Introduction. The various problems that are managed with circular external fixation (e.g. deformity, complex fractures) also typically require serial plain x-ray imaging. One of the challenges here is that the relatively radio-opaque components of the circular external fixator (e.g. the rings) can obscure the view of the area of interest (e.g. osteotomy site, fracture site). In this presentation we describe how the geometry of the x-ray beam affects the produced image and how we can use knowledge of this to our advantage. Whilst this can be applied to any long bone, we have focused on the tibia, given that it's the most common long bone that is treated by circular external fixation. Materials & Methods. In the first part of the presentation we describe the known attributes (geometry) of the x-ray beam and postulate what effect it would have when we x-ray a long bone that is surrounded by a circular external fixator. In the second part we demonstrate this in practice using a tibia and a 3 ring circular external fixator. Differing x-ray beam orientations are used to demonstrate both how the geometry of the beam affects the produced image and how we can use this to our advantage to better visualise part of the bone. Results. The practical part of the study confirmed the theoretical part. Conclusions. Knowledge of the beam geometry can be used to minimise the obscuring nature of the circular fixator. This technique is simple and can be easily taught to the radiographer. It is a useful adjunct for the limb reconstruction surgeon

Aims. Patients undergoing limb reconstruction surgery often face a challenging and lengthy process to complete their treatment journey. The majority of existing outcome measures do not adequately capture the patient-reported outcomes relevant to this patient group in a single measure. Following a previous systematic review, the Stanmore Limb Reconstruction Score (SLRS) was designed with the intent to address this need for an effective instrument to measure patient-reported outcomes in limb reconstruction patients. We aim to assess the face validity of this score in a pilot study. Methods. The SLRS was designed following structured interviews with several groups including patients who have undergone limb reconstruction surgery, limb reconstruction surgeons, specialist nurses, and physiotherapists. This has subsequently undergone further adjustment for language and clarity. The score was then trialled on ten patients who had undergone limb reconstruction surgery, with subsequent structured questioning to understand the perceived suitability of the score. Results. Ten patients completed the score and the subsequent structured interview. Considering the tool as a whole, 100% of respondents felt the score to be comprehensible, relevant, and comprehensive regarding the areas that were important to a patient undergoing limb reconstruction surgery. For individual questions, on a five-point Likert scale, importance/relevance was reported as a mean of 4.78 (4.3 to 5.0), with ability to understand rated as 4.92 (4.7 to 5.0) suggesting high levels of relevance and comprehension. Flesch-Kincaid reading grade level was calculated as 5.2 (10 to 11 years old). Conclusion. The current SLRS has been shown to have acceptable scores from a patient sample regarding relevance, comprehensibility, and comprehensiveness. This suggests face validity, however further testing required and is ongoing in a larger cohort of patients to determine the reliability, responsiveness, precision, and criterion validity of the score in this patient group. Cite this article: Bone Jt Open 2021;2(9):705–709

Introduction. Patients undergoing limb reconstruction surgery often face a challenging and often lengthy process to complete their treatment journey. The majority of existing outcome measures do not adequately capture the patient reported outcomes relevant to this patient group in a single measure. Following a previous systematic review, the Stanmore Limb Reconstruction Score (SLRS) was designed with the intent to address this need for an effective instrument to measure patient reported outcomes in limb reconstruction patients. Materials and Methods. The SLRS was designed following the use of structured interviews with a group of patients who have undergone limb reconstruction surgery, limb reconstruction surgeons, specialist nurses and physiotherapists. This has undergone further adjustment for language and clarity. The score was then trialled on 10 patients who have been through the process of limb reconstruction surgery, with subsequent structured questioning to understand the perceived suitability. Results. Ten patients have completed the score and the subsequent structured interview. All patients found the score acceptable to complete in the time while waiting in clinic. Considering the tool as a whole, 100% of respondents felt the score to be comprehensible, relevant and comprehensive regarding the areas that were important to a patient undergoing limb reconstruction surgery. For individual questions, on a 5 point Likert scale, importance/relevance was reported as a mean of 4.78 (4.3–5), with ability to understand rated as 4.92 (4.7–5) suggesting high levels of relevance and comprehension. Flesh-Kincaid reading grade level was calculated as 5.2 (10–11 years old). Conclusions. The current Stanmore limb reconstruction score has been shown to have acceptable scores from a patient sample regarding relevance, comprehensibility and comprehensiveness. This demonstrates face validity, however further testing required and is ongoing in a larger cohort of patients to determine the reliability, responsiveness, precision and criterion validity of the score in this patient group

Aims

Distraction osteogenesis with intramedullary lengthening devices has undergone rapid development in the past decade with implant enhancement. In this first single-centre matched-pair analysis we focus on the comparison of treatment with the PRECICE and STRYDE intramedullary lengthening devices and aim to clarify any clinical and radiological differences.

Aims

The STRYDE nail is an evolution of the PRECICE Intramedullary Limb Lengthening System, with unique features regarding its composition. It is designed for load bearing throughout treatment in order to improve patient experience and outcomes and allow for simultaneous bilateral lower limb lengthening. The literature published to date is limited regarding outcomes and potential problems. We report on our early experience and raise awareness for the potential of adverse effects from this device.

Aims

The Precice intramedullary limb-lengthening system has demonstrated significant benefits over external fixation lengthening methods, leading to a paradigm shift in limb lengthening. This study compares outcomes following antegrade and retrograde femoral lengthening in both adolescent and adult patients.