The purpose of this study is to compare early return to function in patients treated with closed reduction percutaneous pinning and open reduction internal fixation in displaced fractures of the distal radius.. Hypothesis: Wrist range of motion, grip strength and outcome at 2-3 months after injury are better in patients treated with open reduction, internal fixation (ORIF) than in patients treated with closed reduction percutaneous pinning techniques (CRPP). In addition patients treated with ORIF return to work at faster rates. ...
Open Reduction Internal Fixation (ORIF) involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone. Open reduction refers to open surgery to set bones, as is necessary for some fractures. Internal fixation refers to fixation of screws and/or plates, intramedullary bone nails (femur, tibia, humerus) to enable or facilitate healing. Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infection, which happens when implants such as plates (e.g. dynamic compression plate) are used. Open Reduction Internal Fixation techniques often are used in cases involving serious fractures such as comminuted or displaced fractures or, in cases where the bone otherwise would not heal correctly with casting or splinting alone. Risks and complications may include bacterial colonization of the bone, infection, stiffness and loss of range of motion, non-union, mal-union, damage to the muscles, nerve ...
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Most people are unaware of what a surgical procedure would cost if they were to pay cash. Have you ever tried to look up the cost of a surgical procedure and were unsuccessful? Even if you were able to find the cost of the procedure, you typically find a wide range of cost, and the cost is inconclusive in that it doesnt account for incurred operating room expenses. Imagine you have carpal tunnel syndrome and your deductible is $6,000.00. The bundled cash price for a carpal tunnel release at our facility is $2,550.00 including all incurred expenses for the procedure. If you were to go to a hospital for this procedure, you would most likely end up paying at least double that price ...
High Impacts medical illustrations drive home the graphic reality of any personal injury, while helping explain complex issues and surgical procedures relevant to your case.. ...
Fractured mandibular condyles are common representing 25-35% of all mandibular fractures. They are treated by conservative management (CM) or open reduction/internal fixation (ORIF) but the evidence to support superiority of one method over the other has not been assessed. The aim of this review is to evaluate the current evidence regarding the interventions that can [read the full story…]. ...
Satisfactory pain control can generally be achieved after major surgery of the tibia through a combination of enteral and parenteral medications, neuraxial techniques (such as epidural analgesia), and/or regional techniques (such as sciatic and femoral nerve block). Intramedullary nailing (IMN) and open reduction/internal fixation (ORIF) of the tibia have been important exceptions, and postoperative pain control can be difficult to achieve in these cases.. Surgical repair of fractures of the tibial shaft and of the proximal tibia can be complicated by compartment syndrome, with the possibility of substantial morbidity and loss of function if not detected and treated promptly. It is not always possible to determine preoperatively which tibial fractures are at high risk, and which are low risk for this complication.. The hallmark of compartment syndrome, and often the earliest sign, is pain out of proportion to the nature of the injury. This pain is poorly relieved by morphine or other strong ...
8287 patients were included in this analysis. The mean age of subjects was 58.7 ± 16.5 years and there were 3973 (47.9%) female patients. 102 (1.23%) cases showed the evidence of VTE during the period and 64 were diagnosed postoperatively. Of these, 34 (53%) patients received pharmacological prophylaxis after operation. In-hospital mortality of patients with VTE was 3.9%. Multivariate analysis revealed that associated factors of developing VTE were female patients (odds ratio [OR] 3.24, 95% confidence interval [CI] 1.84 to 5.70, P , 0.001), receiving open reduction internal fixation (ORIF) (OR 2.96, 95%CI 1.49 to 5.88, P = 0.002), and receiving multiple surgeries during the course of hospitalization (OR 32.25, 95%CI 18.21 to 57.11, P , 0.001). ...
