header advert
Results 1 - 3 of 3
Results per page:
Bone & Joint Open
Vol. 5, Issue 3 | Pages 236 - 242
22 Mar 2024
Guryel E McEwan J Qureshi AA Robertson A Ahluwalia R

Aims

Ankle fractures are common injuries and the third most common fragility fracture. In all, 40% of ankle fractures in the frail are open and represent a complex clinical scenario, with morbidity and mortality rates similar to hip fracture patients. They have a higher risk of complications, such as wound infections, malunion, hospital-acquired infections, pressure sores, veno-thromboembolic events, and significant sarcopaenia from prolonged bed rest.

Methods

A modified Delphi method was used and a group of experts with a vested interest in best practice were invited from the British Foot and Ankle Society (BOFAS), British Orthopaedic Association (BOA), Orthopaedic Trauma Society (OTS), British Association of Plastic & Reconstructive Surgeons (BAPRAS), British Geriatric Society (BGS), and the British Limb Reconstruction Society (BLRS).


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_6 | Pages 19 - 19
1 May 2021
Vaidean TG Round JM Qureshi AA
Full Access

Introduction

To report our early experience and suitability over unicortical fixation system to reduce and hold the bone fragments in position during a CHAOS procedure of the femur or tibia during lower limb reconstruction surgery.

Materials and Methods

We report a case series of the first consecutive 10 patients (11 bones) for which this CHAOS technique was used between May 2017 and October 2019 by the same surgeon.

The novel aspect of the procedure was the use of a unicortical device, Galaxy UNYCO (Orthofix, Verona, Italy), which eliminate the need for any change of fixation during the procedure. It also means the intramedullary canal was left free for the intramedullary nailing.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 215 - 215
1 May 2009
Qureshi AA Roberts A
Full Access

Aim: To assess the Interobserver Reliability of the Sauvegrain Skeletal Age Assessment

Methods and Results: Elbow radiographs requested to exclude injury were anonymised. Sixteen examinations were assessed by ten independent orthopaedic specialist registrars or consultants. The Sauvegrain method as modified by Dimeglio was used to score the radiographs. The observations made were then assessed for interobserver reliability by means of a multiple observer Kappa score and the total scores by intra-class correlation coefficient.

Kappa scores for the components of the score were 0.403 for the lateral condyle; 0.492 for the trochlea; 0.354 for the proximal radius and 0.508 for the olecranon. Adding item scores to produce a modified Sauvegrain score had an intra-class reliability of 0.858 (95% CI 0.758 to 0.935).

Conclusions: Methods of identifying skeletal maturation and predicting future growth generally depend on the use of an atlas of hand radiographs. Difficulties with poor interobserver reliability associated with these methods have led to a move towards assessments that do not depend upon bone age estimations. Unfortunately plans based on ratios of growth or average patterns produce errors when unusual types of growth disturbance are present. We conclude that use of a scoring system for maturation assessed by elbow radiographs offers a significant advantage when substituted into the straight-line method of growth prediction. The Sauvegrain method as modified by Dimeglio1 has demonstrated an excellent level of interobserver reliability. We have used Sauvegrain scores to improve the accuracy of timing when using the Mosely straight-line method3.