We reviewed 35 patients who had an amputation following the failure of treatment for severe lower limb trauma. Seven of the amputations were for ischaemia, within one month of
We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot
We investigated the incidence of anomalies in
the vertebral arteries and Circle of Willis with three-dimensional
CT angiography in 55 consecutive patients who had undergone an instrumented
posterior fusion of the cervical spine. We recorded any peri-operative and post-operative complications.
The frequency of congenital anomalies was 30.9%, abnormal vertebral
artery blood flow was 58.2% and vertebral artery dominance 40%. . The posterior communicating artery was occluded on one side in
41.8% of patients and bilaterally in 38.2%. Variations in the vertebral
arteries and Circle of Willis were not significantly related to
the presence or absence of posterior communicating arteries. Importantly,
18.2% of patients showed characteristic variations in the Circle
of Willis with unilateral vertebral artery stenosis or a dominant
vertebral artery, indicating that
We are currently facing an epidemic of periprosthetic
fractures around the hip. They may occur either during surgery or
post-operatively. Although the acetabulum may be involved, the femur
is most commonly affected. We are being presented with new, difficult
fracture patterns around cemented and cementless implants, and we
face the challenge of an elderly population who may have grossly
deficient bone and may struggle to rehabilitate after such
A medical and engineering study was made of 1074 car accidents involving 2520 vehicle occupants. The
We investigated patient characteristics and outcomes of Vancouver type B periprosthetic fractures treated with femoral component revision and/or osteosynthesis. The study utilized data from the Swedish Hip Arthroplasty Register (SHAR) and information from patient records. We included all primary total hip arthroplasties (THAs) performed in Sweden since 1979, and undergoing further surgery due to Vancouver type B periprosthetic femoral fracture between 2001 and 2011. The primary outcome measure was any further reoperation between 2001 and 2013. Cross-referencing with the National Patient Register was performed in two stages, in order to identify all surgical procedures not recorded on the SHAR.Aims
Patients and Methods
The October 2012 Spine Roundup. 360. looks at: a Japanese questionnaire at work in Iran; curve progression in degenerative lumbar scoliosis; the cause of foot drop; the issue of avoiding the spinal cord at scoliosis surgery; ballistic
The August 2012 Trauma Roundup. 360. looks at: pelvic fractures, thromboembolism and the Japanese; venous thromboembolism risk after pelvic and acetabular fractures; the displaced clavicular fracture; whether to use a nail or plate for the displaced fracture of the distal tibia; the dangers of snowboarding; how to predict the outcome of lower leg blast
The aim of this study was to investigate the difference in functional outcome after repair and non-repair of the pronator quadratus muscle in patients undergoing surgical treatment for a distal radial fracture with volar plating. A total of 72 patients with a distal radial fracture were included in this randomized clinical trial. They were allocated to have the pronator quadratus muscle repaired or not, after volar locked plating of a distal radial fracture. The patients, the assessor, the primary investigator, and the statistician were blinded to the allocation. Randomization was irreversibly performed using a web application that guaranteed a secure and tamper-free assignment. The primary outcome measure was the Patient Rated Wrist Evaluation (PRWE) after 12 months. Secondary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH) score, pronation strength, grip strength, the range of pronation and supination, complications, and the operating time.Aims
Patients and Methods
1. A series of 106 central slip
The August 2012 Hip &
Pelvis Roundup. 360. looks at: whether cemented hip replacement might be bad for your health; highly cross-linked polyethylene; iHOT-33 - a new hip outcome measure; hamstring
The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were includedAims
Patients and Methods
Construction of a functional skeleton is accomplished
through co-ordination of the developmental processes of chondrogenesis,
osteogenesis, and synovial joint formation. Infants whose movement in
utero is reduced or restricted and who subsequently suffer
from joint dysplasia (including joint contractures) and thin hypo-mineralised
bones, demonstrate that embryonic movement is crucial for appropriate
skeletogenesis. This has been confirmed in mouse, chick, and zebrafish
animal models, where reduced or eliminated movement consistently yields
similar malformations and which provide the possibility of experimentation
to uncover the precise disturbances and the mechanisms by which
movement impacts molecular regulation. Molecular genetic studies have
shown the important roles played by cell communication signalling
pathways, namely Wnt, Hedgehog, and transforming growth factor-beta/bone
morphogenetic protein. These pathways regulate cell behaviours such
as proliferation and differentiation to control maturation of the
skeletal elements, and are affected when movement is altered. Cell
contacts to the extra-cellular matrix as well as the cytoskeleton
offer a means of mechanotransduction which could integrate mechanical
cues with genetic regulation. Indeed, expression of cytoskeletal
genes has been shown to be affected by immobilisation. In addition
to furthering our understanding of a fundamental aspect of cell control
and differentiation during development, research in this area is
applicable to the engineering of stable skeletal tissues from stem
cells, which relies on an understanding of developmental mechanisms
including genetic and physical criteria. A deeper understanding
of how movement affects skeletogenesis therefore has broader implications
for regenerative therapeutics for
We describe the outcome of tibial diaphyseal
fractures in the elderly (≥ 65 years of age). We prospectively followed 233
fractures in 225 elderly patients over a minimum ten-year period.
Demographic and descriptive data were acquired from a prospective
trauma database. Mortality status was obtained from the General
Register Office database for Scotland. Diaphyseal fractures of the
tibia in the elderly occurred predominantly in women (73%) and after
a fall (61%). During the study period the incidence of these fractures
decreased, nearly halving in number. The 120-day and one-year unadjusted
mortality rates were 17% and 27%, respectively, and were significantly
greater in patients with an open fracture (p <
0.001). The overall
standardised mortality ratio (SMR) was significantly increased (SMR
4.4, p <
0.001) relative to the population at risk, and was greatest
for elderly women (SMR 8.1, p <
0.001). These frailer patients
had more severe
Bicondylar tibial plateau fractures result from
high-energy