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  1. Article ; Online: The Use of Tibial Osteotomy (Ankle Plafondplasty) for Joint Preservation of Ankle Deformity and Early Arthritis.

    Al-Nammari, Shafic Said / Myerson, Mark S

    Foot and ankle clinics

    2016  Volume 21, Issue 1, Page(s) 15–26

    Abstract: Asymmetric ankle osteoarthritis (OA) is an increasingly recognized condition. It is imperative to differentiate between extraarticular and intraarticular deformity and to address these appropriately. Any associated instability and multilevel deformity ... ...

    Abstract Asymmetric ankle osteoarthritis (OA) is an increasingly recognized condition. It is imperative to differentiate between extraarticular and intraarticular deformity and to address these appropriately. Any associated instability and multilevel deformity must be recognized and addressed. Patients with intraarticular varus or valgus asymmetric OA have poorer outcomes and higher rates of recurrence when treated with standard techniques targeted at correction with traditional supramalleolar or inframalleolar techniques. Plafondplasty aims to correct the deformity at its center of rotation and angulation and is associated with low rates of recurrence, substantial postoperative pain relief, functional improvement, and a possible slowing of the degenerative process.
    MeSH term(s) Ankle Joint/diagnostic imaging ; Ankle Joint/surgery ; Disease Progression ; Humans ; Joint Instability/etiology ; Joint Instability/surgery ; Osteoarthritis/diagnostic imaging ; Osteoarthritis/etiology ; Osteoarthritis/surgery ; Osteotomy/methods ; Radiography ; Tibia/diagnostic imaging ; Tibia/surgery
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2051688-5
    ISSN 1558-1934 ; 1083-7515
    ISSN (online) 1558-1934
    ISSN 1083-7515
    DOI 10.1016/j.fcl.2015.09.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus.

    Al-Nammari, Shafic Said / Christofi, Theodoros / Clark, Callum

    Foot & ankle international

    2015  Volume 36, Issue 10, Page(s) 1215–1222

    Abstract: Background: The technique of double first metatarsal osteotomies was first developed in response to the high frequency of recurrence noted in the treatment of severe adolescent congruent hallux valgus deformities. The concept behind the use of this ... ...

    Abstract Background: The technique of double first metatarsal osteotomies was first developed in response to the high frequency of recurrence noted in the treatment of severe adolescent congruent hallux valgus deformities. The concept behind the use of this technique is that it allows the individual correction of each component of the deformity. We have modified the technique for use in adult hallux valgus where the majority of deformities are incongruent deformities and the distal chevron osteotomy is used primarily for its additional translational properties rather than purely to correct the distal metatarsal articular angle (DMAA). We report on a series of double first metatarsal osteotomies (basal opening wedge and distal chevron osteotomy) with Akin osteotomy in the treatment of moderate to severe adult hallux valgus deformity.
    Methods: All patients presenting to our institution with a hallux valgus deformity and treated with this procedure between 2008 and 2013 with a minimum of 1 year of follow-up were identified. Data were obtained through review of case notes, electronic charts, and digital imaging. A total of 50 feet in 48 patients underwent double first metatarsal osteotomy with Akin osteotomy. Three patients were excluded due to loss to follow-up, leaving 47 feet in 45 patients with a mean follow-up of 45 months (range, 14-60 months). Of these 43 (96%) were female and the mean age was 56 years (range, 35-70 years).
    Results: The mean preoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), DMAA, sesamoid position, and lateral first metatarsotalar angle were 42 degrees (range, 32-52 degrees), 18 degrees (range, 6-26 degrees), 12 degrees (range, 4-26 degrees), stage 6 (range, 4-7), and 2 degrees of dorsiflexion (range, 20 degrees of dorsiflexion to 4 degrees of plantar flexion), respectively. The mean postoperative HVA, IMA, DMAA, sesamoid position, and lateral first metatarsotalar angle were 7 degrees (range, 2 to 24 degrees), 4 degrees (range, 4-14 degrees), 6 degrees (range, 10-22 degrees), stage 2 (range, 1-5) and 6 degrees of plantar flexion (range, 8 degrees of dorsiflexion to 18 degrees of plantar flexion), respectively. The osteotomies consolidated at a mean of 7 weeks (range, 5-9 weeks). There were no cases of delayed union or nonunion. Of the cohort, 45 (96%) stated that they were satisfied overall with the results of their surgery and would have it again. The mean postoperative summary index Manchester-Oxford Foot Questionnaire (MOXFQ) score was 12.9 (range, 0-60.9) out of 100 at a mean follow-up of 45 months (range, 14-60 months). For the minority of cases, 8 (17%), that had preoperative scoring, the summary index MOXFQ score was 73.7 (range, 29.7-100).
    Conclusions: The double first metatarsal osteotomy (basal opening wedge and distal chevron osteotomy) with Akin osteotomy provides powerful correction and facilitates correction of the individual components of the hallux valgus deformity. The individual osteotomies that make up this procedure are familiar to the majority of foot and ankle surgeons, thus limiting the associated learning curve.
    Level of evidence: Level IV, retrospective case series.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Cohort Studies ; Female ; Hallux Valgus/diagnostic imaging ; Hallux Valgus/surgery ; Humans ; Male ; Metatarsal Bones/diagnostic imaging ; Metatarsal Bones/surgery ; Middle Aged ; Osteotomy/methods ; Pain Measurement ; Prognosis ; Radiography ; Range of Motion, Articular/physiology ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Sex Factors ; Treatment Outcome
    Language English
    Publishing date 2015-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183283-6
    ISSN 1944-7876 ; 1071-1007
    ISSN (online) 1944-7876
    ISSN 1071-1007
    DOI 10.1177/1071100715589173
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Surgeon's guide to advances in the pharmacological management of acute Charcot neuroarthropathy.

