Artificial intelligence (AI) for paediatric fracture detection: a multireader multicase (MRMC) study protocol.

Introduction: Paediatric fractures are common but can be easily missed on radiography leading to potentially serious implications including long-term pain, disability and missed opportunities for safeguarding in cases of inflicted injury. Artificial intelligence (AI) tools to assist fracture detection in adult patients exist, although their efficacy in children is less well known. This study aims to evaluate whether a commercially available AI tool (certified for paediatric use) improves healthcare professionals (HCPs) detection of fractures, and how this may impact patient care in a retrospective simulated study design.

Radiological outcomes following surgical fixation with wires versus moulded cast for patients with a dorsally displaced fracture of the distal radius: a radiographic analysis from the DRAFFT2 trial.

Aims: The primary aim of this study was to report the radiological outcomes of patients with a dorsally displaced distal radius fracture who were randomized to a moulded cast or surgical fixation with wires following manipulation and closed reduction of their fracture. The secondary aim was to correlate radiological outcomes with patient-reported outcome measures (PROMs) in the year following injury.

Methods: Participants were recruited as part of DRAFFT2, a UK multicentre clinical trial.

Floating Forearm Injury: Monteggia Variant Fracture With an Ipsilateral Distal Radius and Ulna Fracture.

Monteggia variant fracture is a Monteggia fracture (proximal third ulna fracture with radial head dislocation) with an associated radial head fracture, coronoid fracture or complex pattern of injury. We report a rare case of an 80-year-old lady with a right Monteggia variant fracture with an ipsilateral distal radius and ulna fracture leading to a floating forearm injury. To our knowledge, this is the first case report to describe this injury pattern.

Digital templating in hip hemiarthroplasty: Is it possible to accurately predict femoral head size from magnification alone?

Background: Templating is an integral part of pre-operative planning in elective hip arthroplasty to achieve favourable long-term outcomes, but its applications in trauma surgery remain limited. When templating from radiographs without a calibration marker, there is always an element of magnification which must be accounted for. Our aim was to establish our institute-specific magnification and to determine whether using this to predict femoral head size in hemiarthroplasty was more accurate than using set magnifications previously reported in the literature.

Experimental testing of fracture fixation plates: A review.

Metal and its alloys have been predominantly used in fracture fixation for centuries, but new materials such as composites and polymers have begun to see clinical use for fracture fixation during the past couple of decades. Along with the emerging of new materials, tribological issues, especially debris, have become a growing concern for fracture fixation plates. This article for the first time systematically reviews the most recent biomechanical research, with a focus on experimental testing, of those plates within ScienceDirect and PubMed databases.

Carbon fibre reinforced PEEK versus traditional metallic implants for orthopaedic trauma surgery: A systematic review.

Introduction: There is no literature review comparing outcomes of fixation using carbon-fibre-reinforced polyetheretherketone (CFR PEEK) compared to metal implants used in orthopaedic extremity trauma surgery. A systematic review was performed to compare CFR PEEK to metal implants for clinically-important fracture outcomes.

Methods: A search of the online databases of PubMed/Medline, EMBASE and Cochrane Database was conducted.

Mucinous adenocarcinoma of the lung presenting as pathological humeral fracture: a case report and novel surgical treatment.

We present a 73-year-old woman who presented with a pathological fracture of her right humerus. Further imaging and biopsy indicated a mucinous adenocarcinoma of the lung as the primary neoplasm. This represents the first published case of a mucinous adenocarcinoma of the lung presenting as a metastatic lesion of the humerus.

Closed reduction techniques for acute anterior shoulder dislocation: a systematic review and meta-analysis.

Background: Anterior shoulder dislocations are the most common type of joint dislocation with the majority treated with closed reduction. Reduction methods can be grouped into their principle mode of action: traction-countertraction, leverage and scapular manipulation. The best method has yet to be identified and our aim was to find the most effective, safe and least painful method of closed reduction for acute anterior shoulder dislocations.

Assessment of lower limb rotational profile and its correlation with the tibial tuberosity-trochlea groove distance: A radiological study.

Objective: The purpose of our study was to determine whether there is a correlation between the lower limb rotational profile and tibial tuberosity-trochlea groove (TT-TG) distance.

Design And Patients: The computed tomography cross-sectional imaging on 50 patients' lower limbs (100 limbs) was investigated at our institution. The TT-TG distance was measured along with rotational measurements including femoral version (FV), tibial torsion and knee joint rotation angle (KJRA).

Using three-dimensional rapid prototyping in the design and development of orthopaedic screws in standardised pull-out tests.

