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Following dislocation of the glenohumeral joint with an isolated greater tuberosity fracture, closed reduction in the emergency department can lead to fracture propagation or iatrogenic fractures. This article assesses the evidence regarding when anterior dislocations of the shoulder with an isolated fracture of the greater tuberosity can be safely reduced in the emergency department, as there is currently no clear guidance on this. A total of eight articles described 172 cases which underwent closed reduction, which resulted in 22 cases of iatrogenic fractures. Female sex, increased patient age and fragments of the greater tuberosity were associated with an increased risk of iatrogenic fractures. Closed reduction in the emergency department appears to be a safe option in younger patients and those with greater tuberosity fractures less than 40% of the width of the humeral head. [ABSTRACT FROM AUTHOR]

Introduction: This article presents an audit cycle supported quality improvement project addressing best practice in the consent process for lower limb arthroplasty which takes into account the new standard in surgical consent and the importance of material risks. Methods: 50 consecutive total hip and total knee replacement consent forms over a 3-month period were reviewed for legibility and completeness. Following the introduction of a new, pre-printed but customizable consent form the review process was repeated. Results: The introduction of a customizable, pre-printed consent form that can be adjusted to reflect the individualized material risks of each patient increased legibility, reduced inappropriate human error variation and abolished the use of abbreviations and medical jargon. Conclusions: When used as part of an extended consent process, the authors feel that the use of pre-printed but customizable consent forms improves legibility, completeness and consistency and also provides the ability to highlight those complications that are of particular importance for that patient to satisfy the new accepted standard in surgical consent. [ABSTRACT FROM AUTHOR]

The article offers information about hip osteoarthritis (HO). Topics covered include the types of risk factors for getting osteoarthritis of the hip including general factors such as age, sex and genetics, and intrinsic factors like joint laxity, the symptoms and clinical signs of HO including achy groin pain and internal rotation, and the treatment options including physical therapy and intra-articular injections.

The article presents a study related to intraoperative nerve monitoring for patients who underwent primary or revision total shoulder arthroplasty in London, England. It describes the methodology of the study conducted on 21 patients in a 12-month period, in which intraoperative sensory evoked potentials (SEP) were measured and neurophysiological signal change was categorized into unilateral or bilateral decrease in SEP signal. It was found that median nerve appeared most risky.

Rheumatoid arthritis affects around 1% of the global population with a predilection for Western societies. The treatment of the rheumatoid hip has gone through significant changes in recent years. Although osteotomies and synovectomies were previously commonplace, advances in arthroplasty technique and technology has seen these former procedures being performed less commonly. This article tackles some of the key issues with regard to the rheumatoid hip, namely the increased risk and methods of dealing with protrusio acetabuli, the risk of dislocation, infection and rates of aseptic loosening., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)