    Al-Nammari, Shafic Said / Timothy, Theologis / Afsie, Sabokbar

    Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons

    2013  Volume 19, Issue 4, Page(s) 212–217

    Abstract: Acute Charcot neuroarthropathy is a devastating condition and, its incidence is increasing. Currently, treatment consists of immobilisation and off-loading of the involved extremity. Outcomes are frequently poor and novel treatments are being sought ... ...

    Abstract Acute Charcot neuroarthropathy is a devastating condition and, its incidence is increasing. Currently, treatment consists of immobilisation and off-loading of the involved extremity. Outcomes are frequently poor and novel treatments are being sought urgently. This review aims to outline advances in the pharmacological treatment of this, condition. PubMed and the Cochrane Database of systematic reviews were searched. Relevant papers were cross referenced. Eleven original studies were identified. The limited data available suggest pamidronate, alendronate and calcitonin provide some clinical and biochemical improvements while zoledronic acid is deleterious and, increases off-loading times. However, the data is not robust enough to convincingly demonstrate clinically meaningful effects. The studies were predominantly low quality and heterogeneous. They differed markedly in study type, pharmacological agent used, dosing regimen, disease, aetiology/stage/location, concurrent off-loading regimen, outcomes and, follow-up. Few were rigorous in controlling for associated confounding variables and none investigated long term outcomes. The routine use of pharmacological treatment modalities for this condition is not recommended in the United States by the Food and Drug Administration or in the United Kingdom by the National Institute for Health and Clinical Excellence. Given the evidence available this is justified and further higher quality research is required.
    MeSH term(s) Alendronate/therapeutic use ; Alkaline Phosphatase/blood ; Arthropathy, Neurogenic/drug therapy ; Arthropathy, Neurogenic/physiopathology ; Bone Density Conservation Agents/therapeutic use ; Calcitonin/therapeutic use ; Diphosphonates/therapeutic use ; Humans ; Hydroxyproline/urine ; Imidazoles/therapeutic use ; Immobilization ; Insulin-Like Growth Factor I/analysis ; RANK Ligand/physiology ; Randomized Controlled Trials as Topic ; Skin Temperature
    Chemical Substances Bone Density Conservation Agents ; Diphosphonates ; Imidazoles ; RANK Ligand ; TNFSF11 protein, human ; Insulin-Like Growth Factor I (67763-96-6) ; zoledronic acid (6XC1PAD3KF) ; Calcitonin (9007-12-9) ; Alkaline Phosphatase (EC 3.1.3.1) ; pamidronate (OYY3447OMC) ; Hydroxyproline (RMB44WO89X) ; Alendronate (X1J18R4W8P)
    Language English
    Publishing date 2013-12
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 1424533-4
    ISSN 1460-9584 ; 1268-7731
    ISSN (online) 1460-9584
    ISSN 1268-7731
    DOI 10.1016/j.fas.2013.06.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Management of ankle injuries.

    Welck, Matthew / Rafferty, Michael / Eltz, Stephanie / Al-Nammari, Shafic Said / Eseonu, Kelechi Chika

    BMJ (Clinical research ed.)

    2015  Volume 351, Page(s) h6698

    MeSH term(s) Adult ; Ankle Injuries/diagnosis ; Diagnosis, Differential ; Female ; Humans ; Ligaments, Articular/injuries
    Language English
    Publishing date 2015-12-15
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.h6698
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The inadequacy of musculoskeletal knowledge in graduating medical students in the United Kingdom.

