Our data show that the majority of patients undergoing total hip replacement can expect to return to work and sporting activities within 4-6 months. Activities at work are often initially limited and physical performance may not fully return to the expected level. Patients with a high body mass index take longer to return to work and sporting activities.

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The restoration of endodontically treated teeth has undergone significant changes in the last 20 years. Most of these changes are associated with the preservation of tooth structure, this has been achieved first of all with the increasing use of operative microscopes, nickel titanium instruments and more recently cone beam computed tomography; these instruments have allowed the clinicians to reduce significantly the amount of coronal and radicular hard tooth tissue removed in the process of cutting access cavities. The use of composites has also allowed the clinicians to restore with adhesive techniques teeth that would otherwise require extensive and destructive mechanical retentions. The use of partial crowns is becoming increasingly popular and this also helps prevent tooth structure loss. This article will focus on the choices available to restore both anterior and posterior teeth and will focus more on these contemporary adhesive techniques.

This study investigates the relationship between the epidemiology of hand fractures and social deprivation. Data were collected prospectively in a single trauma unit serving a well-defined population. The 1382 patients treated for 1569 fractures of the metacarpals or phalanges represented an incidence of hand fracture of 3.7 per 1000 per year for men and 1.3 per 1000 per year for women. Deprivation was not directly associated with the incidence of hand fracture. Common mechanisms of injury are gender specific. Fractures of the little finger metacarpal were common (27% of the total) and were associated with social deprivation in men (P = 0.017). For women, fractures where the mechanism of injury was unclear or the patient was intoxicated and could not recall the mechanism showed a clear association with deprivation. Affluent patients were more likely to receive operative treatment. Social deprivation influences both the pattern and management of hand fractures.

We aimed to study the effect of smoking on the complication rate and medium-term functional outcome after total hip replacement. 1767 patients undergoing a cemented THR in one hospital were followed up prospectively at 6, 18, 36, and 60 months. Harris Hip Scores, SF-36 scores and complications were recorded. There was no statistically significant difference in early complications and length of hospital stay between smokers and those patients who had never smoked. Smokers were less likely to require a blood transfusion and showed a statistically lower Harris Hip Score at six months but there was no difference seen at the subsequent time-points to five years after surgery. Smoking did not influence the complication rate or medium-term functional outcome at five years after total hip replacement.

Purpose. To identify factors that affect functional outcome one year after distal radial fracture treatment. Methods. 521 women and 121 men aged 16 to 92 (mean, 59) years with distal radial fractures underwent external fixation (n=123), open reduction and internal fixation (n=63), a combination of both (n=10), distal radial osteotomy for symptomatic malunion (n=90), or casting with (n=194) or without (n=162) prior closed manipulation under regional anaesthesia. The indication for surgery (rather than casting) was metaphyseal instability. Radiographic evaluation (dorsal angulation, radial shortening, carpal malalignment, and malunion) was made before and after treatment and after fracture healing. Functional evaluation (range of movement, grip strength, and activities of daily living) was made at a mean of 16 (range, 6-54) months after injury. Results. After multiple regression analysis, poorer functional score was associated with increasing age (p<0.001), dorsal angulation after healing (p<0.016),

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