Orthopaedics and Trauma RSS feed: Current Issue. Orthopaedics and Trauma presents a unique collection of International review articles summarizing the current state of knowledge in orthopaedics. Each issue begins with a focus on a specific area of the orthopaedic knowledge syllabus, covering several related topics in a mini-symposium; other articles complement this to ensure that the breadth of orthopaedic learning is supplemented in a 4 year cycle. http://www.orthopaedicsandtraumajournal.co.uk/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Orthopaedics and Trauma1877-1327256December 2011 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001552/abstract?rss=yesEditorial Board10.1016/S1877-1327(11)00155-2Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6iihttp://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001230/abstract?rss=yesAbstract: Scoliosis is a common paediatric and increasingly common adult problem. Clinical and radiological assessment is the first step in the management. This article outlines how to perform a thorough history and examination of a patient with scoliosis drawing out the differentiating features of idiopathic scoliosis from other varieties such as congenital, neuromuscular, syndromic and adult scoliosis.(i) Clinical assessment of scoliosisAdrian Gardner10.1016/j.mporth.2011.09.002Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity397402http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001461/abstract?rss=yesAbstract: Scoliosis is a three-dimensional deformity of the spine whose cardinal feature is a curve in the coronal plane with a Cobb angle that exceeds 10°. In the growing spine and the degenerative spine scoliosis will evolve over time; the fourth dimension. This article discusses the possible causes of scoliosis in the paediatric population. The aim is to provide the reader with a basic understanding of spinal growth, the natural history of scoliotic spinal deformity and outline the options for treatment.(ii) Scoliosis in children and teenagersNigel W. Gummerson, Peter A. Millner10.1016/j.mporth.2011.11.001Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity403412http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001515/abstract?rss=yesAbstract: In an ageing population adult degenerative scoliosis, a subset of adult scoliosis, is a growing problem. The spinal curves, unlike those of idiopathic scoliosis, are predominantly lumbar. Patients usually complain of axial pain, neurogenic claudication and radicular symptoms. Initial conservative management is indicated. If that fails, surgical treatment may be indicated, which requires careful patient selection, pre-operative assessment and pre-optimization to reduce the incidence of complications. Surgery is aimed at correcting the deformity, achieving adequate decompression, while obtaining solid spinal fusion and restoration of adequate coronal and sagittal balance.(iii) Adult degenerative scoliosisAnant D. Tambe, Antony Louis Rex Michael10.1016/j.mporth.2011.11.006Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity413424http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001473/abstract?rss=yesAbstract: Children and adolescents with neurological conditions develop severe spinal deformities at a high frequency due to muscle weakness and poor neuromuscular control, frequently associated with spasticity. Scoliosis is the most common type of deformity, occasionally associated with increased kyphosis or lordosis and commonly extending to the sacrum and pelvis. The development of severe spinopelvic imbalance can cause back or costo-pelvic impingement pain, affects the patient’s ability to function, impacts on the patient's quality of life and maximizes the need for nursing care. It may give rise to significant respiratory compromise. Surgical correction is indicated in the presence of a progressive deformity that produces functional limitations and severe symptoms especially in growing children. This, by necessity, involves a major procedure with considerable risk of intraoperative and postoperative complications directly related to the severity of deformity, but also to the presence of associated co-morbidities and the degree of neurological disability. A thorough medical assessment is critical in order to establish each patient’s suitability for such major surgery. A well-coordinated multidisciplinary approach will reduce the risks of significant morbidity and mortality, which can occur either during scoliosis surgery, often related to excessive blood loss, or post-surgery, mainly due to pulmonary complications, as well as the risk of infection and generalized sepsis in patients with inherently poor immunological response. Deformity correction and spinal fusion should only be performed in major centres with adequate medical support and by well-trained surgeons who are familiar with the surgical techniques in order to minimize the risk of complications and produce an optimum outcome. This review summarizes the current knowledge on neuromuscular deformities of the spine and provides a rational approach to the evaluation and management of this group of patients.(iv) Development and treatment of spinal deformity in patients with neurological or myopathic conditionsAthanasios I. Tsirikos10.1016/j.mporth.2011.11.002Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity425434http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001424/abstract?rss=yesAbstract: Unicompartmental knee arthroplasty (UKA) is a treatment option when only one compartment of the knee is affected with arthritis. There has been increasing enthusiasm in unicompartmental knee arthroplasty, with improved understanding of surgical principles, newer techniques for improving surgical precision including the use of smaller incisions, and the introduction of newer designs. Past experiences from several centres have been paramount in the education of surgeons with regards to patient selection, technical considerations, and importantly avoiding common pitfalls can lead to early failure of the components.(v) Unicompartmental knee arthroplastyS. Thambapillay, G. Chakrabarty10.1016/j.mporth.2011.10.003Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity435440http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001412/abstract?rss=yesAbstract: Although first described in the 1930’s, it was not until the late 20th century that hip arthroscopy became a well-recognized procedure. Correct patient positioning and portal placement are critical, and failure of either may result in inability to access the joint or damage to important local neurovascular structures. In the hands of an experienced surgeon and anaesthetist the risks are small, but attention to detail is critical. The future of hip arthroscopy is exciting and as the scientific evidence builds it is likely to be an important adjunct to more traditional open hip procedures.