Decision making on timing of surgery for hip fracture patients on clopidogrel.

Patients taking clopidogrel who sustain a fractured neck of femur pose a challenge to orthopaedic surgeons. The aim of this study was to determine whether delay to theatre for these patients affects drop in haemoglobin levels, need for blood transfusion, length of hospital stay and 30-day mortality. A retrospective review of all neck of femur patients admitted at two centres in the North East of England over 3 years revealed 85 patients.

Solitary osteochondroma of the trapezoid disguised as a tooth fragment.

Fight bite injuries of the hand are common presentations in A&E departments and usually result from a fist blow to the mouth. The authors report a case of a 24-year-old man who presented 6 weeks after an injury to his right wrist following an altercation. Radiographic examination and CT scans were in keeping with a tooth fragment embedded in the trapezoid.

The Best Practice Tariff helps improve management of neck of femur fractures: a completed audit loop.

Background: The Best Practice Tariff incentivizes hospitals in the UK to improve the care they deliver, and includes a requirement to deliver multiprofessional care to patients with neck of femur fractures. The Best Practice Tariff for 2010-11 included six targets: (1) surgery within 36 hours, (2) admission under consultant-led joint orthopaedic-geriatric care, (3) admission using a multidisciplinary assessment protocol, (4) review by a geriatrician within 72 hours, (5) geriatrician-directed multi-professional rehabilitation, and (6) assessment for falls and bone protection. The authors chose to audit their Trust's compliance with these targets.

A Review on the Management of Hip and Knee Osteoarthritis.

Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips.

Internal fixation of a traumatic fracture around a hip resurfacing arthroplasty using the proximal femoral locking compression plate.

We report on a 40-year-old man who sustained a traumatic extracapsular fracture of the proximal femur with a Birmingham Hip Resurfacing in situ. It was decided to retain the resurfacing implant and a proximal femoral periarticular locking compression plate (Synthes) was used to stabilise the fracture. The patient regained full range of pain-free movement, and was bearing his full weight on the operated leg by 18 weeks.