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Physical examination of the foot and ankle by orthopaedic and accident and emergency clinicians [Injury 2009;40(2):136–8]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We thank Mr Borland for his comments. We agree that a sound knowledge of limb anatomy is of interest to the vast majority of doctors and not just orthopaedic surgeons. Mr Borland says that 60% of undergraduates will end up as general practitioners, we would argue that a significant amount of a general practitioner's workload are “musculoskeletal” related problems and so it is of utmost importance that they have a good knowledge of limb anatomy to provide good patient care. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Andy Roche, Dan Brown Tags: Correspondence Source Type: journals

Are we failing our students?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I read the study performed by Roche et al. published in February's edition with great interest. As a medical student I was assured that due to the ‘modernisation’ of undergraduate medical training, the focus of study would be less on basic science and more on applied clinical knowledge. As a result I failed to learn much about the anatomy of the human body which was not within the torso. But of course that was fine as 60% of us would go on to be general practitioners and would not need such unimportant facts cluttering up our brains. Of course, as irony would have it, 40% have not gone on to be GPs and found that study...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Steve Borland Tags: Correspondence Source Type: journals

Reconstruction of finger-pulp defect with a homodigital laterodorsal fasciocutaneous flap distally based on the dorsal branches of the proper palmar digital arteryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The homodigital laterodorsal fasciocutaneous flap based on the dorsal branch of the proper palmar digital artery is an ideal alternative to reconstruct the finger-pulp for single-stage reconstruction without sacrificing the proper palmar digital artery and nerve. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Meng Xianyu, Chen Lei, Lu Laijin, Liu Zhigang Tags: Articles Source Type: journals

Learning the lessons from conflict: Pre-hospital cervical spine stabilisation following ballistic neck traumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Penetrating ballistic trauma to the neck is associated with a high mortality rate. Our data suggests that it is very unlikely that penetrating ballistic trauma to the neck will result in an unstable cervical spine in survivors. In a hazardous environment (e.g. shooting incidents or terrorist bombings), the risk/benefit ratio of mandatory spinal immobilisation is unfavourable and may place medical teams at prolonged risk. In addition cervical collars may hide potential life-threatening conditions. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Arul Ramasamy, Mark Midwinter, Peter Mahoney, Jon Clasper Tags: Articles Source Type: journals

Factors affecting results of patients with humeral proximal end fractures undergoing primary hemiarthroplasty: A retrospective study in 42 patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Aim: Our study reports long-term results and factors related to patient satisfaction in the case of primary hemiarthroplasty for humeral proximal end fractures.Patients and methods: We retrospectively evaluated 42 patients with humeral proximal end fractures who underwent primary hemiarthroplasty in our clinic from February 1994 to March 2004. Of the 42 patients, 14 (33%) were male and 28 (67%) female. The mean age was 68.9±5.57 years (age range: 59–81 years). The mean follow-up period was 78.8±26.6 months (range: 48–118 months). We evaluated the following parameters: fracture type according to the Neer cla...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Erdinç Esen, Yunus Doğramacı, Serap Gültekin, Mehmet Ali Deveci, Fatih Suluova, Ulunay Kanatlı, Selçuk Bölükbaşı Tags: Articles Source Type: journals

Removal of erythropoietin from anaemia trauma practice guideline does not increase red blood cell transfusions and decreases hospital utilization costsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Introduction: We previously demonstrated that utilization of erythropoietin (r-EPO) did not significantly reduce blood utilization in trauma patients. We undertook this study to analyze blood utilization 1 year after r-EPO removal from our trauma service anaemia practice management guideline.Methods: Electronic records of patients admitted to the trauma service were retrospectively reviewed for units of packed red blood cells (pRBCs) transfused and for units of r-EPO administered 12 months before the initiation of an anaemia practice guideline (PRE), 12 months during the use of an anaemia guideline (GUIDE), and 1...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: A. Britton Christmas, Steven M. Camp, M. Craig Barrett, Thomas M. Schmelzer, H. James Norton, Toan T. Huynh, Michael H. Thomason, Ronald F. Sing Tags: Articles Source Type: journals

