Andrew D Duckworth

Andrew D Duckworth
The University of Edinburgh | UoE · Edinburgh Orthopaedic Trauma

BSc(Hons), MBChB, MSc, FRCSEd(Tr&Orth), PhD

About

172
Publications
24,772
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4,139
Citations
Citations since 2016
100 Research Items
3444 Citations
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20162017201820192020202120220200400600800
20162017201820192020202120220200400600800

Publications

Publications (172)
Article
Full-text available
Introduction: Socioeconomic deprivation is associated with multi-morbidity and frailty, but influence on hip fracture outcomes is poorly understood. The primary aim was to investigate the association between deprivation and mortality, and secondary aims were to assess the effects on: (i) age at presentation; (ii) inpatient outcomes, and (iii) post...
Article
Full-text available
Purpose The use of computed tomography (CT) in fractures is time consuming, challenging and suffers from poor inter-surgeon reliability. Convolutional neural networks (CNNs), a subset of artificial intelligence (AI), may overcome shortcomings and reduce clinical burdens to detect and classify fractures. The aim of this review was to summarize liter...
Article
Objectives: To delineate whether a "safe" window exists for timing from definitive fixation to definitive soft tissue coverage in the treatment of open tibial diaphyseal fractures requiring flap coverage. Design: International multicenter, retrospective comparative cohort study.Patients/Participants: Three hundred and seventy-three (n=373) patie...
Article
Full-text available
Purpose Frailty is a common clinical syndrome affecting hip fracture patients. Recognising and accurately assessing frailty status is important in clinical and research settings. The Rockwood Clinical Frailty Scale (CFS) is a commonly used instrument and demonstrates a strong correlation with mortality and length of hospital admission following hip...
Article
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Purpose: The aims were to: (1) determine 1-year mortality rates for hip fracture patients during the first UK COVID-19 wave, and (2) assess mortality risk associated with COVID-19. Methods: A nationwide multicentre cohort study was conducted of all patients presenting to 17 hospitals in March-April 2020. Follow-up data were collected one year af...
Article
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Purpose Positive ulnar variance following a distal radius malunion can lead to ulnar-sided wrist pain, loss of grip strength, and distal radioulnar joint impingement. The primary aim of this study is to describe upper limb-specific functional outcomes following ulnar shortening osteotomy (USO) for ulnar-sided wrist pain associated with malunion of...
Article
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Aims The primary aim was to estimate the cost-effectiveness of routine operative fixation for all patients with humeral shaft fractures. The secondary aim was to estimate the health economic implications of using a Radiographic Union Score for HUmeral fractures (RUSHU) of < 8 to facilitate selective fixation for patients at risk of nonunion. Metho...
Article
Aims: The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service. Methods: All adult patients who presented with a clinically suspected scaphoid...
Article
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Research into COVID-19 has been rapid in response to the dynamic global situation, which has resulted in heterogeneity of methodology and the communication of information. Adherence to reporting standards would improve the quality of evidence presented in future studies, and may ensure that findings could be interpreted in the context of the wider...
Article
Purpose To identify predictors of a true scaphoid fracture among patients with radial wrist pain following acute trauma, train 5 machine learning (ML) algorithms in predicting scaphoid fracture probability, and design a decision rule to initiate advanced imaging in high-risk patients. Methods Two prospective cohorts including 422 patients with rad...
Article
Aims The purpose of this systematic review was to determine the rates of union for vascularized versus non-vascularized grafting techniques in the operative management of scaphoid nonunion. Secondary aims were to determine the effect of the fixation techniques used, the source of grafting, as well as the influence of fracture location (proximal pol...
Article
Aims Sarcopenia is characterized by a generalized progressive loss of skeletal muscle mass, strength, and physical performance. This systematic review primarily evaluated the effects of sarcopenia on postoperative functional recovery and mortality in patients undergoing orthopaedic surgery, and secondarily assessed the methods used to diagnose and...
Article
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Aims The primary aim of this study was to determine the rates of return to work (RTW) and sport (RTS) following a humeral shaft fracture. The secondary aim was to identify factors independently associated with failure to RTW or RTS. Methods From 2008 to 2017, all patients with a humeral diaphyseal fracture were retrospectively identified. Patient...
Article
Aims This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods A multicentre collaboration among 112 centres in 14 countrie...
Article
Objectives: The primary aim was to assess patient-reported outcomes ≥1yr following a humeral diaphyseal fracture. The secondary aim was to compare outcomes of patients who united after initial management (operative/non-operative) with those who united after nonunion fixation (NU-ORIF). Design: Retrospective. Setting: University teaching hospit...