Find the best fracture open reduction and internal fixation orif doctors in Gurgaon. Get guidance from medical experts to select fracture open reduction and internal fixation orif specialist in Gurgaon from trusted hospitals - credihealth.com
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The invention refers to a prosthetic device for the application of simultaneous axial and transversal prestressing to obtain stable and elastic osteosynthesis of fractures. The device focuses on the concept of internal fixation with consideration for the natural frequency of the bone. The device for fracture fixation comprises a
F384 - 17 Standard Specifications and Test Methods for Metallic Angled Orthopedic Fracture Fixation Devices , angled devices, bend testing, blade plate, compression hip screw, fatigue test, orthopedic medical devices, surgical devices, surgical implants,,
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the Association for the Study of Internal Fixation spine fracture classification. The axial compressive and torsional force shattered the vertebral body into 2 halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short-segment or long-segment posterior fixation and anterior fusion. MATERIALS AND METHODS: A total of 16 patients with acute, split fracture-dislocation of the lumbar spine from March 2000 to May 2009 in our department were recruited. Seven patients (group I) treated by long-segment posterior fixation (2 levels above and 2 below the fracture) and anterior ...
OBJECTIVES: While osteoporosis has been shown to be a contributing factor in low energy fractures in the elderly, limited data exists regarding the correlation of bone mineral density (BMD) and T-Scores to mortality and failure of fracture fixation. This study seeks to determine the relationship between femoral neck BMD in elderly patients with typical geriatric fractures and mortality and fracture fixation failure using Quantitative Computed Tomography (QCT). MATERIALS AND METHODS: Patients over the age of 65 who sustained fractures of the proximal humerus, distal radius, pelvic ring, acetabulum, hip, proximal tibia, and ankle who also underwent a CT scan that included an uninjured femoral neck were retrospectively reviewed ...
This study was designed to investigate why patients with TSC almost never develop cancer despite high levels of mTORC1 signaling in multiple organs. This is in contrast to the malignancies typically seen in patients with increased mTORC1 signaling due to PTEN mutations (Hu et al., 2005; Inoki et al., 2005). Various models have been proposed to explain this striking discrepancy, including feedback inhibition of AKT through mTORC1 and direct or indirect reductions of mTORC2 activity (Manning et al., 2005). Alternatively, decreased cell proliferation and enhanced cell death in TSC1- or TSC2-deficient cells might compensate for any excessive proliferation induced by increased mTORC1 activity. This model is also supported by complications reported during the generation of mouse embryonic fibroblasts (MEFs) from Tsc2 knockout mice (Zhang et al., 2003). Although derived Tsc2 mutant MEFs initially grew as expected, they rapidly underwent senescence and died. However, the authors circumvented this ...
Study External skeletal fixation (internal fixation) flashcards from awesome possum's class online, or in Brainscape's iPhone or Android app. ✓ Learn faster with spaced repetition.
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Osteosynthesis for fractured forearm (costs for program #106003) ✔ University Hospital RWTH Aachen ✔ Department of Orthopedics ✔ BookingHealth.com
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Surgeons continue to debate the role of surgery in the treatment of acute proximal humerus fractures. Recently, reports have shown a trend towards increased utilization of operative fixation. Surgical options include: all suture fixation, closed reduction and percutaneous pinning, open reduction internal fixation with locked proximal humerus plates, proximal humerus nailing, Bilboquet implants, and arthroplasty. No single form of treatment has been shown to be superior to another. In some patients, there remains debate if surgical options are superior to non-operative management alone. The purpose of this article is to review the natural history of non-operative treatment of proximal humerus fractures, describe the most common surgical treatments, and discuss the sequelae of fractures treated nonoperatively.. ...
Background: Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site,known as minimally invasive plate osteosynthesis (MIPO), has recently become prevalent. This study has beendesigned to assess the outcomes of this treatment for tibial and femoral comminuted fractures.Methods: A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in thiscross-sectional study at Alzahra university hospital in 2015. Eleven patients were excluded due to lack of adequatefollow-ups. Patientsdata including union time; infection in the fractured site; hip and knee range of motion; and anymalunion or deformities like limb length discrepancy were collected after the surgery in every session.Results: Among 32 femoral and 17 tibial fractures, union was completed in48 patients, while only one patient withfemoral fracture had nonunion. The mean union time was 18.57±2.42 weeks. Femur fractures healed faster than tibia(17.76±2.36 compared to 19±2
The recognition and stabilization of any accompanying injuries is the most pressing issue surrounding pelvic injuries in the emergency department (ED). Pelvic fractures resulting from high energy are classified depending upon their involvement of either the pelvic ring or the acetabulum. Pelvic ring fractures can be classified as either stable or unstable. Stable injuries include single breaks in the pelvic ring, diastasis of the pubic symphysis, and fractures of the iliac wings. Unstable injuries include those with two breaks of the pelvic ring (Fig. 31-1) or those having a sacroiliac dislocation/fracture along with an associated rami or pubic symphysis fracture. Stable fractures may be successfully managed nonoperatively. Unstable fracture patterns may require external fixation or open reduction/internal fixation to stabilize the bony injury while allowing for better management of associated injuries. ...
