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Category: Ankle, Arthroscopy, Sports, Trauma Introduction/Purpose: Early clinical examination combined with MRI following a high ankle sprain allows accurate diagnosis of syndesmosis instability. However, patients often present late, and for chronic injuries clinical assessment is less reliable. The aims of the current study were to describe MRI characteristics associated with diagnosed syndesmosis instability, and to assess if MRI characteristics change as the injury becomes chronic. Methods: Patients with a high ankle sprain and proven syndesmosis instability at arthroscopy were retrospectively identified from the logbooks of two fellowship trained foot and ankle surgeons over a five-year period. Patients were excluded if they had a distal fibula fracture or absence of an MRI report by a consultant radiologist. Associations between MRI characteristics and time from injury to MRI scan, categorised as acute (< 6 weeks), intermediate (6-12 weeks) and chronic (> 12 weeks) were examined using the Pearson’s chi-squared or Fisher’s exact tests (significance set at p<0.05). Results: Of the 164 patients, 108 had an MRI scan in the acute period, 32 were classified as intermediate and 24 as chronic. A posterior syndesmosis injury was detected in 93.5% of acute patients, 87.5% of intermediate patients and 54.2% of chronic patients. In the acute group, PITFL injury was detected in 78.7% of patients, posterior malleolus bone oedema in 60.2% and posterior malleolus fracture in 15.7%. The proportion of patients with injury to the PITFL in intermediate patients was 59.4% and 29.2% in chronic patients which was significantly lower than in acute patients (p<0.001). Twenty eight patients with posterior malleolus bone oedema had an apparently normal PITFL. The proportion of patients with posterior malleolus bone oedema or fracture were not significantly different between groups. Conclusion: The most important finding of the current study is that in acute high ankle sprains with syndesmosis instability, MRI detected a posterior syndesmosis injury in 93.5% of patients. Posterior malleolus bone oedema appears to be a marker of an unstable syndesmosis injury, regardless of time from injury to the MRI scan. The ability of MRI to detect a posterior syndesmosis injury reduces significantly if delayed more than 12 weeks. If suspicious of a high ankle sprain, we advocate early MRI assessment to help determine stable versus unstable injuries, as the ability of MRI to detect posterior injuries reduces over time.

Detrital zircon grains preserved within clasts and the matrix of a basal diamictite sequence directly overlying the Carrapateena IOCG deposit in the Gawler Craton, South Australia are shown here to preserve U–Pb ages and geochemical signatures that can be related to underlying mineralisation. The zircon geochemical signature is characterised by elevated heavy rare-earth element fractionation values (GdN/YbN ≥ 0.15) and high Eu ratios (Eu/Eu* ≥ 0.6). This geochemical signature has previously been recognised within zircon derived from within the Carrapateena orebody and can be used to distinguish zircon associated with IOCG mineralisation from background zircon preserved within stratigraphically equivalent regionally unaltered and altered samples. The results demonstrate that zircon chemistry is preserved through processes of weathering, erosion, transport, and incorporation into cover sequence materials and, therefore, may be dispersed within the cover sequence, effectively increasing the geochemical footprint of the IOCG mineralisation. The zircon geochemical criteria have potential to be applied to whole-rock geochemical data for the cover sequence diamictite in the Carrapateena area; however, this requires understanding of the presence of minerals that may influence the HREE fractionation (GdN/YbN) and/or Eu/Eu* results (e.g., xenotime, feldspar).

The advent of the National Policy in 1879 brought dramatic changes in the structure, magnitude, and objectives of Canada's tariff policy. No longer used primarily as a source of revenue for the government, tariffs on imported goods assumed a role as protector of Canadian industry against the encroachment of foreign imports on the Canadian market. In this detailed account of events leading up to the adoption of the National Policy, Ben Forster explores a wide range of political and economic forces and races their influence on successive Liberal and Conservative governments. He examines the pamphlet literature of the protectionists, the private corespondence of political leaders and protectionists, the public press of the day, and legislative journals and other public documents. He weaves the threads of various interests - business, industry, agriculture, and government - into a comprehensive account of the growth of protectionist feeling in Canada. Forster's analysis illuminates a critical chapter in Canadian political history, one with implications for current discussions on import quotas, industrial policy, and free trade

Purpose Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. Methods Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. Results A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. Conclusion It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent would not be an issue in for a national registry where inclusion is automatic unless the patient wishes to opt out. The collection of post-operative patient-reported outcome measures (PROMs) is more problematic, due to an insufficient proportion of individuals providing patient-reported outcomes. Alternative outcome measures are required for an ACL registry in Australia to be successfully implemented. Level of evidence Diagnostic, Level III.

The idea of a tripartite national policy exercises a continuing fascination; it is well ensconced as part of the intellectual feedstock of the Canadian educational system. Certainly, it seems to have broad explanatory power, as it appears to expose the internal logic of transcontinental expansion and industrialization within the nation state. After all, the trinity of immigration and western settlement, railway construction, and tariff protection appeared to intermesh to aid in the creation of a staple-producing, export-oriented western hinterland that at the same time provided a market for the manufactures of Ontario and Quebec. Here was the recipe for a

The diversity of paths to industrialization is illustrated by the example of the cabinet- and furniture-manufacturing industry in Ontario, Canada. Complex and unpredictable demand combined with smaller markets and lower incomes than those in the United States and the relative abundance of wood to limit mechanization and the size of enterprise in the Canadian industry. Small and unpowered workshops remained competitive throughout the nineteenth and into the twentieth century, creating a distinctive industrial experience that reflects the unique interaction of local demand and supply.

The diversity of paths to industrialization is illustrated by the example of the cabinet- and furniture-manufacturing industry in Ontario, Canada. Complex and unpredictable demand combined with smaller markets and lower incomes than those in the United States and the relative abundance of wood to limit mechanization and the size of enterprise in the Canadian industry. Small and unpowered workshops remained competitive throughout the nineteenth and into the twentieth century, creating a distinctive industrial experience that reflects the unique interaction of local demand and supply.

Forster reviews \"Blue Skies and Boiler Rooms: Buying and Selling Securities in Canada, 1870-1940\" by Christopher Armstrong.