Recent meta-analyses have shown reduced re-rupture rates for the surgical management of Achilles ruptures. However percutaneous repair has been demonstrated to lead to improved function, patient satisfaction but greater complications than open repair. In the current economic climate, we believe it is reasonable to consider the financial cost of rupture management for both the patient and the provider. We aimed to determine the cost effectiveness of operative treatment of ruptures of the Achilles tendon based upon theatre occupancy, clinic attendance and cast changes, operative complications and functional assessment score. We audited the cost effectiveness of the surgical management of Achilles tendon ruptures between 2005–2011 in our unit by comparing 49 patients receiving percutaneous repair to 35 patients whom had open repairs (Retrospective cohort study level 3).Background
Methods
Leg length inequality following total hip replacement remains common. In an effort to reduce this occurrence, surgeons undertake pre-operative templating and use various forms of intra-operative measurements, including computer navigation. This study aims to delineate which measurement technique is most appropriate for measuring leg length inequality from a pelvic radiograph. Three observers took a total of 9600 measurements from 100 pelvic radiographs. Four lines were constructed on each of the radiographs, bisecting the acetabular teardrops (Methods 1/2), ishial spines (Method 3/4), inferior sacroiliac joint (Method 5/6) and inferior obturator foramen (Method 7/8). Measurements were taken from these lines to the midpoint on the LT and to the tip of the GT. The effect of pelvic positioning was also assessed using radiographs of a synthetic pelvis and femur using the same eight methods by a single observer (ED). Intra-observer variability was analysed using within subject standard deviation. Inter-observer variability was analysed using the coefficient of inter-observer variability (CIV).Aims
Method