Recovery of brachial plexus injury after shoulder dislocationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Brachial plexus injury is an underestimated complication from anterior dislocation of the shoulder. To our knowledge, there is limited information available about the factors that influence neurological recovery of this injury. We reviewed 15 upper extremities in 14 patients with brachial plexus injuries caused by anterior shoulder dislocation. Two-thirds of the cases had total brachial plexus palsy. With the conservative treatment, the motor recoveries of all cases are full or nearly full within 20 months except intrinsic muscle of the hand. Intrinsic muscle recovery may be better in a younger age group (less th...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Arkaphat Kosiyatrakul, Surasak Jitprapaikulsarn, Sebastein Durand, Christophe Oberlin Tags: Articles Source Type: journals

Ulnar artery distal cutaneous descending branch as free flap in hand reconstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: These authors aimed to evaluate the method and therapeutic effects of surgical hand-wound repair using free vascularised flaps based on the descending ramus of the above-wrist cutaneous branch of the ulnar artery. We retrospectively reviewed records of 75 patients with 79 finger defects who had received hand surgery between January 2001 and December 2007. Soft-tissue defects of the hand were repaired using free flaps with the descending ramus of the above-wrist cutaneous branch of the ulnar artery as the vascular pedicle. Intra-operative and postoperative variations in vascular anatomy were observed and surgical o...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: J.U. Jihui, Yuefei Liu, Ruixing Hou Tags: Articles Source Type: journals

The incidence of scaphoid fracture in a military populationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion/conclusions: When compared to the previous data on scaphoid fractures, our study showed a greater incidence of scaphoid fracture at 1.21/1000 person-years in the US military population. These data are derived from a large database which effectively captures the population at risk. Males, the younger age group and the white race were associated with higher rates of scaphoid injury in this specialised military population. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Jennifer Moriatis Wolf, Laura Dawson, Sally B. Mountcastle, Brett D. Owens Tags: Articles Source Type: journals

Factors affecting infection after calcaneal fracture fixationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: A retrospective study of 178 operatively managed intra-articular calcaneal fractures was undertaken. The primary purpose of the study was to investigate whether delay prior to surgery was related to the prevalence of post-operative deep infection although other factors related to infection were also examined.The deep infection rate was 5.6% but there was no statistical correlation between surgical delay and deep infection. However analysis of the results showed that surgical experience did correlate with deep infection. The infection rate for a group of inexperienced surgeons was 14.3% compared with 2.8% for the ...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Charles M. Court-Brown, Matthias Schmidt, Bernard G. Schutte Tags: Articles Source Type: journals

Treatment of unstable distal clavicle fractures using two suture anchors and suture tension bandsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Coracoclavicular reconstruction using two suture anchors and supplementary interfragmentary fixation using two non-absorbable suture tension bands for acute distal clavicle fracture are reliable techniques for restoring stability in patients with acute distal clavicle fracture. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Sang-Jin Shin, Kwon Jae Roh, Jong Oh Kim, Hoon-Sang Sohn Tags: Articles Source Type: journals

Prospective analysis of a new minimally invasive technique for paediatric Gartland type III supracondylar fracture of the humerusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Minimally invasive surgery with the assistance of mosquito forceps for the reduction of severely displaced supracondylar fracture of the humerus in children was shown to be a safe and effective alternative method. The final functional outcome was the same as that of the standard technique. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Yi-An Li, Pi-Chang Lee, Wei-Tso Chia, Huai-Jen Lin, Fang-Yao Chiu, Tain-Hsiung Chen, Chi-Kuang Feng Tags: Articles Source Type: journals

Complications when using threaded K-wire fixation for displaced intra-articular calcaneal fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: A retrospective chart review was performed on patients treated at a level one trauma centre for displaced intra-articular calcaneal fractures by a single trauma surgeon between January 1998 and July 2007. Patients were treated with open reduction and internal fixation utilising the extended lateral incision and a new type of fixation not described before. Threaded 1.575mm (0.062in.) Kirschner wires (K-wires) were used for fixation post-operatively along with standard plates, screws and bone substitute.There were 278 fractures in 246 patients that were treated with ORIF for displaced intra-articular calcaneal frac...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: A. Ross Demcoe, Marieke Verhulsdonk, Richard E. Buckley Tags: Articles Source Type: journals

Mid-term results of internal fixation of proximal humeral fractures with the Philos plateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Internal fixation with the Philos plate seems to be a reliable option in the operative treatment of upper end humeral fractures, especially in osteoporotic bone. It allows secure fracture fixation and quick shoulder mobilisation, while quick and uneventful fracture healing and very satisfactory clinical results are achieved. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Periklis Papadopoulos, Dimitrios Karataglis, Stavros I. Stavridis, George Petsatodis, Anastasios Christodoulou Tags: Articles Source Type: journals

