There is a disparity in sport-related
Popliteal artery
Aims. Clinical management of open fractures is challenging and frequently requires complex reconstruction procedures. The Gustilo-Anderson classification lacks uniform interpretation, has poor interobserver reliability, and fails to account for
The anterior cruciate ligament (ACL) is frequently injured in elite athletes, with females up to eight times more likely to suffer an ACL tear than males. Biomechanical and hormonal factors have been thoroughly investigated; however, there remain unknown factors that need investigation. The mechanism of
Injuries to the quadriceps muscle group are common in athletes performing high-speed running and kicking sports. The complex anatomy of the rectus femoris puts it at greatest risk of
Aims. To identify unanswered questions about the prevention, diagnosis, treatment, and rehabilitation and delivery of care of first-time soft-tissue knee injuries (ligament
Aims. The aim of this study was to evaluate the association between chondral
Aims. The primary objective of this study was to develop a validated classification system for assessing iatrogenic bone trauma and soft-tissue
Aims. Lateral femoral cutaneous nerve (LFCN)
Aims. Acute and chronic
Aims. The impact of concomitant
Aims. Paediatric triplane fractures and adult trimalleolar ankle fractures both arise from a supination external rotation
Weightbearing instructions after musculoskeletal injury or orthopaedic surgery are a key aspect of the rehabilitation pathway and prescription. The terminology used to describe the weightbearing status of the patient is variable; many different terms are used, and there is recognition and evidence that the lack of standardized terminology contributes to confusion in practice. A consensus exercise was conducted involving all the major stakeholders in the patient journey for those with musculoskeletal injury. The consensus exercise primary aim was to seek agreement on a standardized set of terminology for weightbearing instructions.Aims
Methods
Aims. Lateral femoral cutaneous nerve (LFCN)
Initial treatment of traumatic spinal cord
Shoulder injury related to vaccine administration (SIRVA) is a prolonged episode of shoulder dysfunction that commences within 24 to 48 hours of a vaccination. Symptoms include a combination of shoulder pain, stiffness, and weakness. There has been a recent rapid increase in reported cases of SIRVA within the literature, particularly in adults, and is likely related to the mass vaccination programmes associated with COVID-19 and influenza. The pathophysiology is not certain, but placement of the vaccination in the subdeltoid bursa or other pericapsular tissue has been suggested to result in an inflammatory capsular process. It has been hypothesized that this is associated with a vaccine injection site that is “too high” and predisposes to the development of SIRVA. Nerve conduction studies are routinely normal, but further imaging can reveal deep-deltoid collections, rotator cuff tendinopathy and tears, or subacromial subdeltoid bursitis. However, all of these are common findings within a general asymptomatic population. Medicolegal claims in the UK, based on an incorrect injection site, are unlikely to meet the legal threshold to determine liability. Cite this article:
Aims. The aim of this study was to determine whether early surgical treatment results in better neurological recovery 12 months after
Injuries to the hamstring muscle complex are common in athletes, accounting for between 12% and 26% of all
Aims. Periprosthetic joint infections (PJIs) and fracture-related infections (FRIs) are associated with a significant risk of adverse events. However, there is a paucity of data on cardiac complications following revision surgery for PJI and FRI and how they impact overall mortality. Therefore, this study aimed to investigate the risk of perioperative myocardial
Aims. To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP). Methods. All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of
Aims.
Aims. To evaluate the outcomes of terrible triad
Complex fractures of the femur and tibia with associated severe soft tissue injury are often devastating for the individual. The aim of this study was to describe the two-year patient-reported outcomes of patients in a civilian population who sustained a complex fracture of the femur or tibia with a Mangled Extremity Severity Score (MESS) of ≥ 7, whereby the score ranges from 2 (lowest severity) to 11 (highest severity). Patients aged ≥ 16 years with a fractured femur or tibia and a MESS of ≥ 7 were extracted from the Victorian Orthopaedic Trauma Outcomes Registry (January 2007 to December 2018). Cases were grouped into surgical amputation or limb salvage. Descriptive analysis were used to examine return to work rates, three-level EuroQol five-dimension questionnaire (EQ-5D-3L), and Glasgow Outcome Scale-Extended (GOS-E) outcomes at 12 and 24 months post-injury.Aims
