Introduction

Achilles tendinosis results from a chronic degenerative process within the tendon. Topaz micro-debridement aims to restore the degenerate micro-architecture within the tendon reducing painful symptoms experienced by patients. Topaz micro-debridement has been used to successfully treat upper limb tendinopathies but its application to tendinopathies of the foot and ankle is relatively new. This study aims to assess the functional outcomes following topaz radiofrequency micro-debridement for Achilles tendinosis.

Introduction

Appropriate consenting is part of good medical practice and is a medico-legal necessity for invasive procedures. The BOA recently created generic consent forms covering the relevant complications for orthopaedic procedures, thus providing a standard for all orthopaedic consent. This study aims to assess the quality of consent in orthopaedic practice.

Introduction

‘VTE disease is the new MRSA’, with much attention received in the media and the political world. Following the 2010 NICE guidelines all patients admitted to hospital should have VTE prophylaxis considered and a formal VTE risk assessment done with documentation and review in a 24 hour period. We carried out a completed audit cycle to identify our adherence to these guidelines and introduced a novel method to ensure compliance.

Introduction: The proximal femoral nail antirotation (PFNA) system is a cephalomedullary device originally designed to contend with the challenge of unstable tro-chanteric femoral fractures with the novel helical blade component aimed at limiting femoral head limiting cutout. We demonstrate its use in a variety of cases.

Methods: This is a prospective study of 370 consecutive patients treated with short and long PFNA systems at a single center with 1-year follow-up. The device was used for unstable trochanteric femoral fractures (AO-classification 31. A.2 and A.3), prophylactic and definitive fixation of pathological fractures and high energy femoral fractures for a wide age range (19–101 years). Clinical outcome involved assessment of general mobility & function, operative and post-operative parameters & complications. Radiological outcome involved assessment of blade tip-apex distance, nail tip-femoral scar distance and distal locking configurations.

Results: 17% died within the follow-up period. 72% achieved their pre-trauma mobility status and nearly all fractures healed within 6 months including those in over 85 years. Of 18 problematic cases, serious complications included deep infection, loss of proximal reduction, ipsilateral femoral shaft fracture and periprosthetic supra-condylar fracture. There were no cases of acetabular penetration or blade cut-out. Short PFNA was associated with the majority of femoral shaft fractures and the only significant finding regarding instrumentation.

Discussion: This study supports long PFNA design theory demonstrating adequate purchase in the femoral head-neck zone, shown by lack of cut-out. Positive results have been demonstrated in a variety of cases making it a useful option in fractures in all ages and indications alongside unstable trochanteric configurations.