The purpose of this study was to identify factors associated with limitations in function, measured by patient-reported outcome measures (PROMs), six to nine months after a proximal humeral fracture, from a range of demographic, injury, psychological, and social variables measured within a week and two to four weeks after injury. We enrolled 177 adult patients who sustained an isolated proximal humeral fracture into the study and invited them to complete PROMs at their initial outpatient visit within one week of injury, between two and four weeks, and between six to nine months after injury. There were 128 women and 49 men; the mean age was 66 years (Aims
Patients and Methods
We set out to determine if there is a difference in perioperative outcomes between early and delayed surgery in paediatric supracondylar humeral fractures in the absence of vascular compromise through a systematic review and meta-analysis. A literature search was performed, with search outputs screened for studies meeting the inclusion criteria. The groups of early surgery (ES) and delayed surgery (DS) were classified by study authors. The primary outcome measure was open reduction requirement. Meta-analysis was performed in the presence of sufficient study homogeneity. Individual study risk of bias was assessed using the Risk of Bias in Non-Randomised Studies – of Interventions (ROBINS-I) criteria, with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria used to evaluate outcomes independently.Aims
Materials and Methods
The aim of this study was to investigate the incidence of knee arthroplasty and arthroscopy following patellar fractures, and to compare this with an age- and gender-matched group without a prior patellar fracture. A national matched cohort study based on the Danish National Patient Register including all citizens of Denmark (approximately 5.3 million) was undertaken. A total of 6096 patients who sustained a patellar fracture in Denmark between 1 January 1996 and 31 December 2000 were included. The median age of these patients was 50.6 years (interquartile range (IQR) 28.5 to 68.9); 49.1% were women. Patients were followed-up until 31 December 2015, with regard to treatment with knee arthroplasty and/or knee arthroscopy.Aims
Patients and Methods
The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality. Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors.Aims
Patients and Methods
The aim of this study was to record the incidence of post-traumatic
osteoarthritis (OA), the need for total hip arthroplasty (THA),
and patient-reported outcome measures (PROMS) after surgery for
a fracture of the acetabulum, in our centre. All patients who underwent surgery for an acetabular fracture
between 2004 and 2014 were included. Patients completed the 36-Item
Short Form Health Survey (SF-36) and the modified Harris Hip Score
(mHHS) questionnaires. A retrospective chart and radiographic review
was performed on all patients. CT scans were used to assess the classification
of the fracture and the quality of reduction.Aims
Patients and Methods
This study assessed the association of classes of body mass index
in kg/m2 (classified as normal weight 18.5 kg/m2 to
24.9 kg/m2, overweight 25.0 kg/m2 to 29.9
kg/m2, and obese ≥ 30.0 kg/m2) with short-term
complications and functional outcomes three to six years post-operatively
for closed ankle fractures. We performed a historical cohort study with chart review of 1011
patients who were treated for ankle fractures by open reduction
and internal fixation in two hospitals, with a follow-up postal
survey of 959 of the patients using three functional outcome scores.Aims
Patients and Methods
It has been suggested that the use of a pilot-hole may reduce the risk of fracture to the lateral cortex. Therefore the purpose of this study was to determine the effect of a pilot hole on the strains and occurrence of fractures at the lateral cortex during the opening of a high tibial osteotomy (HTO) and post-surgery loading. A total of 14 cadaveric tibias were randomized to either a pilot hole (n = 7) or a no-hole (n = 7) condition. Lateral cortex strains were measured while the osteotomy was opened 9 mm and secured in place with a locking plate. The tibias were then subjected to an initial 800 N load that increased by 200 N every 5000 cycles, until failure or a maximum load of 2500 N.Aim
Materials and Methods
Intramedullary fixation is considered the most stable treatment for pertrochanteric fractures of the proximal femur and cut-out is one of the most frequent mechanical complications. In order to determine the role of clinical variables and radiological parameters in predicting the risk of this complication, we analysed the data pertaining to a group of patients recruited over the course of six years. A total of 571 patients were included in this study, which analysed the incidence of cut-out in relation to several clinical variables: age; gender; the AO Foundation and Orthopaedic Trauma Association classification system (AO/OTA); type of nail; cervical-diaphyseal angle; surgical wait times; anti-osteoporotic medication; complete post-operative weight bearing; and radiological parameters (namely the lag-screw position with respect to the femoral head, the Cleveland system, the tip-apex distance (TAD), and the calcar-referenced tip-apex distance (CalTAD)).Objectives
Methods
The anterior pelvic internal fixator is increasingly used for
the treatment of unstable, or displaced, injuries of the anterior
pelvic ring. The evidence for its use, however, is limited. The
aim of this paper is to describe the indications for its use, how
it is applied and its complications. We reviewed the case notes and radiographs of 50 patients treated
with an anterior pelvic internal fixator between April 2010 and
December 2015 at a major trauma centre in the United Kingdom. The
median follow-up time was 38 months (interquartile range 24 to 51).Aims
Patients and Methods
To synthesise the literature and perform a meta-analysis detailing
the longitudinal recovery in the first two years following a distal
radius fracture (DRF) managed with volar plate fixation. Three databases were searched to identify relevant articles.
