Functional outcomes of elbow injuries managed according to the Wrightington classification of elbow fracture-dislocations.

Background: This study aims to review the functional outcomes of patients managed by the application of the Wrightington elbow fracture-dislocation classification system and its corresponding management algorithms.

Methods: This is a retrospective consecutive case series of patients over the age of 16 with an elbow fracture-dislocation managed according to the Wrightington classification. The primary outcome was the Mayo Elbow Performance Score (MEPS) at the last follow-up.

Surgical treatments for acute unstable acromioclavicular joint dislocations.

Introduction: Surgical treatment is usually recommended for acute, high-grade acromioclavicular joint (ACJ) injuries. A wide variety of surgical techniques exist, and the literature does not strongly support one over the other. In this literature review, we describe and compare the results of different surgical treatments for the management of acute unstable ACJ dislocation and aim to guide surgeons on optimal treatment.

The role of biodegradable spacer implantation under local anesthesia for patients with massive rotator cuff tears and significant medical comorbidities.

Background: Massive rotator cuff tears are common, and the incidence increases with age. They are a challenging problem to deal with as many are irreparable. While there are a host of surgical options available, these can be prolonged procedures requiring general anesthesia and thus not suitable for elderly patients or those with significant medical comorbidities.

Current concepts in elbow fracture dislocation.

Background: Elbow fracture dislocations are complex injuries that can provide a challenge for experienced surgeons. Current classifications fail to provide a comprehensive system that encompasses all of the elements and patterns seen in elbow fracture dislocations.

Methods: The commonly used elbow fracture dislocation classifications are reviewed and the three-column concept of elbow fracture dislocation is described.

Superior capsular reconstruction for irreparable rotator cuff tears: A literature review and specialist practice report.

Background: Recent evidence continues to confirm the effectiveness of arthroscopic superior capsular reconstruction (SCR) in relieving pain and improving function in an irreparable cuff deficient shoulder. This paper presents an up-to-date literature review on SCRand a tertiary referral unit experience in the United Kingdom.

Methods: Data was prospectively collected on patients undergoing SCR for irreparable rotator cuff tears using a dermal allograft.

Reliability and validity of the Wrightington classification of elbow fracture-dislocation.

Aims: The Wrightington classification system of fracture-dislocations of the elbow divides these injuries into six subtypes depending on the involvement of the coronoid and the radial head. The aim of this study was to assess the reliability and reproducibility of this classification system.

Methods: This was a blinded study using radiographs and CT scans of 48 consecutive patients managed according to the Wrightington classification system between 2010 and 2018.

Survivorship of autologous structural bone graft at a minimum of 2 years when used to address significant glenoid bone loss in primary and revision shoulder arthroplasty: a computed tomographic and clinical review.

Background: Severe glenoid bone loss remains a challenge in patients requiring shoulder arthroplasty and often requires autogenous bone grafting. The purpose of this study was to assess the integrity of the bone graft at 2 years in a series of primary and revision shoulder replacements where glenoid bone loss was managed using a structural autograft (humeral head or iliac crest bone graft) in combination with a trabecular titanium (TT) implant.

Methods: Ethical approval was sought, and the study has a portfolio study status by the NIHR (17/YH/0318).

Does posterior half-wedge augmented glenoid restore version and alignment in total shoulder arthroplasty for the B2 glenoid?

Introduction: Walch type B2 has biconcave glenoid with posterior erosion, bone loss and humeral head subluxation. This leads to decreased glenohumeral contact area and increased contact pressure. During total shoulder arthroplasty(TSA), uncorrected retroversion causes eccentric loading and failure of glenoid component.

Use of stem cells and growth factors in rotator cuff tendon repair.

The management of rotator cuff tears continues to prove challenging for orthopaedic surgeons. Such tears affect most age groups and can lead to significant morbidity in patients. The aetiology of these tears is likely to be multifactorial; however, an understanding of the mechanisms involved is still under review.

Bony non-union in a patient receiving androgen deprivation therapy for prostate cancer.

We present a case of a 76-year-old man who underwent a corrective femoral osteotomy for a varus deformity and stress fractures. The patient was on androgen deprivation therapy (ADT) for prostate cancer and the osteotomy failed to heal. At 13 months, the ADT was stopped and bony union was achieved in 3 months.

Bone marrow derived stem cells in trauma and orthopaedics: a review of the current trend.

Bone tissue engineering is a promising therapeutic option to enhance tissue regeneration and repair. The development of bone tissue engineering is directly related to changes in materials technology. While the inclusion of material requirements is standard in the design process of engineered bone substitutes, it is critical to incorporate clinical requirements in order to engineer a clinically relevant device.

Do we need radiological guidance for intra-articular hip injections?

There is still a debate as to whether radiological guidance is needed for intra-articular hip injections. The aim of this study was to evaluate correct needle positioning for the hip joint performed with a non-radiological method and confirmed on arthrogram under image intensifier. Patients listed for diagnostic and therapeutic hip joint injections were included in our study.

A rare cause of wound infection after an open fracture: Shewanella putrefaciens.

An elderly gentleman presented with an open fracture of the calcaneum and ankle, following a boating accident. Despite treatment with repeated surgical debridement, delayed closure, prolonged antibiotics and strict adherence to national guidelines on the management of open fractures, he developed a wound infection with a rare organism, Shewanella putrefaciens, that appears to be increasing in prevalence.

The relationship between time to surgical debridement and incidence of infection in grade III open fractures.

Objective: The purpose of this study was to determine the association between time to initial debridement and infection rate in high-energy (grade III) open fractures of tibia.

Methods: All patients presenting with open fractures were included in the study. The inclusion criteria were Gustilo III A, B and C open fractures of tibia.

Effects of tranexamic acid on blood loss during total hip arthroplasty.

Purpose: To assess the effects of tranexamic acid (TA) in patients undergoing total hip arthroplasty (THA) for osteoarthritis.

Methods: 42 patients underwent primary THA for osteoarthritis by a single surgeon. 10 men and 11 women who did not receive TA were controls, whereas 9 men and 12 women who received TA constituted the treatment group.