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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_14 | Pages 1 - 1
1 Aug 2017
Hillier D Hawkes D Kenyon P Harrison WJ
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Background

The Fracture Fixation Assessment Tool score (FFATs) was developed as an objective evaluation of post-operative fracture fixation radiographs as a means of appraisal and education. The tool has proven validity, simple to use and based upon AO principles of fracture fixation. This study has been designed to assess how FFATs changes throughout the training program in the UK.

Methods

The local trauma database of a district general hospital, with trauma unit status was used to identify cases. Although FFATs is designed to apply to any fracture fixation, Weber B ankle fractures were selected as common injuries, which constitute indicative cases in T&O training. Grade of the primary surgeon and supervision level were both stratified. The initial and intraoperative radiographs were anonymised and presented to the assessor who had been blinded to the identity and grade of the surgeon, for scoring using FFATs.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 56 - 56
1 Jul 2014
Alizadehkhaiyat O Hawkes D Howard A Frostick S
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Summary Statement

Bio-impedance analysis (BIA) provides a convenient method for the estimation of whole body and segmental measurement of skeletal muscle mass (SMM). BIA-measured SMM parameters may be effectively used for the normalisation of muscle strength and removing body-size dependence.

Introduction

Despite an increasing interest in using bio-impedance analysis (BIA) for the estimation of segmental skeletal muscle mass (SMM); existing data is sparse. On the other hand, there is a need for better understanding of the influence of SMM on gender-related differences in muscle strength. Using BIA technique, this study aimed to measure the SMM, determine its correlation with muscle strength, and examine its relation with gender-related differences in muscle strength.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 73 - 73
1 Dec 2013
Alizadehkhaiyat O Hawkes D Frostick S
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Introduction

Rehabilitation after shoulder arthroplasty is a fundamental in enabling patients achieve a good functional outcome. Therapists must consider the underlying diagnosis, operative technique employed and rotator cuff integrity, amongst other factors, in order to select the most appropriate exercise regime. There is an absence of comprehensive studies in the literature with regard to shoulder rotational exercises. Therefore, this study aimed to describe the shoulder girdle muscle activation strategies during eight commonly cited rotational shoulder exercises.

Method

Thirty healthy subjects with no history of shoulder problems participated in the study. EMG was recorded from 16 shoulder girdle muscles (surface electrodes: anterior, middle and posterior deltoid, upper, middle and lower trapezius, upper and lower latissimus dorsi, upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis and rhomboid major) using a telemetry based EMG system. Five external and three internal rotation exercises were included (table 1). Signal acquisition and processing were in accordance with standardised guidelines. Amplitude normalisation was to external and internal rotation maximum voluntary contraction as appropriate. Mean EMG amplitudes between exercises were compared using repeated measures ANOVA. Data for muscle groups was calculated by averaging the activation of the component muscles.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 64 - 64
1 Sep 2012
Hawkes D Alizadehkhaiyat O Fisher A Kemp G Roebuck M Frostick S
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Introduction

Shoulder motion results from a complex interaction between the interconnected segments of the shoulder girdle. Coordination is necessary for normal shoulder function and is achieved by synchronous and coordinated muscle activity. During rotational movements, the humeral head translates on the glenoid fossa in the anterior-posterior plane. Tension developed by the rotator cuff muscles compresses the humeral head into the glenoid fossa. This acts to limit the degree of humeral head translation and establishes a stable GH fulcrum about which the arm can be moved. Previous studies have been limited by the use of contrived movement protocols and muscular coordination has not been previously considered with regard to shoulder rotation movements. This study reports the activation profile and coordination of 13 muscles and 4 muscle groups during a dynamic rotational movement task based on activities of daily living.

Methods

Eleven healthy male volunteers were included in the study. Electromyography (EMG) was recorded from 13 muscles (10 surface and 3 fine-wire intramuscular electrodes) using a wireless EMG system. EMG was recorded during a movement task in which the shoulder was consecutively rotated internally (phase 1) and externally (phase 2) with a weight in the hand. Muscle group data was calculated by ensemble averaging the activity of the individual component muscles. Mean signal amplitude and Pearson correlation coefficient (PCC) analysed muscle activation and coordination, respectively.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 367 - 367
1 Sep 2005
Penney G Edwards P Hipwell J Hawkes D Slomczykowski M Revie I
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Introduction and Aims: A method has been designed to accurately measure post-operative alignment of hip (acetabular) and knee (femoral and tibial) prosthetic components relative to the pre-operative plan. Conventional methods involve 2D measurements; this new method uses 2D-3D registration to align both the prosthesis and the pre-operative CT volume to the post-operative x-ray.

Method: The method uses an automatic approach to align a CAD model of the prosthesis to the post-operative x-ray. A rendering of the prosthesis is produced and overlaid onto the post-operative x-ray image. The prosthesis can be rotated and translated in 3D to match the outline of the rendering shown on the post-operative x-ray. An initial manual procedure is used to align the rendering of the bone surface from pre-operative CT to the bony anatomy on the post-operative x-ray. This manual registration position is then used as a starting position for an automated intensity-based registration algorithm.

Results: The automated intensity-based registration algorithm allowed 3D verification of the prosthesis position. A number of digitally reconstructed radiographs (DRRs) were produced by casting rays through the pre-operative CT volume. The DRRs were then compared with the post-operative X-ray image using a similarity measure. This similarity measurement was optimised using gradient decent-type search strategy to alter the rotation and translation parameters. If the Hounsfield numbers of the voxels, which the casting rays passed through, were integrated along the ray and projected onto an imaging plane, a radiograph-like image was produced. To concentrate the area of registration and thus quicken registration algorithm, the user also manually defined a region of registration interest. Hence, DRRs were only produced within the region of interest. Due to the large size of the pelvis and tube-like nature of the femur and tibia, a total of 10 starting positions were used for this algorithm. These starting positions were found by adding random Gaussian noise to the parameters found using the manual process. The registration position was defined as the final position that produced the best similarity measurement value.

Conclusion: Validation has demonstrated this method’s accuracy in calculating the post-operative position of acetabular and knee prostheses with respect to the pre-operative plan. The results are repeatable, robust and enable pre- and post-operative 3D implant position comparison. The inaccuracies observed with conventional methods due to incorrect alignment on x-ray are reduced.