Following eligibility screening and quality assessment, data were
extracted and outcomes were assimilated at the post-operative time
points of interest. A state-of-the-art longitudinal mixed-effects
meta-analysis model was employed to analyse the data.Aims
Materials and Methods
To evaluate the outcomes of cemented total hip arthroplasty (THA)
following a fracture of the acetabulum, with evaluation of risk
factors and comparison with a patient group with no history of fracture. Between 1992 and 2016, 49 patients (33 male) with mean age of
57 years (25 to 87) underwent cemented THA at a mean of 6.5 years
(0.1 to 25) following acetabular fracture. A total of 38 had undergone
surgical fixation and 11 had been treated non-operatively; 13 patients
died at a mean of 10.2 years after THA (0.6 to 19). Patients were
assessed pre-operatively, at one year and at final follow-up (mean
9.1 years, 0.5 to 23) using the Oxford Hip Score (OHS). Implant
survivorship was assessed. An age and gender-matched cohort of THAs
performed for non-traumatic osteoarthritis (OA) or avascular necrosis
(AVN) (n = 98) were used to compare complications and patient-reported outcome
measures (PROMs).Aims
Patients and Methods
Fractures of the navicular can occur in isolation but, owing
to the intimate anatomical and biomechanical relationships, are
often associated with other injuries to the neighbouring bones and
joints in the foot. As a result, they can lead to long-term morbidity
and poor function. Our aim in this study was to identify patterns
of injury in a new classification system of traumatic fractures
of the navicular, with consideration being given to the commonly associated
injuries to the midfoot. We undertook a retrospective review of 285 consecutive patients
presenting over an eight- year period with a fracture of the navicular.
Five common patterns of injury were identified and classified according
to the radiological features. Type 1 fractures are dorsal avulsion
injuries related to the capsule of the talonavicular joint. Type
2 fractures are isolated avulsion injuries to the tuberosity of
the navicular. Type 3 fractures are a variant of tarsometatarsal
fracture/dislocations creating instability of the medial ray. Type
4 fractures involve the body of the navicular with no associated
injury to the lateral column and type 5 fractures occur in conjunction
with disruption of the midtarsal joint with crushing of the medial
or lateral, or both, columns of the foot.Aims
Patients and Methods
Fractures of the distal femur can be challenging to manage and
are on the increase in the elderly osteoporotic population. Management
with casting or bracing can unacceptably limit a patient’s ability
to bear weight, but historically, operative fixation has been associated
with a high rate of re-operation. In this study, we describe the outcomes
of fixation using modern implants within a strategy of early return
to function. All patients treated at our centre with lateral distal femoral
locking plates (LDFLP) between 2009 and 2014 were identified. Fracture
classification and operative information including weight-bearing
status, rates of union, re-operation, failure of implants and mortality
rate, were recorded.Aims
Patients and Methods
The aim of this prospective randomised controlled trial was to
compare non-operative and operative management for acute isolated
displaced fractures of the olecranon in patients aged ≥ 75 years. Patients were randomised to either non-operative management or
operative management with either tension-band wiring or fixation
with a plate. They were reviewed at six weeks, three and six months
and one year after the injury. The primary outcome measure was the
Disabilities of the Arm, Shoulder and Hand (DASH) score at one year.Aims
Patients and Methods
Bisphosphonates are widely used as first-line treatment for primary and secondary prevention of fragility fractures. Whilst they have proved effective in this role, there is growing concern over their long-term use, with much evidence linking bisphosphonate-related suppression of bone remodelling to an increased risk of atypical subtrochanteric fractures of the femur (AFFs). The objective of this article is to review this evidence, while presenting the current available strategies for the management of AFFs. We present an evaluation of current literature relating to the pathogenesis and treatment of AFFs in the context of bisphosphonate use.Objectives
Methods
