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Abstract
A prospective review of theatre time utilisation of the senior author's elective orthopaedic lists was carried out over a period of 10 weeks. A total of 41 cases were included. Only 54.0% of theatre time was utilised for operating. The anaesthetic time was 12.0%, and 9.3% of theatre time was used for positioning and draping. Delays in starting the list and turnover time accounted for the remaining 25%.
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Charalambous C, Constantinou A. 422 Investigation of the Apoptotic Pathways Activated by Equol and Tamoxifen in MCF-7 Breast Cancer Cells. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71104-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hassan S, Wall A, Ayyaswamy B, Ayyawamy B, Rogers S, Mills SP, Charalambous CP. Is there a need for early post-operative x-rays in primary total knee replacements? Experience of a centre in the UK. Ann R Coll Surg Engl 2012; 94:199-200. [PMID: 22507727 DOI: 10.1308/003588412x13171221501780] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Early post-operative x-rays are often taken in total knee replacements (TKRs). Patient mobilisation may be delayed until these x-rays are obtained and this may prolong discharge. The aim of this study was to assess the value of such early x-rays and whether they influenced the early post-operative management of these patients. METHODS A total of 624 consecutive TKRs performed at the Blackpool Victoria Hospital over a 34-month period were evaluated. Plain anteroposterior and lateral x-rays were examined. RESULTS Two patients were found to have significant abnormalities: an undisplaced periprosthetic tibial fracture and a partial inferior pole patellar avulsion. Neither of these required further treatment or influenced mobility. No other complications were noted that changed routine post-operative management. CONCLUSIONS These results question the need for immediate x-rays in primary TKRs.
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Orphanos G, Charalambous C, Vrezas I, Kales SN, Charalambous H, Katodritis N, Christodoulides G, Maimaris M, Soteriades ES. Mesothelioma in Cyprus: a case series (1997-2007). Hematol Oncol Stem Cell Ther 2011; 4:193-4. [PMID: 22198194 DOI: 10.5144/1658-3876.2011.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tryfonidis M, Jass GK, Charalambous CP, Jacob S. SUPERFICIAL BRANCH OF THE RADIAL NERVE PIERCING THE BRACHIORADIALIS TENDON TO BECOME SUBCUTANEOUS: AN ANATOMICAL VARIATION WITH CLINICAL RELEVANCE. ACTA ACUST UNITED AC 2011; 9:191-5. [PMID: 15810105 DOI: 10.1142/s0218810404002224] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2004] [Accepted: 09/22/2004] [Indexed: 11/18/2022]
Abstract
We dissected 20 preserved Caucasian cadaveric upper limbs looking at the relation of the superficial branch of the radial nerve (SBRN) to the brachioradialis tendon. SBRN emerged from deep to superficial position by piercing the brachioradialis tendon near its dorsal border in four limbs. The resulting dorsal tendinous band compressed the nerve and prevented longitudinal gliding movement during ulnar flexion. This is likely to increase the risk of chronic compression neuropathy (Wartenberg's syndrome). In two of these four limbs, there was a communication between the SBRN and lateral cutaneous nerve of the forearm. No such communication was found in the remaining 16 forearms. This communication could contribute to the minimal area of sensory loss observed in Wartenberg's syndrome. We recommend that this anatomical anomaly is looked for and if present dealt with during surgical treatment of Wartenberg's syndrome, as it is likely to predispose to chronic compression neuropathy.
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Sahu A, Charalambous CP, Mills SP, Batra S, Ravenscroft MJ. Reoperation for metalwork complications following the use of volar locking plates for distal radius fractures: a United Kingdom experience. ACTA ACUST UNITED AC 2011; 16:113-8. [PMID: 21548144 DOI: 10.1142/s0218810411005205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/14/2011] [Indexed: 12/19/2022]
Abstract
Volar locking plates are increasingly used in the management of distal radius fractures. As with any new implant, understanding the rate and type of potential metalwork related complications is important. In this study, we reviewed 114 distal radius fractures treated with volar locking plating. Our aim was to determine the type and rate of metalwork complications requiring reoperation. In our series, 12 cases (10%) underwent further surgery for metalwork related complications mainly for screw protrusion into the radiocarpal joint following fracture collapse. Our results suggest that volar locking plates are associated with a high rate of metal work related complications requiring further surgery. Technical aspects to reduce such complications are discussed.
