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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_2 | Pages 6 - 6
1 Jan 2014
Kheiran A Makki D Banerjee P Ricketts D
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Introduction:

Unstable ankle fractures are commonly treated with operative fixation. Isolated lateral malleolus fractures (Weber B) are often operated by orthopaedic trainees. Operative fixation of these fractures is included in the index procedures of procedure based assessment (PBA) of intercollegiate Surgical Curriculum Programme (ISCP). Orthopaedic trainees are expected to be competent in this procedure by the end of their training. Fluoroscopic guidance is essential for adequate reduction and safe fixation of these fractures.

Aims:

It is currently unknown if patients are exposed to excess radiation when they are operated by trainees compared to consultant surgeons. It is a common perception that trainees take more time to fix these fractures compared to trained consultants thereby exposing patients to untoward effects of prolonged tourniquet time.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XLIII | Pages 4 - 4
1 Sep 2012
Makki D Haddad B Shahid M Pathak S Garnham I
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Background

The aim of this prospective study was to assess the effectiveness of a single ultrasound-guided steroids injection in the treatment of Morton's neuromas and whether the response to injection correlates with the size of neuroma.

Methods

Forty three patients with clinical features of Morton's neuroma underwent ultrasound scan assessment. Once the lesion was confirmed in the relevant web space, a single corticosteroids injection was given using 40 mg Methylprednisolone along with 1% Lidocaine.

All scans and injections were performed by a single musculoskeletal radiologist. Patients were divided into two groups based on the size of the lesion measured on the scan. Group 1 included patients with neuromas of 5mm or less and Group 2 patients had neuromas larger than 5mm. The Visual Analogue Scale (Scale:0 to 10), the American Orthopaedic Foot and Ankle Society score (AOFAS) and the Johnson satisfaction scale were used to assess patients prior to injection and then at 6 weeks, 6 months and 12 months following the injection.