Intralesional leiomyosarcoma malignant transformation from a biopsied benign angioleiomyoma of the proximal anterior tibia.

We present a novel case of a malignant transformation of an extremity soft tissue angioleiomyoma to leiomyosarcoma in a man in his late 70s who presented with a painful and increasing lump on his anterior tibia. Initial imaging and biopsy showed a benign angioleiomyoma which was excised for symptomatic reasons. An analysis of the resulting specimen revealed a 50×42×15 mm smooth muscle neoplasm consistent with angioleiomyoma with a 22×11 mm entirely intralesional nodular component in keeping with a grade 1 leiomyosarcoma.

Total femoral spanning for distal femur "fragility" fractures utilising nail-plate fixation "short-term experience of a district general hospital".

Purpose: Our primary objective was to investigate the time to radiological union following linked nail-plate fixation of distal femur "fragility" fractures. Secondary objectives were to evaluate all-cause reoperations, 90-day mortality, rate of blood transfusion and the impact on quality of life.

Methods: In this retrospective study of all adults (≥ 65 years) with native or periprosthetic distal femur fragility fractures, underwent a linked nail-plate fixation, data were retrieved on fracture classifications, clinical frailty score, blood transfusion, length of hospital stay, 90-day mortality, time to radiological union, overall complication rates and EuroQoL-5D.

The Role of Anterolateral Ligament Reconstruction or Lateral Extra-articular Tenodesis for Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Clinical Studies.

Background: After its success in restoring rotational stability and reducing failure rates in primary anterior cruciate ligament reconstruction (ACLR), lateral extra-articular tenodesis (LET) or anterolateral ligament reconstruction (ALLR) has been endorsed for use in revision ACLR surgery, where failure rates are historically higher.

Purpose: To perform a systematic review and meta-analysis on whether the addition of a LET or ALLR results in superior clinical outcomes and stability compared with isolated revision ACLR (iACLR).

Study Design: Meta-analysis; Level of evidence, 4.

Outcomes of Unconstrained Proximal Interphalangeal Joint Arthroplasty: A Systematic Review.

Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. Thirty studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included.

Maintaining Postgraduate Healthcare Education During COVID-19: Does a Virtual Format Allow Effective Engagement and Personal Development?

Introduction The COVID-19 pandemic has brought unprecedented challenges in health care, leading to a dramatic change in service provision and impacting surgical training. The availability of a virtual meeting platform allowed our team to develop a new educational programme aiming to maintain an ethos of education safely, focusing on providing an opportunity to develop non-technical skills and maintain reflective practice. Materials and Methods Microsoft Teams was used to conduct two streams of weekly education: a journal club focussing on developing critical evaluation skills, and case-based in-depth discussion forum to develop presentation skills and evidence-based management.

Outcomes of Unconstrained Proximal Interphalangeal Joint Arthroplasty: A Systematic Review.

: Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. : 30 studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included.

Total hip arthroplasty in Parkinson's disease - A systematic review of the current evidence.

This systematic review assessed the efficacy, survivorship, and complications of Total Hip Replacement (THR) in Parkinson's Disease (PD). Databases were searched according to the Preferred Reporting Items for Systematic Reviews. PD patients had higher wound infections, dislocations, peri-prosthetic fractures, and revision surgery compared to their non-PD counterparts.

Direct oral anticoagulants (DOACs) and neck of femur fractures: Standardising the perioperative management and time to surgery.

Demographic projections for hip fragility fractures indicate a rising annual incidence by virtue of a multimorbid, ageing population with more noncommunicable diseases (NCDs). NCDs are characterised by slow progression and long duration ranging from ischaemic cardiovascular disease, cerebrovascular disease, diabetes, chronic obstructive pulmonary disease to various cancers. Management of this disease burden often involves commencing patients on oral anticoagulants to reduce the risk of thromboembolic events.

What is the evidence for chemical thromboprophylaxis in foot and ankle surgery? Systematic review of the English literature.

Venous thromboembolism (VTE) is a well documented complication following lower limb trauma and surgery. The incidence of VTE in hip and knee surgery has been well studied, whereas the incidence in foot and ankle surgery is less clear. There is debate as to which cases require prophylaxis and what is the most effective means by which this is achieved.