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Caliper measurement of the excised femoral head is a standard technique for determination of prosthetic head size during hemiarthroplasty for displaced femoral neck fractures.To evaluate the accuracy of the caliper method of hemiarthroplasty head sizing by comparing it to the native joint congruency (JC) at the weight bearing surface.The diameters of femoral heads in 10 cadaver hip joints were measured...
Interaction between humans and wild animals has increased in recent times, because of overlap of habitats. A proportion of this interaction is violent. Most of the literature describing the injuries sustained by humans in such contact pertains to the involvement of soft tissues. Trauma to bones and joints is only witnessed when larger animals attack humans. We studied the pattern of orthopaedic injuries...
Outcome measures following hip fracture usually consider morbidity and mortality follwing injury. 5 Few studies have looked at post injury discharge location as an outcome measure following hip fracture. Discharging patients to a different location frequently delays discharge whilst the necessary social arrangements are made. Early identification of these patients could reduce these delays...
One of the most demanding steps of an intramedullary nailing is the distal locking. The aim of this study is to evaluate clinically and prospectively a new targeting guide. Twenty-five patients were treated consecutively in two different trauma centres (level one and one general hospital) by two different surgeons who were instructed on using the new device. Reduction of the fracture, intramedullary...
Intra-articular fractures of the tibial plafond are complex injuries which continue to challenge orthopaedic surgeons in achieving anatomic reduction, while allowing early weight bearing and return to activity. Although a wide range of treatment options has been described for fixation of pilon fractures, the unique characteristic of each injury makes it difficult to advocate a general method of choice...
Failure of a dynamic hip screw (DHS) fixation leads to decreased mobility of the patient and frequently to a decrease in general health. The most common mode of failure of a DHS is cut out of the lag screw from the femoral head. The second most common mode of failure is lift-off of the plate from the femur. The aim of this laboratory-based experimental study was to determine whether a DHS secured...
The nonagenarian population is increasing yet there is little known about their survival and mortality rates following hip fractures. The aim was to review and evaluate all the nonagenarians who underwent surgery for intra- or extracapsular hip fracture at the Trauma Unit of the Department of Surgery at the Academic Medical Center (AMC) in Amsterdam in the past 20 years. In this retrospective study,...
Development of pressure sores during hospital admission causes morbidity and distress to the patient, increases strain on nursing resources, delaying discharge and possibly increasing mortality. A hip fracture in elderly patients is a known high-risk factor for development of pressure sores. We aimed to determine the current incidence of pressure sores and identify those factors which were associated...
Replantation is the treatment of choice for traumatic amputation. Its success rates vary, reaching 80% in world's best centres. This study analyses management practices of replantation in a regional centre in a developing country. Out of six replantations, four were successful. The median warm ischaemia time of the severed limb was 4.5h (range 1–13.5) and the median duration of general anaesthesia...
High energy pilon fractures present a unique challenge to the patient and orthopaedic surgeon. Care for the soft tissue envelope is as important as management of this articular fracture. This article reviews the fundamental principles for treatment of the patient with severe pilon fracture. Staged operative care is emphasised to prevent wound and infectious complications which have historically plagued...
We report the results of 52 patients aged 20–55 years with displaced femoral neck fractures, in whom delayed closed reduction and internal fixation was performed. Seven patients developed avascular necrosis (AVN) and non-union was seen in five patients. Whereas most patients with non-union were subjected to repeat procedures, none of the patients with AVN required surgery.The follow-up averaged 40...
Obtaining stable fixation in cases of long bone non-union with segmental bone defects can be challenging. Bone quality is often sub-optimal. Locking plates and structural allografts have both been used clinically in these cases. The objective of this study was to determine the biomechanical characteristics of three constructs that have been employed in this context.A biomechanical study was performed...
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