Alan Middleton

Publications (5)1.93 Total impact

• Article: Volar radiocarpal dislocation: case report and review of literature.

  Kiran Singisetti, Michalopoulos Konstantinos, Alan Middleton
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  ABSTRACT: We describe here an unusual case of volar dislocation of the radiocarpal joint due to a complete tear of the dorsal radiocarpal ligament. Plain radiographs taken at initial presentation did not reveal any obvious abnormality. There was no associated bony lesion or intrinsic wrist ligament injury. Radiocarpal dislocations should be considered in the diagnosis of high-energy wrist injuries, even when initial radiographs look normal. The importance of a high index of suspicion in high velocity wrist injuries and need for further evaluation and imaging is highlighted.
  Hand Surgery 01/2011; 16(2):173-5.
• Article: An unusual cause of scapular winging following trauma in an army personnel.

  Muhammad Mansha, Alan Middleton, Amar Rangan
  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 12/2010; 19(8):e24-7. · 1.93 Impact Factor
• Article: Popliteal block with transfibular approach in ankle arthrodesis: a case series

  Gabriel Akra, Alan Middleton, Akinwande Adedapo, Paul Finn
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  ABSTRACT: Abstract Introduction Ankle arthrodesis is primarily undertaken to control severe pain in the ankle joint. Immediate postoperative pain is usually treated using oral analgesics, intravenous opiates and regional anaesthesia. The outcomes of ankle fusion, including patient satisfaction studies, are well documented in the literature. However, the advantage of popliteal block in the management of early postoperative pain after ankle fusion for osteoarthritis has not been widely reported. This study aims to determine the role of popliteal block using ankle fusion in the management of ankle osteoarthritis. Case presentation Ankle arthrodeses were performed in 27 patients over a five-year period. Eighteen patients were males (one had bilateral arthrodesis) and eight were females. Their mean age was 56 years and they were all Caucasians. The notes and radiographs of the patients were reviewed in retrospect for the duration of their hospital admission, time to union and complications. Conclusion Popliteal block is a safe and effective technique for postoperative analgesia in ankle arthrodesis. By using this technique, we achieved a significant reduction in the duration of hospital stay for our patients after ankle arthrodesis. The resultant cost saving was GBP717 for each patient.
  Journal of Medical Case Reports. 01/2010;
• Source

  Available from: PubMed Central

  Article: Popliteal block with transfibular approach in ankle arthrodesis: a case series.

  Gabriel A Akra, Alan Middleton, Akinwande O Adedapo, Paul Finn
  [show abstract] [hide abstract]
  ABSTRACT: Ankle arthrodesis is primarily undertaken to control severe pain in the ankle joint. Immediate postoperative pain is usually treated using oral analgesics, intravenous opiates and regional anaesthesia. The outcomes of ankle fusion, including patient satisfaction studies, are well documented in the literature. However, the advantage of popliteal block in the management of early postoperative pain after ankle fusion for osteoarthritis has not been widely reported. This study aims to determine the role of popliteal block using ankle fusion in the management of ankle osteoarthritis. Ankle arthrodeses were performed in 27 patients over a five-year period. Eighteen patients were males (one had bilateral arthrodesis) and eight were females. Their mean age was 56 years and they were all Caucasians. The notes and radiographs of the patients were reviewed in retrospect for the duration of their hospital admission, time to union and complications. Popliteal block is a safe and effective technique for postoperative analgesia in ankle arthrodesis. By using this technique, we achieved a significant reduction in the duration of hospital stay for our patients after ankle arthrodesis. The resultant cost saving was GBP717 for each patient.
  Journal of Medical Case Reports 01/2010; 4:135.
• Article: Outcome of ankle arthrodesis using a transfibular approach.

  Gabriel A Akra, Alan Middleton, Akinwande O Adedapo, Andrew Port, Paul Finn
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  ABSTRACT: Variable union rates in ankle arthrodesis using different surgical techniques have been reported in the biomedical literature. However, the advantages of a transfibular approach with sagittal splitting of the fibula have not been widely reported, even though the technique is well known and even described in surgical textbooks. We analyzed outcomes in our practice for all patients who underwent ankle arthrodesis. Over a 5-year period, 2 surgeons using the same transfibular approach performed 26 ankle arthrodeses in 25 patients. The medical records and radiographs of the patients were reviewed for duration of hospital admission, time to union, and complications. All (100%) of the ankle fusions progressed to solid union in a mean postoperative duration of 4.5 ± 1.8 months (range, 2-10 months), and the only clinically significant complication involved 1 patient with suspected complex regional pain syndrome, who responded to treatment and recovered fully.
  The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons 49(6):508-12.