Percutaneous plating in paediatric tibial fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Background: Although non-operative treatment is a mainstay of tibial fracture management in children, certain fractures require a surgical approach. However, choices concerning optimal methods and implants are difficult. The purpose of this study was to determine the effectiveness of percutaneous plating of tibial fractures in children.Materials and methods: Sixteen tibial fractures treated using the percutaneous plating technique between 2000 and 2007 were reviewed. The mean age at operation was 10 years 9 months (range: 6–16 years). There were eight open and closed fractures each. Operative indications were a...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Nazri Mohd Yusof, Chang-Wug Oh, Jong-Keon Oh, Joon-Woo Kim, Woo-Kie Min, Il-Hyung Park, Hee-June Kim Tags: Articles Source Type: journals

Three-dimensional computed tomography imaging increases the reliability of classification systems for tibial plateau fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Three-dimensional CT is a more reliable radiographic modality than 2D CT in evaluation of fracture patterns in tibial plateau fractures. This finding seems to show that more sophisticated imaging techniques can improve the reliability of fracture classification systems. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Yan-Ling Hu, Fa-Gang Ye, Ai-Yu Ji, Guang-Xi Qiao, Hai-Fei Liu Tags: Articles Source Type: journals

Volar locking plates versus Kirschner wires for distal radial fractures—A cost analysis studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: With use of a locked volar plate for patients under the age of 70 years there is a loss of £652 for the Trust with the present NHS tariffs. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Gunaratnam Shyamalan, Chris Theokli, Yemi Pearse, Duncan Tennent Tags: Articles Source Type: journals

Injuries sustained at a temporary ice-skating rink: Prospective study of the Winchester experience 2007–2008Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was undertaken to assess, prospectively, the workload created as a consequence of ice-rink injuries, when the facility was reopened over Christmas 2007.All patients attending from the ice-rink were included and their injuries reviewed. Costs of care were calculated based on ED attendance, out-patient appointments (OPA's), radiography, plaster immobilisation and government tariffs for surgical procedures.The ice-rink was open for 39 days welcoming 43,000 skaters. Sixty-two accidents were recorded in the accident book, 43 attended the ED. Radiographic investigation was necessary for 31 patients. Nineteen had diagn...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: N.K.R. Kelsall, G.W. Bowyer Tags: Articles Source Type: journals

A health economic analysis of the use of rhBMP-2 in Gustilo–Anderson grade III open tibial fractures for the UK, Germany, and FranceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The purpose of this study was to determine the cost savings from a societal perspective for recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) in grade III A and B open tibial fractures treated with a locked intramedullary nail and soft-tissue management in the UK, Germany, and France. Health care system costs (direct health care costs) and costs for productivity losses (indirect health care costs) were calculated using the raw data from the Bone Morphogenetic Protein Evaluation Group in Surgery for Tibial Trauma “BESTT study”. Return-to-work time for estimation of productivity losses was assumed to cor...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Volker Alt, Simon T. Donell, Amit Chhabra, Anthony Bentley, Alexander Eicher, Reinhard Schnettler Tags: Articles Source Type: journals

Examination tests predictive of bone injury in patients with clinically suspected occult scaphoid fractureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The two above-mentioned manoeuvres were most indicative of bone injury in patients with clinically suspected occult scaphoid fracture. These examinations may reduce the number of unnecessary MRI examinations. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Koray Unay, Bahadir Gokcen, Korhan Ozkan, Oguz Poyanli, Engin Eceviz Tags: Articles Source Type: journals

Fresh-frozen vs. irradiated allograft bone in orthopaedic reconstructive surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The use of allograft bone is increasingly common in orthopaedic reconstruction procedures. The optimal method of preparation of allograft bone is subject of great debate. Proponents of fresh-frozen graft cite improved biological and biomechanical characteristics relative to irradiated material, whereas fear of bacterial or viral transmission warrants some to favour irradiated graft. Careful review of the literature is necessary to appreciate the influence of processing techniques on bone quality. Whereas limited clinical trials are available to govern the selection of appropriate bone graft, this review presents ...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: D.J. Costain, R.W. Crawford Tags: Reviews Source Type: journals

