We report our 10-year experience of post-operative complications of calcaneal fractures treated by internal fixation and attempt to correlate these with previously cited patient risk factors. All calcaneal fractures treated by internal fixation in our Major Trauma Centre between September 2002 and September 2012 were identified. Patient indices (age, gender, smoking status and pre-existing co-morbidities), time to surgery and method of surgery (open reduction and internal fixation (ORIF) versus closed reduction and percutaneous fixation) were recorded. Primary outcome was the incidence of wound infection requiring intravenous antibiotics and/or re-operation. Statistical analysis through Mann-Whitney-Wilcoxon testing and relative risk ratio calculations with 95% Confidence Intervals (CI) was performed.Introduction:
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Total ankle replacement is a recognised treatment for disabling end stage ankle arthritis and an alternative to arthrodesis, although results are not yet comparable to other joint replacements. This has stimulated a constant evolution in design of implants and instrumentation. The Nottingham Foot and Ankle Unit used the STAR until 2005, when it switched to Mobility, due to the perceived advantages of less bone resection, improved instrumentation and potentially less polyethylene insert wear. The aim of this study is to report the unit's results and review the different outcomes between the two ankle replacements used. A retrospective analysis of all total ankle replacements carried out by the foot and ankle unit at Nottingham City Hospital between March 1999 and June 2013. Post operative complications, associated reoperations and revisions were recorded. The American Orthopaedic Foot and Ankle Score (AOFAS), Foot Function Index (FFI), European five dimension quality of life scores (EQ-D5) and patient satisfaction was independently assessed at each follow up visit. Other ankle replacements or those performed elsewhere or with less than 12 month follow up were excluded.Introduction:
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Calcaneal fractures are rare but debilitating injuries assumed to affect particular demographic sub groups. This study aimed to relate epidemiological factors (age, gender, smoking status and social deprivation scores) to the incidence of calcaneal fractures requiring operative fixation over a 10-year period. Data (age, gender and smoking status) was extracted from a prospective trauma database regarding calcaneal fractures between September 2002 and September 2012. The Rank of Index of Multiple Deprivation (IMD) scores was collated for each patient and data sub-stratified in 20% centiles. 2010 National Census Data was used to formulate patient subgroups and incidences. Resulting data was subjected to statistical analysis through calculation of relative risk (RR) scores with 95% confidence intervals (95% CI).Introduction:
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Comminuted mid-foot fractures are uncommon. Maintenance of the length and alignment of the medial column, with restoration of articular surface congruity, is associated with improved outcomes. Conventional surgery has utilised open or closed reduction with K-wire fixation, percutaneous techniques, ORIF, external fixation or a combination of these methods. In 2003 temporary bridge plating of the medial column was described to reconstruct and stabilise the medial column. The added advantage of locking plates is the use of angle-stable fixation. We present our experience with temporary locking plates in complex mid-foot fractures. Prospective audit database of 12 patients over a 6 year period (2003-2009). 5 males 7 females mean age 41.9. Mechanism of injury: 11 high-energy injuries (6 falls from height, 5 RTCs), 1 low energy injury. Fracture type: All involved the medial column - 12 fracture dislocations of the medial column. 4 concomitant injuries to the lateral column. All underwent ORIF, realignment, and stabilisation with locking plates across the mid-foot.Introduction
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