A high pre-operative NLR indicates a worse prognosis than in patients with a low NLR. There is potential to use the NLR to direct therapies. A specific cut-off value has not been established from this study and so further research is required.

Obesity is an increasing burden on health-care globally. Significant obesity is presenting at a younger age, with pathology that has not been previously seen. This case report illustrates the catastrophic consequences which may occur when minor trauma occurs in a young person who suffers from morbid obesity. A 19-year-old woman with BMI 50 tripped over an uneven curb, and suffered complete dislocation of the knee with associated popliteal artery injury. She required femoro-popliteal bypass using vein. This case reports the youngest person to suffer from this injury and the first in the UK.

This review suggests marked variation in the management of popliteal fossa venous incompetence. There is a clear need for further research to clarify the role of ablation in the management of symptoms and skin changes.

No abstract

Our aim was to assess the long-term outcome for minor forefoot amputations. A retrospective study of 126 patients who had such amputations between 1999 and 2004 was performed. Patients were divided into 2 groups, diabetic (group A: 79 patients) and nondiabetic (group B: 47 patients). Angiograms were requested in 45 patients in group A compared with 31 patients in group B (P = ·77). In group A, 11 patients underwent further ipsilateral amputations compared with 30 patients in group B (P = ·02.). The 2 groups were equally likely to have vascular reconstruction (35% vs 37%). The overall 5-year mortality was 27%, with 58% of deaths occurring within the first year. This study shows that foot amputees have high mortality and reintervention rates. Adequate utilization of vascular services, extra vigilance in the prevention of complications, and risk factor modifications are required to improve postoperative outcomes.