A5047124896- Hip and Femur Fractures
- Trauma and Emergency Care Studies
- Bone fractures and treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Pelvic and Acetabular Injuries
- Orthopedic Surgery and Rehabilitation
- Traumatic Ocular and Foreign Body Injuries
- Orthopaedic implants and arthroplasty
- Total Knee Arthroplasty Outcomes
- Emergency and Acute Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Hip disorders and treatments
- Disaster Response and Management
- Injury Epidemiology and Prevention
- Clinical practice guidelines implementation
- Surgical site infection prevention
- Shoulder and Clavicle Injuries
- Wound Healing and Treatments
- Musculoskeletal Disorders and Rehabilitation
- Frailty in Older Adults
- Shoulder Injury and Treatment
- Pregnancy-related medical research
- Venous Thromboembolism Diagnosis and Management
- Nursing Roles and Practices
- Viral Infections and Outbreaks Research
James Cook University Hospital
2016-2025
South Tees Hospitals NHS Foundation Trust
2013-2025
University of York
2017-2024
Nuffield Orthopaedic Centre
2022-2024
University of Oxford
2022-2024
Wexham Park Hospital
2022-2024
Teesside University
2022-2024
National Marrow Donor Program
2024
Princess Elizabeth Orthopaedic Centre
2023
University Hospital of Wales
2023
Correct positioning and alignment of components during primary total knee replacement (TKR) is widely accepted to be an important predictor patient satisfaction implant durability. This retrospective study reports the effect post-operative mechanical axis lower limb in coronal plane on survival following TKR. A 501 TKRs 396 patients were divided into aligned group with a neutral (± 3°) malaligned where deviated from by > 3°. At 15 years’ follow-up, 33 458 (7.2%) revised for aseptic...
The aim of this study was to assess the accuracy placement pelvic binders and determine whether circumferential compression at level greater trochanters is best method reducing a symphyseal diastasis. Patients were identified by retrospective review all radiographs performed military hospital over period 30 months. We analysed any radiograph on which buckle binder clearly visible. patients divided into groups according position in relation trochanters: high, trochanteric or low. Reduction...
We describe 261 peripheral nerve injuries sustained in war by 100 consecutive service men and women injured Iraq Afghanistan. Their mean age was 26.5 years (18.1 to 42.6), the median interval between injury first review 4.2 months (mean 8.4 (0.36 48.49)) follow-up 28.4 20.5 (1.3 64.2)). The lesions were predominantly focal prolonged conduction block/neurapraxia 116 (45%), axonotmesis 92 (35%) neurotmesis 53 (20%) evenly distributed upper lower limbs. Explosions accounted for 164 (63%): 213...
Abstract Background Trauma places a significant burden on healthcare services, and its management impacts greatly the injured patient. The demographic of major trauma is changing as population ages, increasingly unveiling gaps in processes managing older patients. Key to improving patient care ability characterise current distribution. Objectives There no contemporary evidence available how age distribution at national level. Through an analysis Audit Research Network (TARN) database, we...
Abstract This study aimed to evaluate the sensitivity and specificity of subepidermal moisture (SEM), a biomarker employed for early detection pressure injuries (PI), compared “Gold Standard” clinical skin tissue assessment (STA), characterize timing SEM changes relative diagnosis PI. blinded, longitudinal, prospective enrolled 189 patients (n = 182 in intent‐to‐treat [ITT]) at acute post‐acute sites (9 USA, 3 UK). Data were collected from patients' heels sacrums using biocapacitance...
Frailty is common in the older population and a predictor of adverse outcomes following emergency elective surgery. Identification frailty key to enable targeted intervention throughout perioperative pathway from contemplation surgery recovery. Despite evidence on how identify modify frailty, such interventions are not yet routine care. To address this implementation gap, guideline was published 2021 by Centre for Perioperative Care British Geriatrics Society, working with patient...
Aims To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that a younger population similar injuries. Patients Methods The Trauma Audit Research Network database was reviewed to identify eligible admitted between April 2012 June 2015. Distribution severity injury, interventions, comorbidity, critical care episodes were recorded. divided into young (64 years or younger) (65 older) patients. Results Of 142 765 adults trauma, 72 942 (51.09 %)...