Introduction. Extra-articular Distal tibia fractures are often difficult to treat since they are close to the ankle joint, usually associated with soft tissue injuries. Minimal invasive Plate osteosynthesis (MIPO) using Locking compression plate (LCP) has replaced the conventional open reduction method since smaller incision and indirect reduction preserves the fracture hematoma and soft tissue vascularity(1). Literature review suggest that both MIPO and Intramedullary nailing (IMN) has been successful in the management of these fractures, but the results are controversial among the two (2-4). MIPO is associated with wound problems, Plate prominence(5), mal-alignment and non-union(6). IMN avoids some of these problems but the technical difficulty in insertion and the risk of mal-union (7), anterior knee pain poses a great challenge in orthopaedics (4). Our hypothesis was that patients treated with IMN has a better outcome than treated with MIPO. The aim of this study is to compare the clinical, ...
Article] Journal of Orthopaedic Trauma. 29(8):349-353, August 2015. (Format: HTML, PDF). Objective: To determine if intraoperative autologous transfusion using a Cell Saver (CS) was routinely indicated for open reduction internal fixation (ORIF) of acetabular fractures, and if so, was there a difference between differing surgical approaches.. Design: Retrospective single-center cohort study.. Setting: University Level 1 trauma center.. Patients/Participants: One hundred forty-five consecutive acetabular fractures using intraoperative autologous transfusion, either treated with an anterior ilioinguinal or a posterior-based Kocher-Langenbeck approach, were compared.. Intervention: Use of CS in ORIF acetabular cases.. Main Outcome Measurements: CS utilization and CS blood return for acetabular ORIF. Mean intraoperative blood loss between the 2 approaches.. Results: CS blood was returned in 29 of the 145 total cases [23/65 anterior (ilioinguinal approach) and 6/80 posterior approach ...
References 1. Parrott S : The economic cost of hip fracture in the UK (2000) www.dti.gov.uk/files/file21463.pdf2. Crossman PT, Khan RJK, MacDowell A, Gardner AC, Reddy NS, Keene GS A survey of the treatment of displaced intracapsular femoral neck fractures in the UK. Injury, 33(2002): 383-3863. Anderson GH, Harper WM, Gregg PJ: Management of the intracapsular fractures of the proximal femur in 1990 : a cause for concern? J Bone Joint Surg (Br) 73B(Suppl 1) (1991) : 734. Parker MJ, Khan RJK, Crawford J, Pryor GA: Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly. J Bone Joint Surg (Br), 84(8) (2002): 1150-55. Davison JNS, Calder SJ, Anderson GH, Ward G, Jagger C, Harper WM, Gregg PJ: Treatment for displaced intracapsular fracture of the proximal femur. J Bone Joint Surg (Br) 83 (2001) : 206-16. Khan RJK, MacDowell A, Crossman PT, Keene GS: Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip - a systematic ...
Although all sorts of ankle injuries are possible, there are essentially two main ways that an individual can sprain an ankle. The first is the most common and it is called an Inversion Sprain or Lateral Ankle Sprain. During this dynamic the person sprains the ankle and for visualization purposes the bottom of the foot pointing in the direction of the other foot. The second sprain is called an Eversion Sprain or Medial Ankle Sprain. This type of sprain the foot is pointing or facing away from the other foot. Eversion Sprains although less common, have a tendency to cause greater damage to the ankle joint often resulting in terrible fractures requiring surgery with plates and screws procedurally labeled as "Open Reduction Internal Fixation" or ORIF. This type of sprain, when severely damaged, tends to be a highly unstable fracture with an inability to walk after the injury because it involves the weight bearing Tibia bone. Inversion Sprains, even when an avulsion fracture occurs, the injured ...
