Background: Heterotopic Ossification (HO) is a well-recognized complication following acetabular fracture fixation and its presence is prognostic for suboptimal clinical outcome. There are many controversies pertaining to its aetiology, including surgical approach, associated injuries and the use of HO prophylaxis. Long term data from high volume centres is necessary to address these issues.
View Article and Find Full Text PDFAssociated injuries frequently occur in patients who sustain fractures of the pelvis. Specifically, high-energy trauma resulting in pelvic fractures places the bladder and urethra at risk for injury, often resulting in significant complications. Timely identification and management of genitourinary injuries minimize associated morbidity.
View Article and Find Full Text PDFJ Emerg Trauma Shock
April 2013
Background: The penalty points system (PPS) was introduced in 2002 in an attempt to reduce the increasing rate of road traffic accident (RTA) related fatalities and serious injuries. Points are awarded based on the severity of the offence and are cumulative. A total of 12 points results in the disqualification from driving.
View Article and Find Full Text PDFInt J Surg Case Rep
April 2013
Introduction: The wear of polyethylene components is a well-recognised long-term complication of total knee arthroplasty.
Presentation Of Case: We present a case of fatigue fracture of a geomedic tibial tray 17 years after implantation. The symptoms were masked by primary osteoarthritis of the contralateral knee.
Introduction: Nail patella syndrome is a rare autosomal dominant hereditary condition, with an incidence of 22 per million in the United Kingdom. The syndrome's most common features include iliac horns, hypoplastic patella and nail dysplasia.
Case Presentation: We report the case of a 26-year-old Caucasian man with nail patella syndrome who sustained a fracture of his right hypoplastic patella after a fall.
Background: Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation.
View Article and Find Full Text PDFSkype is a free program which enables PC users to make video calls to other users with Internet access. We carried out a prospective review of all acromioclavicular joint hook plates for lateral-third clavicle fractures over a five-year period. Functional assessment with Oxford and Constant shoulder scores were carried out using Skype and compared to outpatient review using the Bland-Altman method.
View Article and Find Full Text PDFBackground: Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.
View Article and Find Full Text PDFIntroduction: Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury.
Case Presentation: In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles.
British Trainees have gradually had their working week curtained over the last 8 years. The Republic of Ireland Trainees have not been subjected to the European Working Time Directive prior to 2009 and have therefore worked on average, more hours than their British counterparts. We wanted to see if the differing schemes had an impact on recruiting and training orthopaedic surgeons.
View Article and Find Full Text PDFArch Orthop Trauma Surg
April 2010
Dislocation after primary total hip arthroplasty (THA) is the most commonly encountered complication and is unpleasant for both the patient and the surgeon. Constrained acetabular components can be used to treat or prevent instability after primary total hip arthroplasty. We present the case of a 42-year-old female with a BMI of 41.
View Article and Find Full Text PDFActa Orthop Belg
October 2007
We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.
View Article and Find Full Text PDFFracture of the distal radius from low energy trauma is a common presentation to orthopaedic trauma services. This fragility type fracture is associated with underlying osteoporosis. Osteoporosis is a 'silent disease' where fragility fracture is a common presentation.
View Article and Find Full Text PDFThe presence of periprosthetic malignancy in proximity to arthroplasty implants has been infrequently reported. We present the clinical, radiographic, and pathological features of three patients in whom loosening and failure of total hip arthroplasties occurred secondary to malignant infiltration. They consisted of a 66-year-old man with the first presentation of metastatic gastric carcinoma as a periacetabular lytic lesion, a 64-year-old man presenting with femoral metastases from a previously undiagnosed lung carcinoma, and a 75-year-old woman presenting with a painless discharging thigh sinus around a total hip arthroplasty subsequently diagnosed as immunoblastic lymphoma.
View Article and Find Full Text PDFWe evaluated the performance of 84 Hylamer polyethylene components and zirconia modular femoral heads which were implanted in a single institution over a 5 year period. Patients were followed up for a mean of 6.2 years.
View Article and Find Full Text PDFIntroduction: MR imaging has emerged as an important modality in the non-invasive evaluation of osseous and soft-tissue structures in the post-traumatic knee. However, it is sometimes impossible to determine with confidence if a focus of high signal intensity in the meniscus is confined to the substance of the meniscus or if it extends to involve the joint surface. This is a critical differentiation because the latter represents meniscal tears that can be found and treated arthroscopically, whereas the former represents degeneration, intrasubstance tears or perhaps normal variants that are not amenable to arthroscopic intervention.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
September 2004
There is controversy about the therapy for grade III acromioclavicular dislocation according to Tossy and Rockwood's classification. We identified 25 patients who underwent acromioclavicular joint wiring for grade III subluxations under the care of a single consultant in the last 5-year period. All patients were asked to fill in a DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire to assess outcome following acromioclavicular joint repair, and their clinical notes were reviewed.
View Article and Find Full Text PDFWe reviewed 49 patients following plate osteosynthesis of humeral shaft fractures. There were no complications as a result of surgery. Union occurred in 47 patients (96%) at a mean of 9 weeks.
View Article and Find Full Text PDFBackground: The AO unreamed tibial nail (UTN) has been used for both open and closed tibial fractures. The reported results have been mixed. We evaluated its outcome in our unit.
View Article and Find Full Text PDFThe aim of this study was to examine how commonly implicated prognostic factors are associated with late clinical outcome after reconstruction of acetabular fractures. The clinical outcomes of 180 fractures, treated by a single surgeon over a 10-year period, were assessed using the scoring system of Merle d'Aubigné and Postel. A statistical model was constructed comprising the clinical outcome and nine postulated prognostic factors.
View Article and Find Full Text PDFTo determine if whether there were any changes in numbers of orthopaedic injuries at the emergency/ orthopaedic trauma department requiring treatment that could be related to televised home matches during World Cup 2002. Numbers of patients attending with musculoskeletal injuries directly attributable to world cup celebrations were collected during the four home matches. Attendances from midnight before the match until midday the day after the match were recorded.
View Article and Find Full Text PDFWe report an unusual case of migration of a metal plate from the symphysis pubis to the left ischiorectal fossa, and a technique of using pre-operative CT guided wire localisation of the plate as a successful method of assisting plate retrieval.
View Article and Find Full Text PDFThe management of Jehovah's Witnesses can prove quite challenging to the surgeon who routinely uses blood and blood products in the treatment of anaemia and hypovolaemia. The medical and legal dilemmas are exacerbated when the patient has a critically low haemoglobin level or has suffered life-threatening blood loss following polytrauma. It is essential that the treating physician should have some knowledge and understanding of the beliefs of the Jehovah's Witness in order to effectively minimise and treat blood loss.
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