Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial.

Background: Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. The use of immediate surgical fixation to manage this type of fracture has increased, despite insufficient evidence of improved outcomes over non-surgical management. The SWIFFT trial compared the clinical effectiveness of surgical fixation with cast immobilisation and early fixation of fractures that fail to unite in adults with scaphoid waist fractures displaced by 2 mm or less.

The long-term outcome of the Gschwend-Scheier-Bähler III elbow replacement.

Background: The Gschwend-Scheier-Bähler III (GSBIII) is a semiconstrained, sloppy-hinge total elbow replacement. We report the long-term functional and radiological outcome of a cohort of patients more than 10 years after surgery.

Methods: All GSBIII prostheses implanted from September 1996 to June 2004 were identified from our surgical database.

The effect of using a cement gun with a narrow nozzle on cement penetration for total elbow arthroplasty: a cadaveric study.

Purpose: To compare the cement mantle characteristics associated with use of a narrow nozzle cement gun versus the use of a 60-mL catheter tip syringe.

Methods: Twelve cadaveric distal humeri were cemented with either a cement gun or a syringe without canal occlusion. The humeri were sectioned and photographed.

Pre-operative departmental ultrasound of the rotator cuff: sensitivity and specificity in a regional specialist orthopaedic centre.

Background: The present study aimed to assess the accuracy of radiology department ultrasound scans in identifying rotator cuff tears at our institution, a regional specialist orthopaedic centre.

Methods: Pre-operative ultrasound scan reports were obtained from 64 consecutive patients who subsequently underwent arthroscopic subacromial decompression and/or rotator cuff repair. The ultrasound reports were compared with the arthroscopic findings as a reference standard.

Newcastle approach to the elbow, a cadaveric study.

Aim: The aim of the current study was to assess the amount of the distal humerus articular surface exposed through the Newcastle approach, a posterior triceps preserving exposure of the elbow joint.

Method: Twenty-four cadaveric elbows (12 pairs) were randomized to receive one of the four posterior surgical approaches: triceps reflecting, triceps splitting, olecranon osteotomy and Newcastle approach. The ratio of the articular surface exposed for each elbow was calculated and compared.

Mid-term outcome of GSB-III total elbow arthroplasty in patients with rheumatoid arthritis and patients with post-traumatic arthritis.

Introduction: We reviewed the mid-term outcome of GSB-III semi-constrained total elbow arthroplasty (TEA) and compared the results of patients with rheumatoid arthritis (RA) and those suffering from post-traumatic arthritis (PTA).

Patients: Forty-five patients with 54 replaced elbows, with an average age of 69 (range 49-84) were clinically [using Mayo Clinical Performance Index (MCPI) and Liverpool Elbow Score (LES)] and radiographically assessed. The average follow-up was 54 (range 20-103) months.

Use of the Liverpool Elbow Score as a postal questionnaire for the assessment of outcome after total elbow arthroplasty.

The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment of outcome after total elbow arthroplasty and to correlate the LES and the Mayo Elbow Performance Score (MEPS).