A5103147957- Bone fractures and treatments
- Orthopedic Surgery and Rehabilitation
- Foot and Ankle Surgery
- Sports injuries and prevention
- Hip and Femur Fractures
- Elbow and Forearm Trauma Treatment
- Shoulder Injury and Treatment
- Tendon Structure and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Orthopaedic implants and arthroplasty
- Muscle and Compartmental Disorders
- Knee injuries and reconstruction techniques
- Reconstructive Surgery and Microvascular Techniques
- Ultrasound in Clinical Applications
- Total Knee Arthroplasty Outcomes
Edinburgh Royal Infirmary
2018-2025
Stanford University
2023
Centre for Global Health Research
2023
University of Edinburgh
2021-2023
Wrightington Hospital
2023
Scottish Health Services
2022
Healthcare Improvement Scotland
2022
Clinical Orthopaedics and Related Research
2019
Importance Unstable ankle fractures are routinely managed operatively. However, because of soft tissue and implant-related complications, recent literature has reported on the nonoperative management well-reduced medial malleolus after fibular stabilization, but with limited evidence supporting routine application. Objective To assess superiority internal fixation (displacement ≤2 mm) compared nonfixation stabilization. Design, Setting, Participants This superiority, pragmatic, parallel,...
Importance Humeral shaft fractures are routinely managed nonoperatively, but this approach is potentially associated with higher nonunion rates and inferior functional outcomes when compared operative fixation. Objective To assess whether there any difference in outcome between surgery bracing for adults an isolated, closed humeral fracture. Design, Setting, Participants This prospective, superiority, parallel-group randomized clinical trial was conducted September 2018 October 2023 took...
The evidence for treating acute, unreconstructable radial head fractures in unstable elbows with replacement predominantly consists of short- to mid-term follow-up studies a heterogenous mix implants and operative techniques. Data on longer-term patient-reported outcomes after is lacking.(1) What proportion patients undergo revision or implant removal replacement? (2) At minimum 8 years follow-up, what are the (QuickDASH, Oxford Elbow Score, EuroQol-5D)? (3) factors associated superior...
Intra-articular fractures of the distal end tibia, more commonly referred to as pilon fractures, account for approximately 5% 7% all tibial fractures1,2. Type-C present a unique surgical challenge: total articular fracture contained within vulnerable soft-tissue envelope. Treatment options include internal fixation3, external fixation with or without limited fixation4, and primary ankle arthrodesis2. The management, particularly timing, surgery is often dictated by patient's general state...
To compare the biomechanical failure properties of fibular intramedullary nail with locking plate and lag screw fixation in management unstable elderly distal fractures.Twelve fresh-frozen cadaveric lower limbs (6 matched-pairs) were studied. A simulated OTA/AO 44-B fracture was created, then randomly allocated within each pair to or supplemented an interfragmentary screw. The secured foot rigidly held 20 degrees supination, loaded 700N subjected progressive external rotation until...
Abstract Background There are limited data reporting the outcome of patients with non-operatively managed medial malleolus fractures compared to those treated surgically in presence fibular stabilisation for unstable ankle. Conservative management could result fewer complications, reduced surgical time and lower cost. The purpose this study is determine if any difference exists patient reported outcomes 1 year after surgery between operative non-operative treatment malleolar combination...
Humeral shaft fractures constitute around 1% of adult in the UK, with an annual incidence approximately 13 per 100,000 population. Historically, these injuries have been primarily managed non-operatively, operative fixation reserved for specific indications. Although some recent retrospective studies suggested there are potential benefits over humeral bracing, is a deficiency level 1 evidence to support management as primary treatment fractures. This single-centre prospective randomised...
To identify risk factors for fixation failure, report patient outcomes, and advise on modifications to the surgical technique fibula nail stabilization of unstable ankle fractures.Retrospective review.Academic orthopaedic trauma unit.All 342 patients were identified retrospectively from a prospectively collected single-center database over 9-year period.Unstable fractures managed surgically with nail.The primary short-term outcome was defined as any case that required revision surgery...
Olecranon fractures account for approximately 20% of the proximal part forearm1. Clinicians may consider nonoperative management elderly low-demand patients2, whereas operative fixation is recommended active patients with a displaced fracture. Tension-band wire (TBW) commonly employed simple isolated stable olecranon (type IIA according to Mayo classification)3-5. In contrast, plate thought provide superior outcomes unstable comminuted fractures. Biomechanical principles TBW construct are...
Access to total knee arthroplasty (TKA) is sometimes restricted for patients with severe obesity (BMI ≥ 40 kg/m2). This study compares the cost per quality-adjusted life year (QALY) associated TKA in a BMI above and below kg/m2 examine whether this supported.This single-centre compared 169 consecutive kg/m2) (mean age 65.2 years (40 87); mean 44.2 66); 129/169 female) undergoing unilateral propensity score matched (age, sex, preoperative Oxford Knee Score (OKS)) cohort < 1:1 ratio....
Objectives: To evaluate the short- and long-term patient-reported outcomes of acute compartment syndrome (ACS) complicating a fracture tibial diaphysis. Design: A retrospective review. Setting: Academic orthopaedic trauma center. Patients: We retrospectively identified 559 patients from database over 7-year period. Forty-one (7.3%) underwent fasciotomies for ACS were included in study. matched cohort 185 who did not develop was used as controls. Intervention: Fasciotomy ACS. Main Outcome...
Aims Acute distal biceps tendon repair reduces fatigue-related pain and minimizes loss of supination the forearm strength flexion elbow. We report short- long-term outcome following using fixation with a cortical button techqniue. Methods Between October 2010 July 2018, 102 patients mean age 43 years (19 to 67), including 101 males, underwent less than six weeks after injury, fixation. The primary short-term measure was rate complications. abbreviated Disabilities Arm, Shoulder Hand...
This single-centre prospective randomised trial aimed to assess the superiority of operative fixation compared with non-operative management for adults an isolated, closed humeral shaft fracture. 70 patients were randomly allocated either open reduction and internal (51%, n=36/70) or functional bracing (49%, n=34/70). 7 did not receive their assigned treatment (operative n=5/32, n=2/32); results analysed based upon intention-to-treat. The primary outcome measure was DASH score at 3 months....
Displaced medial malleolar fractures, either in isolation or as part of an unstable ankle fracture dislocation, are conventionally treated with internal fixation. We outline the case a 76-year-old man diabetes presenting grossly deformed open and extruded tibia through large wound. Following irrigation, wound debridement minimally invasive fibular fixation, reduced anatomically. Contrary to traditional teaching, malleolus was left without The patient mobilised partially weight-bearing,...
To (1) describe the percutaneous technique used to reduce and fix a posterior malleolar fracture with anteroposterior screws in patients managed fibular intramedullary nail, (2) selection of whom this can be applied, (3) report clinical patient reported outcome intervention.Retrospective review.Academic orthopaedic trauma center.Thirty-two consecutive mean age 65 years (range, 39-90) over thirteen-year period identified from prospective database.Unstable ankle fractures surgically nail...
Abstract Purpose To determine the feasibility and reliability of ultrasound in assessment humeral shaft fracture healing estimate accuracy 6wk predicting nonunion. Methods Twelve adults with a non-operatively managed were prospectively recruited underwent scanning at 6wks 12wks post-injury. Seven blinded observers evaluated sonographic callus appearance to intra- inter-observer reliability. Nonunion prediction was estimated by comparing images for patients that united ( n = 10/12) those...