Patient reported outcomes after definitive open tibial fracture management.

Aims: Open tibial fractures are often life-changing injuries and patient outcomes remain poor despite the introduction of national management guidelines. The longer-term impact to the patient can be considerable but this is often overlooked in the literature. This study aims to establish the functional, physical, and psychosocial impact of sustaining an open tibial fracture.

Outcomes following the delayed management of open tibial fractures.

Aims: National guidelines set standards for the definitive management of open fractures within 72 h. This study aims to investigate our outcomes where this timeline was unachievable for most cases due to a split-site orthoplastic service.

Patients & Methods: 116 consecutive Gustilo-Anderson grade IIIB & IIIC open tibial fractures presenting to our major trauma centre (MTC) between September 2012 and April 2018 were reviewed.

Surgical management of patellofemoral instability. I. Imaging considerations.

The patellofemoral joint is a complex joint that relies on both bone and soft tissues for its stability. Dysfunction of the patellofemoral joint, whether pain or instability, is a common cause of medial consultation. Thorough clinical and imaging assessment is important for managing these patients, who may require a combination of a bony and soft tissue surgical procedure.

Surgical management of patellofemoral instability part 2: post-operative imaging.

The patellofemoral joint is a complex joint requiring contributions from both bone and soft tissue for its stability. Pathology of the patellofemoral joint manifests as instability or anterior knee pain. Careful clinical and imaging assessment is important for managing these patients with cross-sectional imaging being a vital component in pre-surgical planning.

Regenerative medicine in lower limb reconstruction.

Bone is a highly specialized connective tissue and has a rare quality as one of the few tissues that can repair without a scar to regain pre-injury structure and function. Despite the excellent healing capacity of bone, tumor, infection, trauma and surgery can lead to significant bone loss requiring skeletal augmentation. Bone loss in the lower limb poses a complex clinical problem, requiring reconstructive techniques to restore form and function.

The service impact of failed locking plate fixation of distal tibial fractures: a service and financial evaluation at a major trauma centre.

Introduction: The surgical treatment of distal tibial fractures is challenging and controversial. Recently, locking plate fixation has become popular, but the outcomes of this treatment are mixed with complication rates as high as 50 % in the published literature. There are no reports specifically relating to the financial and resource costs of failed treatment in the literature.

Influence of electron beam melting manufactured implants on ingrowth and shear strength in an ovine model.

Arthroplasty has evolved with the application of electron beam melting (EBM) in the manufacture of porous mediums for uncemented fixation. Osseointegration of EBM and plasma-sprayed titanium (Ti PS) implant dowels in adult sheep was assessed in graduated cancellous defects and under line-to-line fit in cortical bone. Shear strength and bony ingrowth (EBM) and ongrowth (Ti PS) were assessed after 4 and 12 weeks.

Orthopaedic surgery. Joint effort.

Hip replacement surgery is becoming increasingly specialised and evidence shows that, particularly in revision, surgery is best done by specialists. An audit of GPs suggests great variation in referral practice, with one-third prepared to refer to a 'generalist' orthopaedic surgeon. GPs need better communication with hospitals and knowledge of where specialists are available.