Carpal tunnel decompression - De Quervains tenosynovitis decompression - Digital replantation - Dupuytrens contracture release-regional fasciectomy - Extensor tendon repair - Flexor tendon repair - Ganglion cyst-surgical excision - Hand fracture reduction: open reduction internal fixation and K-wiring - Local flaps-advancement, rotational, transpositional - Nail bed repair - Peripheral nerve repair - Skin biopsies - Skin cancer-standard surgical excision and Mohs micrographic surgery - Skin grafts - Trigger finger release - Wound exploration, debridement, repair ± closure ...
Introduction The treatment of displaced, extra-articular fractures of the distal tibia remains controversial. These injuries are difficult to manage due to limited soft tissue cover, poor vascularity of the area and proximity to the ankle joint. Surgical treatment options are expanding and include locked intramedullary nails, plate and screw fixation and external fixator systems. The nail and plate options are most commonly used in the UK, but controversy exists over which treatment is most clinically and cost-effective. In this multicentre randomised controlled trial we aim to assess ratings of disability 6 months postinjury in patients who have sustained a distal tibia fracture treated with either an intramedullary nail or plate and locking screw fixation.. Methods and analysis Adult patients presenting at trial centres with an acute fracture of the distal tibia will be considered for inclusion. A total of 320 patients will provide 90% power to detect a difference of 8 points in Disability ...
ABSTRACT. Intracapsular fractures of the neck of femur in the elderly patient population results in an enormous economic and social burden. The aim of this paper is to present a review of the literature providing guidelines for the management of this common fracture with emphasis on patient selection, optimisation and preventative strategies.. ...
The current study shows that both high LDL-C and low HDL-C levels are independent risk factors for AVNFH. Another interesting finding of our study is that an increase or decrease in only one risk factor has little effect on outcome. Our results are mostly in agreement with findings in the previous literature [1, 7, 11, 12]. The main factors associated with AVNFH involve the type of fracture, the degree of initial displacement, and age at the time of injury. The occurrence of AVNFH is considered to be directly related to the initial fracture displacement [5, 10, 13]. Conversely, our study indicated that postoperative AVNFH occurred in elderly patients with nondisplaced or minimally displaced neck fractures, meaning that in addition to fractures and surgical techniques there remain other factors, such as dyslipidaemia, that can lead to the occurrence of AVNFH. Our study is the first report evaluating the association between dyslipidaemia and AVNFH following low-energy femoral neck fractures ...
HOBBS, HR et al. Open reduction and internal fixation of scapula fractures. SA orthop. j. [online]. 2008, vol.7, n.3, pp.8-15. ISSN 2309-8309.. Scapular fractures requiring surgery are relatively rare injuries. This retrospective review looks at the outcome of open reduction and internal fixation of these fractures and the surgical exposures necessary for their fixation. All surgically treated scapular fractures from January 2000 to December 2006, with the exception of Ideberg type Ia (anterior rim) fractures of less than 25% with an associated dislocation, had their clinical notes and radiology reviewed. The surgical approach was analysed with regard to the fracture classification and exposure. Reduction, union and failure of fixation were assessed. Outcomes were determined with respect to pain and range of movement. At an average follow-up of 9 months (range 6 to 72 months), all of the fractures had united. Twenty out of the 25 patients were pain-free (80%) and the rest only had mild pain. ...
