admitted to 83 hospitals between 22/08/22 – 16/10/22 to determine whether it is possible to predict the proportionality of injuries treated operatively within orthopaedic departments based on their number of Neck of Femur fracture (NOF) patients. More operations were performed for elderly hip fractures alone than for the combined totals of the next four most common fractures: ankle, distal radius,
Virtual mechanical testing is a method for measuring bone healing using finite element models built from computed tomography (CT) scans. Previously, we validated a dual-zone material model for ovine fracture callus that differentiates between mineralized woven bone and soft tissue based on radiodensity. 1. The objective of this study was to translate the dual-zone material model from sheep to two important clinical scenarios: human tibial fractures in early-stage healing and late-stage nonunions. CT scans for N = 19
The current standard of practice following knee arthroplasty is to demonstrate the appropriate alignment of knee replacements using knee radiographs. Recent studies have suggested that standard knee radiographs provide adequate accuracy for tibial prosthesis alignment assessment as compared with long knee view radiographs which are more technically demanding and carry greater radiation exposure. In this study, we aim to address whether alignment measured on standard knee radiographs are reliable and reproducible over time. We examined a cohort of 80 patients 37 male (46%), 43 females (54%), mean age = 68 years) who underwent total knee arthroplasty (TKA). Standard knee anteroposterior radiographs performed within 2 days following surgery were compared to standard knee anteroposterior radiographs taken 1 year following the surgery in patients with well-functioning prosthesis. Tibial prosthesis alignment angles between the longitude of the
Abstract. Objectives. Three-dimensional visualisation of sonographic callus has the potential to improve the accuracy and accessibility of ultrasound evaluation of fracture healing. The aim of this study was to establish a reliable method for producing three-dimensional reconstruction of sonographic callus. Methods. A prospective cohort of ten patients with a closed
The course of secondary fracture healing typically consists of four major phases including inflammation, soft and hard callus formation, and bone remodeling. Callus formation is promoted by mechanical stimulation, yet little is known about the healing tissue response to strain stimuli over shorter timeframes on hourly and daily basis. The aim of this study was to explore the hourly, daily and weekly variations in bone healing progression and to analyze the short-term response of the repair tissue to well-controlled mechanical stimulation. A system for continuous monitoring of fracture healing was designed for implantation in sheep tibia. The experimental model was adapted from Tufekci et al. 2018 and consisted of 3 mm transverse osteotomy and 30 mm bone defect resulting in an intermediate mobile bone fragment in the
Summary Statement. We present a simple and useful geometrical equation system to carry out the pre-operative planning and intra-operative assessments for total knee arthroplasty. These methods are extremely helpful in severely deformed lower limbs. Introduction. Total knee arthroplasty is a highly successful surgery for most of the patients with knee osteoarthritis. With commercial instruments and jigs, most surgeons can correct the deformity and provided satisfactory results. However, in cases with severe extra-articular deformity, the instruments may mislead surgeons in making judgment of the true mechanical axis. We developed a geometrical equation system for pre-operative planning and intra-operative measurement to perform correct bony cuts and achieve good post-operative axis. Patients & Methods. From 2008 to 2012, twenty-four patients with severe extra-articular deformities of low limbs underwent total knee arthroplasties for osteoarthritis. The deformities included malunion of femoral or
INTRODUCTION. Intramedullary nail fixation has been used for successful treatment of long bone fracture such as humerus, tibia and femur. We look at the experience of our trauma unit in treating long bone fracture using the AO approved Expert femoral/tibial nail and proximal femoral nail antirotation (PFNA). We look at the union and complication rates in patients treated with AO approved nailing system for pertrochanteric, femoral and
Fabrication of biogenic coatings with suitable mechanical properties is a key goal in orthopedics, to overcome the limitations of currently available coatings and improve the clinical results of coated implants compared to uncoated ones. In this paper, biological-like apatite coatings were deposited from a natural bone-apatite source by a pulsed electron deposition technique (PED). Bone apatite-like (BAL) films were deposited directly from bone targets, obtained by standard deproteinization of bovine
To review the systemic impact of smoking on bone healing as evidenced
within the orthopaedic literature. A protocol was established and studies were sourced from five
electronic databases. Screening, data abstraction and quality assessment
was conducted by two review authors. Prospective and retrospective
clinical studies were included. The primary outcome measures were
based on clinical and/or radiological indicators of bone healing.
This review specifically focused on non-spinal orthopaedic studies.Objectives
Methods
The treatment of fractures of the proximal tibia is complex and makes great demands on the implants used. Our study aimed to identify what levels of primary stability could be achieved with various forms of osteosynthesis in the treatment of diaphyseal fractures of the proximal tibia. Pairs of human tibiae were investigated. An unstable fracture was simulated by creating a defect at the metaphyseal-diaphyseal junction. Six implants were tested in a uniaxial testing device (Instron) using the quasi-static and displacement-controlled modes and the force-displacement curve was recorded. The movements of each fragment and of the implant were recorded video-optically (MacReflex, Qualysis). Axial deviations were evaluated at 300 N. The results show that the nailing systems tolerated the highest forces. The lowest axial deviations in varus and valgus were also found for the nailing systems; the highest axial deviations were recorded for the buttress plate and the less invasive stabilising system (LISS). In terms of rotational displacement the LISS was better than the buttress plate. In summary, it was found that higher loads were better tolerated by centrally placed load carriers than by eccentrically placed ones. In the case of the latter, it appears advantageous to use additive procedures for medial buttressing in the early phase.
Achieving deep flexion after total knee replacement remains a challenge. In this study we compared the soft-tissue tension and tibiofemoral force in a mobile-bearing posterior cruciate ligament-sacrificing total knee replacement, using equal flexion and extension gaps, and with the gaps increased by 2 mm each. The tests were conducted during passive movement in five cadaver knees, and measurements of strain were made simultaneously in the collateral ligaments. The tibiofemoral force was measured using a customised mini-force plate in the tibial tray. Measurements of collateral ligament strain were not very sensitive to changes in the gap ratio, but tibiofemoral force measurements were. Tibiofemoral force was decreased by a mean of 40% (