Paul A. Banaszkiewicz

Femoral exchange nailing for aseptic non-union: not the end to all problems

We report the results of a single centre prospective study of exchange nailing for aseptic non-union of a femoral fracture. Eighteen patients with 19 aseptic femoral non-unions had exchange nailing performed in our institution. We collected data on mechanism of injury, original fracture type, and indication for exchange nailing, further surgery and major complications. In 11 non-unions (58%), the exchange nail procedure alone resulted in fracture union with a mean time to radiographic union of 9 months (range 3-24 months). The non-union did not heal in five patients, two patients developed an infected non-union, and one patient required dynamisation of the exchange nail. Fracture healing was eventually achieved in 18 non-unions (95%). Complications following exchange nailing occurred in 11 fractures (58%), in which further surgery was required (four repeat exchange nailings, two Ilizarov frame applications and five nail removals). The role of reamed exchange nailing in the treatment of femoral non-union needs to be re-evaluated. Although fracture healing is eventually achieved in most patients, a significant number of them required additional surgery to achieve union or to deal with complications arising from the exchange nailing.

Gym ball exercise leads to recruitment and increased water content of the paraspinal muscles: An MRI pilot study

Study design: Cross-sectional pilot study on 24 healthy volunteers. Objectives: Investigate the value of stabilization exercises using a gym ball in paraspinal muscle activation by measuring changes in muscle signal intensity on MRI before and after exercise. Background: The gym ball is commonly used for rehabilitating spinal dysfunction. It is thought to rehabilitate some key muscle groups in the trunk. Methods: Twenty-four healthy volunteers (aged 21–50, 13 female and 11 male) had special sequence MR images of the lumbar spine showing an axial section of the paraspinal muscles at L4/5 level. Afterwards all were subjected to 10 minutes of exercise on the gym ball followed by repeat MRI scans immediately, 5 and 10 minutes post exercise. Changes in the mean signal intensity at the same region of interest in multifidus, erector spinae and psoas muscles were evaluated using MRI software. Results: The mean signal intensity in the MR images of the same region in the multifidus (P < 0.03) and erector spinae (P < 0.005) muscles significantly increased after gym ball exercise. There was no statistically significant change in the signal intensity of the psoas muscle (P < 0.086). Conclusions: The multifidus and erector spinae muscles of a healthy individual can be activated by performing certain exercises

Postgraduate Orthopaedics. The Candidate's Guide To The Frcs (Tr And Orth) Examination

Postgraduate Orthopaedics. The Candidates Guide To The Frcs (Tr And Orth) Examination - Libros de Medicina - Oposiciones - 55,18

Introduction to Evidence-Based Orthopaedics

Practising surgeons may be unable to keep up with current practice – what seems up to date today can be redundant tomorrow. In paediatric orthopaedics, and the setting of a busy clinical practice, it is challenging to find time to retrieve the best available studies, let alone analyse them, or synthesise the resulting information into a form applicable to one’s own practice. We are hardly alone in this regard (eg, Narayanan and Wright [1]), so this book is a collective effort to probe the common questions arising in our speciality – and look critically for answers within the literature. In this work, we are proud to have brought together the thinking of more than fifty leading paediatric orthopaedic surgeons to assemble the evidence underpinning elements of current practice. The approach has been that of the ‘evidence-based medicine’ pragmatist, written by frontline practitioners.

What to read

In 1975, Valiant showed that Boolean matrix multiplication can be used for parsing contextfree grammars (CFGs), yielding the asympotically fastest (although not practical) CFG parsing algorithm known. We prove a dual result: any CFG parser with time complexity O(gn3−2), where g is the size of the grammar and n is the length of the input string, can be efficiently converted into an algorithm to multiply m × m Boolean matrices in time O(m3−2/3). Given that practical, substantially sub-cubic Boolean matrix multiplication algorithms have been quite difficult to find, we thus explain why there has been little progress in developing practical, substantially sub-cubic general CFG parsers. In proving this result, we also develop a formalization of the notion of parsing.

Postgraduate Orthopaedics: Viva Guide for the FRCS (Tr & Orth) Examination

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Postgraduate orthopaedics : the candidate's guide to the FRCS (Tr & Orth) examination

Machine generated contents note: General guidance / Prash Jesudason -- MCQ and EMI paper guidance / A. S. Rajeev -- The short cases / Andrew Sprowson -- The intermediate cases / Puneet Monga and Rajeev Bansal -- Shoulder and elbow clinical cases / Dave Cloke -- Hand and wrist clinical cases / John W. K. Harrison -- Spine clinical cases / Almas Khan -- Hip clinical cases / Paul A. Banaszkiewicz -- Knee clinical cases / Deiary F. Kader -- Foot and ankle clinical cases / Paul Patterson -- Paediatric clinical cases / Philip Henman -- General viva guidance / Tom Symes -- Shoulder and elbow oral core topics / Asir Aster and Shashi Kanth Godey -- Hip oral core topics / Paul A. Banaszkiewicz -- Knee oral core topics / Deiary F. Kader -- Foot and ankle oral core topics / Paul Patterson -- Spine oral core topics / Niall Craig -- Tumour oral topics / Craig H. Gerrand and Thomas B. Beckingsale -- Syllabus and general guidance / John W. K. Harrison -- Hand oral core topics / John W. K. Harrison -- Paediatric oral topics / S. L. Barker -- Trauma oral topics / Gunasekaran Kumar -- Basic science oral topics / Kevin P. Sherman -- Surgical exposures topics / S. Venkatachalam and Paul A. Banaszkiewicz -- Anatomy / Asir Aster and Paul A. Banaszkiewicz -- SAS doctors and the FRCS (Orth) exam / M. A. Bari -- Article 14 and the FRCS (Orth) exam / Mohan K. Pullagura -- Candidates accounts of the examination / Dave Cloke -- Examination failure / Andrew Port.