Mammalian bite injuries to the hand and their management.

Bite wounds are a common form of hand injury with the potential to lead to severe local and systemic sequelae and permanent functional impairment. Mammalian bite wounds may be caused by a variety of animal class and species; injuries resulting from dogs, cats and humans are the most widely discussed and reported in the literature. Bite wounds may be contaminated with aggressive pathogens and the anatomical vulnerability of structures within the hand means that without early recognition and treatment with irrigation and antibiotics, alongside a low index of suspicion for deep structural involvement requiring formal surgical exploration and washout, the consequences of such injuries can be disastrous.

Clinical advances in bone regeneration.

Understanding of the biology of bone regeneration has been increasing rapidly, with greater appreciation for the importance of biochemical aspects as well as the mechanical requirements for bone to heal. There are a number of situations where there is difficulty in bone healing such as fracture non-union; or growth such as osteogenesis imperfecta; or a requirement for surplus bone to reconstruct defects such as following surgery for tumour excision or limb lengthening. There is a greater understanding of the complex interplay between osteoblasts and osteoclasts, and the chemical mediators that provide signalling along complex pathways.

Revision of unicondylar to total knee arthroplasty: a systematic review.

Isolated unicompartmental osteoarthritis in the young patient is a difficult problem to treat; they may be too young to consider total knee arthroplasty due to difficulties with inevitable future revision. Unicompartmental knee arthroplasty is one possible solution as it is perceived by some as being a smaller surgical insult than total knee arthroplasty, with easier revision to total knee arthroplasty than a revision total knee arthroplasty. A total knee arthroplasty performed as a revision unicondylar knee arthroplasty is thought by some authors to have equivalent functional outcomes to a primary total knee replacement.