Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Purpose: In the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half the peroneus brevis tendon. Methods: We performed a retrospective cohort study of patients who underwent hemi-Castaing ligamentoplasty for chronic lateral ankle instability between 1993 and 2010, with a minimum of one year follow-up. Patients were sent a postal questionnaire comprising five validated outcome measures: Olerud-Molander Ankle Score (OMAS), Karlsson Ankle Functional Score (KAFS), Tegner Activity Level Score (pre-injury, prior to surgery, at follow-up), visual analog scale on pain (VAS) and the Short Form 36 (SF-36). Results: Twenty patients completed the questionnaire on functional outcome. The OMAS showed good to excellent outcome in 80% and the KAFS in 65%, the Tegner Score improved from surgery but did not reach pre-injury levels, the VAS on pain was 1 of 10 and the SF-36 returned to normal compared with the average population. Conclusions: Even though most patients were satisfied with the results, outcome at long-term follow-up was less favourable compared with the literature on anatomical reconstructions. In accordance with the literature, we therefore conclude that the initial surgical treatment of chronic lateral ankle instability should be an anatomical repair with augmentation (i.e. the Broström-Gould technique) and the non-anatomical repair should be reserved for unsuccessful cases after anatomical repair or in cases where no adequate ligament remnants are available for reconstruction

Agile software development – Do we really calculate the costs? A multivocal literature review

Agile software development methods, in their various different forms, have become the basis for most software projects in today’s world. The methodology is present in almost all organisations today. However, despite the popularity, failure rates in software projects remain high. This paper identifies why agile methodologies have become so successful. In addition, the paper discusses certain factors that may often be overlooked in organisations that have adopted agile methods, such as rework, maintainability, adoption, turnover rates and the potential costs associated with each. The research carried out was a multivocal literature review (MLR). Multiple white and grey literature which was deemed to be relevant was selected. 32 contributions from white literature were selected for use in the review as well as 8 from grey literature sources. We find that while agile has many advantages, organisations may overlook the potential downsides of using an agile methodology. If not managed or implemented correctly, organisations risk taking on more hidden and expensive costs, for example in relation to rework. It is important that organisations are sufficiently trained in agile methods in order to succeed