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1

Royal College of Physicians of London. Fractured neck of femur: Prevention and management. London: Royal College of Physicians, 1989.

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2

Jarnlo, Gun-Britt. Hip fracture patients: Background factors and function. Uppsala, Sweden: Printed by Almqvist & Wiksell Tryckeri, 1991.

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3

Jarnlo, Gun-Britt. Hip fracture patients: Background factors and function. Uppsala, Sweden: Printed by Almqvist & Wiksell Tryckeri, 1991.

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4

Onslow, Liz. Prevention and management of hip fractures. London: Whurr, 2005.

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5

Craig, C. E. Audit of patients admitted to accident & emergency with a fractured neck of femur. (Edinburgh): Scottish Office, 1993.

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6

June, Clark, Clinical Standards Advisory Group, and Daphne Heald Research Unit, eds. Towards independence and choice: A review of policy guidance and standards of care for elderly people, using fractured neck of femur as a marker condition : a document review for the Clinical Standards Advisory Group, Department of Health. London: Daphne Heald Research Unit, Royal College of Nursing, 1995.

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7

An atlas of closed nailing of the tibia and femur. London: Martin Dunitz, 1991.

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8

An atlas of closed nailing of the tibia and femur. New York: Springer-Verlag, 1991.

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9

(Matthias), Rapp M., and SpringerLink (Online service), eds. The Double Dynamic Martin Screw (DMS): Adjustable Implant System for Proximal and Distal Femur Fractures. Heidelberg: Steinkopff, 2008.

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10

Biomechanics and osteosynthesis of condylar neck fractures of the mandible. Chicago: Quintessence Pub. Co., 1994.

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11

Pansini, Arnaldo. Median longitudinal cervical somatotomy: Surgical treatment of cervical myelopathy due to degenerative disc disease and syndromes resulting from fracture-dislocation of the cervical spine. [Padua?]: Piccin, 1986.

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12

Fractured Neck of Femur. Royal College of Physicians of London, 1989.

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13

Prevention and Management of Hip Fractures. Wiley, 2005.

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14

(Editor), Jenó Manninger, Ulrich Bosch (Editor), Peter Cserháti (Editor), Károly Fekete (Editor), and György Kazár (Editor), eds. Internal fixation of femoral neck fractures: An Atlas. Springer, 2007.

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15

Agarwal, Anil, Neil Borley, and Greg McLatchie. Orthopaedics. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0016.

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This chapter on orthopaedics outlines the application of a secondary cast to a forearm or leg manipulation under anaesthetic (MUA) of distal radius fracture plus minus insertion of Kirschner wires, intra-articular injections, joint aspirations, and diagnostic arthroscopy. Operations included are fixation of Weber B fracture of ankle, dynamic hip screw (DHS) for extra-capsular neck of femur fracture, fixation of patella fracture by tension band wiring, insertion of traction pins, surgical debridement of traumatic wound, fasciotomy for compartment syndrome of leg, carpal tunnel decompression, surgical approaches to the hip, surgical approach to great toe metatarsophalangeal (MTPJ), and surgical approach to lumbar spine.
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16

Richard, Fordham, and University of York. Centre for Health Economics., eds. A Cost-benefit study of geriatric-orthopaedic management of patients with fractured neck of femur. (York): University of York, Centre for Health Economics, 1986.

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17

White, Jean. Inadvertent hypothermia in elderly patients undergoing surgery for fixation of fractured neck of femur on the orthotec table. WGIHE, 1988.

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18

Prout, Jeremy, Tanya Jones, and Daniel Martin. Anaesthesia for orthopaedic surgery. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0018.

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The risks, benefits, and evidence for use of regional anaesthesia techniques are discussed generally and for specific procedures such as joint arthroplasty. Other perioperative considerations for primary and revision arthroplasty are described. The particular challenges of the patients presenting with fractured neck of femur, physiological changes of older age and goals for perioperative management are highlighted. Surgical procedures for scoliosis are performed in specialist centres and are discussed. Associated medical comorbidity, anaesthetic considerations and neurological monitoring for spinal cord function are described.
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19

Banerjee, Ashis, and Clara Oliver. Anaesthetics and pain management. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198786870.003.0003.

