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This retrospective study with follow-up was undertaken to compare postoperative results and functional outcomes of tibial plateau fractures treated with non-locking and locking plate fixation. Over a 5-year period, 60 tibial plateau fractures were treated with plate fixation. Fracture classifications, complications and tibial alignment were compared, and the Knee Society Knee Score and EuroQol questionnaire were used to evaluate functional outcomes. The mean length of follow-up was 19 months. Although the locking plate cohort had a higher proportion of older patients and severe fractures, less bone grafts were used and less complications were observed. Eighteen percent of cases were malaligned on the coronal plane. The locking plate cohort had some operative advantages and showed less ongoing subsidence for malaligned cases. There was no significant difference in functional outcomes. However a larger study with age, fracture-classification and health status matched cohorts may identify improved functional outcomes in the locking plate cohort. [ABSTRACT FROM AUTHOR]

Background: The efficient use of operating theatres is important to ensure optimum cost–benefit for the hospital and to clear waiting lists. This audit uses the orthopaedic trauma theatre as a model to assess the theatre efficiency at our institution. Methods: We performed a retrospective audit using data gathered from the operating theatre database at our institution. We considered each component of the operating theatre process and integrated them to give a combined value for surgical and anaesthetic time (end utilization) and total theatre efficiency (operating theatre utilization). Results: Results showed that relative to the standards set, changeover time and start times were sub-standard, with consistently prolonged changeovers and late starts. End utilization and operating theatre utilization were 78.8 and 81%, against a standard of 77 and 85–90%, respectively. However, these figures may be misleading due to sub-standard performance in changeover time and other variables. Conclusions: We have highlighted inefficiency in the orthopaedic trauma theatre at our institution and suggest various strategies to improve this that may be applied universally. [ABSTRACT FROM AUTHOR]

We analyze a comprehensive set of our adaptive optics (AO) images taken at the 10 m W. M. Keck telescope and the 8 m Gemini telescope to derive values for the size, shape, and rotational pole of asteroid (16) Psyche. Our fit of a large number of AO images, spanning 14 years and covering a range of viewing geometries, allows a well-constrained model that yields small uncertainties in all measured and derived parameters, including triaxial ellipsoid dimensions, rotational pole, volume, and density. We find a best fit set of triaxial ellipsoid diameters of (a,b,c) = (274 ± 9, 231 ± 7, 176 ± 7) km, with an average diameter of 223 ± 7 km. Continuing the literature review of Carry (2012), we find a new mass for Psyche of 2.43 ± 0.35 × 10 19 kg that, with the volume from our size, leads to a density estimate 4.16 ± 0.64 g/cm 3 . The largest contribution to the uncertainty in the density, however, still comes from the uncertainty in the mass, not our volume. Psyche’s M classification, combined with its high radar albedo, suggests at least a surface metallic composition. If Psyche is composed of pure nickel-iron, the density we derive implies a macro-porosity of 47%, suggesting that it may be an exposed, disrupted, and reassembled core of a Vesta-like planetesimal. The rotational pole position (critical for planning spacecraft mission operations) that we find is consistent with others, but with a reduced uncertainty: [RA;Dec]=[32°;+5°] or Ecliptic [ λ; δ ]=[ 32 ∘ ; − 8 ∘ ] with an uncertainty radius of 3°. Our results provide independent measurements of fundamental parameters for this M-type asteroid, and demonstrate that the parameters are well determined by all techniques, including setting the prime meridian over the longest principal axis. The 5.00 year orbital period of Psyche produces only four distinct opposition geometries, suggesting that observations before the arrival of Psyche Mission in 2030 should perhaps emphasize observations away from opposition, although the penalty then would be that the asteroid will be fainter and further than at opposition. [ABSTRACT FROM AUTHOR]

Background: The sliding hip screw is currently the most frequently used prosthesis used to fix trochanteric fractures of the hip. The 'tip-apex distance' (TAD) has been found to be predictive of hardware failure, with a larger TAD being associated with an increasing risk of 'cut-out'. Previous studies have either used 'hard-copy' radiographs and geometrical aids or a mixture of scanned hard-copy images and extra software to measure TAD. The current study describes a new method of tip-apex distance estimation using an entirely digital picture archiving and communication system (PACS). Materials and Methods: Ten radiographs were measured for TAD by four surgeons of differing experience using the described measurement protocol, at two different time points (4 weeks apart). The results were then subjected to two-tailed t-tests to determine if they differed significantly. Results: No tests attained significance (i.e. no statistical difference existed between the observers' measurements and no difference existed over time from a single observer's results). Conclusion: This study shows that TAD can be easily, accurately and, importantly, reproducibly measured using an entirely digitally based image capture and archiving system. The ease with which the measurements and calculations can be made will facilitate orthopaedic practitioners and trauma units in their auditing activities, and allows for quick TAD estimation in the 'X-ray meeting' environment. [ABSTRACT FROM AUTHOR]

Summary: Background: The sliding hip screw is currently the most frequently used prosthesis used to fix trochanteric fractures of the hip. The ‘tip–apex distance’ (TAD) has been found to be predictive of hardware failure, with a larger TAD being associated with an increasing risk of ‘cut-out’. Previous studies have either used ‘hard-copy’ radiographs and geometrical aids or a mixture of scanned hard-copy images and extra software to measure TAD. The current study describes a new method of tip–apex distance estimation using an entirely digital picture archiving and communication system (PACS). Materials and methods: Ten radiographs were measured for TAD by four surgeons of differing experience using the described measurement protocol, at two different time points (4 weeks apart). The results were then subjected to two-tailed t-tests to determine if they differed significantly. Results: No tests attained significance (i.e. no statistical difference existed between the observers’ measurements and no difference existed over time from a single observer''s results). Conclusion: This study shows that TAD can be easily, accurately and, importantly, reproducibly measured using an entirely digitally based image capture and archiving system. The ease with which the measurements and calculations can be made will facilitate orthopaedic practitioners and trauma units in their auditing activities, and allows for quick TAD estimation in the ‘X-ray meeting’ environment. [Copyright &y& Elsevier]