Current concepts in tibial plateau fractures.

Tibial plateau fractures can range from a simple lateral split pattern to very complex bicondylar injuries that can be a sour- ce of great disability. these fractures can provide a challenge for both junior as well as for senior surgeons alike. careful evaluation of the mechanism of injury and fracture pattern plays a crucial part in the operative planning. Assessment of the soft tissues should be performed carefully and adequate imaging is mandatory to allow a more detailed evaluation of the fracture architecture and pre-operativeplanning. Timely accurate reduction and fixation is the goal. Over the last decade the surgical approach chosen has been largely determined by the fracture pattern. Internal plate osteosynthesis through antero-lateral and postero-medial incisions is the most commonly utilised technique for complex bi-condylar fractures. An early range of motion with special attention to full knee extension is essential for a successful functional outcome. Application of the principles mentioned is a pre-requisite to achieve the best result. New fixation techniques, such as locking plates, have not changed those principles but helped to apply them more reliably.

An insight into the grain auger injury problem in Queensland, Australia.

Grain auger-related injuries were studied by examining the injury data obtained from the Queensland worker's compensation database. Close to 60% of 52 claimants were male employees in the 20 to 34 age group. Fingers, hands, and arms were affected in 65% of all cases, and the auger flighting was involved in 60% of claims. The severity of auger-related injuries is reflected in the high average cost of claims and number of working days lost, which were more than double the all-industries values. Injuries involving the auger flighting are three times more costly (in time and money) than the all-industries values. More claims were made during winter and towards the end of summer, with the majority of injuries occurring in the animal industries. Most incidents occurred in the early or middle periods of a working shift. In addition, two focus group meetings were held to gain a broader perspective of the grain auger injury picture in Queensland, Australia. Focus group participants suggested that the operator's state of mind and attitude to safety are important, while the auger's age, type, and shielding were cited as important risk factors. They suggested that older augers are less likely to be adequately shielded, and mobile augers are most likely to be involved in injury events. The information gained from this study is being used to develop strategies to help farmers minimize injuries associated with the use of grain augers.