Classification and measurement of displacement of isolated greater tuberosity fractures: Intra and interobserver reliability.

Background: Literature demonstrates variability in the amount of displacement of isolated greater tuberosity (GT) fractures and measurement techniques that orthopaedic surgeons deem warrant surgical intervention. This study aims to assess the intra and interobserver reliability for classifying and measuring the displacement amount for isolated GT fractures.

Methods: Eight surgeons, consisting of four shoulder specialists and four trainee surgeons, reviewed 25 plain radiographs on two separate occasions, 3 months apart.

Length of hospital stay following hip fracture and risk of 30 and 90 day mortality in a United Kingdom cohort.

A recent study identified a length of stay (LOS) of 10 days or less following hip fracture is associated with increased risk of 30-day mortality. This effect has not been previously studied for 90-day mortality or in the United Kingdom (UK). Our aim was to investigate the effect of LOS on 30-day and 90-day mortality following hip fracture in a UK population.

Biomechanical investigation of potential prophylactic scoliosis treatments following various sizes of chest wall resection.

Background: A well-known problematic sequela of chest wall resections is development of scoliosis. Despite the seriousness and frequency of scoliosis following chest well resection, the etiology and biomechanical information needed to understand this progression aren't well-known.

Methods: Range of motion of six specimen (C7-L2) was captured using a custom-built six degrees-of-freedom machine in each of three physiological rotation axes.

The effect of computerised tomography on operative planning in posterior malleolus ankle fractures.

Background: The aim of this project was to analyse whether a CT influences surgical planning in ankle fracture involving the posterior malleolus.

Methods: Twenty consecutive patients with fractures involving the posterior malleolus were retrospectively selected and had their plain radiographs and CT scan anonymised. Initially, radiographs alone were presented to nine trauma surgeons to formulate a surgical plan individually.

Templating Hip Arthroplasty.

Background: Different methods have been developed and employed with variable degrees of success in pre-operative templating for total hip arthroplasty. Preoperative templating, especially digital templating, has been claimed to have increased the effectiveness of total hip arthroplasty by improving the precision of prediction of prosthetic implant size.

Aims: The overall aim of this systematic review is to identify whether the use of pre-operative templating in total hip arthroplasty procedures has resulted in increased accuracy, reliability and precision of the procedure.

Short-term risk factors for a second hip fracture in a UK population.

Introduction: A hip fracture carries significant morbidity and mortality-a second fracture of the contralateral hip carries even higher complications. Most second hip fractures occur within 48 months of the first. The aim of this study was to comprehensively analyse all identifiable variables that may increase the risk of a contralateral hip fracture within this time period.

There is no 'weekend effect' in elective orthopaedic surgery.

Introduction The 'weekend effect' is said to occur when patient outcomes are adversely affected by the day of the week on which they present to hospital or have surgery. However, it is uncertain whether such a phenomenon exists for elective orthopaedic surgery. We investigated whether there is a 'weekend effect' in elective orthopaedic patients.

Early mortality and morbidity following a type II odontoid fracture in the elderly.

Background: We aimed to analyse the rates of early and causes of death in patients aged over 65 years with a type II odontoid fracture.

Methods: A consecutive series of 93 patients with a type II fracture of the odontoid process was retrospectively identified. Data collected included patient demographics, co-morbidities, associated injuries, neurological injury, date of death and cause of death.

There is no weekend effect in hip fracture surgery - A comprehensive analysis of outcomes.

Background: Previous studies have shown that some patient groups suffer adverse outcomes if they are acutely admitted to hospital over a weekend. We aimed to investigate this 'weekend effect' at our centre in patients presenting with a hip fracture.

Methods: Consecutive patients undergoing acute hip fracture surgery were identified from a prospective database.

The use of external fixators in the definitive stabilisation of the pelvis in polytrauma patients: Safety, efficacy and clinical outcomes.

Objectives: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients.

Design: A single center retrospective chart review.

Setting: A level-1 trauma center.

A Comprehensive Analysis of the Causes and Predictors of 30-Day Mortality Following Hip Fracture Surgery.

Background: A fracture neck of femur is the leading cause of injury-related mortality in the elderly population. The 30-day mortality figure is a well utilised marker of clinical outcome following a fracture neck of femur. Current studies fail to analyse all patient demographic, biochemical and comorbid parameters associated with increased 30-day mortality.

Achieving hip fracture surgery within 36 hours: an investigation of risk factors to surgical delay and recommendations for practice.

Background: The UK hip fracture best practice tariff (BPT) aims to deliver hip fracture surgery within 36 h of admission. Ensuring that delays are reserved for conditions which compromise survival, but are responsive to medical optimisation, would help to achieve this target. We aimed to identify medical risk factors of surgical delay, and assess their impact on mortality.

Birmingham Mid-Head Resection Periprosthetic Fracture.

Total hip arthroplasty in the young leads to difficult choices in implant selection. Until recently bone conserving options were not available for younger patients with deficient femoral head bone stock. The novel Birmingham Mid-Head Resection (BMHR) device offers the option of bone conserving arthroplasty in spite of deficient femoral head bone stock.

Pain relief management following proximal femoral fractures: Options, issues and controversies.

The majority of proximal femoral fractures occur in the elderly population. Safe and adequate pain relief is an integral part of the overall management of hip fractures. Inherent difficulties in the assessment of pain in elderly need to be taken into account and unique considerations should be made regarding the effective analgesia due to different elderly physiology, and their response to trauma and subsequent surgery.

Pelvic Fractures in Paediatric Polytrauma Patients: Classification, Concomitant Injuries and Early Mortality.

Purpose Of This Study: To review the characteristics, concomitant injuries and mortality in children with polytrauma and associated pelvic fractures treated in a Level-I Trauma Centre.

Materials And Methods: Between December 2003 and November 2013, 49 children with an Injury Severity Score (ISS) of 16 or greater and a pelvic fracture met the inclusion criteria and were evaluated. The mortality, transfusion requirements and length of intensive care unit stay were correlated with the ISS, Abbreviated Injury Scale, concomitant limb and spine fractures, and type of pelvic ring injury (AO/OTA classification).

Cast index in predicting outcome of proximal pediatric forearm fractures.

Background: Many pediatric forearm fractures can be treated in plaster following closed reduction. The cast index (CI, a ratio of anteroposterior to lateral internal diameters of the cast at the fracture site) is a simple, reliable marker of quality of molding and a CI of >0.8 correlates with increased risk of redisplacement.

Panton-Valentine leukocidin osteomyelitis in children: a growing threat.

Panton-Valentine leukocidin-producing Staphylococcus aureus osteomyelitis is associated with multiple complications including multiple abscesses, deep vein thrombosis and fulminant sepsis. This article reviews the literature concerning this emerging threat which is currently under-recognized.