International orthopaedics
-
The American College of Radiologists (ACR) recognises the value of magnetic resonance imaging (MRI) as the investigation of choice in patients with a clinically suspected scaphoid fracture but normal plain radiographs. The Royal College of Radiologists (RCR) in the UK produces no similar guidelines, as evidenced by the inconsistent management of such cases in hospitals around the UK. In discussion with our musculoskeletal radiologists, we implemented new guidelines to standardise management of our patients and now report our findings. ⋯ MRI should be regarded as the gold standard investigation for patients in whom a scaphoid fracture is suspected clinically. It allows the diagnosis of occult bony and soft-tissue injuries that can present clinically as a scaphoid fracture; it also helps exclude patients with no fracture. We believe that there is a need to implement national guidelines for managing occult scaphoid fractures.
-
Our aim was to assess operative treatment for post-traumatic avascular necrosis of the femoral head (ANFH) in adolescents. ⋯ Patients treated for ANFH had good medium-term outcomes after THR for total necrosis and also after VITO for partial necrosis.
-
Sacroiliac screw fixation is the method of choice for the definitive treatment of unstable posterior pelvic-ring injuries; however, this technique is demanding and associated with a high risk of iatrogenic neurovascular damage. This study evaluates whether minimally invasive transiliac locked compression plate stabilisation may be an alternative to sacroiliac screw fixation in unstable posterior pelvic-ring injuries. ⋯ Minimally invasive transiliac locked compression plate stabilisation may be a good alternative to sacral screw fixation because it is quick, safe and associated with a good functional outcome.
-
Randomized Controlled Trial Comparative Study
Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures.
The purpose of this study was to compare femoral head placement, rates of reoperation and cephalic implant cut-out of a screw versus a blade for patients over age 60 with low energy trochanteric fractures (AO/OTA 31-A1, A2, and A3) treated either with sliding hip screw or cephalomedullary nail. ⋯ Both a screw and a blade performed equally well in terms of implant placement in the femoral head and outcome.
-
The aim of this prospective study was to evaluate the patellar height in 90° knee flexion. ⋯ Our results demonstrate a method-dependent discrepancy in the measurement of patellar height. A future study should evaluate this effect in a direct comparison between 30° and 90° knee flexion.