Tight application of a surgical tourniquet prior to inflation increases venous pressure in the upper limb; Potentially resulting in increased blood loss and poorer visibility.

Background: Tourniquets are commonly used in extremity surgery to help provide a bloodless operative field to improve visibility and reduce length of procedures. With the development of WALANT (wide awake, local anaesthetic, no tourniquet) techniques, many surgeons undertake surgery without tourniquet inflation. The correct technique of pneumatic tourniquet application is poorly understood by healthcare staff.

Trends in the surgical management of proximal humerus fractures in Ireland from 2009 to 2022: An increasing usage of reverse shoulder arthroplasty.

Background: Proximal humeral fractures are a common injury accounting for a significant workload across orthopaedic departments. Though often managed non-operatively, surgical management is indicated for a proportion of patients.

Aims: The aim of this study is to examine the trends in the management of proximal humeral fractures within Ireland over the past 13 years.

Glenohumeral joint osteoarthritis is not associated with clavicle fractures in a large arthroplasty cohort.

Introduction: A recent study based on a large osteological collection reported an association between clavicle fractures and osteoarthritis of the glenohumeral joint. No clinical study has yet addressed this potential association. Other radiographic parameters such as the critical shoulder angle have been associated with the risk of glenohumeral joint osteoarthritis.

Multispecialty surgical management of large clavicular tumor: A case report.

Introduction: Primary and metastatic malignancies of the clavicle are extremely uncommon and difficult to treat. It carries a high morbidity rate. Total or partial claviculectomy is the recommended treatment option.

Video Analysis of Shoulder Dislocations in Rugby: Insights Into the Dislocating Mechanisms.

Background: Mechanisms previously described for traumatic shoulder injuries in rugby may not adequately describe all the mechanisms that result in shoulder dislocations.

Purpose: To investigate the mechanism of shoulder dislocation events in professional rugby players through use of systematic video analysis.

Study Design: Case series; Level of evidence, 4.

Do preoperative radiographs help predict intraoperative challenges in revision surgery after previous shoulder hemiarthroplasty?

Background: This study compares preoperative radiographic evaluation with intraoperative video and explant data in patients undergoing revision of a hemiarthroplasty.

Methods: From 2004 to 2017, 182 shoulder hemiarthroplasties underwent revision to reverse shoulder arthroplasty for symptomatic failure. Preoperative radiographs were evaluated for stem fixation, stability, and glenohumeral registry.

Improving preoperative planning of revision surgery after previous anatomic total shoulder arthroplasty.

Background: The purpose of this study was to compare preoperative radiographic evaluation with intraoperative video and explant analysis in patients undergoing revision of a previous anatomic total shoulder arthroplasty (TSA).

Methods: We evaluated the preoperative radiographs of 165 revisions of failed TSAs for component loosening and glenohumeral registry (ie, the spatial relationship of the glenoid component and the prosthetic humeral head). Seventy-nine intraoperative videos were evaluated for component stability, rotator cuff (RC) integrity, synovitis, and glenoid bone loss.

Early Hyperoxia in Patients with Traumatic Brain Injury Admitted to Intensive Care in Australia and New Zealand: A Retrospective Multicenter Cohort Study.

Background: Early hyperoxia may be an independent risk factor for mortality in critically ill traumatic brain injury (TBI) patients, although current data are inconclusive. Accordingly, we conducted a retrospective cohort study to determine the association between systemic oxygenation and in-hospital mortality, in critically ill mechanically ventilated TBI patients.

Methods: Data were extracted from the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database.

Arthrodesis of Little Finger Distal Interphalangeal Joint in Flexion to Regain Sporting Ability.

Background: Finger injuries are common in the sport of hurling. Injury to the little finger distal interphalangeal joint (DIPJ) often occurs when a high dropping ball impacts on the outstretched finger. The little finger contributes to approximately 15% of grip strength.

Assessment of the 2D:4D ratio in aggression-related injuries in children attending a paediatric emergency department.

Background: The 2D:4D ratio is a sexually dimorphic trait. A lower ratio is correlated with sporting prowess, successful financial trading, risk taking behaviour, aggression, and aggression-related injuries, such as the fifth metacarpal fractures.

Aims: We aimed to assess if the ratio correlates to skeletally immature patient aggression.

Bioabsorbable pins for bone fixation in the less invasive innominate osteotomy.

For the less invasive innominate osteotomy for the treatment of developmental dysplasia of the hip, we aim to report radiological outcomes, complication rates and reoperation rates for patients whose bone grafts were secured using bioabsorbable pins. A retrospective study of all patients who underwent less invasive innominate osteotomy for persistent or delayed diagnosis developmental dysplasia of the hip over a period of 2 years from 2008 to 2010 was carried out. A total of 59 hips were identified as having had their bone graft secured with two bioabsorbable pins made from copolymers of L-lactic acid, D-lactic acid and trimethylene carbonate.

Second to fourth digit ratio confirms aggressive tendencies in patients with boxers fractures.