The outcomes of 261 nerve injuries in 100 patients were graded good 173 cases (66%), fair 70 (26.8%) and poor 18 (6.9%) at the final review (median 28.4 months (1.3 to 64.2)). initial grades for 42 sutures graft 11 good, 14 17 poor. After subsequent revision repairs seven, neurolyses free vascularised fasciocutaneous flaps 11, 15 nine Pain was relieved 30 36 by repair, repair or neurolysis, when indicated. difference outcome between penetrating missile wounds those caused explosions not...
Hip fracture remains the biggest single source of morbidity and mortality in elderly trauma population, any intervention focused on quality improvement system efficiency is beneficial for both patients clinicians. Two variables contributory to improving care are time theater length stay, with overall goal being improve as reflected within achievement best practice tariff. One barriers optimizing these preinjury anticoagulation.Building our previous work warfarin this we utilized a regional...
IntroductionDue to their hypocoagulable state on presentation, anticoagulated patients with femoral fragility fractures typically experience delays surgery. There are no large, multicentre studies previously carried out within the United Kingdom (UK) evaluating impact of anticoagulant use in this patient population. This study aimed evaluate current epidemiology and compare perioperative management non-anticoagulated fracture patients.MethodsData was prospectively collected through a...
Objectives: This study investigates the reliability of femoral neck shaft angle (NSA) measurements made with software and images available in routine clinical practice. Methods: Using Centricity Enterprise™ (GE Healthcare Pty Ltd Piscataway, NJ) picture archiving communication system (PACS), NSA proximal femur was measured from anteroposterior radiographs adult hips. 3 independent observers, using a standardised technique, performed total 120 measurements. Results: The Pearson's correlation...
Introduction The average age of patients undergoing orthopaedic trauma surgery increases with over half these procedures performed on older (over 60 years old). Despite this, the treatment varies widely from their younger counterparts. Whilst diverging demographics and differing management are previously reported, no data is available regarding injury characteristics, comparative delays, cancellations or escalation to other lists. Through an analysis ORTHOPOD database, we provide a unique...
Anticoagulation reversal is a common cause of operative delay. We sought to establish for the first time impact this has on best practice tariff (BPT) patients with hip fracture admitted warfarin. All treated operatively over 32-month period were reviewed. Basic demographics, theater, length stay, and mortality recorded all patients. Independent samples t-tests used identify statistically significant differences between warfarin those not taking drug. A total 83 anticoagulated mean...
Malnutrition is common in older people, known to interact with frailty, and a risk factor for wound complications poor functional outcomes postoperatively. Sustaining hip fracture significant life event, often resulting decline mobility ability. A nutritional state may further impede recovery rehabilitation, so strategies improve perioperative nutrition are of considerable importance. We provide review supplement practices this vulnerable growing population.Systematic preoperative oral...
Traditionally, the anterior surgical approach of choice for acetabular reconstruction was ilioinguinal. There has been an increasing usage midline "Stoppa" or "anterior intrapelvic approach." The aim is to report techniques, early results (minimum 1 year), and complications approaches reconstruction.Retrospective case-note review.Pelvic tertiary center.A consecutive series fractures treated at specialist unit were retrospectively reviewed. fracture patterns, incisions used, intraoperative...
Aims The aim of this study was to describe services available patients with periprosthetic femoral fracture (PPFF) in England and Wales, focus on variation between centres areas for care improvement. Methods This work used data freely from the National Hip Fracture Database (NHFD) facilities survey 2021, which asked 21 questions about PPFFs, nine relating clinical decision-making around a hypothetical case. Results Of 174 contributing NHFD, 161 provided full responses 139 submitted PPFF....
This is a multicentre, prospective assessment of proportion the overall orthopaedic trauma caseload UK. It investigates theatre capacity, cancellations, and time to surgery in group hospitals that representative wider population. identifies barriers effective practice will inform system improvements.Data capture was by collaborative approach. Patients undergoing procedures from 22 August 2022 operated on before 31 October were included. Arm one captured weekly capacity. two concerned patient...