Maxillofacial trauma—Developments, innovations and controversiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Despite seat belt and alcohol legislation, craniofacial trauma still remains a common health problem and significant workload in many maxillofacial units. Although management has evolved considerably from “wiring teeth together”, complex fractures can still result in cosmetic and functional deformity. Today's challenge is to consistently restore patients back to their pre-injury form and function—but this is not always possible. Greater understanding and developments have significantly improved outcomes, although controversy still exists in some areas. This review outlines some of these topics. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Michael Perry Tags: Reviews Source Type: journals

Management, complications and clinical results of femoral head fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: A systematic review of the literature was conducted to investigate data regarding femoral head fractures, particularly focusing on their management, complications and clinical results.Twenty-nine eligible articles, meeting prespecified inclusion criteria, reported on 453 femoral head fractures in 450 patients (mean age of 38.9 years with a mean follow-up of 55.6 months). 84.3% of patients had been victims of an automobile accident. The most widespread classification scheme used was that of Pipkin (65.4% of cases) whereas clinical results were evaluated mainly according to Thompson–Epstein criteria (63.3% of cas...
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: P.V. Giannoudis, G. Kontakis, Z. Christoforakis, M. Akula, T. Tosounidis, C. Koutras Tags: Reviews Source Type: journals

Fracture healing and bone regeneration: Autologous bone grafting or BMPs?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In 1915, autologous bone grafting was introduced as a useful surgical technique in the clinical setting. It was not long before its efficacy and safety was recognised and nowadays it is no surprise that over half a million graft harvesting procedures are performed annually in the USA. Common autologous bone graft harvesting sites include the pelvis (anterior/posterior iliac crest), proximal tibia, femur, and distal radius. (Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Authors: Peter V. Giannoudis Tags: Editorial Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Injury)
Source: Injury - November 19, 2009 Category: Orthopaedics Source Type: journals

Subacromial widening osteotomy of the scapular spine: Surgical technique and literature reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Scapular fractures are usually treated non-operatively with short-term sling immobilisation and early active motion. However, some patterns of fracture require surgical reduction and internal fixation with plates and screws. These fracture patterns are rare, and there are few reports regarding long-term outcome of non-operative treatment or the management of the severe malunion which may follow. The definition of malunion is related to fracture type (spine, glenoid neck). We have found no relevant epidemiological data in the literature. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Nicola Lollino, Francesco Caranzano, Paolo Paladini, Fabrizio Campi, Giuseppe Porcellini Tags: Technical Notes Source Type: journals

The invention of the Balkan beam frameEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conventional orthopaedic treatment of long bone fractures often employed an elaborate framework of heavy weights and cables to apply tension and to suspend limbs in an effort to maintain fractured bones under constant longitudinal traction of the limb held suspended and in a semiflexed position. As the limb was kept semiflexed, lesser weights were needed than when the knee was kept extended, therefore eliminating the risks of muscular atrophy and articular laxities. The suspended-semiflexed-traction position allowed the surgeon to continuously monitor the position and any wounds of the fractured limb, which is constantly k...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Andrea Emilio Salvi, Igor Dakovic, Steven Adam Hacking Tags: Technical Notes Source Type: journals

Surgical techniques: how I do it? The Reamer/Irrigator/Aspirator (RIA) SystemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present our current approach to the use of the RIA system, including the preoperative planning, the details of the operative procedure, the pitfalls and the potential complications that could be encountered. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: P.V. Giannoudis, C. Tzioupis, J. Green Tags: Articles Source Type: journals

The national clinical audit of falls and bone health: The clinical management of hip fracture patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: There are currently unacceptable wide variations in the delivery of clinical care to older people presenting with a #NOF. Of concern were the long lengths of time in A&E for many patients and the low level of routine access to pre-operative medical assessment. It is hoped that the launch of joint initiatives between the British Orthopaedic Association and the British Geriatric Society aimed at delivering service improvements in this area should lead to improved outcomes. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Jane Youde, Janet Husk, Derek Lowe, Robert Grant, Jonathan Potter, Finbarr Martin Tags: Articles Source Type: journals

Management of infected femoral nonunions with a single-staged protocol utilizing internal fixationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The results of this study indicate that our standard protocol for treatment of infected nonunion of the shaft of the femur is reliable at obtaining fracture union with a good functional result, while resolving infection despite the reliance upon internal fixation. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Mark L. Prasarn, Jaimo Ahn, Timothy Achor, Paul Matuszewski, Dean G. Lorich, David L. Helfet Tags: Articles Source Type: journals

