Surgical approaches to the hip
The hip is the major articulation between the femur and acetabulum. It is a ball-and-socket synovial joint that allows for versatile and multi-directional movement. Stability of the hip is maintained by a combination of articular congruence, soft tissue constraints and muscular control. These factors are important during arthroplasty where surgical decisions may affect the stability of the implant. The blood supply to the femoral head is predominantly retrograde in adults, with major contributions from the endosteal supply and the retinacular vessels (medial circumflex femoral artery) within the capsule. (Source: Surgery (...
Source: Surgery (Medicine Publishing) - March 14, 2023 Category: Surgery Authors: Shih-Han Chen, Sakeena Abbas, Toby Briant-Evans Tags: Orthopaedics IV: lower limb Source Type: research
Acute compartment syndrome
Compartment syndrome is an orthopaedic emergency. It is defined as an increase in pressure within an osseofascial compartment, which results in hypoxia and necrosis of the structures within the compartment. It is commonly associated with high energy injuries, particularly tibial fractures. Diagnosis is largely based on clinical assessment, with pain as the most important and reliable feature. Other features such as nerve compromise or pulselessness are late signs. Urgent treatment should be based on guidelines written by the British Orthopaedic Association. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 13, 2023 Category: Surgery Authors: Laura Beddard, Charline Roslee Tags: Orthopaedics IV: lower limb Source Type: research
Common knee injuries, diagnosis and management
The knee is a frequently injured joint, and the incidence of injury is increasing. Young adults are most likely to injure their knee through sports participation, and this can result in long-term debility without appropriate early and deferred management. A detailed history and clinical examination, supplemented with radiographic evaluation of the joint and magnetic resonance imaging, assist in the diagnosis and can guide acute and definitive management. Early clinical assessment by an appropriately trained clinician is recommended. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 12, 2023 Category: Surgery Authors: Sam K. Yasen Tags: Orthopaedics IV: lower limb Source Type: research
Pathology of soft tissue tumours
This article provides a short overview of the aetiology and clinical features of soft tissue sarcomas with an update on how molecular genetics is influencing classification and management of these rare tumours. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 11, 2023 Category: Surgery Authors: Anca Oniscu, Donald Salter Tags: Basic Science Source Type: research
Plateaus, shafts and pilons: principles of tibial fractures
An important principle in fracture management, whose underappreciation still commonly prevails, is that due consideration is warranted to traumatized soft tissues, perhaps more of a primary concern than even the bony element of the injury. This philosophy is most exemplified in lower limb injuries; the majority of adult tibial fractures arise from high energy aetiology that results in compromised viability of skin, muscle and periosteum. Often, this is not immediately apparent, and in any case necessitates thought from attending clinicians. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 10, 2023 Category: Surgery Authors: Dylan A. Mistry, Vlad Paraoan, Jayne Ward Tags: Orthopaedics IV: lower limb Source Type: research
Hip fractures and best practice tariffs
Hip fractures or proximal femur fractures describe fractures of the proximal femur from the femoral head to 5 cm below the lower border of the lesser trochanter. Most hip fractures occur in elderly patients whose bones have become weakened by osteopenia or osteoporosis, i.e. a fragility fracture. The prevalence of hip fractures is increasing steadily due to the ageing population. Due to the patient demogr aphic (elderly, likely with multiple comorbidities) numerous guidelines are put in place and continually revised to facilitate best patient outcomes. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 10, 2023 Category: Surgery Authors: Duaa Alim, Louise Nordin Tags: Orthopaedics IV: lower limb Source Type: research
Pathophysiology of urinary tract infections
Urinary tract infections are amongst the most common bacterial infections. They can occur in either an uncomplicated host setting, where there is no underlying structural or functional abnormality of the patient ’s genitourinary tract, or complicated, where there is. For the latter, common predisposing factors are the presence of a foreign body, including urinary catheter, or disruption of normal urinary flow by obstruction or retention. Bacteria vary widely in their ability to successfully invade the uri nary tract; the vast majority of such infections being due to a small number of species. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 10, 2023 Category: Surgery Authors: Chloe Walsh, Tim Collyns Tags: Basic science Source Type: research
Contents
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 1, 2023 Category: Surgery Source Type: research
Editorial Board
(Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - March 1, 2023 Category: Surgery Source Type: research
Approaches to the chest cavity and pulmonary resections
This article summarizes the clinically orientated anatomy of the thoracic cavity, particularly in relation to surgical landmarks. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - February 21, 2023 Category: Surgery Authors: Benjamin R. Waterhouse, Ian Paul Tags: Cardiothoracic surgery – II Source Type: research
Management of airway and chest wall tumours
The management of airway and chest wall tumours is a highly specialized area in thoracic surgery which affects a small number of the wider patient population. Familiarization with thoracic anaesthesia, rigid bronchoscopy, LASER technology, airway stenting not only provides stabilization of the airway and relieves obstruction to breathing but provides lifesaving treatment. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - February 19, 2023 Category: Surgery Authors: Sion Barnard Tags: Cardiothoracic surgery – II Source Type: research
Lung ventilation and the physiology of breathing
This article summarizes the anatomical features of the lungs, airway and thorax pertinent to the physiology of breathing and discusses chemoreceptor detection mechanisms, brainstem centres and relays involved in the control of breathing. We will discuss lung mechanics including spirometry, lung compliance, airway resistance and the role of surfactant and consider how these can be affected by disease states. It is recommended to revise principles of arterial blood gas analysis in addition to this article. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - February 19, 2023 Category: Surgery Authors: Henry Lewith, Jaideep J. Pandit Tags: Basic Science Source Type: research
Lung cancer
remains the greatest cause of cancer-related death in the United Kingdom despite its lower incidence compared to other cancers. It remains very treatable with excellent outcomes in the early stages; however, many patients present with late symptoms. Investigation of lung cancer has changed significantly over the last decade to allow less invasive staging techniques and, more importantly, less invasive operative techniques to allow surgery in patients that may have previously been denied surgery. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - February 17, 2023 Category: Surgery Authors: Peter Mhandu, Niall McGonigle Tags: Cardiothoracic surgery – II Source Type: research
Management of pleural effusions
This article aims to give an overall guide to the causes of pleural effusions and how to manage them. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - February 14, 2023 Category: Surgery Authors: Melanie Jenkins, Thomas Tsitsias, Gowthanan Santhirakumaran Tags: Cardiothoracic surgery – II Source Type: research
Pneumothorax and chest drain insertion
Chest drain insertion is a common procedure used routinely to drain the chest cavity. It can be used to drain air, as is the case of a pneumothorax, or to drain blood (heamothorax), chyle (chylothorax), fluid (pleural effusion) or pus (empyema) from the chest cavity. It is the commonest procedure performed for thoracic trauma. Seldinger and open surgical chest drain insertion are both discussed, as well as the use of ultrasound guidance to aid insertion/aspiration. Air (or fluid) in the pleural cavity causes the lung to collapse and results in a variable degree of impairment of both oxygenation and ventilation. (Source: Su...
Source: Surgery (Medicine Publishing) - February 14, 2023 Category: Surgery Authors: Meadhbh Ni Fhlatharta, Donna A. Eaton Tags: Cardiothoracic surgery – II Source Type: research