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Ravenscroft MJ, Charalambous CP, Mills SP, Woodruff MJ, Stanley JK. Bone-cement interface strength in distal radii using two medullary canal preparation techniques: carbon dioxide jet cleaning versus syringed saline. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2010; 15:95-8. [PMID: 20672396 DOI: 10.1142/s0218810410004618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 10/22/2009] [Accepted: 05/24/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE Loosening is an important cause of failure of upper limb arthroplasty and improvement in cementation techniques may limit this. The currently accepted medullary canal preparation techniques use saline washing and gauze drying. Another method of bone preparation uses carbon dioxide compression gas jet which blows debris from the canal, whilst simultaneously drying the bone. We compared the push out strengths of cement plugs in sections of human cadaveric radii that had been prepared using either syringed saline or carbon dioxide jet cleaning. METHODS Following bone preparation, four radii in each group, were cemented in a standardised fashion, and cut into 1 cm sections. An Instron materials testing machine was used to measure the force needed to push the cement plug out of the bone section. RESULTS The force needed to push out the cement plug was significantly higher in the carbon dioxide jet (median 580.61, IQR 429.10-650.05) as compared to the saline group (median 366.57N, IQR 271.05-502.23), P = 0.009. The mechanism of failure of the bone-cement interface also differed between the two groups, with 100% of the sectioned cortices fracturing prior to cement extrusion in the carbon dioxide jet group, but only 23% of the sectioned cortices doing so in the saline group. CONCLUSION Our results suggest that there is a statistically stronger macro-interlock at the bone-cement interface after preparation of the medullary canals of radii using a carbon dioxide compression gas jet as compared to saline irrigation.
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Tryfonidis M, Charalambous CP, Mills SP, Jass GK, Jacob S, Stanley JK, Hayton MJ. Distal radial and ulnar landmarks used in percutaneous pin fixation: anatomical relationship to the superficial radial and ulnar nerves. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2010; 15:161-4. [PMID: 21089188 DOI: 10.1142/s0218810410004783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 07/27/2010] [Accepted: 08/03/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND The radial and ulnar styloids as well as Lister's tubercle are important surgical landmarks in the surgical treatment of distal forearm fractures. There have been limited studies assessing their relative safety in terms of their distance from superficial nerves which are in danger during surgical procedures. The aim of this cadaveric study was to assess and compare the distance of superficial nerves to these important surgical landmarks. METHODS Twenty embalmed cadaveric upper limbs were dissected exposing the nerves and tendons around the wrist. The radial styloid, Lister's tubercle, ulnar styloid and nerve branches were marked with pins. The distance of the nearest nerve branch to each landmark was measured with a digital calliper. Statistical analysis of the data was performed using SPSS for Windows 11.5 (SPSS Inc., Chicago, IL) using Friedman Tests and Wilcoxon Signed Ranks tests. RESULTS The median distance of the nearest nerve branch to the radial styloid was 5.42 mm, to the Lister's tubercle was 16.68 mm and to the ulnar styloid was 13.56 mm. There was unequal safety for these three surgical landmarks regarding proximity to nerve branches (p < 0.00001). Paired comparison using Wilcoxon Signed Ranks Test showed that the Lister's tubercle was safer than the radial styloid (p < 0.0001) and ulnar styloid (p = 0.04). In addition, the ulnar styloid was safer than the radial styloid (p < 0.001). CONCLUSIONS There is a higher risk of injury to superficial nerves when operating near the radial styloid as it is significantly closer to nerve branches as compared to Lister's tubercle and ulnar styloid.
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Charalambous CP, Alvi F, Sutton P. Conventional diathermy in arthroscopic anterior cruciate ligament reconstruction - a safe and cost-effective alternative to commercial thermal devices. Ann R Coll Surg Engl 2010. [PMID: 20626984 DOI: 10.1308/003588410x12699663903719h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Charalambous CP, Alvi F, Sutton P. Conventional diathermy in arthroscopic anterior cruciate ligament reconstruction – a safe and cost-effective alternative to commercial thermal devices. Ann R Coll Surg Engl 2010; 92:442. [DOI: 10.1308/rcsann.2010.92.5.442a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Charalambous CP, Mills SP, Hayton MJ. Gradual distraction using an external fixator followed by open reduction in the treatment of chronic lunate dislocation. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2010; 15:27-29. [PMID: 20422723 DOI: 10.1142/s0218810410004436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 01/25/2010] [Accepted: 01/27/2010] [Indexed: 05/29/2023]
Abstract
Chronic lunate dislocation is a difficult problem to deal with. We describe a surgical technique whereby gradual wrist distraction is applied using an external fixator followed by open repositioning of the lunate. We have successfully used this technique in a rugby player with an undiagnosed chronic lunate dislocation. Our case was able to return to competitive rugby playing.
