The management of leg lengths in total hip arthroplasty continues to challenge orthopaedic surgeons. The aim of this study is to test the reliability of a measuring device used to measure the resected femoral head and how the resulting intra operatively calculated change in leg length compares to the radiographically measured change in leg length. Four orthopaedic surgeons measured 20 femoral heads and the intra class coefficients of the raters were between 0.955 and 0.990 with a mean difference less 1 mm, indicating the reliability of the device. The 'actual' radiographic leg length correction of 50 patients and the 'predicted' intra operatively calculated correction was analysed with a linear regression model and 47 measurements were within 2 mm and the remaining 3 within 4 mm.
Background: Subtrochanteric femur fractures remain challenging injuries to treat. There is paucity of literature evaluating their outcomes and complications following low-velocity civilian gunshots. The purpose of this study is to evaluate the results of intramedullary nailing of subtrochanteric femur fractures secondary to low-velocity gunshots.
Background: The natural history of rotator cuff tears suggests that not all tears progress and small isolated rotator cuff tears might heal. To date there have been no long-term studies assessing the MRI changes of unrepaired full thickness supraspinatus tears after acromioplasty. Methods: A database of patients from a single surgeon that have had acromioplasty without rotator cuff repair in the last five to 15 years was reviewed. The number of shoulders examined in this study was 17. Patients all completed an Oxford score, Constant score and had an MRI to assess fatty infiltration and atrophy. Results: Mean follow-up time 7.2 years (range, 5-13 years). The patients were divided into three groups depending on the size of the tear at time of surgery: C1 tears (<1 cm) n=5, C2 tears (1-1.9 cm) n=8, C3 tears (2-3 cm) n=4. In the C2 group, MRI evaluation showed there were two patients that had tears that had regressed in size (CI 1.4-36, 4). In the C3 group, MRI evaluation revealed that all (100%) of the rotator cuff tears had significant fatty infiltration and atrophy. There was no statistical difference between groups when assessing Oxford scores (p=0.75) and Constant scores (p=0.69). There was significant association between increase in tear size and fatty infiltration (p=0.028). A possible association was noted between increase in tear size and atrophy (p=0.054). Conclusion: Patients had good long-term clinical outcomes irrespective of tear size. It showed that not all tears progressed to significant fatty change and atrophy.
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