Patient reported outcomes after revision ankle fixation.

Background: Functional outcome following ankle fracture fixation is linked to the restoration of joint congruity, anatomic alignment and stability. If surgical fixation fails to achieve these goals, revision surgery may be indicated. This retrospective study aims to report a consecutive series of fourteen patients with a minimum of one year follow up after revision ankle fixation and describe CT scan based modified Pettrone score used to assess quality of primary fixation.

Circular frame versus reamed intramedullary tibial nail in the treatment of grade III open tibial diaphyseal fractures.

Background: Grade III open tibial diaphyseal fractures are challenging to treat and controversy exists on whether to treat them with an intramedullary nail (IMN) or a circular frame (CF). This study aims to compare outcomes for intramedullary nail and circular frame in the treatment of open tibial diaphyseal fractures.

Methodology: Retrospective study at a major trauma center of all patients admitted with a grade III open tibial diaphyseal fracture between January 2016 and January 2022.

Development of an intervention to support parents receiving treatment in psychiatric inpatient hospital using participatory design methods.

Introduction: When parents of dependent children are treated in psychiatric inpatient hospital, it typically involves separation of parent and child for the duration of treatment, which can be highly distressing to the dyad and can result in disruption to the parent-child relationship. Parents who have experienced hospitalisation have expressed a desire for their parenting identity to be recognized and appropriately engaged with during their treatment. This recognition includes provision of interventions which support them as parents to limit the impact of their mental health on their children.

Fracture-related infection: Analysis of healthcare utilisation and associated costs.

Aims: A consensus definition of fracture related infection (FRI) has been created with the aim of standardising diagnosis and eliminating heterogeneity that prevents accurate comparison between existing studies. FRI remains one of the most challenging complications in musculoskeletal trauma surgery and carries with it a significant cost burden. A review of UK finances has not been completed utilising consensus diagnostic criteria.

Routine, molecular point-of-care testing for SARS-CoV-2 and other respiratory viruses within an acute oncology service improves patient care.

Objectives: COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV-2, within an Acute Oncology Service (AOS).

Methods: This pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK.

Fluid shear stress affects the metabolic and toxicological response of the rainbow trout gill cell line RTgill-W1.

The Rainbow trout gill cell-line (RTgill-W1) has been accepted by the Organisation for Economic Co-operation and Development (OECD TG249) as a replacement for fish in acute toxicity tests. In these tests cells are exposed under static conditions. In contrast, in vivo, water moves over fish gills generating fluid shear stress (FSS) that alters cell physiology and response to toxicants.

Management of Open Ankle Fractures in Elderly Patients With a Fibula Nail is a Safe and Reliable Technique.

Background: Ankle fractures are becoming more common in the elderly and their management is frequently challenging. There is increasing evidence of good outcomes following fibula nail fixation in the management of ankle fractures. The use of a fibula nail in open fractures comes with potential advantages such as minimal soft tissue dissection, early rehabilitation, and decreased wound complications.

Gravity assisted reduction of ankle (GARA) fractures: Results of a novel technique for relocating displaced ankle fractures in the emergency setting in comparison to traditional manipulation and reduction (TMR) technique.

Background: Ankle fracture displacements cause significant discomfort to the patient and can compromise soft tissues including the neurovascular structures. Prompt reduction and plaster splint application are vital in the early management of these potentially limb-threatening conditions. The process can be distressing for the patient often requiring additional personnel or equipment.

Avoiding iatrogenic vascular injury in tibial external fixation with half pins. An in-vivo study based on CT angiography.

Background: External fixation is an important tool in the management of variety of tibial fractures. Appropriate half pin insertion is important, to provide stable fixation without compromising the surgical field for definitive surgical procedures, and avoiding further damage to the important structures of the traumatized limb. There is paucity of literature about the optimal trajectories and safe corridors for half pins insertion based on in vivo studies.

Single stage versus two-stage orthoplastic management of bone infection.

Introduction: Bone infection cases with major soft tissue loss have conventionally been treated with a staged orthoplastic approach, addressing the infection first followed by definitive management to achieve bony stability and soft tissue cover. In the last few decades, specialist centers have advocated for single stage bony stabilization with soft tissue coverage. We aimed to investigate the outcomes of patients that underwent a single stage versus a two-stage orthoplastic intervention.