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Charalambous CP, Gullett TK, Philips N, Funk L, Ravenscroft MJ. L-configuration re-attachment of distal biceps tendon rupture. Ann R Coll Surg Engl 2009; 91:165-6. [PMID: 19579301 DOI: 10.1308/rcsann.2009.91.2.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Charalambous CP, Mosey C, Johnstone E, Akimau P, Gullett TK, Siddique I, Wilkes RA. Improving osteoporosis assessment in the fracture clinic. Ann R Coll Surg Engl 2009; 91:596-8. [PMID: 19558771 DOI: 10.1308/003588409x432400] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION The aim of this study was to compare the effectiveness of different ways of referring patients to an osteoporosis assessment service at an orthopaedic fracture clinic of a hospital in the UK. PATIENTS AND METHODS Three methods of identifying and referring to an osteoporosis assessment service were evaluated. RESULTS Relying on doctors for such a referral gave a catchment rate of only 1.6%. Involving patients themselves, asking them to self-refer, increased the catchment rate to 63% (P < 0.0001). Having a specialist osteoporosis and fracture liaison nurse present in clinic and reviewing the notes of patients checking in, to see if they match criteria for osteoporosis assessment, further increased catchment to 77% (P = 0.036). CONCLUSIONS Simply having an osteoporosis assessment service and strict criteria to identify which patients should be referred to such a service will not necessarily increase catchment rate for osteoporosis patients. A nurse physically present in the clinic provided the best result, and supports the need of investing in an osteoporosis and fracture liaison nurse.
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Charalambous CP, Gullett TK, Ravenscroft MJ. A modification of the McLaughlin procedure for persistent posterior shoulder instability: technical note. Arch Orthop Trauma Surg 2009; 129:753-5. [PMID: 18709379 DOI: 10.1007/s00402-008-0721-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Indexed: 11/24/2022]
Abstract
We describe a modification of the McLaughlin procedure for persistent posterior shoulder instability following posterior glenohumeral dislocation with a large antero-medial reverse Hill-Sachs lesion. In the original McLaughlin description, the subscapularis was divided close to its insertion to the lesser tuberosity and sutured into the reverse Hill-Sachs lesion using bone drill holes. In our newly described technique, the subscapularis tendon is not divided but is instead plicated into the reverse Hill-Sachs lesion using suture anchors inserted in the humeral head defect. We present the case of a patient with persistent posterior instability following traumatic posterior glenohumeral dislocation, successfully treated with our new technique.
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Charalambous CP, Alvi F, Phaltankar P, Gagey O. Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study. Knee 2009; 16:183-6. [PMID: 19272780 DOI: 10.1016/j.knee.2008.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 11/06/2008] [Accepted: 11/10/2008] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data from the industry prior to deciding which harvester to use seems desirable.
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Samarji RS, Charalambous CP, Waldron S, Noble J. Placement of a palpable marker adjacent to the mid-inguinal point: assessment of a clinical method for detecting the femoral head centre during knee arthroplasty. Knee 2009; 16:228-30. [PMID: 19101150 DOI: 10.1016/j.knee.2008.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 11/07/2008] [Accepted: 11/10/2008] [Indexed: 02/02/2023]
Abstract
Localization of the centre of the femoral head is vital when using extra-medullary femoral alignment systems in knee arthroplasty. This study investigated the accuracy of a palpable marker placed in the groin for detecting the centre of the femoral head. A table tennis ball, 38 mm in diameter, was taped 2.5 cm perpendicular to the mid-inguinal point in patients having a plain radiograph of the pelvis. The mean horizontal distance between the centre of the table tennis ball and a vertical line passing through the centre of the femoral head was 8.62 mm (range 0-28.6, SD 6.76). In 100% of cases the horizontal distance between the centre of the table tennis ball and a vertical line passing through the centre of the femoral head was less than one diameter of the table tennis ball. Using a theoretical mechanical axis model our clinical method would confer an error equal to or less than 2 degrees from the weight-bearing axis of the knee in up to 98% of cases. In conclusion, our results suggest that the clinical method reported here provides a simple and reliable way of localizing the centre of the femoral head in knee arthroplasty.
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Ravenscroft M, Charalambous CP, Haines JF, Trail IA. Outcome of stemmed shoulder hemi-arthroplasty revision. Arch Orthop Trauma Surg 2009; 129:797-9. [PMID: 18719928 DOI: 10.1007/s00402-008-0728-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2008] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We report our experience of revision of failed stemmed shoulder hemi-arthroplasty for causes other than infection. MATERIAL/METHOD Seventeen revisions were followed for a minimum of 2 years. Fifteen cases were revised for symptomatic glenoid erosion. Sixteen were revised to a total shoulder arthroplasty and one to a cuff tear arthropathy head. RESULT The mean visual analogue pain score following revision surgery was reduced from 6.7 to 3.2 (P = 0.008). However the Constant-Murley and the Association of Shoulder and Elbow Surgeons scores failed to improve significantly. CONCLUSION We conclude that revision surgery for failed stemmed shoulder hemi-arthroplasty improves pain but not function.