(vi) An introduction to hip arthroscopy part one: surgical anatomy and techniquePeter D.H. Wall, Jamie S. Brown, Shanmugam Karthikeyan, Matthew Wyse, Damian Griffin10.1016/j.mporth.2011.10.002Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity441447http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711000273/abstract?rss=yesAbstract: Stump pain following lower limb amputation is common. Correct management relies on an accurate diagnosis of the underlying aetiology. The radiological diagnosis of the main causes of stump pain is discussed, with cases presented in a quiz format.(vii) Radiology Quiz: Lower limb amputation stump painBahir Almazedi, James J. Rankine10.1016/j.mporth.2011.02.001Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity448453http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001242/abstract?rss=yesAbstract: Blount’s disease is an uncommon disorder of the postero-medial proximal tibial physis, which produces a varus proximal tibia, tibial internal torsion, procurvatum and shortening. Blount described infantile and adolescent types. The precise pathogenesis of the condition remains obscure but associations include an early walking age, obesity, familial tendency and Afro-Caribbean race. It is frequently bilateral.The diagnosis of Blount’s disease follows clinical assessment and radiographs of the knee, which show a progressive varus deformity and typically an increased metaphyseal-diaphyseal angle. The natural history of the condition is adult knee pain, deformity and arthrosis. Treatment is dependent on the age of the child, the stage of the disease and the amount of angular and articular deformity present. Bracing may be used for early stage infantile disease. Surgical treatment options include hemiepiphysiodesis, osteotomy and bar excision. Monitoring of limb alignment and length is required until skeletal maturity.(viii) Blount’s diseaseT. Nunn, P. Rollinson, B. Scott10.1016/j.mporth.2011.09.003Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Mini-Symposium: Spinal Deformity454461http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711001503/abstract?rss=yesCME questions based on the Mini-Symposium on “Spinal Deformity”10.1016/j.mporth.2011.11.005Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6CME Section462463http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711000893/abstract?rss=yesAnswers to CME questions based on the Mini-Symposium on “Foot and Ankle”10.1016/j.mporth.2011.07.002Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6CME Section464464http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS187713271100056X/abstract?rss=yesMost books reviewed in this journal are textbooks that can be dipped into in order to find a specific piece of information, or to help understand a particular problem. This one is written in a narrative style, however, and really needs to be read through from cover to cover in order to comprehend the developing arguments and explanations. The topic is the psychology of decision making across all surgical specialities, so no a priori knowledge of the relevant theories is assumed. It is, however, easy to read and fulfils its own purpose by encouraging the reader to reflect on their own style and to question their own behaviours. It begins by reviewing the recent introduction of the WHO checklist and I was concerned that we were heading to a recommendation of protocol- and guideline-driven practice. However, after highlighting the enormous benefits that rigorous team functioning can bring to patient safety there is a deeper review of decision making psychology with illustrations not only from aviation, but also from the military and fire services, brought to life by regular clinical vignettes to root the message in medical practice. Moving on, therefore, we look at intuitive thinking and how this can be developed, such that one is left with much to think about. I don’t know if the bad decision makers could be made better by digesting this work – the earlier chapters suggest that they might be the ones least likely to benefit. However, those looking for self-improvement will come away with much to contemplate. It isn’t a book that will help prepare trainees for any exam they are currently likely to encounter in their professional careers, but is a book that I could recommend anyone to read, whatever their career stage.Smart surgeons – smart decisionsDavid Limb10.1016/j.mporth.2011.04.003Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Book Reviews465465http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711000558/abstract?rss=yesOperative Techniques in Adult Reconstruction Surgery is one of a series of seven operative techniques books. It is divided into three sections, Hip Reconstruction, Hip Preservation and Knee Reconstruction. There are 30 chapters, to which 59 international authors have contributed, although the majority are from North America. It is briefcase-sized and therefore easily portable, but if you forget your book there is a full online version that is made available to the reader once registered on a website using an access code provided with the book.Operative techniques in Adult Reconstruction SurgeryChris Brew10.1016/j.mporth.2011.04.002Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Book Reviews465465http://www.orthopaedicsandtraumajournal.co.uk/article/PIIS1877132711000340/abstract?rss=yesOperative Techniques in Pediatric Orthopaedics is one of a series covering all the orthopaedic sub-specialities. It is an atlas of operative surgery but also has background information on the conditions covered. It is a comprehensive book covering both elective and trauma paediatric surgery. It also has descriptions of certain procedures, for example psoas lengthening at the pelvic brim, which I have not been able to find good, well illustrated, descriptions of previously.Operative techniques in pediatric orthopaedicsJoshua Bridgens10.1016/j.mporth.2011.02.006Orthopaedics and Trauma 25, 6 (2011)2011-12-01Orthopaedics and Trauma2011-12-01256S1877-1327(11)X0007-6Book Reviews465466