Article
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Purpose The aim of this study was to report outcomes following mini-open lower limb fasciotomy (MLLF) in active adults with chronic exertional compartment syndrome (CECS). Methods From 2013–2018, 38 consecutive patients (mean age 31 years [16–60], 71% [n = 27/38] male) underwent MLLF. There were 21 unilateral procedures, 10 simultaneous bilateral...
Article
»: Suspected scaphoid fractures are a diagnostic and therapeutic challenge despite the advances in knowledge regarding these injuries and imaging techniques. The risks and restrictions of routine immobilization as well as the restriction of activities in a young and active population must be weighed against the risks of nonunion that are associate...
Conference Paper
Full-text available
Background The distribution of professional golfing injuries is poorly understood. Objective The aim of the study was to perform a systematic review to describe the epidemiology of musculoskeletal injuries in professional golfers. Design A systematic review using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline...
Conference Paper
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Purpose: There is a paucity of literature regarding the long-term outcomes of scaphoid fractures managed with acute percutaneous fixation. The aim of this study was to report the long-term functional outcomes and complication rates following early percutaneous fixation of acute fractures of the scaphoid. Methods: A trauma database was searched to...
Article
Purpose The primary aim was to determine independent patient, injury and management-related factors associated with symptomatic venous thromboembolism (VTE) following acute Achilles tendon rupture (ATR). The secondary aim was to suggest a clinical VTE risk assessment tool for patients with acute ATR. Methods From 2010-2018, 984 consecutive adults...
Article
The primary aim of this study was to identify factors associated with nonresponse to routinely collected patient-reported outcome measures (PROMs) after hand surgery. The secondary aim was to investigate the impact of nonresponder bias on postoperative PROMs. We identified 4357 patient episodes for which the patients received pre- and 1-year postop...
Article
Objectives: (1) To describe the percutaneous technique used to reduce and fix a posterior malleolar fracture with anteroposterior (AP) screws in patients managed with a fibular intramedullary nail, (2) describe the selection of patients to whom this technique can be applied, and (3) report the clinical and patient reported outcome of this interven...
Article
Objectives: To document union rate, complications and patient-reported outcomes after open reduction and internal fixation (ORIF), with and without bone grafting (BG), for humeral diaphyseal nonunion after failed nonoperative management. Design: Retrospective. Setting: University teaching hospital. Patients and intervention: From 2008 to 201...
Article
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Background Acute carpal tunnel syndrome (ACTS) is a known complication of distal radius fractures. This study aimed to document the demographics, range of presenting symptoms and risk factors of patients who develop ACTS following a fracture of the distal radius. Methods A retrospective review of 1189 patients with an acute distal radius fracture...
Article
Aims Acute distal biceps tendon repair reduces fatigue-related pain and minimizes loss of supination of the forearm and strength of flexion of the elbow. We report the short- and long-term outcome following repair using fixation with a cortical button techqniue. Methods Between October 2010 and July 2018, 102 patients with a mean age of 43 years (...
Article
Background Dupuytren’s contracture was recently designated a prescribed occupational disease when it occurs in patients with previous hand–arm vibration (HAV) exposure. Aims The aims of this study were to describe the impact of self-reported HAV exposure on upper limb function and satisfaction following surgery for Dupuytren’s contracture. Method...
Article
Aims: The aim of this study was to compare the outcome in patients who did and did not undergo continuous compartment pressure monitoring (CCPM) following a tibial diaphyseal fracture. Patients and Methods: We performed a retrospective cohort study of 287 patients with an acute tibial diaphyseal fractures who presented to three centres over a two-y...
Article
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Introduction Correct femoral tunnel position in anterior cruciate ligament reconstruction (ACLR) is critical in obtaining good clinical outcomes. We aimed to delineate whether any difference exists between the anteromedial and trans-tibial portal femoral tunnel placement techniques on the primary outcome of ACLR, graft rupture. Method Adult patien...
Article
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INTRODUCTION The Coronavirus Disease 2019 (COVID-19) pandemic resulted in major disruption to hip fracture services. This frail patient group requires specialist care, and disruption to services is likely to result in increases in morbidity, mortality and long-term healthcare costs. AIMS To assess disruption to hip fracture services during the COV...
Article
Objective: To compare the outcome of fibular nailing with plate fixation for unstable fractures of the ankle in a cohort of patients under the age of 65. Setting: two international university trauma centres,Patients/Participants 125 patients 18-64 years of age with an acute unstable fracture of the ankle. Intervention: Patients were randomized...
