Decision making on timing of surgery for hip fracture patients on clopidogrel.

Patients taking clopidogrel who sustain a fractured neck of femur pose a challenge to orthopaedic surgeons. The aim of this study was to determine whether delay to theatre for these patients affects drop in haemoglobin levels, need for blood transfusion, length of hospital stay and 30-day mortality. A retrospective review of all neck of femur patients admitted at two centres in the North East of England over 3 years revealed 85 patients.

Solitary osteochondroma of the trapezoid disguised as a tooth fragment.

Fight bite injuries of the hand are common presentations in A&E departments and usually result from a fist blow to the mouth. The authors report a case of a 24-year-old man who presented 6 weeks after an injury to his right wrist following an altercation. Radiographic examination and CT scans were in keeping with a tooth fragment embedded in the trapezoid.

The Best Practice Tariff helps improve management of neck of femur fractures: a completed audit loop.

Background: The Best Practice Tariff incentivizes hospitals in the UK to improve the care they deliver, and includes a requirement to deliver multiprofessional care to patients with neck of femur fractures. The Best Practice Tariff for 2010-11 included six targets: (1) surgery within 36 hours, (2) admission under consultant-led joint orthopaedic-geriatric care, (3) admission using a multidisciplinary assessment protocol, (4) review by a geriatrician within 72 hours, (5) geriatrician-directed multi-professional rehabilitation, and (6) assessment for falls and bone protection. The authors chose to audit their Trust's compliance with these targets.

A Review on the Management of Hip and Knee Osteoarthritis.

Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips.

Internal fixation of a traumatic fracture around a hip resurfacing arthroplasty using the proximal femoral locking compression plate.

We report on a 40-year-old man who sustained a traumatic extracapsular fracture of the proximal femur with a Birmingham Hip Resurfacing in situ. It was decided to retain the resurfacing implant and a proximal femoral periarticular locking compression plate (Synthes) was used to stabilise the fracture. The patient regained full range of pain-free movement, and was bearing his full weight on the operated leg by 18 weeks.

MRSA in a large German University Hospital: Male gender is a significant risk factor for MRSA acquisition.

Background: The continually rising number of hospital acquired infections and particularly MRSA (Methicillin-resistant Staphylococcus aureus) colonization poses a major challenge from both clinical and epidemiological perspectives. The assessment of risk factors is vital in determining the best prevention, diagnosis and treatment strategies.

Materials And Methods: We analyzed 798 cases of MRSA in a large German University Hospital over a 7-year period.

Longitudinal in vivo effects of growth hormone overexpression on bone in transgenic mice.

Unlabelled: In this study we examined the effect of systemic overexpression of GH on bone in transgenic mice longitudinally in vivo over a period of 9 months. We observed substantially increased BMC in GH transgenic mice and a significant reduction in serum osteocalcin. GH effects on bone were strongly dependent on gender and developmental stage.

Precision of high-resolution dual energy X-ray absorptiometry of bone mineral status and body composition in small animal models.

The purpose of this study was to analyze the in situ precision (reproducibility) of bone mineral and body composition measurements in mice of different body weights and rats, using a high-resolution DXA (dual energy X-ray absorptiometry) scanner. We examined 48 NMRI mice weighing approximately 10 to 60 g, and 10 rats weighing approximately 140 g. Four repeated measurements were obtained on different days.

Precision and accuracy of peripheral quantitative computed tomography (pQCT) in the mouse skeleton compared with histology and microcomputed tomography (microCT).

Unlabelled: pQCT was evaluated for accuracy of phenotypic characterization of mouse bone in vivo. Bones (tibia, femur, spine) of 27 animals were measured ex vivo with pQCT, microCT, and histomorphometry and of 23 mice in vivo (pQCT). pQCT yielded satisfactory in vivo precision and accuracy in skeletal characterization.

Body composition, bone mass and microstructural analysis in GH-transgenic mice reveals that skeletal changes are specific to bone compartment and gender.

Experimental and clinical studies suggest that high serum levels of growth hormone (GH) increase cortical but not trabecular bone. We studied body composition and bone structure in transgenic mice (MT-bGH) with systemic overexpression of GH. Body composition was examined with dual-energy X-ray absorptiometry (DXA), ashing, and chemical analysis, and the femora with DXA and micro computerized tomography.

[Sex-specific analysis of bone mass in normal and growth hormone transgenic mice using dual energy x-ray absorptiometry (DXA)].

The aim of the present study was the non-invasive, sex-specific measurement of bone mass in bovine growth hormone (bGH) transgenic mice and normal controls with dual energy X-ray absorptiometry (DXA). The transgenic mouse constitutes a suitable animal model to study the influence of growth hormone on the skeletal system. We analysed 28 animals, aged 12 weeks (14 transgenic, 14 controls, 7 male and 7 female, respectively), using a peripheral DXA scanner that had been adapted to the measurement of small animals.