This randomised prospective study compared two operations for trapeziometacarpal joint osteoarthritis: trapeziectomy with Flexor carpi radialis ligament reconstruction, tendon interposition and Kirschner wire insertion followed by splintage for 6 weeks (T+LRTI) and excision of the trapezium with no Kirschner wire and immobilisation of the thumb in a soft bandage for only 3 weeks (T). Sixty-seven thumbs with trapeziectomy (T) and 61 with trapeziectomy and ligament reconstruction and tendon interposition (T+LRTI) were assessed preoperatively and at 3-months and 1-year after surgery. Forty-seven percent and 73% of patients reported no pain or only aching after use at 3-months and 1-year respectively and the DASH and Patient Evaluation Measure (PEM) outcome scores reduced postoperatively indicating improved function. However the pain, DASH and PEM scores, and also key and tip thumb pinch and all the other clinical outcome measures, did not differ significantly between the two groups at either 3-months or 1-year after surgery.

Morton's neuroma is a common cause of metatarsalgia caused by intermetarsal digital nerve thickening. This study reviews the pathology, presentation, symptoms and signs, and patient satisfaction with surgical treatment. Seventy-eight patients (82 feet) were treated for Morton's metatarsalgia by excision of the interdigital nerve. The patients were followed-up for a mean of 4.6 years (range 0.8-8.1 years) and scored using the Foot Functional Index and the American Orthopedic Foot Ankle Society scoring system. In 74 patients the Foot Functional Index was more than 85 (maximum score 100). Seventy-one patients scored more than 90 on the American Orthopedic Foot Ankle Society scoring system with two patients scoring 100 (maximum score). Postoperatively, 82% reported excellent or good results, 10% had a fair result with restriction of activities or pain and 8% had no improvement at all after surgery while 71% had restrictions with footwear.

We showed that despite local trust adherence to Department of Health policy, sharps injury reporting rates are inadequate. Further investment into healthcare worker education as well as a facilitation of the process of reporting may be necessary to improve reporting rates.

Purpose Major pelvic injuries resulting from high-energy trauma require emergency hospital treatment, and part of the initial management includes mechanical stabilisation of the pelvis. Controversies include binder position, use in lateral compression injuries and application during radiological assessment. We present the results of a survey of both emergency department and orthopaedic specialties. Methods A telephone survey of all 144 trauma units in the UK accepting adult pelvic trauma patients was carried out in July 2012. The duty registrar for the emergency and orthopaedic departments was contacted and asked to complete a questionnaire. Results A response rate of 100 % was achieved. Pelvic binders were available for use in approximately three quarters of the trauma units surveyed. Eight-five emergency department (59 %) and 79 orthopaedic (54.9 %) registrars had been given training on pelvic binder application. Fiftysix emergency department (38.9 %) and 114 orthopaedic (79.1 %) registrars identified the level of the greater trochanters as the most suitable position for the binder. Forty-five emergency department (31.3 %) and 58 orthopaedic (40.3 %) registrars used pelvic binders in suspected lateral compression injuries. One hundred and twenty-six emergency department (87.5 %) and 113 orthopaedic (78.5 %) registrars would not release the binder during radiological assessment of the pelvis in a haemodynamically stable patient.

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We report on a prospective series of 201 primary uncemented total hip arthroplasties with a Bicontact prosthesis at a mean follow-up of 12.9 years. The mean Harris hip score improved from 41 before surgery to 89 at final follow-up. Two femoral stems, one each for infection and fracture, and 12 cups were revised. The mean number of years to revision post-primary surgery was 8.7 years (six months to 16 years). The cumulative survival of the prosthesis was 95.42% for any cause at ten years and 93.57% at 12 years. Survivorship for aseptic loosening of the femoral stem was 100%. In our series, the Bicontact uncemented total hip arthroplasty stem without hydroxyapatite coating showed excellent survival and the cup survival was comparable to other leading series.

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This series demonstrates that arthroscopic excision of fractures of the radial head and neck is reliable, reproducible and safe, with similar results to open excision. There may also be additional benefits in the short term with regards to speed of healing and rehabilitation.