Chapter
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Wrist fractures account for 3–9% of all athletic injuries. Fractures of the wrist involve the distal radius, distal ulna and the carpus. Distal radius fractures and scaphoid fractures are more common than fractures of the distal ulna and other carpal bones. Prompt diagnosis and appropriate early management are essential to avoid adverse outcomes. T...
Article
Purpose To describe patients’ self-reported hand normality before and after surgery for Dupuytren contracture and to determine whether this metric could be used as an adjunct to determine the success of surgery. Methods Preoperative and 1-year postoperative Quick–Disabilities of the Arm, Shoulder, and Hand and EuroQol 5-Dimensions 5-level scores w...
Article
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Objectives: To compare the biomechanical failure properties of the fibular intramedullary nail with locking plate and lag screw fixation in the management of unstable elderly distal fibular fractures. Methods: Twelve fresh-frozen cadaveric lower limbs (six matched-pairs) were studied. A simulated OTA/AO 44-B fracture was created, then randomly a...
Article
Aims The primary aim was to assess the rate of postoperative COVID-19 following hip and knee arthroplasty performed in March 2020 in the UK. The secondary aims were to assess whether there were clinical factors associated with COVID-19 status, the mortality rate of patients with COVID-19, and the rate of potential COVID-19 in patients not presentin...
Article
Background The primary aim was to identify patient and injury factors independently associated with humeral diaphyseal fracture nonunion after non-operative management. The secondary aim was to determine the effect of management (operative/non-operative) on nonunion. Methods From 2008-2017, 734 humeral shaft fractures (732 consecutive skeletally-m...
Article
Aims The primary aim was to determine the influence of COVID-19 on 30-day mortality following hip fracture. Secondary aims were to determine predictors of COVID-19 status on presentation and later in the admission; the rate of hospital acquired COVID-19; and the predictive value of negative swabs on admission. Methods A nationwide multicentre retr...
Chapter
This chapter summarizes the seminal literature relating to factors that increase the risk of distal radius fracture instability and secondary displacement. The currently available evidence indicates that increasing age and the presence of dorsal comminution are strongly predictive of secondary displacement. Several other risk factors have also been...
Article
Full-text available
Aims The aims of this meta-analysis were to assess: 1) the prevalence of coronavirus disease 2019 (COVID-19) in hip fracture patients; 2) the associated mortality rate and risk associated with COVID-19; 3) the patient demographics associated with COVID-19; 4) time of diagnosis; and 5) length of follow-up after diagnosis of COVID-19. Methods Search...
Article
Purpose: This study describes the impact of self-reported hand-arm vibration (HAV) exposure on patient-reported outcomes, health-related quality of life, and satisfaction after carpal tunnel release. Methods: We prospectively collected data from Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH), patient satisfaction, and 5-level EuroQo...
Article
Aims: The aim of this study was to determine the current incidence and epidemiology of humeral diaphyseal fractures. The secondary aim was to explore variation in patient and injury characteristics by fracture location within the humeral diaphysis. Methods: Over ten years (2008 to 2017), all adult patients (aged ≥ 16 years) sustaining an acute fr...
Article
Aims The primary aim of this study was to assess the independent association of the coronavirus disease 2019 (COVID-19) on postoperative mortality for patients undergoing orthopaedic and trauma surgery. The secondary aim was to identify factors that were associated with developing COVID-19 during the postoperative period. Methods A multicentre ret...
Article
Background There has been a shift toward functional nonoperative rehabilitation in the treatment of Achilles tendon rupture (ATR) despite a shortage of studies directly comparing nonoperative functional rehabilitation with traditional nonoperative immobilization. Purpose To compare patient-reported outcome measures and functional outcomes for nono...
Article
Objectives: To evaluate the short- and long-term patient reported outcomes of acute compartment syndrome (ACS) complicating a fracture of the tibial diaphysis. Design: Retrospective review. Setting: Academic orthopaedic trauma centre. Patients: We retrospectively identified 559 patients from a trauma database over a 7-year period. Forty-one...
Article
Aims The primary aim was to assess the independent influence of coronavirus disease (COVID-19) on 30-day mortality for patients with a hip fracture. The secondary aims were to determine whether: 1) there were clinical predictors of COVID-19 status; and 2) whether social lockdown influenced the incidence and epidemiology of hip fractures. Methods A...
Article
Aims The aim was to compare long-term patient-reported outcome measures (PROMs) after operative and nonoperative treatment of acute Achilles tendon rupture in the context of a randomized controlled trial. Methods PROMs including the Short Musculoskeletal Function Assessment (SMFA), Achilles Tendon Total Rupture Score (ATRS), EuroQol five-dimension...
