Recurrence in CTEV is not uncommon and as the child becomes older the foot in question is often stiffer and less amenable to the more traditional serial casting Ponseti method. Treatment of these recurrent CTEV feet with external fixators has been previously documented. We aim to present the Sheffield technique of an external circular frame with adjunctive hindfoot and midfoot osteotomies to correct relapsed CTEV and their associated Roye (outcome) scores. Retrospective analysis of patient records from 1999 to 2019 were performed for those undergoing frame correction of CTEV. Patients were included if there was adjunctive foot osteotomies in the setting of CTEV frame correction and willingness to partake in retrospective Roye outcome scoring. The Roye score was sent out in the mail to parents asking for scoring of the current level of symptoms.Introduction
Materials and Methods
Low dose technology of an EOS scanner allows mechanical axis radiographs to be produced using a continuously moving x-ray emitting a thin beam to form a single image which includes all three joints, without the need for stitching. The aim of this study was to identify necessary improvements to enable effective interpretation of the radiographs, and to assess whether the quality of the radiographs varied by production method compared to a previous audit of CR and DR radiographs. 8 domains were identified based on a previous audit using the acronym MECHANIC each defining the qualities required for a radiograph to meet the criteria. 100 mechanical axis radiographs produced using conventional and digital methods were analysed in the original study to assess how many radiographs met the described criteria. The same criteria were amended and used to assess 123 different mechanical axis radiographs in the follow up study following the introduction of the EOS scanner, in which 77 were produced using EOS and 46 were produced using conventional and digital methods.Introduction
Materials and Methods
To determine the impact of COVID-19 on orthopaediatric admissions and fracture clinics within a regional integrated care system (ICS). A retrospective review was performed for all paediatric orthopaedic patients admitted across the region during the recent lockdown period (24 March 2020 to 10 May 2020) and the same period in 2019. Age, sex, mechanism, anatomical region, and treatment modality were compared, as were fracture clinic attendances within the receiving regional major trauma centre (MTC) between the two periods.Aims
Methods
We aim to demonstrate the value of deep tissue biopsies to guide antimicrobial treatment of diabetic ulcers. Some recent studies have advocated the role of superficial swabs to guide antibiotic treatment in comparison to deep tissue biopsies previously perceived as the gold standard of microbiology diagnosis. We performed a retrospective analysis of microbiology culture results of patients with infected diabetic ulcers comparing superficial versus deep biopsy microbiology results. Forty-one diabetic ulcers in 41 patients were included. The mean numbers of isolates from soft tissue and bone biopsies were 2.1 and 1.8 respectively. 39/41 combined soft tissue and bone biopsies were culture positive. The most prevalent organism seen in deep samples was Staphylococcus aureus (14) followed by anaerobes (9), and enterococcus (9). In superficial swab cultures 21 patients (51%) cultured non-specific, mixed skin flora and enteric species. The remaining 20 patients cultured Staphylococcus aureus (11), Streptococcus (6), Pseudomonas (2) and anaerobes (6). Three superficial swabs matched deep tissue biopsy cultures. 16 deep biopsies grew organisms seen none specifically in superficial swab cultures with 22 deep tissue biopsies cultures growing organisms not seen on superficial swab with 8 being anaerobes. We have shown that in 54% of cases, deep tissue cultures isolated organisms that were not grown by superficial swab cultures. We highlight the importance of deep tissue biopsies to guide effective treatment.
Enhanced Recovery Protocol (ERP) for elective total hip or total knee replacement has become the gold standard. The main principles are to reduce bleeding, both with a tranexamic acid infusion and local injection of adrenaline, and to reduce the risk of postoperative thrombo-embolic complications by early mobilisation, enabled by local anaesthetic infiltration at time of surgery. The aim of this study is to evaluate the impact of the ERP. A retrospective review was performed including all patients who underwent primary hip or knee arthroplasty surgery between January 2011 and December 2013. The ERP was implemented in our department in August 2012 thus creating two cohorts; the traditional postoperative group and those undergoing ERP. Outcome measurements of length of stay, postoperative transfusion, thrombo-embolic complications and number of re-admissions were assessed.Introduction
Methods
Literature in respect to the MRI appearances of surgically confirmed spring ligament pathology is sparse. The authors conducted a retrospective review of MRI examinations comprising 13 patients with surgically proven spring ligament abnormality. Records for operations performed for planovalgus foot deformity with operation notes confirming presence of spring ligament abnormality were obtained for patients treated 2010–11. Of 32 procedures 13 patients (3 male, 10 female) mean age 48.5 (range, 21–86 years) underwent preoperative MRI scanning using a standard musculoskeletal protocol on a T1.5 unit. Scans were retrospectively reviewed by one of the senior authors and consultant musculoskeletal radiologist for pathological findings.Introduction
Methods
