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The foot is commonly affected in systemic diseases such as rheumatoid arthritis and diabetes mellitus. Treating patients who suffer with foot pathology secondary to systemic diseases requires a multidisciplinary approach, following the principles outlined within this review. There is little high level evidence in this field, such as prospective controlled clinical trials, hence much of what we know and practise is based upon the expert opinion of key individuals in specialist centres, to whom we owe a great debt. [ABSTRACT FROM AUTHOR]

Evidence based medicine should underpin the practice of all orthopaedic surgeons. Spinal pathology should be considered in the differential diagnosis for pain in every upper and lower limbs region and an understanding of spinal anatomy and physiology is vital in the management of the trauma patient. We present ten key articles, which have been selected for their impact within the field. They encompass trauma, degenerative, inflammatory, deformity and emergency spinal disorders. The articles range from level I randomized control trials to level V expert opinion. An understanding of their methodology and key findings should be part of the core knowledge encompassing spinal surgery and will, in particular, be of benefit for those preparing for final professional examinations. [ABSTRACT FROM AUTHOR]

Evidence based medicine should underpin the practice of all orthopaedic surgeons. Hand and wrist conditions comprise one eighth of the FRCS viva, and questions on hand and wrist surgery also feature in the trauma viva and upper limb clinical cases. Consequently, detailed knowledge of hand and wrist pathologies and their management is critical for exam success. To meet the criteria of a classic paper within hand surgery it must refine or describe a technique, the techniques must survive the passage of time and it must change the course of treatment. We list 10 key articles which have been selected for their impact within the field. [ABSTRACT FROM AUTHOR]

Triple arthrodesis has for many years been a gold-standard treatment for a multitude of hindfoot deformities and arthritis since it was first described in 1923 by Edwin W. Ryerson of Chicago (1872–1961). However, in contemporary foot and ankle practice there has been a shift toward joint preserving techniques. In this article we cover the biomechanics of the triple joint and the surgical technique for a standard two-incision approach. The role of this once common procedure in modern foot and ankle practice is assessed by a systematic review of the literature reporting series of triple arthrodesis over the past 10 years. 13 studies met the inclusion criteria and reported the results of 515 operations in 481 patients. The three most common diagnoses were tibialis posterior insufficiency (30%), inflammatory arthropathy (19%) and neuromuscular disorders (18%). Subjective outcome was good in 75%, fair in 18% and poor in 7.9% (n = 354). The complication rate was relatively high, with wound complications and/or infections in approximately 10% and non-union of at least one joint in 6.5%. There have been recent advances in surgical technique. It is possible to perform triple arthrodesis through a single medial incision and a double arthrodesis (subtalar and talonavicular joint) via a medial approach is currently emerging as a good alternative for the plano-valgus foot. External fixation can be useful for gradual correction of severe deformity and surgeons have started using arthroscopic techniques with early success. In conclusion, the triple arthrodesis is still alive and remains a useful operation for the foot and ankle surgeon. However, trainees should be aware of the alternatives and aim to preserve healthy joints where possible. [ABSTRACT FROM AUTHOR]

The use of xenograft tissue in orthopaedics has an interesting history and has yielded mixed clinical results, although the potential future application of xenografts processing with novel techniques is promising. This review aims to cover the basics of tissue rejection, zoonoses and processing methods, as well as the laboratory and clinical evidence for the use of bone and soft tissue xenografts. [ABSTRACT FROM AUTHOR]

Abstract: Over recent decades, the concept of Evidence-Based Medicine has come to form the cornerstone of clinical practice in all medical specialities, including Trauma and Orthopaedic Surgery. Management of the trauma patient is part of everyday practice for most Orthopaedic Surgeons. As such, it is important to be aware of the seminal research studies that have informed current clinical practice. It is also important that all surgeons, including surgeons-in-training, follow the process of ongoing professional development such that their clinical practice remains current and up to date. In this article, we critically evaluate a number of important research papers, which have been selected for their impact on contemporary clinical practice, recognized in many orthopaedic teaching programmes. [Copyright &y& Elsevier]

Abstract: Evidence Based Medicine is at the heart of contemporary clinical practice, underpinning modern orthopaedics. Orthopaedic surgeons have always had an affinity for the historical origins of their speciality, and lessons learned from the early pioneers continue to influence current practice. We present a concise review of some of the influential papers in the field of children''s orthopaedics. Reference to historical work informs current practice, in respect of pathology, classification, management principles, and potential pitfalls. Although all training programmes develop orthopaedic clinicians to the level of a generalist, as orthopaedic practice has become increasingly sub-specialized, paediatric orthopaedics has evolved into a well-defined and distinct discipline. As an aide memoire to those in established practice, and as a revision aid to those preparing for their exit examinations, we outline eight seminal papers in children''s orthopaedics. These papers have been selected both for their importance in modern everyday practice and their recognition within orthopaedic teaching. [Copyright &y& Elsevier]