Novel clinical and radiological measures of lower limb obesity.

Osteoarthritis of the knee is strongly associated with central obesity, and the prevalence of obesity in patients undergoing knee arthroplasty procedures is expected to increase. Central obesity is associated with multiple adverse outcomes after knee arthroplasty, but the impact of obesity specifically around the operated knee is poorly understood. One reason for this is the absence of a standardized measure, analogous to BMI for central obesity, to facilitate research.

Excised Femoral Heads in Hip Fracture Patients: Is Osteoporosis Worse Than Cancer?

Introduction Annually 80,000 hip fractures are treated at an estimated cost of two billion pounds. The 2011 guidance from the Royal College of Pathologists recommended all specimens where there is fracture through or below the articular surface should be examined to exclude/ identify an underlying cause (pathological fracture). The questions posed in this study are three-fold.

Preoperative sizing of hip hemiarthroplasties to accurately estimate head size from non- standardised pelvic radiographs: Can it be done?

Background: Preoperative sizing of implants for hip fracture patients requiring a hemiarthroplasty is difficult due to non-standardised radiographs, absence of sizing marker, variable patient position and body habitus. We investigated whether a simple tool could help predict femoral head size, allowing surgeons to safely proceed with surgery when implant stocks are limited, and to potentially improve theatre efficiency.

Methods: Three independent reviewers measured the maximum width of the contralateral (intact) femoral head using PACS software in 50 cases of intracapsular hip fracture.

Congenital talipes equinovarus and congenital vertical talus secondary to sacral agenesis.

Sacral agenesis is a rare congenital defect which is associated with foot deformities such as congenital talipes equinovarus (CTEV) and less commonly congenital vertical talus (CVT). We report a 3-year-old Caucasian girl who was born with right CTEV and left CVT secondary to sacral agenesis. Her right foot was managed with a Ponseti casting method at 2 weeks, followed by an Achilles tenotomy at 4 months.

Unusual fracture combination in a paediatric acute ankle (combined medial talar compression fracture with medial malleolus fracture in an immature skeleton): a case report.

Talar compression fractures are uncommon orthopaedic injuries, especially in the immature skeleton. Fractures of the talar body constitute >5% of all foot and ankle fractures. The combination of a medial compression fracture and corresponding medial malleolar fracture is rare and not previously reported injury in the literature.

Minimising negative ankle and foot X-rays in the Emergency Department -- are the Ottawa ankle rules good enough?

Objectives: To review fracture rates in patients who had X-rays of either the ankle or foot or both in the Emergency Department of a district hospital.

Method: A retrospective review of 2589 Emergency Department patients who had X-rays of the ankle or foot or both over a 12-month period.

Results: There were 1199 ankle X-rays taken of which 193 (16%) showed a significant fracture.