    Al-Nammari, Shafic Said / Pengas, Ioannis / Asopa, Vipin / Jawad, Ali / Rafferty, Michael / Ramachandran, Manoj

    The Journal of bone and joint surgery. American volume

    2015  Volume 97, Issue 7, Page(s) e36

    Abstract: Background: Musculoskeletal symptoms are common reasons for patients seeking medical attention. Basic competency in musculoskeletal medicine is therefore essential for all clinicians. To our knowledge, this is the first assessment of the competency in ... ...

    Abstract Background: Musculoskeletal symptoms are common reasons for patients seeking medical attention. Basic competency in musculoskeletal medicine is therefore essential for all clinicians. To our knowledge, this is the first assessment of the competency in musculoskeletal medicine of medical students in the United Kingdom.
    Methods: Medical students were enrolled after passing final university examinations and being awarded degrees of Bachelor of Medicine, Bachelor of Surgery (MBBS) or Medicinae Baccalaureus, Baccalaureus Chirurgiae (MBChB) in 2013 and were assessed with use of the Freedman and Bernstein musculoskeletal cognitive examination tool.
    Results: Two hundred and thirty students were recruited, of whom 210 were suitable for inclusion. Only 21% (forty-four students) passed the assessment. Mandatory exposure to musculoskeletal medicine during medical school consisted of orthopaedics for 100% of participants for a mean duration of 2.65 weeks, rheumatology for 96% of participants for a mean duration of 2.5 weeks, and sports medicine for 1% of participants for a mean duration of two weeks. There was a significant difference (p = 0.002) in scores between those with career interests in musculoskeletal specialties (69.3%) and the rest of the cohort (54.9%). There was also a significant difference (p = 0.001) in scores between participants with career interests in general practice (42%) and the rest of the cohort (56%). Only 40% of participants considered themselves competent in musculoskeletal medicine. Fifty-five percent thought that musculoskeletal conditions would be an important component of their future practice.
    Conclusions: Our findings suggest that medical schools may be currently failing to ensure that medical students have a basic competence in musculoskeletal medicine. Further investigation is warranted to fully assess the current training provided by U.K. medical schools in musculoskeletal medicine, and appropriate steps must be taken to improve the quantity and quality of training in musculoskeletal medicine in the United Kingdom.
    MeSH term(s) Career Choice ; Clinical Competence ; Curriculum ; Education, Medical, Undergraduate/standards ; Humans ; Orthopedics/education ; Rheumatology/education ; Surveys and Questionnaires ; United Kingdom
    Language English
    Publishing date 2015-04-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.N.00488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Smartphones in orthopaedics.

    Al-Hadithy, Nawfal / Gikas, Panagiotis D / Al-Nammari, Shafic Said

    International orthopaedics

    2012  Volume 36, Issue 8, Page(s) 1543–1547

    Abstract: With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five ... ...

    Abstract With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.
    MeSH term(s) Cell Phone/trends ; Education, Medical, Continuing/trends ; Guidelines as Topic ; Humans ; Orthopedic Procedures ; Orthopedics/education ; Orthopedics/trends ; Photography
    Language English
    Publishing date 2012-03-17
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 80384-4
    ISSN 1432-5195 ; 0341-2695
    ISSN (online) 1432-5195
    ISSN 0341-2695
    DOI 10.1007/s00264-012-1527-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Best Evidence Topic report. Bet4. Radial or dorsal backslab in colles' fractures.

    Farrar, N Greville / Al-Nammari, Shafic Said / Ferguson, Craig

    Emergency medicine journal : EMJ

    2008  Volume 25, Issue 4, Page(s) 224

    MeSH term(s) Aged ; Casts, Surgical ; Colles' Fracture/therapy ; Emergency Service, Hospital ; Evidence-Based Medicine ; Humans ; Radius
    Language English
    Publishing date 2008-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emj.2008.058198
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Letter to the editor: Differences in outcome between Maori and Caucasian patients undergoing total joint arthroplasty for osteoarthritis.

    Al-Hadithy, Nawfal / Al-Nammari, Shafic Said / Mordecai, Simon

    Journal of orthopaedic surgery (Hong Kong)

    2010  Volume 18, Issue 3, Page(s) 393; author reply 394

    MeSH term(s) Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; European Continental Ancestry Group ; Humans ; New Zealand ; Oceanic Ancestry Group ; Osteoarthritis, Hip/ethnology ; Osteoarthritis, Hip/surgery ; Osteoarthritis, Knee/ethnology ; Osteoarthritis, Knee/surgery ; Treatment Outcome
    Language English
    Publishing date 2010-12
    Publishing country England
    Document type Comment ; Letter
    ZDB-ID 1493368-8
    ISSN 2309-4990 ; 1022-5536
    ISSN (online) 2309-4990
    ISSN 1022-5536
    DOI 10.1177/230949901001800332
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The portrayal of bone tumours in the press.