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Emergency medicine trainees are required to complete an anaesthetic placement and obtain basic anaesthetic competencies. This chapter is not intended to provide the practical skills for delivering an anaesthetic. Instead, this chapter focuses on the theory of managing and predicting a difficult airway in the emergency department, which is more likely to appear in the short-answer (SAQ) paper. It also focuses on procedural sedation which also may appear in the SAQ paper due to its growing use in the emergency department (ED). This chapter also covers pain management, for which the Royal College of Emergency Medicine (RCEM) have introduced clinical standards. In addition, this chapter covers the use of peripheral nerve blocks such as a fascia iliaca block for neck of femur fractures. Due to the growing use of peripheral nerve blocks in the ED, such detailed knowledge is required.
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20

Sell, Alex, Paul Bhalla, and Sanjay Bajaj. Anaesthesia for orthopaedic and trauma surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0063.

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This chapter is divided into three main sections. The first section concerns the patient population that presents for orthopaedic surgery, specifically examining chronic diseases of the musculoskeletal system and the medications commonly used for their management, and the impact this has when these patients present for surgery. Included in this section are the surgical considerations and the anaesthetic implications of orthopaedic surgery, ranging from patient positioning to bone cement implant syndrome. The last part of this first section looks at specific orthopaedic operations, starting with the most commonly performed, hip and knee arthroplasties, and moving onto the specialist areas of spinal deformity, paediatric, and bone tumour surgery that are not usually found outside of specialist centres. The middle section gives a brief overview on analgesia concentrating on pharmacological methods as, although orthopaedic surgery lends itself well to regional anaesthesia, this is covered elsewhere in its own dedicated chapters. No section on analgesia would be complete without mentioning enhanced recovery: the coordinated, multidisciplinary approach that improves the patient experience, increases early mobilization, and reduces length of stay, which should be the standard obtained for every patient. The final section covers the anaesthetic management of in-hospital trauma, giving an overview on initial assessment, timing of surgery, and management of haemorrhage and coagulopathy. This section finishes by covering the orthopaedic-specific topics of compartment syndrome, fat embolism syndrome, and the management of fractured neck of femur and spinal injury.
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21

Aronson, J., J. Schatzker, R. Bombelli, and R. Feinstein. Intertrochanteric Osteotomy. Springer London, Limited, 2012.

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22

Jarvis, Wingrove T., and Ananda M. Nanu. Supracondylar fractures of the femur. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012054.

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♦ Supracondylar fractures of the femur are seen in the young (high energy) and the old (low energy). Both groups have their own specific problems♦ The advantages and disadvantages of each surgical option must be considered in relation to the individual patient and their fracture pattern.
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23

Hollinghurst, David. Injuries of the femur and patella in children. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.014009.

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♦ There is considerable scope for remodelling in the child’s femur♦ Significant overgrowth may correct shortening after a fracture♦ Below the age of 5 years femoral fractures may be treated non-operatively in a spica or with traction; above the age of 11 years surgical stabilization of the fracture will normally be needed♦ Flexible intramedullary nails have largely replaced external fixators♦ Fractures involving the distal femoral physis need careful treatment and follow-up as they may lead to significant growth arrest♦ Osteochondral fractures accompany a proportion of acute patella dislocations.
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24

Parker, Martyn J. Femoral neck fractures. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012051.

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♦ Intracapsular fractures are classified by division into those fractures that are essentially undisplaced and those that are displaced♦ Undisplaced fractures are generally treated by reduction and internal fixation♦ Displaced fractures may be treated by reduction and internal fixation but this incurs the potential complications of re-displacement of the fracture, non-union, and avascular necrosis♦ Displaced fractures in the elderly are generally treated with a replacement arthroplasty.
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25

Bosch, Ulrich, Jenö Manninger, Péter Cserháti, Karoly Fekete, and György Kazar. Osteosynthese der Schenkelhalsfraktur: Ein Bildatlas. Springer London, Limited, 2005.

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26

(Editor), Jenö Manninger, Ulrich Bosch (Editor), Péter Cserháti (Editor), Karoly Fekete (Editor), and György Kazar (Editor), eds. Osteosynthese der Schenkelhalsfraktur: Ein Bildatlas. Springer, 2004.

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27

Glasper, Edward Alan, Gillian McEwing, and Jim Richardson, eds. Musculoskeletal problems. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780198569572.003.0015.

