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The Bone & Joint Journal
Vol. 103-B, Issue 5 | Pages 902 - 907
1 May 2021
Marson BA Ng JWG Craxford S Chell J Lawniczak D Price KR Ollivere BJ Hunter JB

Aims

The management of completely displaced fractures of the distal radius in children remains controversial. This study evaluates the outcomes of surgical and non-surgical management of ‘off-ended’ fractures in children with at least two years of potential growth remaining.

Methods

A total of 34 boys and 22 girls aged 0 to ten years with a closed, completely displaced metaphyseal distal radial fracture presented between 1 November 2015 and 1 January 2020. After 2018, children aged ten or under were offered treatment in a straight plaster or manipulation under anaesthesia with Kirschner (K-)wire stabilization. Case notes and radiographs were reviewed to evaluate outcomes. In all, 16 underwent treatment in a straight cast and 40 had manipulation under anaesthesia, including 37 stabilized with K-wires.


Bone & Joint 360
Vol. 5, Issue 1 | Pages 2 - 8
1 Feb 2016
Bryson D Shivji F Price K Lawniczak D Chell J Hunter J


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 15 - 15
1 Mar 2006
Chell J
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The management of adolescent hallux valgus presents a considerable challenge for the orthopaedic foot surgeon. Those presenting fall into two groups, idiopathic and neuromuscular. The management of the symptomatic hallux in neuromuscular cases is more clearly defined with arthrodeses of the first metatarsal-phalangeal joint being the treatment of choice. This affords the most consistent long-term results and the greatest degree of correction.

In the idiopathic symptomatic hallux valgus the treatment is more variable depending on the severity of the deformity and the underlying pathological changes. The demographics of adolescent hallux valgus and its associated abnormalities are discussed. There is a higher incidence of an increase in the distal metatarsal articular angle in severe cases where combined surgical intervention in the form of double and triple osteotomies may be required to achieve long-term correction and a treatment algorithm is presented. Since approximately half of symptomatic patients will be under 10 years of age with significant residual growth early surgical intervention has a higher recurrence than in the mature foot.


The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 7 | Pages 1083 - 1083
1 Sep 2000
CHELL J HUNTER JB


The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 3 | Pages 462 - 462
1 Apr 2000
CHELL J DAVIS TRC


The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 2 | Pages 306 - 306
1 Mar 2000
CHELL J FLOWERS MJ


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 6 | Pages 1085 - 1085
1 Nov 1999
HARRIS NJ CHELL J BLACK PRM


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 5 | Pages 868 - 870
1 Sep 1999
Chell J Stevens A Davis TRC

We studied 58 women of employable age with the carpal tunnel syndrome in order to determine whether the histological appearances of the carpal tunnel, tenosynovium and flexor retinaculum are influenced by work practices. Age, body mass index and the duration of symptoms did not correlate with the extent of oedema or fibrosis within the tenosynovium. The incidence of abnormality on histological examination of the tenosynovium was the same in employed and unemployed patients (p = 1.0), and was not influenced by the level of repetition (p = 0.89) or force (p = 0.29) of work. Myxoid degeneration within the flexor retinaculum was, however, more common in women undertaking ‘high-force’ work. Apart from this finding, the results suggest that work practices do not affect tenosynovial thickening, fibrosis or oedema in patients with carpal tunnel syndrome.


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 4 | Pages 745 - 745
1 Jul 1999
CHELL J HARRIS N


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 4 | Pages 744 - 744
1 Jul 1999
HARRIS NJ CHELL J SMITH TWD


The Journal of Bone & Joint Surgery British Volume
Vol. 80-B, Issue 4 | Pages 631 - 635
1 Jul 1998
Clark DI Chell J Davis TRC

We have reviewed 11 patients with congenital absence of the thumb, treated by pollicisation of the index finger, after follow-up for 20 to 38 years. Seven of the hands also had an associated radial club-hand deformity.

Function as assessed by the Percival score was excellent in six, good in three, fair in two and poor in four; three of the poor results were in patients with radial club hand. Ten of the 15 transfers were used as normal thumbs, but in five hands function required trick movements. Of the seven unilateral cases, two transplants were used as the dominant hand, and in another two thumb strength was more than 50% of that on the opposite side.

For patients with isolated congenital absence of the thumb, pollicisation of the index finger gives good functional and cosmetic results which are maintained. The results are less reliable for those with radial club hand.