Multiple devices can stabilise the MTP joint for arthrodesis. The ideal implant should be easy to use, provide reproducible and high quality results, and ideally enable early rehabilitation to enable faster return to function, whilst lessening soft tissue irritation. We prospectively evaluated the combination of the IO-Fix (Extremity Medical, NJ, USA) device which consists of an intra-osseous post and lag screw that offers these features with full bearing of weight after surgery. 67 feet in 65 patients were treated over 31 months. After excluding patients lost to follow-up, undergoing revision arthrodesis, or concomitant first ray procedures, there were 54 feet in 52 patients available with a minimum 12 month follow-up with clinical and radiographic outcomes. All patients were treated using a similar operative technique with immediate bearing of weight in a rigid soled shoe.Abstract
Background
Methods
FHL transfer for management of chronic Achilles' tendon ruptures is done both open and endoscopically. But there are no published studies comparing open and endoscopic results. Our study aims to compare them and determine the suitability of these methods. Fourteen patients were treated endoscopically while 26 with an open technique. Of the 26, fourteen had an open Achilles tendon repair and FHL transfer while 12 has only open FHL transfer. All the endoscopic patients had only an FHL transfer. We compared demographics, complications of the procedure, recovery times, return to work and strength after 1 year. We noted ATRS at 6 months and 1 year for all three groups. We also conducted an MRI scan of three patients each of the three groups to determine the state of Achilles tendon and FHL tendon after 1 year of surgery.Abstract
Introduction
Materials and methods
The aim of our study was to assess the ability of orthopaedic surgical trainees to adequately assess ankle radiographs following operative fixation of unstable ankle fracture. We identified 26 Supination-External rotation (SER) stage IV fractures, and 4 Pronation-External rotation (PER) stage III fractures treated surgically in our institution. Radiographs were evaluated for shortening of the fibula, widening of the joint space, malrotation of the fibula and widening of the medial clear space. Trainees were shown these radiographs and asked to comment on the adequacy of reduction. They were then given a simple tutorial on assessing adequacy of reduction and asked to reassess these radiographs. The parameters discussed included assessment of medial clear space, drawing of the tibiofibular line, use of the “circle sign” and measurement of the talocrural angle. There was a statistically significant improvement from 64% to 71.4% (P< 0.05) in the radiographs correctly assessed by orthopaedic trainees following a short tutorial on radiographical assessment.Background
Methods and results
The safe and effective management of orthopaedic patients out of hours requires the communication of radiographs between junior residents and their non-resident seniors. Despite stringent guidelines issued by the Caldecott Guardian on the transmission of patient sensitive data, there is no data describing actual exchanges in the literature. The objective was t describe current trends in the transmission of patient sensitive data between resident Orthopaedic juniors and their non-resident seniors out of hours. The method was a Questionnaire survey polling Orthopaedic registrars in North London. Seventy-six (76) trainees participated in the survey. Fifty Three (53) trainees received radiographs for review off site. Forty-eight (48) reported receiving patient radiographs for review to their personal email account. 48% of these trainees reported that the images contained patient sensitive information. 40% of the trainees who received images to their personal email had a NHS mail account which was not used. Remote access to patient radiographs improves patient management out of hours. Although there is some awareness of Caldecott guidelines for the handling of patient sensitive electronic data, compliance is extremely poor. We recommend that all trainees who routinely handle patient sensitive data remotely acquire a free NHS mail account for receiving patient radiographs