Incidence of traumatic long-bone fractures requiring in-hospital management: A prospective age- and gender-specific analysis of 4890 fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Background: Musculoskeletal trauma represents a considerable global health burden; however, reliable population-based incidence data are lacking. Thus, we prospectively investigated the age- and sex-specific incidence patterns of long-bone fractures in a defined population.Methods: A 4-year prospective study of all long-bone fractures in a defined Norwegian population was carried out. The demographic data, as well as data on fracture type and location and mode of treatment were collected using recognised classification (e.g., AO/OTA – Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association; ...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Terje Meling, Knut Harboe, Kjetil Søreide Tags: Articles Source Type: journals

Musculoskeletal injuries in break-dancersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Background: Since no epidemiologic studies have been reported about musculoskeletal injuries in break-dancers, there are no data on the rates and patterns of musculoskeletal injuries in this population that clinicians can use to find ways to decrease injury rate.Hypothesis: We believe that the incidence of injuries in break-dancers is higher than assumed and that injury rates and patterns differ between professional and amateur dancers.Study design: Descriptive epidemiologic study.Materials and methods: Of a total of 42 study subjects, 23 were professional dancers and 19 were amateur dancers. Injury frequency, si...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Chul Hyun Cho, Kwang Soon Song, Byung Woo Min, Sung Moon Lee, Hyuk Won Chang, Dae Seup Eum Tags: Articles Source Type: journals

Outcome and complications of treatment of ankle diastasis with tightrope fixationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Fixation of ankle syndesmosis injury with a fibre-wire tightrope has previously been reported. Early clinical results indicate that it can remain in situ indefinitely without complications. We are the first to report complications with the use of this device. Six patients were treated for ankle diastasis using the tightrope. These included four Weber C fractures, one Maisonneuve fracture and one isolated diastasis without fracture. Fractures were treated according to AO-ASIF principles and the tightrope applied through a plate in three cases and directly through the fibula in three cases. In two cases the device ...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: H.J.S. Willmott, B. Singh, L.A. David Tags: Articles Source Type: journals

FiberWire® is superior in strength to stainless steel wire for tension band fixation of transverse patellar fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Background: The metal implants used to achieve fixation of displaced transverse patellar fractures are associated with implant failure, postoperative pain and a significant re-operation rate. Recent studies have examined braided suture as a possible alternative to stainless steel wire to increase patient satisfaction and decrease re-operation rates, but suture has not demonstrated clearly superior fixation strength. FiberWire® is a reinforced braided polyblend suture that has demonstrated superior characteristics to the previous sutures studied and has not to our knowledge been examined as a material for tension...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: P.B. Wright, V. Kosmopoulos, R.E. Coté, T.J. Tayag, A.D. Nana Tags: Articles Source Type: journals

Motorcyclist “biker couples”: A descriptive analysis of orthopaedic and non-orthopaedic injuriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The term “biker couple” is becoming an increasingly common site in emergency departments. The purpose of this study was to identify orthopaedic and non-orthopaedic injury patterns among this unique patient group. A 14-year (1993–2006) retrospective review of a Level I Trauma Institute Registry was performed. Patient demographic and injury data were obtained from 21 confirmed biker couples (n=42). Nineteen of 21 biker couple pairs (90.5%) included a male driver and a female passenger. Drivers were more likely to have a positive blood alcohol concentration/toxicology test. Drivers had a greater incidence of s...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Joshua Murphy, John Nyland, Jacob Lantry, Craig Roberts Tags: Articles Source Type: journals

The role of LISS (less invasive stabilisation system) in the treatment of peri-knee fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The purpose of present study was to evaluate the role of LISS after a large series of patients in whom a fracture around the knee had been treated with this uniform technique. Between April 2004 and September 2006, 210 patients with a total of 216 fractures around the knee were treated with LISS, all at the Affiliated Hospital to Nantong University. Patients were followed for a mean of 27 months (range 12–42 months). 26 patients were excluded from the study. The remaining 184 patients with a total of 189 fractures of either distal femur (85 cases) or proximal tibia (104 cases) were available for analysis. The m...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Fan Liu, Ran Tao, Yi Cao, Youhua Wang, Zhenyu Zhou, Hong Wang, Yongqiang Gu Tags: Articles Source Type: journals

