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Introduction

Schatzker V & VI tibial plateau fractures are serious life-changing injuries often resulting in significant complications including post-traumatic arthritis. Reported incidence of secondary TKA following ORIF of all tibial plateau fractures is 7.3% and 13% for Schatzker V & VI tibial. This study reports a 15-year single centre experience of CEF of Schatzker V & VI fractures including PROMs and incidence of secondary TKA. This study was approved by the local Institutional board.

Materials & Methods

All patients from 2007 – 2022 with Schatzker V or VI fractures treated with CEF were identified from a departmental limb reconstruction registry and included in this retrospective study. Patients’ demographics were collected from electronic institutional patient system. Further data was collected for secondary intervention, adverse events, and alignment at discharge. All deceased patients at the time of the study were excluded.

Each participant completed a questionnaire about secondary intervention, EQ-5D-3L and Oxford Knee Score (OKS).


Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_5 | Pages 11 - 11
23 Apr 2024
Lineham B Faraj A Hammet F Barron E Hadland Y Moulder E Muir R Sharma H
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Introduction

Intra articular distal tibia fractures can lead to post-traumatic osteoarthritis. Joint distraction has shown promise in elective cases. However, its application in acute fractures remains unexplored. This pilot study aims to fill this knowledge gap by investigating the benefits of joint distraction in acute fractures.

Materials & Methods

We undertook a restrospective cohort study comprising patients with intra-articular distal tibia and pilon fractures treated with a circular ring fixator (CRF) at a single center. Prospective data collection included radiological assessments, Patient-Reported Outcome Measures (PROM), necessity for additional procedures, and Kellgren and Lawrence grade (KL) for osteoarthritis (OA).

137 patients were included in the study, 30 in the distraction group and 107 in the non-distraction group. There was no significant difference between the groups.


Bone & Joint Open
Vol. 3, Issue 5 | Pages 359 - 366
1 May 2022
Sadekar V Watts AT Moulder E Souroullas P Hadland Y Barron E Muir R Sharma HK

Aims

The timing of when to remove a circular frame is crucial; early removal results in refracture or deformity, while late removal increases the patient morbidity and delay in return to work. This study was designed to assess the effectiveness of a staged reloading protocol. We report the incidence of mechanical failure following both single-stage and two stage reloading protocols and analyze the associated risk factors.

Methods

We identified consecutive patients from our departmental database. Both trauma and elective cases were included, of all ages, frame types, and pathologies who underwent circular frame treatment. Our protocol is either a single-stage or two-stage process implemented by defunctioning the frame, in order to progressively increase the weightbearing load through the bone, and promote full loading prior to frame removal. Before progression, through the process we monitor patients for any increase in pain and assess radiographs for deformity or refracture.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_6 | Pages 24 - 24
1 May 2021
Ting J Muir R Moulder E Hadland Y Barron E Sharma H
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Introduction

Superficial pin site infection is a common problem associated with external fixation, which has been extensively reported. However, the incidence and risk factors with regards to deep infection is rarely reported in the literature. In this study, we investigate and explore the incidence and risk factors of deep infection following circular frame surgery. For the purpose of this study, deep infection was defined as: persistent discharge or collection for which surgical intervention was recommended.

Materials and Methods

Retrospective review of all patients whom underwent frame surgery between 1st of April 2015 to 1st April 2019 in our unit with a minimum of 1 year follow up following frame removal. We recorded patient demographics, patient risk factors, trauma or elective procedure, number of days the frame was in situ, location of infection and fracture pattern.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_8 | Pages 30 - 30
1 May 2018
Sadekar V Moulder E Hadland Y Barron E Sharma H
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Introduction

Fracture and deformity after frame removal is a known risk in 9–14.5% of patients after circular frame treatment. The aims of this study were to assess the effectiveness of our staged protocol for frame removal and risk factors for the protocol failure.