Methods
We reviewed 101 patients with
Abstract. Nerve transfer has become a common and often effective reconstructive strategy for proximal and complex peripheral nerve
Aims. Although infrequent, a fracture of the cuboid can lead to significant
disruption of the integrity of the midfoot and its function. The
purpose of this study was to classify the pattern of fractures of
the cuboid, relate them to the mechanism of
Aims. The crucial role of the radial head in the stability of the elbow in terrible triad
Sporting
Aims. In a randomized controlled trial with two-year follow-up, patients treated with suture button (SB) for acute syndesmotic
Aims. The glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment. Materials and Methods. A systematic search was conducted using PubMed (MEDLINE), Web of Science, Embase, and Cochrane (January 1997 to September 2017), with references from articles also evaluated. Studies reporting patients who experienced an acute posterior glenohumeral joint subluxation and/or dislocation, as well as the aetiology of posterior glenohumeral dislocations, were included. Results. A total of 54 studies met the inclusion criteria. In total, 182 patients were included in this analysis; study sizes ranged from one to 66 patients, with a mean age of 44.2 years (. sd. 13.7). There was a higher proportion of male patients. In all, 216 shoulders were included with 148 unilateral
Aims. We aimed to identify the pattern of nerve
Aims. Fractures of the navicular can occur in isolation but, owing
to the intimate anatomical and biomechanical relationships, are
often associated with other
We retrospectively reviewed the hospital records of 68 patients who had been referred with an
We have investigated iatrogenic popliteal artery
injuries (PAI) during non arthroplasty knee surgery regarding mechanism
of
Aims. This study reports the outcomes of a technique of soft-tissue coverage and Chopart amputation for severe crush
We present our experience of managing patients
with iatropathic brachial plexus
The purpose of this study was to describe the anatomical distribution and incidence of fatigue
We report the functional and socioeconomic long-term
outcome of patients with pelvic ring
The Essex-Lopresti
We describe 261 peripheral nerve
Traditionally, informed consent for clinical
research involves the patient reading an approved Participant Information
Sheet, considering the information presented and having as much time
as they need to discuss the study information with their friends
and relatives, their clinical care and the research teams. This
system works well in the ‘planned’ or ‘elective’ setting. But what
happens if the patient requires urgent treatment for an
We reviewed the records of children referred to our hospital between April and September 2005 who had been injured whilst trampolining. Of 88 such children there were 33 boys and 55 girls with a mean age of 8 years 6 months (2 years 4 months to 15 years 9 months). Most of the
Vascular
The Essex-Lopresti
We have reviewed 22 patients at a mean of 30 years (28 to 31) after a whiplash
The diagnosis of nerve
Aims. We aimed to evaluate the temperature around the nerve root during drilling of the lamina and to
determine whether irrigation during drilling can reduce the chance of nerve root
Ankylosing spondylitis (AS) is a progressive
multisystem chronic inflammatory disorder. The hallmark of this pathological
process is a progressive fusion of the zygapophyseal joints and
disc spaces of the axial skeleton, leading to a rigid kyphotic deformity
and positive sagittal balance. The ankylosed spine is unable to
accommodate normal mechanical forces, rendering it brittle and susceptible
to
This is a case series of prospectively gathered
data characterising the
Non-accidental
Most
Injuries to the foot in athletes are often subtle
and can lead to a substantial loss of function if not diagnosed
and treated appropriately. For these
A total of 11 patients with combined traumatic
Aims. The best time for definitive orthopaedic care is often unclear
in patients with multiple
Injuries to the limb are the most frequent cause
of permanent disability following combat wounds. We reviewed the medical
records of 450 soldiers to determine the type of upper limb nerve
injuries sustained, the rate of remaining motor and sensory deficits
at final follow-up, and the type of Army disability ratings granted.
Of 189 soldiers with an
While
Aims. The aim of this study was to investigate the long-term clinical
and radiological outcome of patients who suffer recurrent injuries
to the anterior cruciate ligament (ACL) after reconstruction and
require revision surgery. Patients and Methods. From a consecutive series of 200 patients who underwent primary
reconstruction following rupture of the ACL, we identified 36 who
sustained a further rupture, 29 of whom underwent revision surgery.