Isolated locked compression plating for Vancouver Type B1 periprosthetic femoral fracturesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Open reduction internal fixation of Vancouver Type B1 periprosthetic femoral fractures using a lateral locked-plate that spans the full extent of the femur as the sole method of stabilisation is a successful treatment method that minimises soft-tissue dissection and provides adequate fixation strength to maintain fracture alignment to fracture union. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Ginger K. Bryant, Saam Morshed, Julie Agel, M. Bradford Henley, David P. Barei, Lisa A. Taitsman, Sean E. Nork Tags: Articles Source Type: journals

Bolt fixation for syndesmotic injuriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: We performed a retrospective study of 28 patients who underwent bolt fixation for a syndesmotic injury to the ankle. The mean follow-up period was 66 months (range: 24–139 months). The results of surgery were assessed clinically and radiographically. Overall, this fixation device was found to adequately stabilise the syndesmosis during healing. Radiologically accurate syndesmosis reduction was achieved in 26 patients. The mean AOFAS score was 86 (range: 33–100). The majority of patients were very satisfied with the overall result. It is a simple and quick operative procedure providing reliable syndesmotic red...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: J. De Vil, F. Bonte, H. Claes, W. Bongaerts, K. Verstraete, R. Verdonk Tags: Articles Source Type: journals

Mechanical testing of different hip protectors according to a European StandardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion: This is the first study using a standardised mechanical test on hip protectors and allows an objective comparison because only mechanical properties are tested. New hip protectors with improved mechanical properties are superior to conventional hip protectors. Furthermore, they allow a more appealing design that increases the comfort of the wearer. Mechanical testing should be performed as a first step and has to be followed up by clinical trials to determine and clarify their overall effect. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Lukas A. Holzer, Gobert von Skrbensky, Gerold Holzer Tags: Articles Source Type: journals

“Challenges in the management of fractures in osteopetrosis”! Review of literature and technical tips learned from long-term management of seven patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present an account of seven patients treated for various fracture related problems occurring throughout their life due to this disease. Difficulties encountered during their treatment prompted us to present some general management principles. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Amit Bhargava, Manesh Vagela, C.M.E. Lennox Tags: Articles Source Type: journals

Does placing screws off-centre in tubular bone alter their pullout strength?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Screws are used to fix broken bones either directly or through plates. Surgeons sometimes find that a screw they have used is not quite in the centre of the bone but to one side or maybe even the edge. It has been postulated that screws catching the edge of the bone do not give good fixation and may even predispose to fractures.We conducted the present experiment using porcine femora to see if a screw's transverse plane position in the bone made any difference to its pullout strength. 20 cortical screws were inserted into the cortical segments of 5 pig femora (4 screws per femur) using the standard AO technique. ...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: A.V. Acharya, S.L. Evans Tags: Articles Source Type: journals

Morphological changes in the cervical intervertebral foramen dimensions with unilateral facet joint dislocationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The lack of change in nerve root area indicates that the associated nerve injury with unilateral facet joint dislocation is probably due to distraction rather than due to direct nerve root compression. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Nabil A. Ebraheim, Jiayong Liu, Satheesh K. Ramineni, Xiaochen Liu, Joe Xie, Ryan G. Hartman, Vijay K. Goel Tags: Articles Source Type: journals

Factors affecting the fracture healing in treatment of tibial shaft fractures with circular external fixatorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, our results indicate that non-union infection and not using supplementary fixation techniques are the major factors that delay the healing time. Supplementary fixation enhances the reduction rate and a low reduction score is related with the occurrence of a pin-track infection. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Kadir Bahadır Alemdaroğlu, Uğur Tiftikçi, Serkan İltar, Nevres Hürriyet Aydoğan, Talip Kara, Doğan Atlıhan, A. Sabri Ateşalp Tags: Articles Source Type: journals

Implant orthopaedic surgery in HIV asymptomatic carriers: Management and early outcomeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The authors conclude that if a prolonged prophylactic antibiotic therapy and systematic antiretroviral therapy are given to HIV immune-depressed carriers undergoing implant orthopaedic surgery, their post-operative infection risk may be close to that of non-HIV carriers. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: J. Bahebeck, D. Handy Eone, B. Ngo Nonga, T. Ndjie Kingue, M. Sosso Tags: Articles Source Type: journals