The majority of orthopaedic screws are designed, tested and manufactured by existing orthopaedics companies and are predominantly developed with healthy bone in mind. The timescales and costs involved in the development of a new screw design, for example, for osteoporotic bone, are high. In this study, standard wood screws were used to analyse the concept of using three-dimensional printing, or rapid prototyping, as a viable stage of development in the design of a new bone screw.

Improving the quality of operative notes by implementing a new electronic template for upper limb surgery at the Royal Derby Hospital.

The RCS has published clear and succinct guidelines dictating the necessity for the documentation of legible and timely surgical operative notes and exactly what should be included. A baseline study within the upper limb unit at our trust showed a 71.1% adherence with the RCS guidelines with an average delay of typing of notes after dictation was 11.

Computed tomography review of tarsal canal anatomy with reference to the fitting of sinus tarsi implants in the tarsal canal.

Sinus tarsi implants are used in the treatment of symptomatic hyperpronating flexible flatfeet in children. Although some implants are inserted only into the sinus tarsi, others occupy both the sinus tarsi and the tarsal canal. The stem that is anchored in the tarsal canal depends on interference fit for the initial resistance to slippage.

Acetabular rim profile measurement in femoroacetabular impingement patients - biomed 2011.

Morphological variations in hip joint anatomy are a possible mechanism for femoroacetabular impingement (FAI) which leads to hip osteoarthritis. Significant geometric variations of the acetabular rim exist between patients including variations in depths of the postereosuperior depression (PSD) and psoas valley (PV). Computed tomographic scans of 48 FAI patients were segmented to create three-dimensional bone reconstructions.

Operative management of intra-articular distal interphalangeal joint fractures of the hand.

The management of intra-articular fractures of the hand represents a challenge. Large articular fragments require reduction and operative fixation. A number of surgical techniques have been described in literature, with variable results.

The influence of head size and sex on the outcome of Birmingham hip resurfacing.

Background: Hip resurfacing has gained popularity for the treatment of young and active patients who have arthritis. Recent literature has demonstrated an increased rate of revision among female patients as compared with male patients who have undergone hip resurfacing. The aim of the present study was to identify any differences in survival or functional outcome between male and female patients with osteoarthritis who were managed with metal-on-metal hip resurfacing.

Surgical treatment of complex distal humeral fractures: functional outcome after internal fixation using precontoured anatomic plates.

Hypothesis: Several studies have shown good results with internal fixation of distal humeral fractures; however, few have focused specifically on anatomic parallel plate fixation using the same implant and postoperative regimen. The purpose of this study was to determine the functional outcome after open reduction and internal fixation of these complex fractures using parallel precontoured anatomic plates.

Materials And Methods: This was a retrospective single-surgeon series involving 16 patients (12 women, 4 men) treated with a double-column parallel plating technique.

Is the tip of the greater trochanter a reliable reference for the rotation centre of the femoral head in total hip arthroplasty?

A variety of techniques have been used to determine intra-operative leg length during total hip arthroplasty. One method often described is using the tip of greater trochanter as the reference for the rotation centre of the femoral head to align the femoral component. There is little in the literature to support this method of leg length restoration.

Good result after surgical treatment of Pellegrini-Stieda syndrome.

Ossification of the femoral attachment of the medial collateral ligament (MCL) of the knee with associated pain and restricted movements is rare and is characteristic of the Pellegrini-Stieda (PS) syndrome. Although in mild cases conservative treatment is often successful, patients with more significant bone formation and persistent symptoms require surgical excision. We describe a case of PS syndrome with a description of the surgical technique consisting of excision of the bony lesion and reconstruction of the MCL by using the adductor magnus tendon.

Removal of broken solid femoral nail: a modified bent tip guide wire technique.

A broken solid femoral nail can be challenging to remove. We describe a modified bent tip guide wire technique for extraction of a broken solid retrograde femoral nail from the proximal femur. The broken nail was removed successfully through the original retrograde entry point to allow for an exchange femoral nailing in a patient with a hypertrophic non-union.

Biomechanical comparison of pull-out force of unicortical versus bicortical screws in proximal phalanges of the hand: a human cadaveric study.

Background: Bicortical fixation of proximal phalangeal fractures may damage underlying flexor tendons secondary to drilling and screw protrusion in the dorsal-ventral direction. The aim of this study was to measure and compare the pull-out force of unicortical screws compared to bicortical screws in human cadaveric proximal phalanges to identify optimal configuration for internal fixation.

Methods: Forty proximal phalanges were harvested.