Patients were reviewed prospectively at one, two, seven, 15 and
about 20 years after their original surgery. Primary outcome measures
were the number of further ruptures, the posterior tibial slope
(PTS), and functional and radiological outcomes. These were compared
with a gender and age matched cohort of patients who underwent primary
ACL reconstruction only. Results. At a mean follow-up of 18.3 years (14.3 to 20.2), 29 patients
had undergone revision surgery and within this revision group 11
had sustained more than three ruptures of the ACL (3 to 6). The
mean age at the time of revision reconstruction was 26.4 years (14
to 54). The mean PTS was significantly higher in those patients
who suffered a further
The modified Smith–Petersen and Kocher–Langenbeck
approaches were used to expose the lateral cutaneous nerve of the
thigh and the femoral, obturator and sciatic nerves in order to
study the risk of
Restoration of hand function is rarely achieved after a complete closed traction lesion of the supraclavicular brachial plexus. We describe the
The aim of this study was to determine whether exposure of human articular cartilage to hyperosmotic saline (0.9%, 600 mOsm) reduces in situ chondrocyte death following a standardised mechanical
High-pressure injection
We describe a management strategy for upper- and lower-limb fractures with associated arterial
Hand function was evaluated in 105 patients who had been operated on in early infancy for brachial plexus birth palsy. The mean follow-up after surgery was for 13.4 years (5.0 to 31.5). Fine sensation, stereognosis, grip and pinch strength and the Raimondi scale were recorded. Fine sensation was normal in 34 of 49 patients (69%) with C5–6
Seat-belt fractures of the lumbar spine in adolescents and adults are well recognised but there are few reports of these
This review discusses the causes, outcome and prevention of whiplash
1. Injuries of the sternum from flexion-compression violence are described and contrasted with
We describe 20 patients, aged between 43 and 88 years, with delayed nerve palsy or deepening of an initial palsy caused by arterial
Crushing of the radial side of the hand results in a wide spectrum of
This paper describes seven patients who developed late vertebral deformity after flexion
We studied 50 consecutive patients presenting at an accident department after rear-end vehicle collisions and recorded symptoms and psychological test scores within one week of
We studied a consecutive series of 58 patients with penetrating missile
We report a case of osteonecrosis of the femoral head in a young man who is a carrier of the prothrombin gene mutation. We suggest that an electrical
A prospective study of 33 civilian parachutists with 41
The late results of tarsometatarsal
Many authors recommend surgery to remove retropulsed bone fragments from the canal in burst fractures to 'decompress' the spinal canal. We believe, however, that neurological damage occurs at the moment of
Antegrade intramedullary nailing of fractures of the shaft of the humerus is reported to cause impairment of the shoulder joint. We have reviewed 33 patients with such fractures to assess how many had
We reviewed 110 patients with an unstable fracture of the pelvic ring who had been treated with a trapezoidal external fixator after a mean follow-up of 4.1 years. There were eight open-book (type B1, B3-1)
Peripheral nerve
Injuries to the spinal cord may be associated with increased healing of fractures. This can be of benefit, but excessive bone growth can also cause considerable adverse effects. We evaluated two groups of patients with fractures of the spinal column, those with neurological compromise (n = 10) and those without (n = 15), and also a control group with an isolated fracture of a long bone (n = 12). The level of transforming growth factor-beta (TGF-β), was measured at five time points after
Locognosia, the ability to localise touch, is one aspect of tactile spatial discrimination which relies on the integrity of peripheral end-organs as well as the somatosensory representation of the surface of the body in the brain. The test presented here is a standardised assessment which uses a protocol for testing locognosia in the zones of the hand supplied by the median and/or ulnar nerves. The test-retest reliability and discriminant validity were investigated in 39 patients with
Forty-six children with Monteggia fracture-dislocations have been studied. The circumstances of the accident could rarely be recalled so that the mechanism of
We conducted an anatomical study to determine
the best technique for transfer of the anterior interosseous nerve (AIN)
for the treatment of proximal ulnar nerve
1. We have described what happens to patients a number of years after
Disruption of the major ligaments of the knee was seen in six young men, five parachutists and a house painter, after what we have termed abduction-traction
The results of treatment of Lisfranc
Complete dislocation of the knee is a relatively rare condition. When it occurs as a result of high-velocity
The clinical results in a series of 131 patients with 134 brachial plexus
We treated 43 acute tears of the calcaneofibular ligament by operation in 43 patients after subtalar arthrography. There were 22 men and 21 women with a mean age of 22.3 years (14 to 61). Anteroposterior (AP), lateral and oblique views were obtained with the foot in 45° of internal rotation and the ankle in the neutral position. Any communication or leakage to the ankle, tendon sheaths, subcutaneous tissue and sinus tarsi was recorded. We examined an oblique view of the microrecess along the interosseous ligament and an AP view of the lateral recess just under the distal end of the fibula. We also studied a control group of 27 patients with isolated
We investigated the response of chronic neck and shoulder pain to decompression of the carpal tunnel in 38 patients with whiplash
We studied 57 patients with isolated lunotriquetral
A case of locked hypersupination of the distal radio-ulnar joint is described in which the ulnar displacement was purely rotational rather than volar. The mechanism of
Nerve
The outcomes of 261 nerve
In this paper we propose a new classification
of neurogenic peri-articular heterotopic ossification (HO) of the
hip based on three-dimensional (3D) CT, with the aim of improving
pre-operative planning for its excision. . A total of 55 patients (73 hips) with clinically significant
HO after either traumatic brain or spinal cord
Clinicians are often asked by patients, “When
can I drive again?” after lower limb injury or surgery. This question
is difficult to answer in the absence of any guidelines. This review
aims to collate the currently available evidence and discuss the
factors that influence the decision to allow a patient to return
to driving. There is currently insufficient evidence for any authoritative
body to determine fitness to drive. The lack of guidance could result
in patients being withheld from driving for longer than is necessary,
or returning to driving while still unsafe. Cite this article:
This is a retrospective study of 612 cases of iatropathic
We report the management and outcome of 35 lower limb fractures with associated severe vascular
There are many causes of paraspinal muscle weakness which give rise to the dropped-head syndrome. In the upper cervical spine the central portion of the spinal cord innervates the cervical paraspinal muscles. Dropped-head syndrome resulting from