Open Ankle Arthrodesis: a Systematic Review of Approaches and Fixation Methods.

Background: Open ankle arthrodesis (OAA) remains the most widely used operation in end-stage ankle osteoarthritis. However, there is a large variation in terms of approach and fixation methods. The aim of this systematic review was to assess the effect of different approaches and fixation methods on the union rate, complication rate and functional outcome in OAA.

Midfoot Charcot Neuro-arthropathy Precipitated by First or Fifth ray Amputation.

Background: Charcot Neuro-arthropathy (CN) can occur spontaneously in a neuropathic foot but is often precipitated by an insult to the foot, such as trauma. We noted an association between 1st and 5th ray amputations and the development of midfoot CN in our clinics. We therefore set out to analyse our data over a 6-year period to evaluate and improve our practice.

An Approach to Managing Midfoot Charcot Deformities.

We present an approach to managing complex deformities in Charcot neuroarthropathy that typically present around the midfoot. This approach follows a stepwise progression from prevention, early detection, nonoperative through to operative management. It centers on multidisciplinary care with input from diabetologists, orthotists, plaster technicians, physiotherapists, orthopedic, vascular, and/or plastic surgeons.

How well do we reduce ankle fractures intra-operatively: A retrospective 1 year review using Pettrone's criteria.

Introduction: Ankle ORIF is a common orthopaedic procedure. Assessment of the reduction is often performed by 'eyeballing' the intra-operative images.

Aims: This study aimed to assess the radiographic reduction of all ankle fracture ORIFs at COCH over a 1-year period using Pettrone's criteria METHOD: Using the trauma database at the COCH all patients admitted for ankle ORIF over a 1 year period (n = 284) were identified.

Pain and outcomes of carpal tunnel release under local anaesthetic with or without a tourniquet: a randomized controlled trial.

Unlabelled: We conducted a prospective randomized controlled trial to investigate carpal tunnel decompression under local anaesthesia. Carpal tunnel decompression was performed in 37 wrists using local anaesthesia and an arm tourniquet and 36 without tourniquet but with a local anaesthetic mixture containing adrenaline. Patients who underwent carpal tunnel decompression using a tourniquet experienced a significantly greater degree of pain when compared with those who did not have a tourniquet.

The Ntcheu derotation splint for lower limb traction.

The Ntcheu derotation splint is recommended as a tool to improve the care of patients in lower limb traction. It avoids the various problems associated with the traditional plaster boot that is routinely used (stiffness, pressure sores, cost and time). It is easy to make, is relatively low cost and uses widely available materials.

The management of isolated closed femoral shaft fractures in a district hospital in Malawi.

Unlabelled: We prospectively studied the inpatient management of closed femoral shaft fractures in adults over 10 months at Ntcheu District Hospital, Malawi.

Results: We had 20 patients, who stayed for an average of 46 days in hospital. The average time to apply traction was 2.

Management of a tibial periprosthetic fracture following revision knee arthroplasty using a pulsed electromagnetic field stimulation device: a case report.

Periprosthetic fractures associated with total knee arthroplasty are rare but present a challenging problem particularly when associated with revision arthroplasty. Fractures around tibial stems are particularly difficult with no accepted technique in their management. This case describes a tibial periprosthetic fracture following a revision knee arthroplasty which was successfully managed with a Pulsed ElectroMagnetic Field bone stimulation device.

Tibial nerve impingement secondary to posterior cement extrusion after unicompartmental knee arthroplasty.

Unicompartmental knee replacements have become increasingly popular with improved survivorship and clinical results. This has been combined with minimally invasive surgery to further improve patient recovery and rehabilitation. Despite improved instrumentation, it remains a technically demanding procedure.

Clinical audit of the management of stable ankle fractures.

Introduction: Ankle fractures are common and 'stable' ankle fractures comprise 40-75% of this group. Studies show that these injuries can be managed successfully in a functional brace, with no need for further radiographs and minimal out-patient follow-up. We aimed to audit current practice and introduce change in order to improve treatment and produce financial savings.