The aim of this study is to identify the incidence of the presence of an Inverted Radial Reflex (IRR) in asymptomatic subjects with Adolescent Idiopathic Scoliosis and determine its significance. Our study group consists of Adolescent Idiopathic Scoliosis patients who presented consecutively in our institution from June to September 2010. They were either seen in outpatient clinics or as elective admissions prior to operative correction of their spinal deformity. The presence of an idiopathic scoliosis deformity and the absence of any abnormal neurological symptoms were our inclusion criteria. They were examined by two clinicians for the presence of IRR using a tendon hammer. As part of their management all such patients routinely undergo an MRI scan in our Trust to investigate for the presence of intraspinal pathology. When the IRR was present we looked at their MRI scans to identify any relevant abnormalities. Results: We identified 100 subjects. There were 72 females and 28 males with an average age of 15 years. The IRR was present in 12 cases and in 6 of them the sign was present bilaterally. There were no further associated signs or symptoms. All cases had recently undergone MRI of their whole spine and their investigations did not demonstrate any abnormalities in the lower cervical spine.Aim
Methods
This study aims to identify factors that influence the Cobb angle at presentation to a tertiary referral scoliosis centre, and the outcome of the referrals. 81 consecutive patients referred were reviewed retrospectively. Hospital database, clinic letters and radiographs were examined. Patient demographics, mode of referral (GP vs. tertiary), severity and type of scoliosis were recorded. The season of referral was defined as ‘warm’ between months of June and September, and ‘cold’ between November and March. Cobb angle measurements were made independently on digital radiographs by 2 Orthopaedic trainees.Purpose
Methods
Clinical outcomes and radiographic analysis was performed. The Vancouver Classification was used to classify periprosthetic fracture. The MDI score was calculated using radiographs, as a control (gold standard), Yeung’s CBR score was calculated [4]. See Figure 1. A receiver operating characteristic (ROC) curve was formulated for both and area under the curve (AUC) compared. Intra and inter-observer correlations were determined. Cost analysis was also worked out.
62 periprosthetic fractures occurred in the uncemented group (15.2%), 9 in the cemented group (5.9%), p<
0.001. The revision rate for sustaining a periprosthetic fracture (uncemented group) was 17.7%, p<
0.001 and 90 day mortality 19.7%, p<
0.03. MDI’s AUC was 0.985 compared to CBR’s 0.948, p<
0.001. See Figure 2. The MDI score cut-off to predict fracture was 21, sensitivity 98.3%, specificity 99.8%, PPV 90.5%, NPV 98%. ANCOVA ruled out any other confounding factors as being significant. The intra and inter-observer Pearson correlation scores were r=0.99, p<
0.001. The total extra cost due to the intra-operative fractures was £93,780.
Distal femoral LCP was used in 41 consecutive distal AO type A and type C fractures; Vancouver C periprosthetic femoral shaft fractures and Lewis and Rorabeck Type 2 periprosthetic supracondylar fractures of the femur between Oct 2005 and Feb 2008 at a District General Hospital in UK. We aim to present the functional and radiological results at a mean duration of 18.7 months after the surgery. Between Oct 2005 and Feb 2008, forty patients with a total of forty-one fractures were treated with a distal femoral LCP. There were seventeen male patients and twenty three female patients with a mean age of 73.8 years. There were 29 distal femoral fractures (AO type A = 20; type C = 9) and 12 periprosthetic fractures (Vancouver C = 4; Lewis and Rorabeck Type 2 = 8). Six of the fractures were open. Clinical and radiographic results, including union time, malalignment and implant complications were assessed. Function was assessed by using the Knee Society score. The mean duration of follow-up was 18.7 months (range, seven to thirty five months). Thirty seven fractures united during this follow up. Three fractures which showed features of delayed or non union needed additional procedures. Screw loosening necessitating screw removal was required in three patients. Deep infection was seen in one patient. Malalignment more than 10 degrees in AP or Lat views was evident in five cases. Excellent to good Knee Society score was achieved in 82 percent of cases. Fair to poor score was seen in 18 percent of cases. Distal femoral locking plates offer more fixation versatility without an apparent increase in mechanical complications or loss of reduction.
