The impact of reducing the femoral stem length in total hip arthroplasty during gait.

Aim: The length of the femoral stem in total hip arthroplasty (THA) is a practical consideration to prevent gait impairment. The aim of this study was to determine if reducing the femoral stem length in THA would lead to impaired gait biomechanics.

Methods: Patients uniformly with the same brand implant of differing lengths (100 mm vs 140-166 mm) were taken retrospectively from a prospective trial introducing a new short stem.

Evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool in a real-time simulation setting (Distributed Interactive Simulation): a randomized controlled trial.

Introduction: Working time regulations, senior led service delivery and increasing complexity of surgical technology has led to significant strains in surgical training. Additionally, the current COVID-19 pandemic has placed substantial limitations on surgical training worldwide. Contact free, remote, web-based, validated learning tools which are easily accessible and allows repeated, sustained practice are the need of the hour.

Supra-patellar nailing for isolated closed tibial shaft fractures: Medium term functional outcomes from an Academic Level 1 Trauma centre.

Aims The aim of this study was to assess functional outcome, at medium-term follow up, in patients undergoing intra-medullary nailing of tibial shaft fractures, using the supra-patellar approach. Materials and methods The study included patients with intra-medullary nailing, for diaphysial tibia fractures, between March 2013 to August 2015. An initial audit compared short-term functional outcomes at 15 months, between the supra and infra-patellar approaches, using a cohort of 20 patients (10 in each group).

A comparative study of 5 different antibiotic prophylaxis regimes in 4500 total knee replacements.

Aim: To compare the incidence of surgical site infection with different antibiotic regimes in elective total knee arthroplasty. We hypothesise that a single high dose of Teicoplanin and Gentamicin is as effective as other regimes.

Methods: A retrospective study of prospectively collected data on a total of 4500 elective knee replacements over a 9-year period was conducted in a district general hospital.

The unicompartmental knee is the preferred side in individuals with both a unicompartmental and total knee arthroplasty.

Purpose: To determine the preferred knee in patients with both one total and one unicompartmental knee arthroplasty.

Method: Patients simply with a unicompartmental (UKA) and total knee arthroplasty (TKA) on contralateral sides were retrospectively screened from three senior knee surgeon's logs over a 15 year period. Patients safe and free from other diseases to affect gait were approached.

Smartphones in orthopaedics: a decade of innovation.

Smartphones have become a mainstream feature in medicine since the introduction of the Apple iPhone in 2007. Over the last decade they have taken on increasing prominence with multiple uses in daily practice. They have long been used for group messaging and accessing patient's electronic records while mobile.

Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre.

Aim: To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a non-designer centre.

Methods: In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Post-operative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications.

Trauma simulation training: a randomized controlled trial -evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool.

Background and purpose - Cognitive task analysis (CTA) has been used extensively to train pilots and in other surgical specialties. However, the use of CTA within orthopedics is in its infancy. We evaluated the effectiveness of a novel CTA tool to improve understanding of the procedural steps in antegrade femoral intramedullary nailing.

Extensive gluteal haematoma after an intracapsular hip fracture in a patient on warfarin.

We describe a case of a patient on warfarin who developed an extensive haematoma after a hip hemiarthroplasty and was successfully treated with embolisation. This case highlights the importance of regular haematology input, careful consideration of a suitable surgical approach, close monitoring of postoperative wounds in patients on warfarin and the emerging role of embolisation.