The aims of this study were to undertake a prospective randomised trial to compare functional outcome, strength and range of motion after treatment of medial collateral ligament injuries by either early unprotected mobilisation or mobilisation with a hinged brace. Patients were randomised into either unprotected mobilisation or mobilisation with a hinged brace. Assessments occurred at 2 weeks, 6 weeks, 3 months and 6 months. Outcome measures included validated questionnaires (International Knee Documentation Committee and Knee Injury and Osteoarthritis Outcome Score scores), range of motion measurements and strength testing.Introduction
Methods
To report the rate of early revision (within two years) after shoulder arthroplasty and identify any patient, disease or prosthesis factors that may be associated with these early failures. The AOA National Joint Replacement Registry has recorded 7113 shoulder arthroplasty procedures up to December 2009. Data recorded includes diagnosis, patient demographics and prosthesis details. The main outcome of this analysis was the time to first revision of all primary shoulder arthroplasty recorded by the Registry. The cumulative per cent revision (CPR) of shoulder arthroplasty procedures was estimated using the Kaplan-Meier method. Cox proportional hazard models were used to test significance between groupsAims
Methods
The aim of this study was to compare biomechanical properties of pre-contoured plate fixation using different screw fixation modes in a mid-shaft clavicle fracture model. Fourth generation biomechanical clavicle sawbones with a mid-shaft osteotomy were plated in one of three modes: nonlocking bicortical, locking bicortical and locking unicortical mode. The specimens were then tested to failure in four-point bending and pull-off tests.Aims
Methods
Our purpose was to study the functional outcome and electrophysiologically to assess the axially nerve function in patients who have undergone surgery using a deltoid-splitting approach to treat complex proximal humeral fractures. This was a prospective observational study and was carried out in the Shoulder injury clinic at a university teaching hospital. Over a one-year period we treated fourteen locally-resident patients (median age 59 years) who presented with a three- or four-part proximal humeral fracture. All patients were treated using the extended deltoid-splitting approach, with open reduction, bone grafting and plate osteosynthesis. All patients were prospectively reviewed and underwent functional testing using the DASH, Constant and SF-36 scores as well as spring balance testing of deltoid power, and dynamic muscle function testing. At one year after surgery, all patients underwent EMG and nerve latency studies to assess axillary nerve function. Thirteen of the fourteen patients united their fractures without complications, and had DASH and Constant score that were good, with comparatively minor residual deficits on assessment of muscle power. Of these thirteen patients, only one had evidence of slight neurogenic change in the anterior deltoid. This patient had no evidence of anterior deltoid paralysis and her functional scores, spring balance and dynamic muscle function test results were indistinguishable from the patients with normal electrophysiological findings. One of the fourteen patients developed osteonecrosis of the humeral head nine months after surgery and had poor functional scores, without evidence of nerve injury on electrophysiological testing. Reconstruction through an extended deltoid-splitting approach provides a useful alternative in the treatment of complex proximal humeral fractures. The approach provides good access for reduction and implant placement and does not appear to be associated with clinically-significant adverse effects.
