Aims

Following cast removal for nonoperatively treated distal radius fractures, rehabilitation facilitated by advice leaflet and advice video were compared to a course of face-to-face therapy.

Aims

The aim of this study is to develop a core set of outcome domains that should be considered and reported in all future trials of childhood limb fractures.

Background

Due to the overwhelming demand for trauma services, resulting from increasing emergency department attendances over the past decade, virtual fracture clinics (VFCs) have become the fashion to keep up with the demand and help comply with the BOA Standards for Trauma and Orthopaedics (BOAST) guidelines. In this article, we perform a systematic review asking, “How useful are VFCs?”, and what injuries and conditions can be treated safely and effectively, to help decrease patient face to face consultations. Our primary outcomes were patient satisfaction, clinical efficiency and cost analysis, and clinical outcomes.

Aims

To determine the role of early MRI in the management of suspected scaphoid fractures.

1. Four cases of facial paralysis from the incorrect use of Von Rosen or Barlow type splints are described. 2. Attention is drawn to the subcutaneous and therefore vulnerable position of the facial nerve in the newborn

Aims

To determine the likelihood of achieving a successful closed reduction (CR) of a dislocated hip in developmental dysplasia of the hip (DDH) after failed Pavlik harness treatment We report the rate of avascular necrosis (AVN) and the need for further surgical procedures.

1. Butler's operation for the correction of the dorsally adducted fifth toe is described. 2. It is a simple and safe operation not needing splints, and giving good reliable results. 3. The results of seventy operations performed over ten years are studied

I have tried to stimulate interest in movement as a method of treatment. It is too much to expect that I shall have won over to my way of thinking doctors who are addicts of rest. I shall be content if they will occasionally ask: "Is my splint really necessary?"

1. Dislocation and subluxation of the hip has been produced in young rats by application of splints reaching from the hip to the foot, bringing the hip into extension. 2. Progressive acetabular dysplasia and anatomical abnormalities of the head and neck of the femur occurred. 3. Results of the experiments suggest that post-natal extension of the hip is of importance in the pathogenesis of congenital dislocation of the hip in man

A 16-year-old boy was involved in an agricultural accident in which he sustained a large wound to the right arm and forearm. Radiological examination showed loss of the distal half of the humerus. A posterior splint was applied and after two months there was regeneration of the distal humerus including the articular portion. He was able to use his arm at five months. Twenty years later, he had a painless elbow and a 70° range of movement

From 1962 to 1986, 117,256 neonates were screened for congenital dislocation of the hip (CDH). When the primary physical examination was performed by the junior paediatric staff there was a persistent late diagnosis rate of 0.5 per 1000 live births. When the primary examination was undertaken by experienced orthopaedic personnel (1982 to 1984) the late diagnosis rate fell and fewer infants were splinted

We suggest that, after an initial course of treatment in the accepted manner by gentle manipulations without anaesthetic, followed by splinting for a period of three or four months, the talo-calcaneal index should be measured on radiographs taken in the standard positions described. Should the correction be inadequate–that is, should the talo-calcaneal index be under 40 degrees even though clinically the foot appears corrected–further treatment should immediately be undertaken

1. This clinical investigation compares the results with varying periods of immobilisation after the primary repair of extensor tendons over the metacarpo-phalangeal joints of the fingers. 2. One hundred and thirty-seven Bantu mine workers with such injuries were each splinted for either one day, ten days or three weeks, and the results were compared. 3. The results indicate that the optimum period of splintage is ten days

1. A specially designed splint is described with which it is possible to maintain the reduction of a paralytic dislocation in a child with spina bifida cystica. The results of its use in a series of thirteen cases are recorded. 2. It is suggested that all such children presenting in the first year of life, in whom the power of the flexor and adductor muscle groups is preserved, should be treated initially in this way until the prognosis for the individual can be accurately assessed. 3. The theoretical implications of the findings are discussed

We studied, ten patients (11 elbows) who had undergone 14 allograft-prosthesis composite reconstructions following failure of a previous total elbow replacement with massive structural bone loss. There were nine women and one man with a mean age of 64 years (40 to 84), who were reviewed at a mean of 75 months (24 to 213). One patient developed a deep infection after 26 months and had the allograft-prosthesis composite removed, and two patients had mild pain. The median flexion-extension arc was 100° (95% confidence interval (CI) 76° to 124°). With the exception of the patient who had the infected failure, all the patients could use their elbows comfortably without splints or braces for activities of daily living. The mean Mayo Elbow Performance Index improved from 9.5 (95% CI 4.4 to 14.7) pre-operatively to 74 (95% CI 62.4 to 84.9) at final review. Radiologically, the rate of partial resorption was similar in the humeral and ulnar allografts (three of six and four of eight, respectively; p > 0.999). The patterns of resorption, however, were different. Union at the host-bone-allograft junction was also different between the humeral and ulnar allografts (one of six and seven of eight showing union, respectively; p = 0.03). At medium-term follow-up, allograft-prosthesis composite reconstruction appears to be a useful salvage technique for failed elbow replacements with massive bone loss. The effects of allograft resorption and host-bone-allograft junctional union on the longevity of allograft-prosthesis composite reconstruction, however, remain unknown, and it is our view that these patients should remain under long-term regular review

1. In a survey of 107 cases of Erb's paralysis, twenty-seven instances of incipient or actual posterior dislocation of the upper end of the radius were discovered. 2. The type of case in which the dislocation occurs is defined and the early clinical and radiographic signs of the displacement are described and illustrated. 3. The probable causes—muscle imbalance and rigid splinting over a long period—are adumbrated and the prevention and remedies are suggested. 4. The occurrence of anterior dislocation—six cases—and its significance are discussed