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The Journal of Bone & Joint Surgery British Volume
Vol. 46-B, Issue 4 | Pages 664 - 673
1 Nov 1964
Smyth EHJ Ellis JS Manifold MC Dewey PR

1. A method of internal fixation of displaced subcapital fractures of the femoral neck is described, and a consecutive series of seventy-one patients whose fractures were treated by this method is reviewed. 2. It is claimed that this method gives better mechanical fixation than a trifin nail and that the operation is less formidable than the insertion of a pin and plate. 3. It is suggested that with improved fixation the avascular head can be supported while revascularisation occurs


The Journal of Bone & Joint Surgery British Volume
Vol. 54-B, Issue 4 | Pages 677 - 686
1 Nov 1972
Wilson DW

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 internal fixation


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 1 | Pages 113 - 116
1 Jan 1999
Rowan R Davey KJ

We describe a surgical technique for ankle arthrodesis using an anterior approach to the ankle and internal fixation with an anteriorly-placed AO T plate. A total of 33 patients who had ankle arthrodeses have been followed retrospectively. Thirty-one (94%) of the ankles fused although two patients developed tibial stress fractures. Four patients had a superficial infection which did not prevent union. The surgical technique is simple, easily reproducible and gives excellent clinical results with a high rate of union


The Journal of Bone & Joint Surgery British Volume
Vol. 75-B, Issue 5 | Pages 804 - 807
1 Sep 1993
Wright T Miller G Vander Griend R Wheeler D Dell P

Nine patients with nonunited humeral shaft fractures were treated by open reduction and internal fixation with an intramedullary fibular bone graft and a compression plate. Fixation of the screws was enhanced by passing them through the fibula as well as the two humeral cortices (quadricortical fixation). Eight of the nine fractures united at an average of 3.5 months. Tests on cadaver bones showed that quadricortical fixation was as strong as methylmethacrylate augmentation and significantly better than bicortical fixation


The Journal of Bone & Joint Surgery British Volume
Vol. 75-B, Issue 5 | Pages 789 - 793
1 Sep 1993
Radford P Needoff M Webb J

We made a randomised prospective comparison of the Dynamic Hip Screw and the Gamma locking nail for the internal fixation of 200 petrochanteric femoral fractures in elderly patients. There was less intraoperative blood loss and a lower rate of wound complications in the patients treated by the Gamma nail. They had, however, a high incidence of femoral shaft fracture which we relate in part to implant design. We do not recommend the use of the Gamma nail for these fractures


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 6 | Pages 920 - 921
1 Nov 1995
Stromsoe K Hoqevold H Skjeldal S Alho A

We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and internal fixation to two treatment groups to examine the influence of the repair of a ruptured deltoid ligament. No differences were found except for a longer duration of surgery in the repair group. Our findings suggest that a ruptured deltoid ligament can be left unexplored without any effect either on early mobilisation or on the long-term result


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 1 | Pages 14 - 18
1 Jan 1990
Walters J Shepherd-Wilson W Lyons T Close R

We describe the use of Ender nails for the internal fixation of femoral shaft fractures by a closed technique via the greater trochanter and report the treatment of 100 patients with 106 fractures, of which 88 were reviewed 12 months or more after operation. There was primary union in 85 fractures (96.6%) and significant angulation, rotation or leg length discrepancy in eight (9%). We discuss the principles of management which we have evolved


The Journal of Bone & Joint Surgery British Volume
Vol. 72-B, Issue 1 | Pages 116 - 120
1 Jan 1990
Howard P Makin G

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 internal fixation was associated with a higher amputation rate than either external fixation or simple splintage, particularly for upper tibial injuries. External fixation is recommended as the method of choice for the stabilisation of the skeletal injury. A selective policy is advised for fasciotomy


The Journal of Bone & Joint Surgery British Volume
Vol. 71-B, Issue 1 | Pages 118 - 120
1 Jan 1989
Lewis S Pozo J Muirhead-Allwood W