Orthoplastic Management of Open Midfoot Injuries: Is Functional Limb Salvage Possible?

High energy open midfoot injuries are uncommon but devastating injuries. A combination of complex fracture dislocations and soft tissue injury patterns render reconstruction challenging. The aim of this study was to assess the surgical and patient reported outcomes following orthoplastic management of open midfoot injuries in a Major Trauma Center.

A Development of the Essex-Lopresti Maneuver: Minimally Invasive Reduction and Fixation of Tongue-Type Calcaneal Fractures via a Single Incision.

Tongue-type calcaneal fractures are a subset of displaced intraarticular calcaneal fractures. A reduction maneuver for this fracture pattern was described by Essex-Lopresti. The aim of this article is to describe a modification of this technique that allows reduction and fixation of tongue-type calcaneal fractures via a single, minimally invasive incision.

A Functional Topographic Map for Spinal Sensorimotor Reflexes.

Cutaneous somatosensory modalities play pivotal roles in generating a wide range of sensorimotor behaviors, including protective and corrective reflexes that dynamically adapt ongoing movement and posture. How interneurons (INs) in the dorsal horn encode these modalities and transform them into stimulus-appropriate motor behaviors is not known. Here, we use an intersectional genetic approach to functionally assess the contribution that eight classes of dorsal excitatory INs make to sensorimotor reflex responses.

Rapid Access Palliative Radiotherapy Programmes.

One of the greatest successes of radiotherapy has been its ability to palliate symptoms from advanced and metastatic cancers. Unfortunately, patients face barriers to accessing care and the demand for treatment is rising. Rapid access palliative radiotherapy programmes were created in response to these concerns, and over time they have proliferated and succeeded internationally.

Does the Use of Blocking Screws Improve Radiological Outcomes Following Intramedullary Nailing of Distal Tibia Fractures?

Aim: The aim of this study is to assess whether the addition of blocking screws during intramedullary nailing of a distal tibia fracture improved the radiological outcome and prevented a loss of fracture alignment. As a secondary outcome, the time to radiographic union was compared to see if a more rigid bone-implant construct had an effect on healing.

Methods: We searched computerized records at a UK level 1 major trauma center.

An evolution in the management of fractures of the ankle: safety and efficacy of posteromedial approach for Haraguchi type 2 posterior malleolar fractures.

Aims: There has been an evolution recently in the management of unstable fractures of the ankle with a trend towards direct fixation of a posterior malleolar fragment. Within these fractures, Haraguchi type 2 fractures extend medially and often cannot be fixed using a standard posterolateral approach. Our aim was to describe the posteromedial approach to address these fractures and to assess its efficacy and safety.

Healthy infant with a blistering rash.

The parents denied any environmental exposures and said that the child hadn't had contact with anyone with a similar rash. The distribution of the rash was revealing.

The patterns of injury and management of cuboid fractures: a retrospective case series.

Aims: Although infrequent, a fracture of the cuboid can lead to significant disruption of the integrity of the midfoot and its function. The purpose of this study was to classify the pattern of fractures of the cuboid, relate them to the mechanism of injury and suggest methods of managing them.

Patients And Methods: We performed a retrospective review of patients with radiologically reported cuboid fractures.

Combinatorial hydrogel library enables identification of materials that mitigate the foreign body response in primates.

The foreign body response is an immune-mediated reaction that can lead to the failure of implanted medical devices and discomfort for the recipient. There is a critical need for biomaterials that overcome this key challenge in the development of medical devices. Here we use a combinatorial approach for covalent chemical modification to generate a large library of variants of one of the most widely used hydrogel biomaterials, alginate.

Intensity-modulated radiation therapy to bilateral lower limb extremities concurrently: a planning case study.

Non-melanomatous skin cancers represent 80% of all newly diagnosed cancers in Australia with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) being the most common. A previously healthy 71-year-old woman presented with widespread and tender superficial skin cancers on the lower bilateral limbs. External beam radiation therapy through the use of intensity-modulated radiation therapy (IMRT) was employed as the treatment modality of choice as this technique provides conformal dose distribution to a three-dimensional treatment volume while reducing toxicity to surrounding tissues.