Smartphones are now a ubiquitous presence within the modern healthcare setting. Uses such as internet, database software and storage of medical textbooks, all contribute to the clinical value of the devices. Within orthopaedics, transmission of digital images via smartphones is now routinely used to obtain instant second opinions of trauma radiographs. However questions remain as to whether smartphone image quality is sufficient for primary diagnosis and secondary consultation To assess the accuracy of diagnosis made when radiographs are viewed on a smartphone screen in comparison with a standard digital monitor. Also to assess the diagnostic confidence, diagnostic difficulty, subjective image quality and formulation of management plan.Background
Aim
Hip fractures pose a significant burden on the healthcare system. Hyperglycaemia and a state of Type 2 diabetes exists post operatively. Being normoglycaemic has well documented benefits. Pre operative carbohydrate loading has been shown to have two good effects. It decrease hyperglycaemia post operatively and allows the patient to undergo less strict fasting protocols. Insulin resistance to date has not been examined in these patients and this was determined using a validated formula (HOMA/IR). Three trauma hospitals were enrolled and patients with hip fractures requiring operative fixation were enlisted. Exclusion criteria: diabetic patients and inability to imbibe. 100 neck of femur fractures were examined. 46 patients were fasted normally. 32 test patients were given a carbohydrate rich drink pre operatively the night before surgery and in the morning up to 2 hours prior to surgery. 22 patients were excluded. Serum random glucose and insulin levels were taken on admission. Fasting serum glucose and insulin levels were taken on day one post operatively.Aims
Methods
Malnutrition has been suggested to increase the risk of falls in frail elderly. It has been hypothesised that elderly, orthopaedic trauma patients may be malnourished. We conducted an observational study to identify if this was the case. 30 trauma patients (? 65 years) admitted for surgical intervention for a fracture were recruited. Consent/ethical approval was obtained. Serum markers (LFTs, CRP, U&Es, FBC, magnesium), anthropometric measurements (triceps skin-fold thickness [TSF], mid-arm circumference [MAC], body mass index [BMI]) and short form mini-nutritional assessment (MNA-SF®) were carried out at presentation and at 3 months post-operation. Serum markers were also repeated at day 1 and day 3 post-operation.Background
Methods
Acetabular fractures are a challenging problem. It has been published that outcome is dependent upon the type of fracture, the reduction of the fracture and concomitant injuries. The end-points of poor outcome include avascular necrosis of the femoral head, osteoarthritis. However, we lack definitive statistics and so counselling patients on prognosis could be improved. In order to achieve this, more outcome studies from tertiary referral centres are required. We present the first long term follow up from a large tertiary referral Centre in Ireland. We identified all patients who were ten years following open reduction and internal fixation of an acetbular fracture in our centre. We invited all of these patients to attend the hospital for clinical and radiographic follow-up. As part of this, three scoring systems were completed for each patient; the Short-form 36 health survey (SF36), the Merle d'Aubigné score and the Short Musculoskeletal Functional Assessment (SMFA).Introduction
Methods
To report clinical results of patients who underwent closed reduction and percutaneous iliosacral screw fixation for Tile Type C fractures. Retrospective, we collected data using medical records and images of patients treated in our centre. Prospectively, we followed up patients with two questionnaires. Minimum follow up time was 12 months with the mean being 24 months. 36 patients were followed up with a mean age 34 years (range 14- 65) from 2001-2009. Fracture types included 1 C1-1, 18 C1-2, 26 C1-3. Functional status was assessed using the Majeed pelvic score and the Iowa pelvic Score.Objective
Materials and Methods
It is recommended that the ankle be held in dorsiflexion at the time of placement of syndesmosis screw. We assessed the validity of this recommendation. A two-part roentgenographic and computerised analysis of distal tibiofibular syndesmosis. The first part involved recruitment of 30 healthy adult volunteers. The second part involved 15 ankle fractures with syndesmotic injury requiring syndesmosis screw placement. In the first part individuals maximally dorsiflexed and plantarflexed their ankles in a specialised jig for standardisation. Mortice views were taken and intermalleolar distance measured. In the second part mortice views were taken in plantarflexion and dorsiflexion before and after the placement of syndesmosis screw in theatre. The intermalleolar distance was then measured.Introduction
Materials and methods
