Radiographic and Clinical Evaluation of Syndesmotic Screws in Treating Injuries of the Distal Aspect of the Tibiofibular Syndesmosis

Background: Several factors can affect the success of surgical treatment of injuries to the distal aspect of the tibiofibular syndesmosis, including the bony articulation between the distal aspect of the fibula, tibia, and the supporting ligamentous structures; number and size of screws; number of cortices penetrated; and planned routine removal of screws. Methods: We conducted a retrospective review of radiographs and clinic notes for all patients who underwent open reduction and internal fixation of injury to the tibiofibular syndesmosis, which was performed by a single surgeon (RAM), between January 2011 and December 2014. Only screws were used. The screws were removed postoperatively if pain was noted or if requested by the patients. Exclusion criteria included patients with fractures treated initially with external fixation and patients with diabetic neuropathy; ultimately, 44 patients were included in the study. Results: During postoperative follow-up, eight screws broke and six screws loosened. Two broken screws and one loose screw were causing symptoms of pain and subsequently removed. One broken screw was replaced owing to loss of fixation. Four intact screws were causing pain and later removed. Conclusions: There is not a clearly defined advantage to routine screw removal. Risks and costs associated with an additional operative treatment for routine removal are likely unnecessary, but removal when the hardware results in pain is recommended. Treatment outcomes were similar between cortices crossed, number of screws used, and placement of screws through plates

Ipsilateral Femoral Neck and Shaft Fractures with a Floating Knee Injury: A Case Report

Isolated ipsilateral fractures of the femoral neck and shaft are rare injuries. Similarly, a floating knee (ie, ipsilateral fractures of the femur and tibia) is uncommon. We describe a 34-year-old man with ipsilateral fractures of the femoral neck and shaft with an ipsilateral floating knee after a motorcycle collision. He was treated with operative fixation, and was walking without assistive devices at his most recent follow-up appointment in February 2019. We believe this to be a unique combination of injuries not yet described in studies

Worlds Apart: a comparative analysis of discourses of English in the curricula of England and Australia

A comparative analysis of English in the primary curricula of England and Australia reveals markedly different policy perspectives of the functions and purposes of language, literacy and literature in these two Anglophone countries. Whilst the Australian curriculum incorporates ‘the basics’ with broader socio-linguistic views of language in an attempt to construct breadth and balance, the English curriculum is predominantly a didactic adherence to ‘the old basics’. Using discourse and content analysis, a systematic review of the two curricula is undertaken and evaluated by applying Cox's five models of English and Kalantzis et al.'s four paradigms of literacy. The results of this study have important implications for teachers, academics and policy-makers in all Anglophone countries, especially the two countries that are the focus of the study

Character development through the curriculum: teaching and assessing the understanding and practice of virtue

This article reports on the differential impact of a curriculum intervention on students’ understanding and practice of virtue. The research is germane given Ofsted’s new requirement that its inspectors should assess how the curriculum in all schools in England and Wales supports students’ character development. Results are reported here for a total of 1226 eleven- and twelve-year-olds assessed at the beginning and end of their first secondary school term: 822 children in nine program schools, where students experienced the Narnian Virtues character education English curriculum, and 404 children in eight control schools that did not experience the intervention (2 lessons per week over 12 weeks). Mean scores for knowledge and understanding of virtues (wisdom, love, integrity, fortitude, self-control and justice) in the experimental group showed a significant increase from pre- to post-test, which was not the case for the control group. Although scores pre- to post-test for the experimental group declined on a number of (self-assessed) character measures, this decline was not as pronounced as it was for the control group. That children’s understanding of character improved rapidly in the experimental group is important, as knowledge of virtue generally precedes behavioural application

New populist parties in Western Europe

This article addresses the electoral success of far right political parties in West European party systems and suggests that there is a new type of party ‐ the New Populist. Differentiating between neo‐fascism and the New Populism is instructive in two senses. First, it reveals that the current wave of comparative electoral success is more associated with the New Populism than neo‐fascism. Second, it demonstrates that there are certain parallels between the New Politics and the New Populism thereby suggesting that changes in the contemporary far right may well be telling indicators of changes in West European societies that are deeper set than a simple resurgence of racist and anti‐immigrant sentiment