Background: Upper limb second to fourth digit ratio (2D:4D) has been shown to be dependent on prenatal androgen exposure. A longer relative fourth digit to second digit is indicative of increased intrauterine testosterone exposure prenatally and the converse is also true for oestrogen exposure. The 2D:4D ratio has implications in the sporting, academic, financial and sexual arenas.

Digital photography for assessment of shoulder range of motion: A novel clinical and research tool.

Purpose: Maintenance of a pain-free functional range of motion is the aim of surgery for shoulder trauma. The aim of this study was to show that the range of motion can be accurately assessed using digital photographs.

Materials And Methods: We reviewed 17 patients who had undergone surgery for shoulder trauma.

Use of a geometric formula to improve the radiographic correction achieved by the scarf osteotomy.

Background: Many procedures for hallux valgus treatment have high recurrence rates, often related to operative considerations such as accuracy of deformity correction, soft tissue balancing and sesamoid alignment. Inadequate distal metatarsal-articular angle (DMAA) correction is common with uni- and bi-planar osteotomies which principally address the inter-metatarsal angle (IMA). The scarf osteotomy is a tri-planar osteotomy which corrects the DMAA and IMA, thereby achieving a more anatomical correction and potentially reducing the recurrence rate.

Imaging the spine for tumour and trauma--a national audit of practice in Irish hospitals.

Background And Purpose: The provision of appropriate spinal imaging in cases of acute injury as a consequence of trauma or tumour is becoming ever more challenging. This study assessed the use of multimodal radiological investigations in the management of spinal cord compression as a result of trauma and metastatic cancer in all major Irish hospitals.

Methods: We conducted a questionnaire of thirty four hospitals in an effort to assess the provision of these services to patients with possible spinal cord compromise.

The role of pre-operative assessment and ringfencing of services in the control of methicillin resistant Staphlococcus aureus infection in orthopaedic patients.

Background: MRSA is a major economic and health issue internationally and as such is of particular importance in the appropriate management of orthopaedic patients. Bone, joint and implant infection can lead to unfavourable outcomes with a long protracted in hospital stay inevitable. The cost for the patient, the hospital and society are substantial.

Clavicle fractures: a comparison of five classification systems and their relationship to treatment outcomes.

We compared five classification systems for clavicle fractures. The aim of this study was to evaluate the prognostic value of each system. Over a two-year period we reviewed all new radiographs of the shoulder region and identified 487 clavicle fractures.

The 100 classic papers of orthopaedic surgery: a bibliometric analysis.

The credibility and creativity of an author may be gauged by the number of scientific papers he or she has published, as well as the frequency of citations of a particular paper reflecting the impact of the data on the area of practice. The object of this study was to identify and analyse the qualities of the top 100 cited papers in orthopaedic surgery. The database of the Science Citation Index of the Institute for Scientific Information (1945 to 2008) was used.

N-acetylcysteine protects striated muscle in a model of compartment syndrome.

Background: To avoid ischemic necrosis, compartment syndrome is a surgical emergency treated with decompression once identified. A potentially lethal, oxidant-driven reperfusion injury occurs after decompression. N-acetylcysteine is an antioxidant with the potential to attenuate the reperfusion injury.

A pilot evaluation of a neuromuscular electrical stimulation (NMES) based methodology for the prevention of venous stasis during bed rest.

Bed rest poses an increased risk factor for a potentially fatal venous thromboembolism (VTE). Lack of activation of the calf muscle pump during this resting period gives rise to venous stasis which may lead to deep vein thrombosis (DVT) development. Our aim was to investigate the effects that 4h of bed rest have on the lower limb hemodynamics of healthy subjects and to what extent electrically elicited contractions of the calf muscles can alleviate these effects.

Enteropathy associated T-cell lymphoma resulting in restrictive cardiomyopathy and mimicking myocardial infarction.

A 64-year-old woman was referred with a short history of abdominal pain, anorexia and weight loss. Investigations revealed a probable enteropathy associated T-cell lymphoma (EATL). Further investigations revealed evidence of what appeared to be a myocardial infarction.

A hemodynamic study of popliteal vein blood flow: the effect of bed rest and electrically elicited calf muscle contractions.

Venous stasis, due to lack of activation of the calf muscle pump of postoperative patients, can result in the development of a thrombus which, in turn, can lead to a potentially fatal pulmonary embolism. The presented study investigates the effects that four hours of bed rest has on the lower limb hemodynamics of healthy subjects and, to what extent electrically elicited contractions of the calf muscles can alleviate these effects. Results indicated that the non-stimulated group experienced a decline in popliteal venous blood flow of approximately 45 % and a 10 % decrease in heart rate.

Multidisciplinary team meetings and their impact on workflow in radiology and pathology departments.

Background: The development of multidisciplinary team meetings (MDTMs) for radiology and pathology is a burgeoning area that increasingly impacts on work processes in both of these departments. The aim of this study was to examine work processes and quantify the time demands on radiologists and pathologists associated with MDTM practices at a large teaching hospital. The observations reported in this paper reflect a general trend affecting hospitals and our conclusions will have relevance for others implementing clinical practice guidelines.