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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_11 | Pages 9 - 9
1 Feb 2013
Simpson-White R Bryant R Davies A
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Aim

The purpose of this study was to quantify the number of children treated with ESIN (elastic stable intra-medullary nails) at our institution and to determine what proportion of these nails have been removed and the time and difficulty taken to do so.

Methods

Patients treated with ESIN between 2000 and 2005 were identified by database search. Their notes were reviewed to record patient and initial nailing details, and timing, difficulty and length of metalwork removal procedures. Complications leading to premature removal or following nail extraction were noted.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_6 | Pages 16 - 16
1 Feb 2013
Moulder E Davies A
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A study to assess the clinical importance of asymmetric thigh creases as the sole clinical sign in the diagnosis of developmental dysplasia of the hip.

METHOD

All consultant clinic letters have been saved on a hospital hard drive since 1999. This drive was searched for the terms “thigh crease” and “skin crease”. Irrelevant letters and referral letters describing factors that would indicate screening in our unit were excluded leaving those with the sole referral complaint of asymmetric thigh creases (ATC).

We also reviewed the original referrals of developmental dysplasia of the hip (DDH) patients managed by open or closed reduction. These patients were identified through operative coding. All available hard copy notes were reviewed and patients with neuromuscular conditions or longitudinal deficiency were excluded.

Results were inputted into an Excel spreadsheet and analysed by a statistician at the University of Sheffield assuming a background population incidence for DDH of 1 in 1000.

RESULTS

399 computer files containing the search terms were identified. Many contained whole clinics of patient letters. After exclusions we identified 229 patients with the sole referral complaint of ATC.

Three of the 229 patients had DDH, which was not statistically significant (p=0.107). The majority of the normal patients had radiological investigations.

Hard copy notes were available and relevant for 130 of the 289 operatively managed patients, of whom one was initially referred with the sole complaint of ATC.

Orthopaedic specialist examination demonstrated all four patients initially referred with only ATC had decreased abduction and shortening.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_6 | Pages 12 - 12
1 Feb 2013
Larnert P Madan S Giles S Davies A Jones S Fernandes J
Full Access

Aim

To evaluate the influence of arthrodiatasis in the natural history of the stages of the disease radiologically and also the timing of arthrodiatasis.

Materials and methods

44 patients with Perthes' disease that had articulated hip distraction were radiologically evaluated. We assessed these based on Joseph's modified Elizabethtown classification before, during and soon after distraction. Other parameters used were the application of common radiological grading systems and other features.