Two stage cementation and screw augmentation of large acetabular defects in low demand patients: Early results and surgical technique.

Introduction: The reconstruction of large acetabular defects in revision hip arthroplasty represents a challenge to the surgeon and increases the complexity of the case. There are different options to overcome the problem of acetabular deficiency. In the elderly low demand patients, the main objective of revision surgery is to provide pain relief, allow immediate full weight bearing, and an early return to function.

Interruption of long-term warfarin is not necessary in patients undergoing total hip arthroplasty.

Introduction: The management of anticoagulation in patients undergoing arthroplasty remains a challenge. Guidelines for perioperative management of long-term warfarin recommend discontinuation of warfarin preoperatively in low risk patients. We hypothesised that patients who had their warfarin continued during the perioperative period would have shorter hospital stay and no significant increase risk of surgical complications compared to patients who had their warfarin interrupted.

Birmingham Hip Resurfacing: A Single Surgeon Series Reported at a Minimum of 10 Years Follow-Up.

We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris.

The presentation of scaphoid non-union.

A retrospective study of 30 patients presenting with scaphoid non-union was performed. The results showed that eight had been treated in plaster for a mean of 6 weeks and discharged from follow-up. They presented with established non-union at a mean of 60.

Nice hips: shame about the conclusions.

In April 2000 the National Institute for Clinical Excellence (NICE) issued their first appraisal in the field of surgery, "Guidance on the selection of prostheses for primary total hip replacement". NICE has already been heavily criticised for its recommendations in the field of medicine, due to its perceived role in rationing healthcare. This paper examines the conclusions of the appraisal committee (which included only two orthopaedic surgeons), the evidence on which they drew their conclusions and the evidence that was overlooked.

Harvesting split skin grafts of appropriate thickness using the hand-held knife.

Split skin grafting is an often used method of covering small skin defects and ulcers. We describe a simple technique to help determine the appropriate setting for the hand-held knife. This provides skin of adequate thickness when harvesting graft from the thigh and permits good regeneration of the donor site.

Zickel supracondylar nailing for supracondylar femoral fractures in elderly or infirm patients. A review of 33 cases.

We report 33 cases of femoral supracondylar fracture in elderly or debilitated patients treated by Zickel supracondylar nails. Most of the patients were female and their mean age was 79 years. All had concurrent medical problems and only nine could walk unaided.

Proximal radioulnar translocation in association with posterior dislocation of the elbow.

Proximal radioulnar translocation in association with posterior dislocation of the elbow in childhood is a very rare injury. The aetiology is considered to be iatrogenic, resulting from an inappropriate reduction technique. Two cases are described that challenge this view.

Economic evaluation of extracorporeal shock wave lithotripsy, percutaneous ultrasonic lithotripsy, and standard surgical treatment of urolithiasis--a Canadian perspective.

In order to provide information for decision making regarding urolithiasis treatment programs for the population of the Central West Region (population 1.8 million) of Ontario, we conducted an incremental cost-effectiveness analysis of standard surgery, percutaneous ultrasonic lithotripsy, and extracorporeal shock wave lithotripsy for the removal of renal and ureteric stones. Estimates of costs and effects were calculated for a 5-year period, beginning in 1985.