Involving patients and clinicians in the development of a randomised clinical trial protocol to assess spinal manual therapy versus nerve root injection for patients with lumbar radiculopathy: a patient and public involvement project to inform the SALuBRITY trial design.

Background: Spinal manual therapy and corticosteroid nerve root injection are commonly used to treat patients with lumbar radiculopathy. The SALuBRITY trial-a two parallel group, double sham controlled, randomised clinical trial-is being developed to compare their effectiveness. By gathering patients' and clinicians' perspectives and involving them in discussions related to the trial research question and objectives, proposed trial recruitment processes, methods, and outcome measures, we aimed to improve the relevance and quality of the SALuBRITY trial.

Involving patients and clinicians in a pilot randomised clinical trial of spinal manual therapy versus nerve root injection for lumbar radiculopathy: protocol of a patient and public involvement project.

Introduction: A patient and public involvement (PPI) project will be embedded within the SALuBRITY pilot trial, a two parallel group, double sham controlled, randomised clinical trial. The study aims to compare the effectiveness of spinal manual therapy and corticosteroid nerve root injections, two methods commonly used to treat patients with lumbar radiculopathy. We aim to gather patients' and clinicians' perspectives and involve them in decisions related to the research question and objectives, proposed trial recruitment processes and methods, and proposed outcome measures.

Long-term outcome after surgical treatment of intra-articular tibial plateau fractures in skiers.

Introduction: Tibial plateau fractures occur frequently during downhill skiing. There is a lack of information about the outcome and development of posttraumatic osteoarthritis after internal fixation of such fractures at long-term follow-up in skiers.

Materials And Methods: A population of 83 skiers was followed up in a case series after internal fixation of intra-articular tibial plateau fractures AO-OTA 41 B1-B3 and C1-C3.

Long-term radiographic appearance of calcium-phosphate synthetic bone grafts after surgical treatment of tibial plateau fractures.

Objectives: Synthetic bone grafts (SBGs) are widely used to fill bone defects after fracture reduction. This study assessed the long-term resorption of two different calcium phosphate products (A=ChronOS™ inject and B=Norian SRS; both DePuy Synthes, Oberdorf, Switzerland) used in the surgical treatment of tibial plateau fractures.

Design: Long-term clinical and radiologic follow-up of 52 patients after surgical treatment of intraarticular tibial plateau fractures augmented with SBGs.

Rivaroxaban for Thromboprophylaxis After Nonelective Orthopedic Trauma Surgery in Switzerland.

This study investigated the effectiveness and the outcomes of rivaroxaban vs the standard of care for venous thromboembolic prophylaxis in patients undergoing fracture-related surgery. A total of 413 patients undergoing fracture-related surgery from 9 Swiss orthopedic and trauma centers were enrolled. The authors selected the type of venous thromboembolic prophylaxis according to standardized medical practice at the participating centers before the inclusion of patients: 208 patients received rivaroxaban and 205 received the standard of care.

Evaluation of a treatment algorithm for acute traumatic osseous Bankart lesions resulting from first time dislocation of the shoulder with a two year follow-up.

Background: Studies dealing with acute osseous Bankart lesions and corresponding treatment strategies are rare. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations.

Methods: 25 patients were included in this retrospective case series.

Sports activity after surgical treatment of intra-articular tibial plateau fractures in skiers.

Background: Tibial plateau fractures occur frequently while participating in winter sports, but there is no information on whether skiers can resume sports and recreational activities after internal fixation of these fractures.

Hypothesis: Skiers can resume low-impact sports activity after internal fixation of tibial plateau fractures.

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

Biomechanical comparison of different fixation techniques for reconstruction of tibial avulsion fractures of the anterior cruciate ligament.

Purpose: The most common fixation techniques for tibial avulsion fractures of the anterior cruciate ligament (ACL) described in the literature are screw and suture fixation. The fixation of these fractures with the TightRope® device might be an alternative. Up to now it has been commonly used in other injuries, such as acromioclavicular joint or syndesmosis ruptures.

[A penetrating volar foreign body: a wooden splinter beneath the flexor tendons].

Hand injuries are among the most common injuries seen in general practitioner (GP) consultation hours and emergency departments and are most often affecting the dominant hand. We report on a case of unsuccessful primary exploration of the volar hand for a foreign body by the GP. In regard to detailed history of the injury mechanism, we performed the clinical examination and an additional ultrasound evaluation of the hand, suggesting evidence for a foreign body and a laceration of one of the flexor tendons.

Can complications of titanium elastic nailing with end cap for clavicular fractures be reduced?

Background: We found treatment of clavicular midshaft fractures using titanium elastic nails (TENs) in combination with postoperative free ROM was associated with a complication rate of 78%. The use of end caps reduced the rate to 60%, which we still considered unacceptably high. Thus, we explored an alternative approach.

A New Injectable Brushite Cement: First Results in Distal Radius and Proximal Tibia Fractures.

Objective: The restoration of metaphyseal defects remains a challenge for the treating surgeon. Although injectable brushite cements may help to refill bone defects stabilized with internal fixation, human data remains unavailable. The main goal of this prospective multicenter study was to observe the performance of this material in a clinical setting.

Intramedullary nailing of clavicular midshaft fractures with the titanium elastic nail: problems and complications.

