The Impact of Hospital Transfers on Surgical Delay and Associated Postoperative Outcomes for Hip Fracture Patients in Scotland: A Cohort Study.

: Hip fractures exert a substantial burden on hospital systems. Within Scotland 20% of the population resides rurally, warranting investigation of how this impacts prompt access to surgical care. This study aims to determine whether indirect hospital admission via hospital transfer affects the likelihood of surgical management within 36 h for hip fracture patients.

Impaired Cardiac and Skeletal Muscle Energetics Following Anthracycline Therapy for Breast Cancer.

Background: Anthracycline-related cardiac toxicity is a recognized consequence of cancer therapies. We assess resting cardiac and skeletal muscle energetics and myocyte, sarcomere, and mitochondrial integrity in patients with breast cancer receiving epirubicin.

Methods: In a prospective, mechanistic, observational, longitudinal study, we investigated chemotherapy-naive patients with breast cancer receiving epirubicin versus sex- and age-matched healthy controls.

To fuse or not to fuse: The elderly patient with lumbar stenosis and low-grade spondylolisthesis. Systematic review and meta-analysis of randomised controlled trials.

Background: The optimum surgical intervention for elderly patients with lumbar spinal stenosis (LSS) and low-grade degenerative-spondylolisthesis (LGDS) has been extensively debated. We conducted a systematic review and meta-analysis of randomised-controlled-trials (RCTs) comparing the effectiveness of decompression-alone against the gold-standard approach of decompression-with-fusion (D + F) in elderly patients with LSS and LGDS.

Methods: A systematic literature search was performed on published databases from inception to October-2021.

Anatomical study of the human sacral hiatus and implications for successful caudal epidural injection.

Background: Caudal epidural injection (CEI) is a commonly used procedure to treat back and leg pain secondary to nerve root irritation, predominantly in the context of spinal canal stenosis. Key to a successful outcome is correct needle placement. Although fluoroscopic guidance confirms accurate needle placement, it does not help in determining the starting point, which can lead to multiple needle insertions.

Primary and Secondary Total Knee Arthroplasty for Tibial Plateau Fractures.

The surgical management of tibial plateau fractures can be technically demanding. In younger patients, the mainstay is fixation with cartilage preservation. In older patients with osteoporotic bone, this method has higher rates of fixation failure; in addition, it requires prolonged bed rest or protected weight bearing, which are major challenges in this group.

Volar locking plate fixation for distal radius fractures: Does age affect outcome?

Background: The AAOS guidelines are unable to recommend for or against operative treatment of distal radius fractures in older patients.

Aims: This study compares the outcomes of older patients (≥60 years) against a cohort of younger patients treated with volar locking plate (VLP) fixation.

Methods: We assessed 78 patients, comparing range of movement (ROM), grip and pinch strength, subjective Visual Analogue Score (VAS) for pain and function and composite outcome scores.

A novel technique to practice using a high-speed burr for spinal anterior cervical discectomy and fusion.

Background: Anterior cervical discectomy and fusion has been a successful procedure in terms of patient satisfaction in the management of cervical myelopathy and radiculopathy. The procedure involves an anterior approach to the cervical vertebral column and decompression of the neural elements.

Aim: A key part of the procedure is the removal of the posterior osteophyte.

Low Back Pain: Current Surgical Approaches.

Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed by nonoperative measures.

Wet or dry bandages for plaster back-slabs?

Cotton crêpe and stretch bandages are commonly used in back-slabs and casts in orthopaedic practice. In theory they allow swelling to occur after injury while splinting the fracture. The application of a wet bandage prevents the Plaster-of-Paris (POP) setting too rapidly, giving time to apply a mould or attain correct limb position.