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To understand the relationship between standardisation and originality in surgery, the contributions of three surgeons in the 20th century are analysed. The individual Arbuthnot Lane, the collectivist Robert Jones and the scientist Alexis Carrel changed the practice of orthopaedic surgery. It is argued that the factors influencing innovation are not binary but multifactorial and that advances in surgery occur when individual freedom is permitted within a system. It is concluded that innovation and standardisation in orthopaedic surgery need not conflict with each other. [ABSTRACT FROM AUTHOR]

This study sought to examine the ability of motion analysis to detect long and short-term changes in performance following lumbar decompression surgery. These changes were compared with changes in more traditional questionnaire based assessments of outcome. Fifty-two patients from an original pool of 84 patients who underwent spinal surgery were assessed pre-operatively using spinal motion analysis and standard questionnaires of pain and function. These assessments were repeated at 6 weeks, and 6 months post-operatively. Significant Improvements in back and leg pain were noted at 6 weeks (p < 0.001) with no further improvements occurring at 6 months. Changes in the Oswestry Disability Score were noted only at the 6-month review, and only certain constructs of the SF-36 reported improvement. Of the motion analysis measures only measures of sagittal posture and anterior-posterior flexion appeared sensitive to change in the patient's condition. However, change in motion was not correlated with change in functional disability scales or pain. Measures of posture and range of motion of flexion may provide useful indices of objective performance in future outcome studies, however, they do not correlate with changes in subjective function or pain, thus their full relevance remains uncertain. [ABSTRACT FROM AUTHOR]

External fixation of fractures is now used frequently in orthopaedics. This paper reviews the results of 30 fractures treated by a single bar system, the Sukhtian-Hughes, over a period of 4 years. The results are encouraging, particularly in compound tibial fractures and in patients with non-union of fractures. [ABSTRACT FROM AUTHOR]