Methods and materials

We identified 299 consecutive patients who underwent circular frame fixation for fracture or deformity correction in our unit from our prospective database. All 247 patients who followed the staged frame removal protocol were included in this study. We reviewed the electronic clinical record and radiographs of each patient to record demographics, risk factors for treatment failure and outcome following frame removal. We defined failure of the protocol as a re-fracture or change in bony alignment within 12 weeks of frame removal. Results underwent statistical analysis using Chi square analysis.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_7 | Pages 11 - 11
1 Feb 2013
Henderson D Hadland Y Barron E Sharma H
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Abstract

We present here the results of a prospective follow-up study of radiological and functional outcome in 43 patients treated using the Taylor Spatial Frame (TSF) for definitive management of tibial fractures.

Patients & Methods

Over a five-year period data was collected from all patients completing treatment of a tibial fracture with the TSF. Residual deformity on x-ray and functional outcomes using the EQ-5D health status questionnaire, Iowa Knee and Ankle-Evaluation Rating System scores and Olerud & Molander Ankle Score (OMAS) were recorded one year following completion of frame treatment.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_7 | Pages 18 - 18
1 Feb 2013
Menakaya C Hadland Y Barron E Sharma H
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Introduction

The optimal treatment of high-energy tibia fractures remains controversial. The role of external fixators has been shown to be crucial. This study aimed to compare the effectiveness of using either Taylor Spatial Frame (TSF) or Ilizarov frames in treatment of high-energy tibia fractures in a tertiary trauma referral centre.

Methodology

Retrospective review of consecutive series identified two treatment groups; Group 1(TSF) and Group 2 (Ilizarov). Time in frame (healing time) was defined as time from insertion to removal of frame. All patients with incomplete data secondary to loss to follow-up or death were eliminated.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_7 | Pages 3 - 3
1 Feb 2013
Sivasankaran K Chaturvedi A Madhu T Hadland Y Sharma H
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AIM

To study the incidence of thromboembolism among patients treated with ring fixators in lower limb injuries and their risk factor association.

METHODS & MATERIALS

Notes of 180 (130 men & 50 women) patients treated with circular frame were retrospectively studied. Risk factors for thromboembolism as advised by NICE were recorded and scored. The duration of pre-operative limb immobilisation, hospital stay and duration of frame, were also recorded.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_7 | Pages 6 - 6
1 Feb 2013
Chaturvedi A Hadland Y Sharma H
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Introduction

The Ilizarov (IF) and Taylor Spatial (TSF) external fixator frames are commonly used to manage complex fractures and bone deformities and a dedicated Frame Service Team at our unit supports patients during pre- and post-operative period. Few studies have assessed the satisfaction of patients who have been treated with Circular frames.

Methods

A questionnaire was designed and distributed to 56 consecutive patients treated with a circular frame. Data was collected prospectively. Questions were focused on information given pre op, during treatment, overall satisfaction with the frame, morbidity and areas in which the frame service could be improved.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 1 - 1
1 Jan 2013
Rambani R Lambden B Fortnam M Barron E Hadland Y Singh J Sharma H
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Background

Complex tibial fractures are difficult to treat. The costs associated with hospitalization can be substantial, yet it is unknown how these vary depending upon the type of implant used. There have been multiple studies on economics of tibial fractures but none of these studies actually focussed on costing of illizarov and taylor spatial frames. We discuss the cost analysis of 200 tibial fractures treated with illizarov or taylor spatial frames. The purpose of this study was to compare the cost of treatment of complex tibial fractures with reimbursement given to the hospital in treating such injuries.

Methods

We evaluated the economical data of 200 patients with complex tibial fractures treated with illizarov frame or taylor spatial frame from May 2005 to May 2010. Demographic data, fracture classification and method of surgical treatment along with the length of hospital stay were recorded in detail. The total cost calculated was then compared to the range of reimbursement price based on HRG (human Resource Group) coding. The implant cost was determined from the buying cost of institution.