This observational study examines the effect of the COVID-19 pandemic upon the paediatric trauma burden of a district general hospital. We aim to compare the nature and volume of the paediatric trauma during the first 2020 UK lockdown period with the same period in 2019. Prospective data was collected from 23 March 2020 to 14 June 2020 and compared with retrospective data collected from 23 March 2019 to 14 June 2019. Patient demographics, mechanism of injury, nature of the injury, and details of any surgery were tabulated and statistically analyzed using the independent-samples Aims
Methods
The anterior exposure of the upper thoracic spine using standard methods is often difficult and limited. We report our experience using a technique described by Sundaresan et al. (1984) in which the medial portion of one
A minority of cases of osteopetrosis show in addition syndactyly and distal phalangeal anomalies. The seven cases that have been reported with this combination have had an unusual degree of density and thickening of the skull vault, face and mandible, and of the shafts of the metacarpals, metatarsals, proximal phalanges and
1. A method of treating chronic acromio-clavicular dislocation by transfer of the coracoid process to the
The place and effectiveness of surgery for acromioclavicular dislocation is disputed. We have reviewed 29 patients all treated by an operation which holds the
Twenty-three patients with a severe refractory painful arc syndrome have been treated by excision of the outer end of the
We have reviewed 12 fractures of the coracoid process. In two of these patients the fracture extended into the body of the scapula and resulted in displacement of the glenoid. In some cases, there were associated acromioclavicular and glenohumeral dislocations or fractures of the
Aneurysmal bone cysts (ABCs) are locally aggressive lesions typically found in the long bones of children and adolescents. A variety of management strategies have been reported to be effective in the treatment of these lesions. The purpose of this review was to assess the effectiveness of current strategies for the management of primary ABCs of the long bones. A systematic review of the published literature was performed to identify all articles relating to the management of primary ABCs. Studies required a minimum 12-month follow-up and case series reporting on under ten participants were not included.Aims
Methods
We describe a method for approaching the lower cervical and upper thoracic spine, the brachial plexus and related vessels. The method involves the elevation of the medial corner of the manubrium, the sternoclavicular joint, and the medial half of the
A consecutive series of 150 patients with clavicular fractures is presented. In 81% detailed information regarding the mechanism of the injury was available and, of these, 94% had fractured their
Condensing osteitis of the clavicle was first described as a disease entity in 1974. There is painful localised swelling of the
We report a case of multicentric massive osteolysis. A 52-year-old woman presented with a three-year history of progressive deformities of the hands. She had osteolytic lesions of the metacarpals and metatarsals, and resorption of the terminal phalanges. During follow-up over four years osteolysis spread to affect the ribs,
1. Details of clinical, radiological, biochemical and histological investigations of a case of metaphysial dysostosis are presented. 2. The patient was a boy of seven years, and showed widespread lesions (involving long bones of limbs, small bones of hands and feet, pelvis,
The use of the upright position of the patient, and a vertical incision for exposure of the brachial plexus, has been attended by no complications or serious hazards. The aid of skilled anaesthetists is acknowledged. The structures are visible and accessible; the operative field is steady; bleeding is controlled easily; and dissection is facilitated. By this technique it has been possible to explore a larger field from above, and division of the
1. Screw fixation of
1. It is suggested that replacement of the costo-clavicular ligament is mechanically an essential part of the operative treatment of recurrent sterno-clavicular dislocation. 2. Tenodesis of the subclavius appears to be the simplest and safest way of achieving such replacement. 3. Two cases are described of recurrent sterno-clavicular dislocation treated by this procedure and capsulorrhaphy. 4. Full function was restored in both cases; and there had been no recurrence at the times of follow-upâthree years and six months after operation in the first case, and twelve months after operation in the second. In this case the joint had withstood violence that had shattered the
The primary aim of this study was to determine if delayed clavicular fixation results in a greater risk of operative complications and revision surgery. A retrospective case series was undertaken of all displaced clavicular fractures that underwent plate fixation over a ten-year period (2007 to 2017). Patient demographics, time to surgery, complications, and mode of failure were collected. Logistic regression was used to identify independent risk factors contributing towards operative complications. Receiver operating characteristic (ROC) curve analysis was used to determine if a potential ‘safe window’ exists from injury to delayed surgery. Propensity score matching was used to construct a case control study for comparison of risk.Aims
Patients and Methods
We reviewed 67 consecutive patients with fractures of the coracoid process, classifying them by the relationship between the fracture site and the coracoclavicular ligament. The 53 type-I fractures were behind the attachment of this ligament, and the 11 type-II fractures were anterior to it. The relationship of three fractures was uncertain. Type-I fractures were associated with a wide variety of shoulder injuries and consequent dissociation between the scapula and the
The aim of this retrospective study was to review a series of patients with ipsilateral fractures of the neck of the scapula and of the
Major ruptures of the rotator cuff were repaired in 89 patients over a six-year period, using an approach through the split deltoid muscle and the bed of the excised outer centimetre of the