1. A method of
1. Twenty-two feet injured at the tarso-metatarsal level are reviewed. 2. Experiments with eleven cadaveric feet are reported. 3. The injuries are caused by forced plantar-flexion combined with rotation in most cases. Crushing of the foot alone often does not produce dislocation. 4. A classification is suggested. 5. The results of various treatments in this small series are presented. It is concluded that anatomical reduction is important, achieved if necessary by operation and
We describe a surgical technique for ankle arthrodesis using an anterior approach to the ankle and
Nine patients with nonunited humeral shaft fractures were treated by open reduction and
We made a randomised prospective comparison of the Dynamic Hip Screw and the Gamma locking nail for the
We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and
We describe the use of Ender nails for the
We report the management and outcome of 35 lower limb fractures with associated severe vascular injuries treated over a 15-year period. Limb survival was related to the period of ischaemia. Management of the fractures by immediate open reduction and
We reviewed seven patients with coronal fractures of the lateral femoral condyle and studied the mechanism of injury and the radiological features. The influence of soft tissue attachments on the displacement and the blood supply were investigated by clinical and cadaveric studies. All three fractures which were initially undisplaced lost position early during conservative management.
In children, nonunion of fractures of the waist of the scaphoid is uncommon. Treatment has included bone grafting without
Fourteen patients with ankylosing spondylitis had an extension osteotomy for severe flexion deformity of the spine. The Smith-Petersen technique was modified by using a compression device which allows a slow, finely controlled closure of the osteotomy, and provides rigid
Two patients are described, each with a fracture-dislocation of the hip combined with a fracture of the neck of the same femur. Open reduction combined with
The results of operation for traumatic anterior dislocation of the head of the radius in eight children have been reviewed. We are satisfied on the basis of the results obtained and the outcome in one untreated patient that operative reduction is fully justified, provided that the annular ligament is reconstructed and
1. In a series of 129 tibial fractures treated by compression plates, a high incidence of complications causing delay in healing was found in alcoholics and persons with abnormal personality traits. 2. The healing time and time off work for these people were about doubled. 3. The indications for
We have reviewed the results of treating 75 fractures of the proximal femoral shaft in the presence of a cemented femoral prosthesis. A simple radiographic classification into four types is proposed, and suggestions are made on the appropriate management of each. Comminuted fractures around the implant need early revision, whilst spiral fractures in this region may be treated conservatively or by operation. Transverse fractures at the level of the tip of the prosthesis are difficult to manage, and may require open reduction and
1. The results of treatment of 100 consecutive patients with pertrochanteric and basal fractures of the femur treated by early operative fixation with a McKee two-piece nail and plate are reviewed. 2. Technical failures are analysed and discussed. 3. The pattern of mortality is discussed and contrasted with that in a comparable series of patients treated conservatively. 4. It is concluded that early operative fixation is the method of choice in the management of these fractures, and that the McKee pin and plate is a satisfactory and reliable device for securing
We reviewed 27 patients with small-fragment fractures or osteotomies treated by
“Get It Right First Time” (GIRFT) and NHS England’s Best Practice Tariff (BPT) have published directives advising that patients over the ages of 65 (GIRFT) and 69 years (BPT) receiving total hip arthroplasty (THA) should receive cemented implants and have brought in financial penalties if this policy is not observed. Despite this, worldwide, uncemented component use has increased, a situation described as a ‘paradox’. GIRFT and BPT do, however, acknowledge more data are required to support this edict with current policies based on the National Joint Registry survivorship and implant costs. This study compares THA outcomes for over 1,000 uncemented Corail/Pinnacle constructs used in all age groups/patient frailty, under one surgeon, with identical pre- and postoperative pathways over a nine-year period with mean follow-up of five years and two months (range: nine months to nine years and nine months). Implant information, survivorship, and regular postoperative Oxford Hip Scores (OHS) were collected and two comparisons undertaken: a comparison of those aged over 65 years with those 65 and under and a second comparison of those aged 70 years and over with those aged under 70.Aims
Methods
Twenty patients with an average age of eighteen and a half years sustained osteochondral fractures of the lateral femoral condyle as the result of a sudden twist and valgus strain to the straight or almost straight knee. All the patients felt sudden pain at the moment of injury, all had a haemarthrosis, and yet the fracture escaped early diagnosis in one-third of the cases.