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. Internal fixation gave good results at review, and is recommended to avoid the risk of malunion and possible secondary osteoarthritis


The Journal of Bone & Joint Surgery British Volume
Vol. 77-B, Issue 1 | Pages 98 - 100
1 Jan 1995
Mintzer C Waters P Simmons B

In children, nonunion of fractures of the waist of the scaphoid is uncommon. Treatment has included bone grafting without internal fixation, bone grafting with Kirschner-wire fixation, and screw fixation without bone grafting. We report the successful use of Herbert screw fixation and iliac-crest bone grafting in five cases, all of which healed without further surgery. At an average follow-up of 3.3 years, the range of motion, grip strength, carpal stability, and radiological appearances were all excellent


The Journal of Bone & Joint Surgery British Volume
Vol. 67-B, Issue 2 | Pages 204 - 210
1 Mar 1985
McMaster M

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 internal fixation. There were no serious neurological complications. All the patients were able to see straight ahead after operation, and all had solid fusion at nine months, having maintained good correction


The Journal of Bone & Joint Surgery British Volume
Vol. 66-B, Issue 1 | Pages 45 - 48
1 Jan 1984
Klasen H Binnendijk B

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 internal fixation was performed in both cases. Eight years later one patient had developed avascular necrosis of the femoral head; no signs of avascular necrosis or associated arthritis have appeared in the other patient after four years. A plea is made for considering this more conservative type of operation for these serious injuries before resorting to total hip replacement


The Journal of Bone & Joint Surgery British Volume
Vol. 59-B, Issue 4 | Pages 402 - 407
1 Nov 1977
Lloyd-Roberts G Bucknill T

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 internal fixation employed. We have not seen unilateral congenital dislocation and doubt its existence. Secondary subluxation of the distal radio-ulnar joint has been noted in an untreated patient


The Journal of Bone & Joint Surgery British Volume
Vol. 56-B, Issue 4 | Pages 730 - 734
1 Nov 1974
Karlström G Olerud S

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 internal fixation in such patients should therefore be sharply defined and, if used, added protection should be given by institutional care and by well controlled plaster casts


Bone & Joint 360
Vol. 10, Issue 2 | Pages 53 - 55
1 Apr 2021


The Journal of Bone & Joint Surgery British Volume
Vol. 70-B, Issue 3 | Pages 386 - 389
1 May 1988
Cooke P Newman J

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 internal fixation


The Journal of Bone & Joint Surgery British Volume
Vol. 40-B, Issue 4 | Pages 694 - 700
1 Nov 1958
Bremner RA Graham WD

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 internal fixation


The Journal of Bone & Joint Surgery British Volume
Vol. 74-B, Issue 6 | Pages 853 - 857
1 Nov 1992
Pihlajamaki H Bostman O Hirvensalo E Tormala P Rokkanen P

We reviewed 27 patients with small-fragment fractures or osteotomies treated by internal fixation with absorbable self-reinforced poly-L-lactide pins. The follow-up time ranged from eight to 37 months. The two most common indications were chevron osteotomy of the first metatarsal bone for hallux valgus and displaced fracture of the radial head. No redisplacements occurred, and there were no signs of inflammatory foreign-body reaction. Biopsy in two patients 20 and 37 months after implantation showed that no polymeric material remained


Bone & Joint Open
Vol. 2, Issue 5 | Pages 293 - 300
3 May 2021
Lewis PM Khan FJ Feathers JR Lewis MH Morris KH Waddell JP

Aims

“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.

Methods

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.


The Journal of Bone & Joint Surgery British Volume
Vol. 60-B, Issue 2 | Pages 199 - 202
1 May 1978
Matthewson M Dandy D

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. Internal fixation of the fragment with early mobilisation is recommended if the diagnosis is made within two weeks of injury, and excision of the fragment if it is only later identified