Identifying optimal treatment strategies for inpatients with traumatic foot and ankle injuries has been hampered by a wide variety of outcome measures with unproven reliability and validity. It remains plausible that the choice of functional outcome measures may influence measurement of treatment effects. This prospective observational study aims to measure the correlation and agreement across six functional outcome measures in patients with traumatic foot and ankle injuries. Patients 18 years of age or older with a traumatic foot or ankle injury completed the Short Form-12 (SF-12), Short Musculoskeletal Functional Assessment (SMFA), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Questionnaire and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale at a single follow-up visit. Raw scores were calculated and transformed to a functional level of excellent, very good, good, fair or poor. Pearson correlation co-efficients providing measures of correlation and agreement between functional levels were assessed.Purpose
Methods
The distal femur fracture is a difficult injury that affects young men andelderly women. The tissue stripping that occurs with the traditional approach has been a factor in the development of complications like infection and nonunion. This study addresses the issue of minimally invasive approach. Does the LISS system really improve the results of such fracture? Fifty-two patients were included in the trial from six academic trauma centres. Twenty-eight fractures had been randomised to be fixed with the LISS device, while twenty-four had the DCS implant. Type C3 fractures were excluded as they were not amenable for fixation with DCS system. All procedures were performed via minimally invasive technique. The LISS system had the targeter that helped with plate insertion and distal diaphyseal screws placement. Radiography was utilised in the case of the DCS distal screws insertion. All fractures went onto union, except two participants in LISS group who had to be revised due to loss of reduction, in the early post-operative peroid. There were three nonunions in the same group. These required a re-operation. Further more, a LISS participant who had re-injured his distal femur (unrelated to LISS plate), was fixed with different implant. There was a single nonunion with the DCS group that needed revision surgery. There was one participant from each group who had drifted into varus. Neither required a re-operation. This translated into a 21% re-operation rate in the LISS system compared to 4% with the DCS device. Our data supports the use of the DCS system in the fixation of distal femur fractures (except Type C3} via a minimally invasive approach. The LISS implant seems to be technique dependent. In our centre, the LISS plate had been discontinued in favour of the DCP and LCP systems.
Oxford joint scores are increasingly being used in evaluating outcomes following orthopaedic surgery. These patient-reported outcome measures (PROM) have been well validated, but only before and after surgical intervention. We postulated that the scores would deteriorate in the normal population with age. Members of the public accompanying patients to out-patients and the emergency department in our hospitals were asked to complete an Oxford score questionnaire having ascertained that they had no previous problem with that joint. Exclusions included other multiple joint pathologies and known connective tissue disorders. Power analysis advocated 40 subjects per decade per joint for significance at the 80% mark. 993 subjects between 20 and 80 years of age completed the forms. There were more females than males. The scores were analysed using STATA 8 software. Non-parametric tests of variance, regression analysis, and ANOVA were used. The data were analysed by decades.Background
Methods
The objective of this meta-analysis was to compare the effects of early and delayed surgery on the risk of mortality, common post-operative complications, and length of hospital stay among elderly hip fracture patients. We searched MEDLINE and EMBASE for relevant prospective studies evaluating surgical delay in patients undergoing surgery for hip fractures published in all languages between 1966 and 2008. Two reviewers independently assessed methodological quality and extracted relevant data.Purpose
Methods
An MRI scan of the patient's hip, knee and ankle is used to produce The Signature patient specific jig. The jig is used to aid the accuracy of implantation of a TKR. This study compared the accuracy of implantation of a TKR using The Signature patient specific jig or a standard jig. There is no difference in alignment between a patient specific and standard jig assisted TKR.Background
Hypothesis
