Aims.
Aims. To determine the likelihood of achieving a successful closed reduction (CR) of a dislocated hip in developmental dysplasia of the hip (DDH) after failed Pavlik harness treatment We report the rate of avascular necrosis (AVN) and the need for further surgical procedures. Methods. Data was obtained from the Northern Ireland DDH database. All children who underwent an attempted closed reduction between 2011 and 2016 were identified. Children with a dislocated hip that failed Pavlik harness treatment were included in the study. Successful closed reduction was defined as a hip that reduced in theatre and remained reduced. Most recent imaging was assessed for the presence of AVN using the Kalamchi and MacEwen classification. Results. There were 644 dislocated hips in 543 patients initially treated in Pavlik harness. In all, 67 hips failed Pavlik harness treatment and proceeded to arthrogram (CR) under general anaesthetic at an average age of 180 days. The number of hips that were deemed reduced in theatre was 46 of the 67 (69%). A total of 11 hips re-dislocated and underwent
Introduction. Developmental dysplasia of the hip (DDH) can be managed through a variety of different surgical approaches from closed reduction to simple tenotomies of the adductors and through to osteotomies of the femur and pelvis. The rate of redislocation following
Abstract. Background. The incidence of periprosthetic fractures of the femur around a total knee arthroplasty (TKA) is rising and this is owed to the increased longevity that today's TKA implants allow for, as well as an aging population. These injuries are significant as they are related to increased morbidity and mortality. Methods. We retrospectively reviewed all periprosthetic fractures around a TKA that presented to our NHS Trust between 2011 to 2020. Medical records were reviewed. Treatment, complications and mortality were noted. Results. 37 patients (34 females) with an average age of 84 (range 65–99) met the inclusion criteria for this study. 17 patients (45.9%) underwent
Introduction. Ankle fractures in the elderly have been increasing with an ageing but active population and bring with them specific challenges. Medical co-morbidities, a poor soft tissue envelope and a requirement for early mobilisation to prevent morbidity and mortality, all create potential pitfalls to successful treatment. As a result, different techniques have been employed to try and improve outcomes. Total contact casting, both standard and enhanced
Introduction: The incidence of DDH has decreased dramatically during the last thirty years. The first reason was the introduction of targeted examination of all newborn babies (in the Czech Republic since 1977) and then our system was adopted by all of the other European countries. In the 1960s about 15% of all children were treated for different stages of hip dysplasia and there were 3% of true dislocations. These very high numbers of less serious grades of DDH are partially due to over-diagnosis and over-treatment. In the 1980s, the numbers had been reduced to 5% of dysplasias and 0.8% of dislocations. The introduction of ultrasound examination according to Graf within the first week of life has contributed to further reduction of DDH cases. Material and Methods:
Background. Studies have compared
The risk of AVN is high in Unstable Slipped Capital Femoral Epiphysis (SCFE) and the optimal surgical treatment remains controversial. Our AVN rates in severe, unstable SCFE remained unchanged following the introduction of the Modified Dunn Procedure (MDP) and as a result, our practice evolved towards performing an Anterior
Purpose: To compare the incidence of avascular necrosis, and radiological outcomes between groups treated by closed reduction,
Management of acetabular fractures in the elderly population remains somewhat controversial in regards to when to consider is
Background. Sub-trochanteric fractures are challenging to treat due to various anatomical and biomechanical factors. High tensile forces contribute to the challenge of fracture reduction. Intramedullary nailing has become the treatment of choice. If anatomical reduction is not achieved, any mal-alignment will predispose to implant failure.
Lisfranc injuries are uncommon and can be challenging to manage. There is considerable variation in opinion regarding the mode of operative treatment of these injuries, with some studies preferring primary arthrodesis over traditional
Purpose of the study. This study aims to evaluate the use of closed reduction of hips with developmental dysplasia of the hip (DDH) and medial
Avascular necrosis (AVN) of the femoral head is a potentially devastating complication of treatment for developmental dysplasia of the hip (DDH). AVN most commonly occurs following operative management by closed (CR) or
Introduction. Intraarticular calcaneal fractures often need
Abstract. Objective. To compare the clinical and radiological outcome between less invasive stabilization system (LISS, Synthes, Paoli, PA.) and
To compare the clinical and radiographic outcomes of Type III supracondylar fractures of the humerus in children managed either by
Aim. The objective was to assess whether late presentation of DDH leads to an increase in treatment magnitude and cost. Method. This was a retrospective review of prospectively collected data from our hip instability clinic database. All patients presenting to our hip instability clinic that required any form of treatment for DDH between 1990 and 2005 were included. Children were grouped according to age at presentation and then treatment requirements were reviewed. Average costs were calculated based on procedures performed. Results. 84% of children presenting before 6 weeks were treated successfully with abduction bracing, versus none after the age of 10 months. The need for
Background. Outcome of Type II and III (Sander's CT classification) fracture of the calcaneum who underwent
Aim. To compare the rate and severity of avascular necrosis following medial open and closed reduction in developmental hip dysplasia and the resulting influence on femoral and acetabular development. Method. The radiographs and hospital records of 118 patients with dislocation of the hip were reviewed. 57 patients (66 hips) underwent medial