Innominate Osteotomy first described by Salter is one of the commonest procedures performed for treatment of Developmental Dysplasia of the Hip (DDH) in children. We recently described a less invasive technique for Innominate Osteotomy, which significantly reduces the operation time without compromising outcome (J Pediatr Orthop B. 2010 Jul;19(4):318–22). As part of the evolution of this procedure we now routinely use bioabsorbable pins (INION OTPS PIN, made from co-polymers of L-lactic acid, D-lactic acid and trimethylene carbonate) instead of K-wires to secure the graft. We prospectively followed-up 120 consecutive cases done using bioabsorbale pins over a 2 year period. The surgical technique was as described in our less invasive innominate osteotomy paper. Average age at surgery was 24 months (18–52) with mean follow-up period of 15 months (6–24 months). The mean preoperative acetabular index was 36.2o. Our results show a mean acetabular index of 18.7o (P< 0.0001) at latest follow-up with no loss of correction. We recorded three superficial wound infections (one MRSA), all resolved uneventfully. There was no foreign body reaction. The use of bioabsorbable pins eliminates the need for a second anaesthetic to remove the pins with significant cost benefit without compromising outcome.
Trauma is the leading cause of death and disability in children. Pelvic fractures although rare, with a reported incidence of one per 100,000 children per year are 2nd only to skull fractures with respect to morbidity. The objectives of this study were to improve understanding of paediatric pelvic fractures through a concise review of all aspects of these fractures and associated injuries. Understanding the patterns in which paediatric pelvic fractures and their associated injuries occur and the outcome of treatment is vital to the establishment of effective preventative, diagnostic and therapeutic interventions. All children admitted to our unit with a pelvic fracture over the 14-year period from January 1995 to December 2008 were identified. The complete medical records and radiographs of all patients were obtained and reviewed. Data recorded included, age, sex, mechanism of injury, Glasgow Coma Score, Injury Severity Score, fracture type, radiological investigation, length of in-patient stay, length of intensive care unit stay, blood transfusion requirement, associated injuries, management (both orthopaedic and non-orthopaedic), length of follow-up, and outcomeIntroduction
Patients and Methods
Athletes significantly alter their lumbar spinal motion when performing squat lifting at heavy weights. This altered motion effects a change in pressure in the posterior annulus of lumbar discs.
48 athletes performed 6 lifts at 40% maximum, 4 lifts at 60% maximum and 2 lifts at 80% maximum. Zebris 3-D motion analysis system used to measure lumbar spine motion. Exercise then repeated with weight lifting support belt. 4 cadaveric sheep spinal motion segments fixed to tension/compression loading frame, allowing compression replicating the forces seen in in vivo study. Pressure measurement achieved using a Flexiforce single element force sensor strip, positioned at posterior annulus. Posterior annulus pressure measured during axial compression and on compression with specimen fixed at 3° of extension.Hypothesis
Methods
