Advertisement for orthosearch.org.uk
Results 1 - 4 of 4
Results per page:
Applied filters
Include Proceedings
Dates
Year From

Year To

Abstract

Introduction

Transforming outpatient services is a key commitment set out in the NHS Long Term Plan, with particular emphasis on digital solutions to reduce outpatient follow-up (FU) by 25%. This study looks at the potential for removing knee arthroscopy FU by providing a bespoke multimedia report for each individual patient, generated using the Synergy™ Surgeon App (Arthrex)

Methodology

Single District Hospital using a 3 Phase study

Phase 1 – Assessment of cost and environmental impact of outpatient follow up appointments

Phase 2 – Bench marking of existing pathways and patient experience.

Phase 3 – Qualitative assessment of multimedia report feedback of 30 patients


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 251 - 251
1 Sep 2012
Sturdee S Duffy D Dimitriou R Giannoudis P Templeton P
Full Access

Purpose

The purpose of this study was to prospectively evaluate the rehabilitation outcome of children following operative and non-operative stabilisation of long bone fractures sustained in conjunction with an acquired brain injury (ABI).

Materials and Methods

Between 1996 and 2002, children up to 16 years of age who were admitted to the Paediatric Intensive Care Unit (PICU) with an ABI and concomitant tibial or femoral shaft fractures were considered eligible for inclusion. Children who died or were unable to walk before the accident were excluded. All data relating to the sustained injuries, the duration of PICU inpatient stay, the fracture treatment and the functional outcome were collected prospectively. The severity of the injuries was assessed using the Injury Severity Score (ISS) and the Glasgow Coma Score (GCS). The duration of time was taken from admission to reaching rehabilitation milestones; the ability to sit, stand and walk was then assessed. Total duration of hospital inpatient stay and mobility on discharge were also recorded. Operative skeletal stabilisation included external or internal fixation, as well as flexible intramedullary nailing. Statistical analysis was performed using the Mann-Whitney U Test.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_I | Pages 68 - 68
1 Jan 2004
Wall OR Duffy D Macdonald DA
Full Access

Abstract We have prospectively analysed a single-surgeon series of 35 consecutive revision THRs with AAOS bone loss grade II–III, requiring morcelised allograft (ethylene oxide sterilised) for acetabular defects. Patients have been followed up for a minimum of 5 years. Although the results are encouraging, we are observing migration patterns in some cases.

Method Twenty-one patients were eligible for final analysis (follow-up for at least 5 years, range 5 to 10 years). Follow-up has consisted of clinical assessment (Charnley activity, pain, function, satisfaction) and a radiographic assessment (AP X-ray) of the replacement hip. Our study end-points are 1) prosthesis revision and, 2) acetabular cup migration at last follow-up.

Results There were 6 deaths with less than 5 years follow-up (unrelated causes) and 2 cases have been lost to subsequent follow-up. Two cases had deep infection (revised to a girdlestones procedure at 9 months and 2 years respectively) and there were no early dislocations. One case underwent further revision at 4 years follow-up due to symptomatic (superior) cup migration and three cases are awaiting imminent out-patient assessment. Twenty-one cases have had a mean follow-up of 5.83 years. Eight cases (23%) have shown no cup migration. Five have shown only late stage migration, 4 cases have shown both initial and then late migration whilst 3 cases have shown only intermediate migration followed by stability. One case has shown progressive migration throughout follow-up. All 13 cases (37%) exhibiting migration are still asymptomatic.

Conclusion Our results show that use of morcelised acetabular allograft for revision hip surgery with deficient medial and superior acetabular wall is a useful surgical procedure. Our results over a minimum of 5 years follow-up are comparable to others in this field. However, the relatively high number of revision cases from our data which have shown, as yet, asymptomatic cup migration causes concern for future management of these patients. It is imperative that all such cases have regular (annual) indefinite follow-up. We are concerned that further cases may present with acetabular cup migration in view of our results.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 274 - 274
1 Mar 2003
Duffy D Cliffe MJ Murdoch-Eaton DD Templeton MP
Full Access

Objective: Prior to the appointment of a dedicated paediatric orthopaedic consultant at a tertiary referral centre (Feb 1999) the treatment of long bone fractures in paediatric patients with associated head injuries was predominately conservative. Current practice is now for early surgical stabilisation wherever possible. The aim of the study was to assess whether this change in clinical practice had resulted in any alteration in outcome.

Design: A prospective analysis of patients admitted to the paediatric intensive care unit between Feb 1996 and Jan 2002.

Setting: Leeds General Infirmary

Main outcome measures: Duration of ICU admission and time to independent walking was assessed.

Results: A total of 37 patients were included in the study.17 patients were treated conservatively and 19 surgically .A reduction of approximately 30% was observed in ICU stay and time to independent walking was observed in those patients that underwent early surgical stabilisation. Conclusions: Early surgical stabilisation of long bone fractures in head injured children allows quicker rehabilitation