    Al-Nammari, Shafic Said / Danesh, Arash / Mussa, Mohamed / Al-Hadithy, Nawfal

    Musculoskeletal surgery

    2013  Volume 97, Issue 1, Page(s) 21–23

    Abstract: The media are pivotal in educating and informing the general public. The stories they cover and how they cover them has a powerful influence on public perceptions. There have been no previous reports of the portrayal of bone tumours in the press. ... ...

    Abstract The media are pivotal in educating and informing the general public. The stories they cover and how they cover them has a powerful influence on public perceptions. There have been no previous reports of the portrayal of bone tumours in the press. LexisNexis™ Professional search engine used to retrieve articles from all United Kingdom National Newspapers over one year containing terms "bone tumour/bone tumour" and 46 other named bone and joint tumours from May 2009 to May 2010. A total of 253 relevant articles were found. Seven per cent solely bone tumour related, 41% main theme and 52% mentioned in passing. 52% mentioned tumour type. These were 51% multiple myeloma, 15% Ewing's sarcoma, 9% sarcoma unspecified, 6% clear cell sarcoma, 4.5% epithelial sarcoma, 4% synovial sarcoma, 3% osteosarcoma, 3% bony metastasis and 1.5% chondrosarcoma. Benign bone tumours not mentioned. Article focus: chemotherapy 17%, surgeon/doctor 7% and new surgical technique 2%. The overall attitudinal tone of the articles were 52% negative, 32% neutral and 16% positive. Only 13% quoted an oncologist, and 1% an orthopaedic surgeon. Quality of medical information provided was limited with 90% providing no meaningful medical information and this medical information being correct only 68% of the time. Articles with quotes from a doctor were significantly more likely to contain meaningful medical information than those without-33 versus 4%, respectively (p < 0.001 Chi-squared test)-and there was a trend for them to be more factually correct overall-68 versus 50% (p = 0.192 Fisher's exact Test).
    MeSH term(s) Bone Neoplasms/pathology ; Bone Neoplasms/therapy ; Chemotherapy, Adjuvant/methods ; Chondrosarcoma/pathology ; Chondrosarcoma/therapy ; Humans ; Multiple Myeloma/pathology ; Multiple Myeloma/therapy ; Newspapers as Topic ; Orthopedic Procedures ; Osteosarcoma/pathology ; Osteosarcoma/therapy ; Research Report ; Sarcoma, Ewing/therapy ; Sarcoma, Synovial/pathology ; Sarcoma, Synovial/therapy ; Treatment Outcome ; United Kingdom
    Language English
    Publishing date 2013-03-06
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 2495458-5
    ISSN 2035-5114 ; 2035-5106
    ISSN (online) 2035-5114
    ISSN 2035-5106
    DOI 10.1007/s12306-013-0247-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Management of achilles tendon injury: A current concepts systematic review.

    Gulati, Vivek / Jaggard, Matthew / Al-Nammari, Shafic Said / Uzoigwe, Chika / Gulati, Pooja / Ismail, Nizar / Gibbons, Charles / Gupte, Chinmay

    World journal of orthopedics

    2015  Volume 6, Issue 4, Page(s) 380–386

    Abstract: Achilles tendon rupture has been on the rise over recent years due to a variety of reasons. It is a debilitating injury with a protracted and sometimes incomplete recovery. Management strategy is a controversial topic and evidence supporting a definite ... ...

    Abstract Achilles tendon rupture has been on the rise over recent years due to a variety of reasons. It is a debilitating injury with a protracted and sometimes incomplete recovery. Management strategy is a controversial topic and evidence supporting a definite approach is limited. Opinion is divided between surgical repair and conservative immobilisation in conjunction with functional orthoses. A systematic search of the literature was performed. Pubmed, Medline and EmBase databases were searched for Achilles tendon and a variety of synonymous terms. A recent wealth of reporting suggests that conservative regimens with early weight bearing or mobilisation have equivalent or improved rates of re-rupture to operative regimes. The application of dynamic ultrasound assessment of tendon gap may prove crucial in minimising re-rupture and improving outcomes. Studies employing functional assessments have found equivalent function between operative and conservative treatments. However, no specific tests in peak power, push off strength or athletic performance have been reported and whether an advantage in operative treatment exists remains undetermined.
    Language English
    Publishing date 2015-05-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2649712-8
    ISSN 2218-5836
    ISSN 2218-5836
    DOI 10.5312/wjo.v6.i4.380
    Database MEDical Literature Analysis and Retrieval System OnLINE

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