Tibialis anterior tendon ruptures are rare but debilitating injuries. A high index of suspicion is warranted in patients presenting with atraumatic anterior ankle pain, especially in conjunction with diabetes or inflammatory disease. The authors present a case report of bilateral sequential rupture of tibialis anterior tendons, a discussion of management, and a review of the literature.
external fixator or plating anteriorly. 17 patients (group 2) exhibited minimal displacement less than 5 mm and were not stabilised. Rotational instability >2 cm was characterised by complete fracture of the sacrum posteriorly. Stabilisation of the pelvic ring in group I was associated with a significant reduction of the VAS within 72 h from surgery, early ambulation and discharge from the hospital. Conclusion: This study supports the view that not all LCI fracture patterns are mechanically stable. Examination under anaesthesia of the pelvic ring can assist the clinician in the decision-making progress.Background: Clinical coding has attracted significant interest recently as it has become synonymous with reimbursement. We hereby present the results of first and largest study in the UK involving 547 orthopaedic trauma cases wherein a meticulous in-depth analysis was performed. Study design: Completed audit cycle. Objectives: To review the existing coding for orthopaedic trauma, to ascertain accuracy of procedural codes and to identify limitations, implement changes, re-evaluate and close the audit loop. Methods: All orthopaedic trauma surgeries (244 cases) performed over 1 month (March 2006) were comprehensively analysed. The primary procedural accuracy of OPCS4.2, its limitations and loss of revenue due to missing codes (6 patients) were determined. Changes were implemented to streamline/optimise financial reimbursement and improve data quality/accuracy by education/training. Electronic discharge summaries were implemented to enhance efficiency. The audit loop was subsequently closed to evaluate implementation of these changes by re-auditing all trauma surgeries performed in the same month the following year, i.e. March 2007 (303 cases) against OPCS4.3 codes. Results: The primary procedural accuracy was 95.38% (11/238 coding errors) and omissions in 6 patients resulted in net loss of
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