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Despite the lack of robust evidence, numerous different “track and trigger” warning systems have been implemented. These have only been validated in an emergency medical admissions setting. The Modified Early Warning Score (MEWS) is the chosen track and trigger system used in the University Hospitals of Leicester trauma unit, but has not been validated in trauma patients. A considerable proportion...
Non-union occurs in 5–10% of all fractures and is caused by a variety of mechanical and biological factors. Stable fixation is essential and many authors recommend the addition of bone graft. Our aim was to evaluate the results of internal fixation using Judet decortication and compression plating for long bone fractures and assess the impact of bone grafting on union rates. Our study group comprised...
Distraction osteogenesis (DO) has been accepted as an effective technique for bone lengthening. However, the long treatment period and possible fibrous union or nonunion hampers its further clinical application. Bone regeneration in DO involves multiple stages of repair and coordinated action of multiple cell types. Consequently, it may be possible to enhance bone regeneration through treatment strategies...
Pertrochanteric fractures are a rising major health-care problem in the elderly and their operative stabilisation techniques are still under discussion. Furthermore, complications like cut-out are reported to be high and implant failure often is associated with poor bone quality. The PFNA ® with perforated blade offers a possibility for standardised cement augmentation using a polymethylmethacrylate...
Hoffa fractures represent coronal fractures of the femoral condyles. Isolated Hoffa fractures are rare and current management of these fractures is based on a few descriptions in literature. The goal of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment.A total of 18 isolated Hoffa fractures were identified during the study period...
Lower limb amputation (LLA) is life-changing surgery. Shorter residual limbs are known to place greater physiological strain on patients than longer residual limbs; however, there is ongoing debate as to whether through-knee amputations are preferable to above-knee amputations. This analysis aims to resolve this question by systematically collecting and pooling published and unpublished data on this...
We propose to look at the quality of performance metrics reporting in papers comparing two or more treatments. Our goal is to provide additional context in the focus on evidence-based medicine.We reviewed papers (1082 papers with 98 papers meeting the inclusion criteria) from four important orthopaedic journals published in 2009 to quantify and analyse the quality of papers reporting performance metrics,...
External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS ® Standard Fixator (4 joints) with the Orthofix ProCallus Fixator ® (2 joints), which differ in possibilities for adapting...
Complex tibial plateau fractures can be difficult to characterise on plain radiographs and two-dimensional computed tomography (2D CT). The present study evaluated whether three-dimensional computed tomography (3D CT) reconstructions can improve the reliability of complex tibial plateau fracture characterisation and classification.Forty-five consecutive intra-articular fractures of the tibial plateau...
The aim of the present study was to comparatively analyse certain outcome measures of open tibial fractures, stratified per grade of open injury and method of treatment. For this purpose, a systematic review of the English literature from 1990 until 2010 was undertaken, comprising 32 eligible articles reporting on 3060 open tibial fractures. Outcome measures included rates of union progress (early...
The advent of modern arthroscopic techniques has lead to widespread surgical repair of multiligament injuries of the knee. Although functional outcomes may be linked to the recovery of strength and range of movement, studies have failed to report objective measures of strength recovery. The primary aim of this study was to describe the recovery of isokinetic quadriceps and hamstrings’ strength. The...
Osteoporosis (OP) is one of the most prevalent metabolic bone disorders worldwide and it is associated with a higher incidence of fractures. The aim of this study was to identify OP as a risk factor for the development of nonunion.In a prospective database all patients aged >50 years with an acute fracture were screened for osteoporosis from September 13, 2004 till February 9, 2009. Bone mineral...
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