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Science
CASE NOTES
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Tuesday 21:00-21:30
Repeat Wednesday 16:30
Dr Mark Porter gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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LISTEN AGAINListen 30 min
Listen to 30 May
PRESENTER
DR MARK PORTER
Dr Mark Porter
PROGRAMME DETAILS
Tuesday 30 May 2006
A nurse applys a plaster cast to a broken arm

Full programme transcript >>

Fractures

This week's episode of Case Notes is all about fractures.

Dr Mark Porter's guest in the studio is Professor David Marsh of the Academic Centre for Clinical Orthopaedics at University College London. They'll be discussing what happens when a bone breaks, who suffers from fractures and the latest treatments available.

Metatarsals

A broken metatarsal is one type of fracture that's had more than its fair share of headlines in recent weeks. It's the bone that runs from the ankle to the toe, and footballer Wayne Rooney broke one in his right foot last month.

Claudia Hammond visits the London Bridge Hospital to find out more about metatarsals from Consultant Orthopaedic Surgeon Mr Sam Singh and his patient Dan who is recovering from his second metatarsal fracture.

Ilizarov Frames

The Ilizarov frame is a specialised type of external fixator. It was developed after the Second World War by surgeon Gavril Abramovich Ilizarov for correcting non healing or poorly set fractures. He is said to have got the idea from a cartwheel.

An Ilizarov frame uses a metal ring to surround the fractured area; metal spokes attached to the ring then pierce the flesh to fix the bone in position. Three of these 'cartwheels' are attached around the break and connected with metal poles, which are then fixed with adjustable screws and an external fixator to pull the bones into the correct position.

It may sound like an instrument of torture, but, as Mr Roger Atkins of the Bristol Royal Infirmary, tells Mark, the Ilizarov frame stimulates bone formation to allow the fracture to heal more quickly, plus there's none of the maddening itching plaster-cast wearers suffer.

BMPs

Harnessing the power of growth factors is another way of helping difficult fractures to heal. Bone morphogenetic proteins - or BMPs - are naturally-occurring growth factors that promote bone formation and healing after injury.

BMPs can now be produced synthetically and can be applied directly onto a fracture site during surgery.

Mr Peter Giannoudis, Consultant Orthopaedic surgeon at St James' Infirmary in Leeds, tells Mark how BMPs are used, and which patients benefit from them.
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