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Bone 470Skeletal muscle 472Classification of fractures 474Treatment of fractures 476Management of a child with a fractured femur 478Fractured tibia and fibula 480Supracondylar fracture of humerus 482Fractured radius and ulna 484Fractures of metacarpals and metatarsals 486External fixation ...
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28

Gardiner, Matthew D., and Neil R. Borley. Trauma and orthopaedic surgery. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199204755.003.0009.

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This chapter begins by discussing the basic principles of musculoskeletal physiology, fracture assessment, and fracture management, before focusing on the key areas of knowledge, namely congenital and developmental conditions, the foot, the ankle, the knee, the femoral and tibial shaft, the proximal femur, the pelvis, the shoulder, the upper limb, degenerative and inflammatory arthritis, bone and joint infection, crystal arthropathies, musculoskeletal tumours, and metabolic bone conditions. The chapter concludes with relevant case-based discussions.
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29

Malik, Ahmad K., and Aresh Hashemi-Nejad. The young arthritic hip. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.007007.

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♦ Impingement:• Primary femoroacetabular impingement:▪ Cam type▪ Pincer type▪ Combined cam and pincer• Secondary femoroacetabular impingement:▪ Slipped upper femoral epiphysis (cam type)▪ Protusio (pincer type)▪ Retroverted acetabulum (pincer type)▪ Malunited femoral head/neck fracture (cam type)▪ Acetabular fracture (pincer type)▪ Perthes disease (cam type)♦ Instability:• Developmental dysplasia of the hip (treated/residual and untreated)• Dislocation• Subluxation• Dysplasia♦ Inflammatory:• Juvenile idiopathic arthritis• Rheumatoid arthritis.
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30

Mason, Will, and David Warwick. Bone and joint injuries of the hand. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757689.003.0005.

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The small bones and joints of the hand are vulnerable to fracture and dislocation. These same structures need to be pain-free, stable, and mobile for proper function. Careful diagnosis and meticulous management is required. This may entail early mobilization (e.g. a metacarpal neck fracture) or temporary splinting (e.g. mallet fracture), early repair (e.g. unstable thumb ulnar collateral avulsion), complex sequential and dynamic splinting (e.g. central slip rupture); percutaneous wires (e.g. Bennett’s fracture) or plate fixation (e.g. displaced index metacarpal shaft). There is often a trade-off between the mobilization required to avoid stiffness and the immobilization required to allow anatomical healing. Rigid surgical fixation with meticulous hand therapy may both contribute in certain patients.
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31

Agarwal, Anil, Neil Borley, and Greg McLatchie. ENT. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0014.

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This chapter on ENT outlines procedures like aural microsuction, nasal endoscopy, nasolaryngoscopy, pharyngoscopy, microlaryngoscopy, Dix Hallpike test and Epleu manoeuvre, nasal cautery, reduction of nasal fracture, drainage of orbital abscess, drainage of a peritonsillar abscess (Quincy), sphenopalatine artery ligation, biopsy of oral lesion, changing tracheostomy tube, removal of foreign body from the nose of a child, myringotomy, and insertion of grommet. Operations included are myringoplasty, tympanoyomy and tympanoplasty, excision of external canal osteoma/exostosis, cortical mastoidectomy, mastoid exploration, cochlear implantation, pinnaplasty, stapedectomy and ossciculoplasty, septoplasty, middle meatal antrostomy, nasal polypectomy, ethmoidectomy, septorhinoplasty, dacrocystorhinostomy (DCR), Caldwell–Luc, tracheostomy, excision of neck node, branchial cyst excision, excision of thyroglossal cyst, uvulopalatopharyngoplasty, parotidectomy, submandibular gland excision, neck dissection, total laryngectomy, tonsillectomy, adenoidectomy, and laryngo-tracheal reconstruction.
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32

Chapman, Jens R., and Richard J. Bransford. Emergency management of the traumatized cervical spine. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012038.

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♦ Unconscious patients should have CT scan of neck♦ Emergency MRI if possible in spinal cord injury♦ Avoid flexion/extension views if possible♦ In spinal shock avoid over transfusion and consider epinephrine; high dose steroids probably not indicated♦ Reduce dislocation acutely (MRI before in intact patients if possible)♦ Do not put distraction injury into traction♦ Urgent surgery for traumatic disc hernaition, expanding epidural haematoma, depressed lamina fracture or complex facet fractures with dislocation.
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33

Wilson-MacDonald, James, and Andrew James. Complications of fractures. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012002.

