Nerve damage is a complication of THA and TKA procedures. The incidence of subclinical nerve injury following arthroplasty is unknown. The aim was to determine the prevalence of asymptomatic nerve deficits in an arthroplasty population group, and the incidence of post-operative changes in nerve function. A Secondary aim was to identify the nature of any deficits. And the association between nerve deficits and history of backache. A non-randomised prospective series of patients undergoing lower limb arthroplasty for osteoarthritis were studied at a single hospital. The peroneal nerve was investigated using nerve conduction in forty patients. Twenty patients had upper limb testing to differentiate between a polyneuropathy or isolated lower limb neuropathy. Nerve function deficits were detected in the peroneal nerve in fifteen patients pre-operatively and fifteen post-operatively, of those twelve had A waves detected suggestive of a generalised neuropathy. Ten patients who had upper limb testing had a conduction defect (five had asymptomatic Carpal tunnel). There was a positive correlation between presence of post-operative deficit and age(r=0.389, p=0.013). A negative correlation was found for presence of post-operative A waves and BMI(r=−0.370, p=0.019). The prevalence of pre-operative subclinical peroneal neuropathy is much higher than expected in this group (37.5%) of arthroplasty patients. There is a strong correlation between presence of post-operative conduction abnormalities and age. There is no relationship between peripheral neuropathy and history of backache or residual post-operative deficit.
Intra-articular fractures of the distal radius are common injuries. Their pathogenesis involves a complex combination of forces, including ligament tension, bony compression and shearing, leading to injury patterns that challenge the treating surgeon. The contribution of the radiocarpal and radioulnar ligaments to articular fracture location has not previously been described. Computed tomography (CT) scanning is an important method of evaluating intra-articular distal radius fractures, revealing details missed on plain radiographs and influencing treatment plans. We retrospectively reviewed CT scans of acute intra-articular distal radius fractures performed in one institution from June 2001 to June 2008. Forty- five of 145 scans were deemed unsuitable due to poor quality or presence of internal fixation in the distal radius, leaving 100 fractures for review. Fracture line locations were mapped to a standardised distal radius model, and statistically analysed in their relationship to ligament attachment zones.Purpose
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