Background: Intramedullary nailing of clavicular midshaft fractures using the titanium elastic nail has been described as a technically easy, minimally invasive operation with few complications and an early return to competitive sports.

Hypothesis: The results reported thus far have been positive. The titanium elastic nail is associated with multiple intraoperative and postoperative problems.

[Management of bicondylar fractures of the tibial plateau with unilateral fixed-angle plate fixation].

Background: This study was initiated to evaluate early results of a locked screw plate for unilateral fixation of bicondylar fractures of the tibial plateau. Emphasis was laid on malreduction, secondary loss of reduction, union rate, and infection.

Material And Methods: A case series of patients with AO/ASIF 41-C type fractures treated with the less invasive stabilization system for the proximal lateral tibia (LISS PLT) were prospectively followed up until 11-13 months after surgery.

Snowboarder's talus fracture: treatment outcome of 20 cases after 3.5 years.

Background: Fracture of the lateral process of the talus is a typical snowboarding injury. Basic data are limited, particularly with respect to treatment and outcome.

Hypothesis: As the axial-loaded dorsiflexed foot becomes externally rotated and/or everted, fracture of the lateral process of the talus occurs.

[New surgical treatment procedures in fractures of the distal tibia (LCP, MIPO)].

All along the operative treatment of distal tibial fractures is a difficult procedure. In most cases the clinical situation is characterized by small distal fragments in combination with crucial soft-tissue conditions. That's why complications as primary or secondary displacements, mal unions, delayed or non unions and as well as a high rate of deep wound infection are often seen.

Fulkerson's modified Elmslie-Trillat procedure for objective patellar instability and patellofemoral pain syndrome.

Twenty two knees were either operated for objective patellar instability (Group A: 14 patients) or patellofemoral pain syndrome (Group B: 8 patients) using Fulkerson's modified Elmslie-Trillat procedure. The objective of this retrospective study was to evaluate the results of this method and to detect whether or not there were differences in the outcome comparing the two groups. Twenty knee joints (Group A: 13; group B: 7) were available for clinical and radiographic examination after an overall mean follow-up of 63 months.

[Isolated coracoid fracture--open reposition and osteosynthesis--report of 3 cases].

Unlabelled: Usually coracoid-fractures are "chain-injuries" in association with complex shoulder injuries. Isolated fractures of the coracoid process are uncommon. In the literature there is no consensus about the treatment.

[Pneumatic tourniquet as a repositioning aid in closed intramedullary nailing].

The use of an extrawide pneumatic tourniquet as a reduction aid for closed intramedullary nailing is described, even in combination with the distractor. The principle is similar to that applied in fracture bracing as described by Sarmiento: the reduction of the fragments is achieved by ligamentotaxis (traction on the limb) combined with gentle concentric soft tissue compression exerted by the inflated tourniquet. We have applied the simple, non-invasive technique in over 30 fractures with good results.

[Computer-assisted prospective wound infection monitoring. 1: Ideas and principles].

The prospective recording of nosocomial infections can be regarded as a quality control measure whereby exact data collection and analysis will improve recognition of the individual aspects of hygiene deficiency in the hospital and thus reduce the incidence of nosocomial infections. Wound infections will be recorded on the basis of the CDC definitions for nosocomial infections (1988) and according to three categories of cleanliness for all operations: aseptic, contaminated, infected. A computer program is recommended for data collection and exact analysis--if possible, combined with an internal hospital communication system.

[High grade liver rupture--is nonsurgical therapy feasible?].

Although well accepted in pediatric patients, the nonoperative management of severe blunt hepatic trauma in adults remains controversial. On the basis of 3 cases with major liver injury, the rationale and prerequisites for a successful nonoperative treatment are discussed.

Tibial fractures treated with the AO unreamed tibial nail.

During the last 2 years 20 fractures of the tibial shaft have been treated with the new, 'unreamed' solid AO tibial nail (UTN). There were 13 open fractures, while four of the seven closed fractures had severe soft tissue injuries. There were nine fractures classified as 'complex' or type C according to the AO classification.

[Distal radius fractures: conservative or surgical treatment?].

The "classical" Colles fracture of the distal radius is the most common fracture in the adult. In order to reduce the still rather high rate of permanent disability, this fracture involving a functionally important joint requires accurate reduction. The AO-fracture classification introduced by Müller not only defines the severity of an injury, but also allows for decision-making as to the most adequate treatment.

[Initial results with the unreamed AO tibial nail].

It is generally accepted that intramedullary nailing in combination with reaming should be avoided in treating open fractures. However, the use of an unreamed, solid nail combined with interlocking also allows stabilization of open and complex fractures. 20 tibia fractures (65% open, 45% complex fractures) have been treated by the AO unreamed tibial nail (UTN), 12 (5 of them open fractures) by direct nailing and 8 after initial stabilization by an external fixator.

[Initial experiences with the unreamed AO tibial nail].

It is generally accepted that intramedullary nailing in combination with reaming should be avoided in treating open fractures. However the use of an unreamed, solid nail combined with interlocking allows stabilization also of open and complex fractures. 20 tibia fractures (65% open, 45% complex fractures) have been treated by the AO unreamed tibial nail (UTN), 12 (5 of them open fractures) by direct nailing and 8 after initial stabilization by an external fixator.