A novel scoring system incorporating sarcopenia to predict postoperative survival in spinal metastasis.

Background Context: As the prevalence of spinal metastasis rises, methods to predict survival will become increasingly important for clinical decision-making. Sarcopenia may be used to predict survival in these patients.

Purpose: The purpose of this study to develop a prediction model incorporating sarcopenia for postoperative survival in patients with spinal metastasis.

The Not-So-Merry-Go-Round: Traumatic Inferior-Anterior Hip Dislocation in a 9-Year-Old.

Merry-go-rounds are not as innocuous as they may seem. Pediatric hip anterior-inferior dislocations are very rare and can be associated with low-energy trauma. Prompt recognition of pediatric hip dislocations is vital, and this should be treated as a time-sensitive orthopedic emergency.

Treatment of Pasteurella multocida Cervical Epidural Abscess.

A 51-year-old left-handed Caucasian female with no significant medical history presented with a two-week history of severe neck pain and bilateral upper limb weakness. Neurological examination revealed weakness and altered sensation in the C5-T1 distribution bilaterally, more severe on the left with Medical Research Council's scale (MRC scale) of muscle power grade 3/5 and 4/5 on the right with upper motor neuron signs. Short-TI Inversion Recovery (STIR) and T2 weighted MRI imaging revealed increased signal at the C6-7 disc representing discitis, as well an anterior epidural collection from C5 to C7, with associated cord compression.

Vancomycin-Induced DRESS Syndrome: An Important Concern in Orthopedic Surgery.

DRESS (drug reaction with eosinophilia and systemic symptoms) is a potentially serious complication when prolonged courses of antibiotics are given to patients, with an average onset of 2-6 weeks after commencement. There is a high mortality rate (1-10%). We report the case of a 62-year-old male who developed DRESS after seven weeks of antibiotic treatment with vancomycin for a deep spinal metalwork infection.

Retained Foreign Body in a Diabetic Patient's Hand.

Background: Diabetic peripheral neuropathy puts patients at increased risk of acute injury by foreign bodies and also contributes to delayed presentation and diagnosis.

Case Report: We describe a 57-year-old patient with poorly controlled type 1 diabetes who presented with a three-week history of worsening swelling and erythema in the metacarpophalangeal joint of his left thumb. He denied any previous trauma or injury and was initially treated with intravenous antibiotics.

Requesting spinal MRIs effectively from primary care referrals.

Objective: To define if MRI scans can accurately be requested based on information provided in the primary care referral and, therefore, streamline the patient journey. The demand for outpatient spinal appointments significantly exceeds our services' ability to provide efficient, high-quality patient care. Currently, magnetic resonance imaging (MRI) of the spine is requested following first consultation.

Fracture clinic redesign: improving standards in patient care and interprofessional education.

Introduction: Current fracture clinic models, especially with the advent of reductions in junior doctors' hours, may limit outpatient trainee education and patient care. We have designed a new fracture clinic model, involving an initial consultant-led case review focused on patient management and trainee education.

Methods: Prospective outcomes for all new patients attending the redesigned fracture clinic over a 3-week period in 2010 (n = 240) were compared with a historical cohort from the same period in 2009 (n = 296).

Efficacy of outpatient bilateral simultaneous hallux valgus surgery.

Bilateral simultaneous hallux valgus correction is traditionally performed as an inpatient procedure due to concerns regarding adequate postoperative analgesia and difficulty mobilizing. We prospectively evaluated 40 consecutive patients (80 feet) who underwent outpatient surgical correction of bilateral symptomatic hallux valgus. Patients underwent preoperative radiological and clinical assessment using pain and American Orthopaedic Foot & Ankle Society (AOFAS) hallux assessment scores.