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Children's Orthopaedics

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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 16 - 16
1 Jan 2013
Zenios M Zamani F Oyadiji S
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Purpose of the study

The aim of this mechanical study was to investigate the ability of cannulated fixation bolts to stop wire slippage in Ilizarov circular external fixators.

Methods and Results

Three types of cannulated fixation bolts (Smith and Nephew, Orthofix and one designed by the authors) were tested on Ilizarov rings to compare their performance. Three levels of bolt torques were applied and the wires were pulled to measure the load at which the wire will start to slip or fail. It was revealed that the initial resistance to slippage is due to plastic deformation of the wire under the clamp and is in fact governed by the size of this deformation. The slippage was found to occur in a slip/stick fashion, as the plastic deformation was propagated along the wire.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 2 - 2
1 Jan 2013
Wells-Cole E Ali F Fines D Griffiths A Zenios M
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The aim of this retrospective study is to compare the different anaesthetic techniques in children undergoing circular frame application for lengthening and deformity correction. Data was collected from 68 cases on severe pain episodes, postoperative duration of analgesia, requirement for top-up analgesia, complications and side-effects and number of osteotomies. The three analgesic methods used were morphine infusion (M), epidural analgesia (E) and continuous peripheral nerve blocks (CPNB). There was a significant difference between the number of episodes of severe pain experienced by the patients receiving a morphine infusion when compared to the epidural and CPNB groups (M vs. E p<0.0001, M vs. CPNB p=0.018). CPNB were associated with the lowest incidence of severe pain episodes and top-up analgesia requirements. The difference in the incidence of nausea and vomiting between the methods was approaching significance (p=0.06). A significant difference was found when comparing epidural and morphine infusions (p=0.05). Epidural analgesia was associated with significantly more nausea and vomiting (p=0.023), and motor blockade (p<0.01) than CPNB. The results show the most effective method of post-operative analgesia for our paediatric patients, in light of pain episodes and associated side-effects, is sciatic nerve catheterisation with continuous infusion.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXV | Pages 7 - 7
1 Jul 2012
Lammin K Taylor J Zenios M
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Purpose

To assess the initial rise in inflammatory markers in paediatric patients presenting with long bone osteomyelitis and whether this is comparable with that in septic arthritis, and diagnostic.

Methods

All radiologically confirmed cases of long bone osteomyelitis without septic arthritis, joint effusion or abscess, in paediatric patients, presenting to one hospital over an eighteen-month period were included. These patients were compared with all culture positive septic arthritides presenting to the same hospital within the same period. Inflammatory markers taken on the day of admission were studied.