Minimally Invasive Approach to the Management of Recurrent Spontaneous Hemarthrosis After Total Knee Replacement: A Report of Two Cases.

Spontaneous recurrent hemarthrosis of the knee after total knee arthroplasty is an infrequent complication. Early recognition and prompt diagnosis are essential to avoid issues such as joint stiffness, chronic pain, and limited mobility. Conservative treatment methods are often effective.

Stress Avulsion Fracture of the Patellar Tendon Following Open Reduction and Internal Fixation of a Transverse Patella Fracture With Cannulated Screws.

A stress-avulsion fracture of the inferior pole of the patella is rare. We report a case of a 65-year-old woman who underwent open reduction and internal fixation for a transverse fracture of the patella using cannulated screws inserted from the inferior pole of the patella. Subsequently, the patient developed an avulsion fracture of the inferior pole of the patella due to a stress riser from the prominent screw head.

Incisional metastatic breast carcinoma deposit in a total knee replacement presenting as peri-prosthetic joint infection-a case report.

Cutaneous metastasis from the primary breast carcinoma occurs when the disease is wide spread and can present as skin infection especially in a previous well-healed scar. If the secondary deposit is over a total knee incisional site it can mimic peri-prosthetic joint infection. We report a rare and unusual case of a woman who presented with clinical signs and symptoms of a peri-prosthetic total knee replacement which on biopsy turned out to be cutaneous metastasis from a previously treated breast cancer.

A comparative study of hip fracture care and outcomes in major trauma centres versus trauma units.

Introduction: There is good evidence to support that major trauma networks significantly reduce morbidity and mortality in severely injured patients. However, following the introduction of major trauma centres (MTCs) in England in 2012, early concerns were raised regarding the effect on hip fracture patients. The aim of our study was to review data from the National Hip Fracture Database for fractured neck of femur (FNOF) patients, comparing patient outcomes between MTCs and trauma units (TUs), and the national regions of the UK.

Peroneal artery safe zone in the posterolateral approach to the distal tibia: A CT angiogram based anatomical study.

Objectives: The posterolateral approach to the distal tibia is commonly used for stabilisation of ankle fractures as it allows good visualisation and direct reduction of the posterior distal tibia and malleolar fragments. This approach can also be used for internal fixation of an associated lateral malleolus fracture. The aim of our study is to describe the surgical anatomy of the peroneal artery (PA) in relation to the tibial plafond and the distal fibula; thereby suggesting a safe zone during proximal dissection of posterolateral approach.

Effect of Covid-19 on best practice care of hip fracture patients: An analysis from the National Hip Fracture Database (NHFD).

Background: Best practice tariff (BPT) has brought significant improvements in hip fracture care; the 2019 report showing a 30-day mortality of 6.1%. Data relating to more than 65,000 patients who sustain a fractured neck of femur (FNOF) are recorded each year in the National Hip Fracture Database (NHFD).

The use of ultrasound in the diagnosis of adverse reaction to metallic debris following metal on metal hip replacement.

Background And Purpose: The role of imaging in the diagnosis of adverse reaction to metallic debris (ARMD) with metal on metal (MoM) hip replacements is still unclear. A comparative study was undertaken to evaluate the efficacy of ultrasound in diagnosis of ARMD.

Patients And Methods: The study group included 35 patients with a clinical and histological diagnosis of ARMD.

Effect of Sodium Hyaluronate on Recovery after Arthroscopic Knee Surgery.

The aim of this study was to evaluate the effect of a single immediate postoperative instillation of 10 mL of sodium hyaluronate (Viscoseal) into the knee following arthroscopy. A single-center, prospective, randomized, controlled study was undertaken. Consenting knee arthroscopy patients were randomized into two groups following surgery: the study group received 10 mL of sodium hyaluronate intra-articularly, while the control group received an intra-articular instillation of 10 mL of Bupivacaine.

Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years.

Introduction: Navigation technique for total knee replacement has been shown to improve accuracy of prosthesis alignment in several studies. The purpose was to compare the patient-reported outcome measures in primary total knee replacement (TKR) using navigation versus conventional surgical technique at 1- and 2-year follow-up.

Materials And Methods: A retrospective review of prospectively collected patient-reported outcome data for 351 consecutively performed primary TKR was included in the study.

Volar radiocarpal dislocation: case report and review of literature.

We describe here an unusual case of volar dislocation of the radiocarpal joint due to a complete tear of the dorsal radiocarpal ligament. Plain radiographs taken at initial presentation did not reveal any obvious abnormality. There was no associated bony lesion or intrinsic wrist ligament injury.

Shoulder ultrasonography versus arthroscopy for the detection of rotator cuff tears: analysis of errors.

Purpose: To compare shoulder ultrasonography with arthroscopy for detecting specific rotator cuff tears.

Methods: 96 shoulders in 56 men and 34 women aged 28 to 65 (mean, 42) years with rotator cuff problems underwent a shoulder ultrasonography by a single radiologist, and then a shoulder arthroscopy by a single surgeon. The ultrasonographic and arthroscopic findings were compared with regard to tendon-specific tears and disparities in diagnosis.

Good medical records: a guide for the foundation year doctor.

Maintaining good medical records is essential for providing safe and effective patient care. The General Medical Council (2006), in Good Medical Practice, suggests that doctors should 'keep clear, accurate, legible and contemporaneous patient records which report the relevant clinical findings, the decisions made, the information given to patients and any drugs or other treatment prescribed'. While good medical practice is necessary throughout one's medical career it is important to develop good qualities early in the training.

Nailing versus plating in humerus shaft fractures: a prospective comparative study.

There is a debate about the choice of operative intervention in humerus shaft fractures requiring surgical intervention. A prospective, comparative study of management of acute humeral shaft fractures treated by antegrade interlocking nail fixation and dynamic compression plating was undertaken over a period of three years. Twenty patients of interlocking nailing and sixteen patients of plating were included after considering the inclusion and exclusion criteria.

Postoperative acute compartment syndrome in the nonoperated "well leg": implications to orthopaedic nursing.

Acute compartment syndrome after fractures and injuries and in operated limbs is a dreadful complication and is well known to orthopaedic nursing community. Acute compartment syndrome in a nonoperated leg after an orthopaedic procedure has been infrequently reported and discussed. It has been more commonly discussed in colorectal, gynecologic, and urologic practice.

Penetrating injury of the hand with a door handle: a case report.

Introduction: Penetrating injuries of the hand with various sharp objects have previously been reported. In this report we describe an unusual penetrating injury of the hand caused by a door handle.

Case Presentation: A 32-year-old woman presented with a door handle stuck into her hand.

Novel use of Steinman pin in removal of broken interlocking screws.

Broken screws after interlocking nailing of long bones are commonly seen in Orthopaedic practice. Removal of such screws can be difficult particularly the distal part which is often held within the bone. We describe a simple technique of using Steinman pin to aid removal of broken screws in a case of non-union fracture tibia with broken interlocking nail and screws.