Do partial glenohumeral degenerative changes in patients undergoing arthroscopic rotator cuff repair influence clinical outcomes?

Background: The prognostic factors for patients with full-thickness rotator cuff tears (RCTs) include tear size, muscle atrophy and fatty infiltration. However, the influence of early coexisting degenerative changes on RCT outcomes is unappreciated. The purpose of this study was to calculate the impact that pre-existing partial glenohumeral cartilaginous changes have on patients undergoing arthroscopic RCT repair.

Outcome following management of unstable lateral end clavicle fractures with locking plate and coracoid anchor augmentation.

Background: Management of complex lateral end clavicle fractures with coraco-clavicular ligament disruption can be challenging.

Methods: We prospectively analysed 19 (17 M:2F) patients from January 2014 to June 2016. Six patients had intra-articular fractures (Edinburgh-3B2) and the remaining were extra-articular (3B1).

Management of open elbow fractures: experiences and outcomes from a UK major trauma center.

Hypothesis And Background: Open fractures about the elbow are an infrequent but complex injury with limited existing literature. The aims of the study were to review the treatment strategies of open elbows fractures, functional outcome and complication rates associated with the injury, and correlate the outcome with the topography of the fracture.

Methods: Patients (n = 21) with open elbow fractures injuries over a 2-year period were analyzed.

Outcomes of orthopaedic trauma patients undergoing surgery during the peak period of COVID-19 infection at a UK major trauma centre.

Background: To review the clinical outcomes of all patients undergoing emergency orthopaedic trauma surgery at a UK major trauma centre during the first 6 weeks of the COVID-19 related lockdown.

Methods: A retrospective review was performed of all patients who underwent emergency orthopaedic trauma surgery at a single urban major trauma centre over the first six-week period of national lockdown. Demographics, co-morbidities, injuries, injury severity scores, surgery, COVID-19 status, complications and mortalities were analysed.

Improving the efficiency of ankle fracture care through home care and day-surgery units: Delivering safe surgery on a value-based healthcare model.

Objectives: Preoperative home care for suitable patients with ankle fractures is becoming an increasingly common practice. It allows adequate time for reduction of ankle swelling following a decision to undertake operative fixation has been made. We aim to assess the safety, efficiency, cost-effectiveness and differences in clinical & patient outcomes of day surgery unit (DSU) care for ankle fracture treatment in selected patients.

Role of Wrist Arthroscopy in the Management of Established Scaphoid Nonunion.

Patients with scaphoid nonunion and wrist pain may have a wide spectrum of potential concomitant pathologies that may be diagnosed and potentially managed arthroscopically. The aim of this study is to assess the usefulness of wrist arthroscopy in the assessment and treatment of scaphoid nonunion and any associated injuries. We retrospectively reviewed 34 consecutive patients with established scaphoid nonunion between January 2006 and December 2012 who had undergone arthroscopic assessment.

Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial.

Background: Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. The use of immediate surgical fixation to manage this type of fracture has increased, despite insufficient evidence of improved outcomes over non-surgical management. The SWIFFT trial compared the clinical effectiveness of surgical fixation with cast immobilisation and early fixation of fractures that fail to unite in adults with scaphoid waist fractures displaced by 2 mm or less.

The staged management of gleno-humeral joint osteonecrosis in patients with haematological-induced disease-a cohort review.

Purpose: A formalised, universally accepted, radiological staging system of gleno-humeral joint osteonecrosis (ON) is lacking. Consequently, there is absence of a standardised management strategy. The aim is to propose a simple radiological staging system of gleno-humeral joint ON based on principles of the Association Research Circulation Osseous (ARCO) Society and review of clinical practice.

The high-risk polytrauma patient and inferior vena cava filter use.

Objectives: The aim of this study was to assess the impact on practice of vena cava filter insertion guidelines (Eastern Association for the Surgery of Trauma: practice management guidelines).

Design: The study was performed at a level 1 trauma centre with data from the 'Trauma Audit and Research Network' cross-referenced to hospital data.

Results: A total of 1138 specific 'high-risk' major trauma patients were identified over a 6-year period.

Intratendinous supraspinatus cyst as a cause of shoulder impingement.

We report the case of a 29-year-old gentleman with shoulder impingement. An articular-sided intratendinous supraspinatus cyst was identified as the cause of his symptoms. Arthroscopic cyst debridement resulted in a good outcome at 1-year follow-up.

Functional Outcomes Following Pilon Fractures of the Middle Phalanx Managed with the Ligamentotaxor External Fixator.

Background: The surgical aims in managing displaced intra-articular fractures of the base of the middle phalanx include early joint reduction, maintaining congruence and early mobilization. Achieving this can be a challenge. However dynamic external fixators offer a solution.

Scapular spine stress fractures: To fix or not to fix, our experience in a patient with bilateral fractures and review of the literature.

We report a case of bilateral scapular spine stress fracture, treated conservatively on one side and operatively on the other side. Besides, we performed a literature review to establish management options. A 61-year-old right-handed gentleman came to our clinic with acute on chronic deterioration of shoulder pain and loss of arm function.

Management of heterotopic ossification and restricted forearm rotation after tension band wiring for olecranon fracture.

A 32-year-old lady presented to our clinic with persistent painful restriction of her dominant forearm movements for three months after tension band wiring of olecranon. She had full elbow flexion and extension; however, her forearm rotations were restricted and painful. Investigations revealed prominent tips of the wire, eroding the radial tuberosity with heterotopic ossification between the radius and ulna.

An analysis of acromioclavicular joint morphology as a factor for shoulder impingement syndrome.

Background: The present study aimed to determine whether acromioclavicular (AC) joint morphology was a factor in the development of symptomatic impingement necessitating AC joint excision.

Methods: We performed a prospective cohort study on all patients undergoing AC joint excision for symptomatic joint pain unresponsive to conservative treatment between 2009 and 2011. This involved 106 consecutive patients (57 women, 49 men, average age 54 years, age range 33 to 76 years).

An analysis of partial width flexor tendon graft preparation on porcine models: the optimal split?

Partial width tendon grafts are commonly used in upper limb reconstructive surgery. Different techniques are described to harvest the graft including a "cheese wire" technique to split the tendon along its fibres with a filament. However no study has looked at the best material for this purpose.

Surgical repair of chronic tears of the hip abductor mechanism.

Lateral sided hip pain frequently presents to the orthopaedic clinic. The most common cause of this pain is trochanteric bursitis. This usually improves with conservative treatment.

Arthroscopic excision of sternoclavicular joint.

We report an unusual case of chronic inflammatory arthropathy involving the sternoclavicular joint. Arthroscopic debridement of the sternoclavicular joint cavity was accompanied with the arthroscopic excision of the medial end of clavicle. Twelve months post-surgery the patient is asymptomatic with no signs of recurrence and a full pain free range of movement.

Outcome of surgery in patients with painful dorsal wrist ganglia and arthroscopic confirmed ligament injury: a five-year follow-up.

We report the outcome of a five-year follow-up after wrist arthroscopy and excision of painful dorsal wrist ganglia. The findings at the time of surgery have previously been published. Patients responded to a validated postal questionnaire regarding ganglion recurrence, wrist pain and function.