Simultaneous bilateral femoral neck fracture is a very rare condition, even in osteoporotic elderly individuals. We report an atypical case of a young male adult who developed simultaneous bilateral femoral neck fractures without previous trauma or overuse. A 33-year-old man presented with discomfort in the bilateral groin, which had started 2 weeks previously. Bilateral femoral neck fractures were observed on a radiograph, and in addition, a fracture line was seen at the right subchondral region of the acetabulum using magnetic resonance imaging (MRI). Although the patient had no obvious risk factors associated with bone fragility, his bone mineral density measured using dual X-ray absorptiometry indicated severe osteoporosis (lumber spine: T score − 3.4 standard deviation [SD]; femoral neck: T score − 2.8 SD). Serum 25-hydroxyvitamin D level was deficient (19 ng/mL), which was considered to be partly due to non-sunlight exposure for 3 years owing to social withdrawal. Bilateral osteosynthesis was
Orthopedics | Pediatric femoral neck fractures are rare injuries that are associated with a high risk of osteonecrosis of the femoral head. This study compared pediatric patients with fully displaced femoral neck fractures treated with either open reduction and internal fixation (ORIF) or closed reduction and internal fixation (CRIF). After institutional review board approval was obtained, the authors
The ultimate goal of management of proximal humeral fractures in the elderly patient is to get the patient independently mobile. This article will review the current literature regarding this cohort of patient. Recent Cochrane reviews and a large multicentre randomised study question the role of surgical intervention. Implant design is evolving rapidly, and many elderly patients now behave more like the younger patient. There remains little compelling evidence to guide decision-making for the complex proximal humeral fracture in the elderly, and the decision needs to be made on a case-by-case basis taking into account the patients comorbidities, the fracture pattern and characteristics, the attending surgeons skill sets, and the availability of equipment. ...
Femoral neck fracture is an important early complication after hip resurfacing. Our aims were firstly to determine the incidence of fracture in an independent series and secondly, in a case control study, to investigate potential risk factors. Fifteen femoral neck fractures occurred in a series of 842 procedures, representing an incidence of 1.8%. No relationship existed between age, sex, and fracture incidence. Mechanical factors such as notching, femoral neck lengthening, and varus alignment of the femoral component were found to have a similar incidence in both fracture and control groups. The proportion of patients that had at least 1 mechanical risk factor was not different between the 2 groups (fracture group, 50%; control group, 41%). Established avascular necrosis of the femoral head was evident in all retrieved femoral heads (n = 9) of patients who sustained postoperative fracture; in none of these patients was avascular necrosis the initial diagnosis. This study suggests that in our practice,
The worldwide increase in hip fractures is a major challenge to the health care system and society. The proper treatment of femoral neck fractures in the elderly is still controversial, and even more so from an international perspective. Optimising the treatment for improved outcomes and a reduced need for secondary surgery is mandatory for humanitarian and economical reasons. The importance of incorporating the patients perspective of the outcome in clinical trials has been acknowledged and there are now numerous instruments for assessing the quality of life. We evaluated two quality of life instruments, the EQ-5D and the SF-36, in patients with femoral neck fractures and also measured the quality of life two years after different interventions. The EQ-5D was validated in two prospective studies and it appeared to be an appropriate quality of life instrument in elderly patients with femoral neck fractures. There was a good correlation between the quality of life (EQ-5Dindexscores) and other ...
Knee - Tibial Plateau Fractures with Surgery ,Depicts a tibial plateau fracture with surgical fixation. Surgery steps: A. Incision into the lateral knee to expose the fractures, B. Anterior hip incision with harvest of bone graft from the right iliac crest, C. Fractures are reduced and secured with bone graft, plate and multiple screws. Lastly, a single anterior view of the knee bones shows the final appearance of the knee with all fixation hardware in place. May be customized by editing labels, or by combining artwork with graphics from our 15,000 image library.
My Dr did a Percutaneous Fixation of the Medial Tibial Plateau Fracture. I do not see a code for this type of procedure anywhere - The closest thing I
Extra capsular fractures which involve the femoral trochanters include intertrochanteric and subtrochanteric fractures. The intertrochanteric fracture is by far the most common and is classified according to the status of the lesser and greater trochanter. If neither of these is fractured, the fracture is termed a two part fracture. If either the lesser or greater…
66.66%) undergone surgical fixation with k wires with 16 patients treated with percutaneous k wire fixation & 4 patients with open reduction & internal fixation with k wires, 13 (65%) patients had excellent results, 6 (30%) patients had good results & 1(5%) patient had fair result. The remaining 10 (33.33%) patients with type III fracture was treated conservatively with closed manipulation & reduction & above elbow pop slab (with elbow in 1100-1200 of flexion) and strapping of elbow around chest. , out of which 6 (60%) patient had excellent results, 2 (20%) patients had good results, 1 (10%) patient had fair result & 1(10%) patient had poor results. Out of 5 patients with type II fracture, 4 (80%) patients were treated conservatively with closed reduction and above elbow pop slab & all had excellent results, 1(20%) patient was treated with open reduction & internal fixation with k wires had good result. Out of 2 patients with TYPE I fracture all were treated conservatively in an above elbow pop ...