Article
Full-text available
Aims This study aims to define the epidemiology of trauma presenting to a single centre providing all orthopaedic trauma care for a population of ∼ 900,000 over the first 40 days of the COVID-19 pandemic compared to that presenting over the same period one year earlier. The secondary aim was to compare this with population mobility data obtained fr...
Article
Full-text available
Aims This study aims to define the epidemiology of trauma presenting to a single centre providing all orthopaedic trauma care for a population of ∼ 900,000 over the first 40 days of the COVID-19 pandemic compared to that presenting over the same period one year earlier. The secondary aim was to compare this with population mobility data obtained fr...
Article
The United Kingdom National Institute for Health and Care Excellence considers a procedure to be cost-effective if the cost per quality-adjusted life year gained falls below a threshold of £20,000–£30,000 (€22,600–33,900; US$24,600–$36,900). This study used cost per quality-adjusted life year methodology to determine the cost-utility ratio of A1 pu...
Article
We compared the functional outcomes, health-related quality of life, and satisfaction in diabetic and non-diabetic patients undergoing A1 pulley release for trigger finger in 192 patients. Preoperative and postoperative Quick Disabilities of the Arm, Shoulder and Hand questionnaire (Quick DASH), EuroQol-5 dimensions, and satisfaction scores were co...
Article
This study describes functional outcomes, patient satisfaction, and health-related quality of life (HRQoL) following open revision carpal tunnel decompression (CTD) for recurrent carpal tunnel syndrome (CTS). Postoperative results were available for 16 hands in 15 patients (100% at mean follow-up at 19.9 months). This was a prospective study at a s...
Article
This study investigated the impact of self-reported hand-arm vibration (HAV) exposure on patient-reported functional outcomes (PROMs), Health-related quality of life (HRQoL), and patient satisfaction following carpal tunnel decompression (CTD). This was a single-centre prospective study investigating postoperative PROMs in 609 patients undergoing e...
Article
Aims: Currently, periprosthetic fractures are excluded from the American Society for Bone and Mineral Research (ASBMR) definition of atypical femoral fracture (AFFs). This study aims to report on a series of periprosthetic femoral fractures (PFFs) that otherwise meet the criteria for AFFs. Secondary aims were to identify predictors of periprosthet...
Article
Aims The primary aim of this study was to develop a reliable, effective radiological score to assess the healing of humeral shaft fractures, the Radiographic Union Score for HUmeral fractures (RUSHU). The secondary aim was to assess whether the six-week RUSHU was predictive of nonunion at six months after the injury. Patients and Methods Initially...
Article
This prospective single-centre study describes the functional outcomes, satisfaction and health-related quality of life after open revision carpal tunnel decompression for recurrent carpal tunnel syndrome. The QuickDASH, patient satisfaction and EuroQol-5 dimensions questionnaires were collected preoperatively and postoperatively over a 5-year peri...
Article
Full-text available
Intra-articular fractures of the distal end of the tibia, more commonly referred to as pilon fractures, account for approximately 5% to 7% of all tibial fractures 1,2. Type-C fractures present a unique surgical challenge: a total articular fracture contained within a vulnerable soft-tissue envelope. Treatment options include internal fixation 3 , e...
Article
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Background: There are limited data reporting the outcome of patients with non-operatively managed medial malleolus fractures compared to those treated surgically in the presence of fibular stabilisation for unstable fractures of the ankle. Conservative management could result in fewer complications, reduced surgical time and lower cost. The purpos...
Chapter
Full-text available
A delay in the diagnosis of acute compartment syndrome (ACS) is associated with a potentially devastating outcome for the patient. A key risk factor for ACS is youth, with more than two-thirds of cases associated with an underlying fracture. Pain is noted as the index or key sign associated with ACS. However, clinical assessment alone has been docu...
Article
Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19...
Article
Full-text available
Background: Humeral shaft fractures constitute around 1% of adult fractures in the UK, with an annual incidence of approximately 13 per 100,000 population. Historically, these injuries have been primarily managed non-operatively, with operative fixation reserved for specific indications. Although some recent retrospective studies have suggested the...
Article
Background: The evidence for treating acute, unreconstructable radial head fractures in unstable elbows with radial head replacement predominantly consists of short- to mid-term follow-up studies with a heterogenous mix of implants and operative techniques. Data on longer-term patient-reported outcomes after radial head replacement is lacking. Qu...
Article
The medial malleolus, once believed to be the primary stabilizer of the ankle, has been the topic of conflicting clinical and biomechanical data for many decades. Despite the relevant surgical anatomy being understood for almost 40 years, the optimal treatment of medial malleolar fractures remains unclear, whether the injury occurs in isolation or...