Avascular necrosis after internal fixation of intracapsular hip fractures; a study of the outcome for 1023 patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: We prospectively studied 1023 patients who sustained an intracapsular hip fracture that was treated with internal fixation using contemporary methods. The overall incidence of avascular necrosis (AVN) was 6.6%. AVN was less common for undisplaced (4.0%) than for displaced fractures (9.5%) and in men (4.9%) than women (11.4%) who had a displaced fracture. The incidence of AVN for those aged less than 60 years and who sustained a displaced fracture was 20.6%, compared to 12.5% for those aged 60–80 years and 2.5% for those aged more than 80 years. Our study showed an increased risk of AVN with younger age and in f...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: C.L. Loizou, M.J. Parker Tags: Articles Source Type: journals

Delayed operative treatment of syndesmotic instability. Current concepts reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In subacute (6 weeks to 6 months) total ruptures the focus is to restore the normal anatomy by repair of the ruptured ligament with placement of a syndesmotic screw. On base of the literature in combination with experience in clinical practice some guidelines are formulated. If inadequate remnants of the anterior inferior tibiofibular ligament (AITFL) are present, a tendon graft can be used. The insertion of the AITFL on the tibia can be medialised with a bone block and fixed with a screw. For the treatment of persistent widening and late instability these reconstruction techniques have to be used combined with...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Michel P.J. van den Bekerom, Peter A.J. de Leeuw, C. Niek van Dijk Tags: Reviews Source Type: journals

The Canadian Orthopaedic Trauma Society: A model for success in orthopaedic researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The Canadian Orthopaedic Trauma Society has been a promoter of multicentre research studies for more than a decade. From its modest beginnings, the group has grown to over 50 members who meet twice a year. The following article is a review of how the group developed to become a leader in level-one orthopaedic research.The success of the group stems from the respect and collaboration amongst the surgeons and research coordinators. This is most evident in the design of new studies. Surgeons and coordinators both have input into new protocols and this has been essential in designing protocols that are followed to co...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: Ross K. Leighton, Kelly Trask Tags: Reviews Source Type: journals

Payment by results (PbR) in orthopaedic trauma: Where are we losing?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Clinical coding has attracted significant interest recently as it has become synonymous with reimbursement. We hereby present the results of first and largest study in the UK involving 547 orthopaedic trauma cases wherein a meticulous in-depth analysis was performed. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: N.S. Harshavardhana, A. Sahu, S. Maret, A. Sangar, P. Jairaj, S.W. Richards Tags: BTS Winning Abstracts 2009 Source Type: journals

Lateral compression type I injuries of the pelvic ring: Are they mechanically stable?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Aim: To investigate whether lateral compression type I injuries of the pelvic ring are inheritably mechanically stable. Patients and methods: Between January 2005 to January 2007 all consecutive admissions of a tertiary referral center for pelvic ring reconstruction with a LCI injury pattern were eligible for inclusion. Exclusion criteria were other patterns of pelvic ring injuries. All patients underwent radiological assessment including AP pelvis, inlet/outlet views and CT. Patient demographics, mechanism of injury, other associated injuries, ISS, length of hospitalisation, type of operation, mode of mobilization, preop...
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: N.K. Kanakaris, C. Tzioupis, V.S. Nikolaou, P.V. Giannoudis Tags: BTS Winning Abstracts 2009 Source Type: journals

The presence and pattern of vascular insufficiency in the older patient suffering an unstable ankle fracture: The relationship to skin and wound complicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hypothesis: Impaired vascularity of the skin in elderly ankle fracture patients causes the skin and wound complications. Materials and methods: This is part of a RCT comparing ORIF and close contact casting (CCC) for isolated unstable ankle fractures in patients >60 years. Assessments over 6 months: (i) transcutaneous O2 saturation (TcPO2) of medial and lateral ankle skin, (ii) Ankle-Brachial Pressure Index (ABPI), (iii) 3-vessel arterial duplex scan, (iv) distal calf perforator artery patency. The uninjured limb was the control. (Source: Injury)
Source: Injury - October 5, 2009 Category: Orthopaedics Authors: K.M. Willett, B. Gray, S. Lamb, A. Handa, S. Lamb, R. Handley Tags: BTS Winning Abstracts 2009 Source Type: journals