Subcapital fracture is the commonest type of intracapsular fracture of the proximal femur. The fracture line extends through the junction of the head and neck of femur.
Fracture of the femoral neck is quite uncommon in children [1-4], and most orthopaedic surgeons have the opportunity to treat such fractures very few times during their career. The literature recommends early and aggressive treatment for optimum results and to avoid a high rate of complications associated with this fracture [1, 4-11]. However, delay in receiving definitive treatment is a common occurrence in the developing world. The main causes are illiteracy, the urge to receive cheap quack treatment due to poverty and lack of more scientific resources in far-reaching regions, and sometimes late referral by hospitals or the general physician from remote areas. In our study, all the children received femoral neck fracture from high-energy trauma. Our aim in this study was to evaluate outcome following delayed fixation of pediatric femoral neck fractures in an attempt to establish a cause−effect relationship and the factors influencing the outcome. In addition, we analyzed the effect of joint ...
A Home for people suffering from tibial plateau fractures with sections on recovery tips & tricks, physiotherapy treatment healing and more.
Background Open supracondylar fractures of the femur are complex injuries usually presenting in a polytraumatized patient. Partial circumferential bone loss may result at the time of injury or during debridement. The way in which the fracture is treated has a substantial influence on the local mechanical and biological environment, which in turn will influence the quantity and quality of the osteogenic response. Although early skeletal stabilization can stop the cycle of injury, remove nidus for infection, and halt ongoing hemorrhage, it may be prudent to delay definitive surgery until the patients general condition is optimized. Meanwhile, debridement and a preliminary spanning external fixator is used to stabilize the fracture. The use of a locked plate for the fixation of supracondylar fracture of the femur with partial bone loss creates a rigid biomechanical environment needed for healing and maintenance of alignment until fracture healing. Patients and methods Eighteen patients with open ...
The cancellous screw has an extremely low profile head to reduce soft tissue irritation. A step drill with laser depth marking countersinks the screw head flush to bone when used as a suture fixation post. The smooth shank with suture groove orients the sutures safely under the head during screw insertion. The optional, low profile spiked washer may be used in conjunction with the cancellous screw for fixation of soft tissue or tendons directly to bone. The 6.5 mm diameter screw and washer are manufactured using titanium ASTM F-136 alloy ...
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Successful result depends on good fracture reduction and implant position. The risk of cut-out is directly dependent on the quality of fracture reduction and on implant position [1]. Tip apex distance not important in PFN. Tip apex distance is probably not as important in Proximal Femur nail as it is in Dynamic Hip screw as TAD scale is linear and not multidirectional [2].. Difficulties in PFN. ...
BACKGROUND: Controversy exists regarding the optimal treatment for patients with displaced intracapsular fractures of the proximal femur. The recognised treatment alternatives are arthroplasty and internal fixation. The principal criticism of internal fixation is the high rate of non-union; up to 30% of patients will have a failure of the fixation leading to revision surgery. We believe that improved fracture healing may lead to a decreased rate of failure of fixation. We therefore propose to investigate strategies to both accelerate fracture healing and improve fixation that may significantly improve outcomes after internal fixation of intracapsular femoral fractures. We aim to test the clinical effectiveness of the osteoinductive agent platelet rich plasma and conduct a pilot study of a novel fixed-angle fixation system. DESIGN: We have planned a three arm, single centre, standard-of-care controlled, double blinded, pragmatic, randomised clinical trial. The trial will include a standard two-way