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♦ Fat embolism syndrome is defined as the presence of globules of fat in the lungs and in other tissues and occurs occasionally in long bone fractures♦ Reflex sympathetic dystrophy is characterized by intense prolonged pain, vasomotor disturbance, delayed functional recovery, and trophic changes♦ Avascular necrosis typically affects intra-articular bone after fracture and can occur in up to 70% of displaced talar neck fractures♦ Immobility associated with recovery from fracture is associated with deep vein thrombosis, which carries a risk of pulmonary embolism, and should be treated with anti-coagulants♦ Gas gangrene is a rapidly-spreading infection of devitalized tissue, removal of the affected area and treatment with penicillin is required♦ Compartment syndrome within a closed compartment can result in tissue ischaemia and necrosis followed by fibrosis and muscle contracture
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34

Griffiths, Richard, and Ralph Leighton. Orthopaedic surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719410.003.0018.

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This chapter discusses the anaesthetic management of orthopaedic surgery. It begins with general principles of the anaesthetic management of orthopaedic surgical patients, including the management of fat embolism syndrome, bone cement implantation syndrome, compartment syndrome, and the use of tourniquets. Surgical procedures covered include total hip joint replacement (including revision total hip joint replacement), femoral neck fracture surgery, total knee joint replacement, arthroscopy, cruciate ligament repair, ankle surgery, foot surgery, spinal surgery (including the cervical spine), shoulder surgery (including total shoulder joint replacement), elbow replacement surgery, hand surgery, and trauma, including fractures of limbs or spine.
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35

Griffiths, Richard, and Ralph Leighton. Orthopaedic surgery. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198719410.003.0018_update_001.

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This chapter discusses the anaesthetic management of orthopaedic surgery. It begins with general principles of the anaesthetic management of orthopaedic surgical patients, including the management of fat embolism syndrome, bone cement implantation syndrome, compartment syndrome, and the use of tourniquets. Surgical procedures covered include total hip joint replacement (including revision total hip joint replacement), femoral neck fracture surgery, total knee joint replacement, arthroscopy, cruciate ligament repair, ankle surgery, foot surgery, spinal surgery (including the cervical spine), shoulder surgery (including total shoulder joint replacement), elbow replacement surgery, hand surgery, and trauma, including fractures of limbs or spine.
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36

Chan, Kevin, Rishi Dihr, and Michael Fox. Spinal Accessory Nerve Injury. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0025.

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Spinal accessory nerve (SAN) injuries can be idiopathic or iatrogenic. Providers who understand the essential anatomy of the SAN can direct the history, physical exam, and ancillary studies to localize the lesion, while considering the differential diagnosis. The differential diagnosis includes both traumatic and atraumatic causes, including penetrating or blunt trauma to the neck, fracture malunion, glenohumeral instability, brachial neuritis, progressive neuromuscular disease, and cerebrovascular accident. The chapter discusses the timing of, and indications for, operative exploration, with or without nerve repair, as well as the details of the surgical procedure. The authors provide instructive pearls for initial management, establishing patient expectations, and potential complications.
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37

Henry, M. Stress fractures. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012017.

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♦ Stress fractures are fractures occurring as the result of repetitive, submaximal loads, in the absence of a specific precipitating traumatic event.♦ These fractures can be subdivided into two groups on the basis of aetiology. Whereas ‘fatigue fractures’ result from the excessive repetitive (i.e. abnormal) loading of normal bone, ‘insufficiency fractures’ are fractures resulting from normal forces acting on abnormal bone.♦ Early diagnosis allows the initiation of effective treatment that can prevent prolonged pain and disability, as well as avoiding the progression to displacement or a non-union.♦ While management decisions are generally focused on activity modification, protection of weight bearing, and immobilization, there is a subset of fractures at high risk for progression to complete fracture, non-union, or delayed union. These high-risk stress fractures, including tension-side femoral neck fractures and anterior tibial cortex fractures, require aggressive treatment to prevent the sequelae of poor healing.
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