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Hatzitolios A, Athyros V, Karagiannis A, Savopoulos C, Charalambous C, Kyriakidis G, Milidis T, Papathanakis C, Bitli A, Vogiatsis I, Ntaios G, Katsiki N, Symeonidis A, Tziomalos K, Mikhailidis D. Implementation of strategy for the management of overt dyslipidemia: The IMPROVE-dyslipidemia study. Int J Cardiol 2009; 134:322-9. [DOI: 10.1016/j.ijcard.2009.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 11/21/2008] [Accepted: 02/06/2009] [Indexed: 11/15/2022]
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Charalambous CP, Stanley JK, Siddique I, Aster A, Gagey O. Posterolateral rotatory laxity following surgery to the head of the radius: biomechanical comparison of two surgical approaches. ACTA ACUST UNITED AC 2009; 91:82-7. [PMID: 19092009 DOI: 10.1302/0301-620x.91b1.21039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The lateral ligament complex is the primary constraint to posterolateral rotatory laxity of the elbow, and if it is disrupted during surgery, posterolateral instability may ensue. The Wrightington approach to the head of the radius involves osteotomising the ulnar insertion of this ligament, rather than incising through it as in the classic posterolateral (Kocher) approach. In this biomechanical study of 17 human cadaver elbows, we demonstrate that the surgical approach to the head can influence posterolateral laxity, with the Wrightington approach producing less posterolateral rotatory laxity than the posterolateral approach.
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Charalambous CP, Akimau P, Wilkes RA. Hybrid monolateral-ring fixator for bone transport in post-traumatic femoral segmental defect: a technical note. Arch Orthop Trauma Surg 2009; 129:225-6. [PMID: 18297294 DOI: 10.1007/s00402-008-0598-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Indexed: 11/29/2022]
Abstract
Bone transport for large femoral segmental bone defects is a technically challenging task. We describe a patient with a 14 cm bone loss at the metaphyseal/diaphyseal junction of the distal femur, treated with a monolateral/ring fixator hybrid. We propose that such combination can provide sufficient stability for bone tranport to be successfully completed.
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Charalambous CP, Wilkes RA. Bone Grafting of the Un-United Docking Site in Bone Transport: Description of a Percutaneous Approach. Ann R Coll Surg Engl 2008; 90:613. [DOI: 10.1308/rcsann.2008.90.7.613a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Posterolateral rotatory instability is the most common type of symptomatic chronic instability of the elbow. In this condition the forearm complex rotates externally in relation to the humerus, causing posterior subluxation or dislocation of the radial head. The lateral ligament complex, radial head and coronoid process are important constraints to posterolateral rotatory instability, and their disruption is involved in the pathogenesis of this condition. The diagnosis relies on a high index of clinical suspicion, active and passive apprehension tests, and examination under anaesthesia. Surgical treatment has given consistently successful results. Open reconstruction of the lateral ligaments with a tendon graft has been the procedure of choice, with arthroscopic techniques emerging as a potential alternative.
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Decatris M, Charalambous H, Darby A, Christodoulides G, Charalambous C, Katodrytis N. Concurrent chemoradiotherapy (ConCRT) in locally advanced (LA) non-small cell Lung Cancer (NSCLC); 3-year experience at the Bank of Cyprus (BoC) oncology centre. Lung Cancer 2008. [DOI: 10.1016/s0169-5002(08)70083-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Charalambous CP, Tryfonidis M, Alvi F, Moran M, Fang C, Samarji R, Samaraji R, Hirst P. Inter- and intra-observer variation of the Schatzker and AO/OTA classifications of tibial plateau fractures and a proposal of a new classification system. Ann R Coll Surg Engl 2007; 89:400-4. [PMID: 17535620 PMCID: PMC1963574 DOI: 10.1308/003588407x187667] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the intra- and inter-observer variation of the Schatzker and AO/OTA classifications in assessing tibial plateau fractures, using plain radiographs. PATIENTS AND METHODS Fifty tibial plateau fractures were classified independently by six observers as per the Schatzker and AO/OTA classifications, using antero-posterior and lateral plain radiographs. Assessment was done on two occasions, 8 weeks apart. RESULTS We found that both the Schatzker and AO/OTA classifications have a high intra-observer (kappa = 0.57 and 0.53, respectively), and inter-observer (kappa = 0.41 and 0.43, respectively) variation. Classification of tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression +/- split conferred improved inter- and intra-observer variation. CONCLUSIONS The high inter-observer variation found for the Schatzker and AO/OTA classifications must be taken into consideration when these are used as a guidance of treatment and when used in evaluating patients' outcome. Simply classifying tibial plateau fractures into unicondylar versus bicondylar and pure splits versus articular depression +/- split may be more reliable.
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Beesley MF, Zubairy AI, Charalambous CP. An objective method to assess the efficacy of theatre scissors. Ann R Coll Surg Engl 2007; 88:677. [PMID: 17396356 PMCID: PMC1963821 DOI: 10.1308/rcsann.2006.88.7.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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