Fibular malreduction is a common and important cause of pain after surgical fixation following a syndesmosis injury, but it is unclear which components of malreduction correspond to clinical outcome. Plain radiographs have been shown to be unreliable at measuring malreduction when compared to CT scans. A number of published methods for measuring fibular position rely on finding the axis of the fibula. Elgafy demonstrated that fibular morphology varies greatly, and some studies have demonstrated difficulty finding the fibular axis. We developed a new method of measuring the distal fibular position on CT images. We used CT studies in 16 normal subjects. Two assessors independently measured the ankle syndesmosis using the Davidovitch method, and our new protocol for fibular AP position, diastasis and fibular length.Introduction:
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Government figures show a trend of increasing incidence in motorcycle trauma in the UK over the last decade. These patients often have multiple injuries and place a significant burden on the admitting units. In the face of changes to health service funding, with the introduction of Payment by Results, we wanted to determine the true cost of treating these patients in the setting of a District General Hospital. We undertook a retrospective case-note review of all the motorcyclists involved in road traffic accidents (MRTAs) requiring admission for treatment in 2004. Patients were identified using the hospital computer system. A supplementary telephone survey was also undertaken to retrieve information not previously recorded. The following parameters were analysed: demographic and admission details, motorcycle and accident details, admitting specialty, injury pattern, nature and number of investigations, treatment, outcome and cost.Introduction
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