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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_13 | Pages 11 - 11
1 Sep 2014
Rawoot A du Toit J Ikram A
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Aims

Comparison of the outcome between the supine or prone positioned child with a supracondylar humerus fracture by measuring anaesthetic and operating time, functional outcomes and complications.

Methods

All children with isolated Gartland 2 and 3 supracondylar humerus fractures were who were admitted to our institute, were asked to participate in the the study. For surgery, the participating children were either operated on in a ‘supine’ or ‘prone’ position. The children were randomly allocated to either the ‘supine’ or ‘prone’ position. The fractures were preferably treated by closed reduction and percutaneous pinning with k-wires. However, if the fracture proved difficult to reduce, we proceeded to open reduction via medial and lateral approach. All fractures were stabilized with one medial and one lateral k-wire. The children were immobilized in a reinforced above elbow back-slab. Total anaesthetic and surgical time were meticulously recorded. Patients were followed up in our outpatient clinic at one week, four weeks (at which time the k-wires were removed). Three months post operatively, elbow extension, flexion and total range of movement was assessed in all children. Results Twenty children with isolated Gartland 2 and 3 supracondylar humerus fractures were included in this study. Nine children (5 ± 1 years, 7 boys and 2 girls) were operated on in a prone position, while 11 children (6 ± 2 years, 10 boys and 1 girls) were operated on in a supine position.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_29 | Pages 44 - 44
1 Aug 2013
Rawoot A Nel L Dunn R
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Introduction:

Circumferential arthrodesis of the spine may be achieved by posterior-only or anterior and posterior surgery. Posterior-based interbody fusions have significant limitations including unreliable improvement of segmental lordosis and variable rates of post-operative radiculopathy. Combined anterior and posterior surgery introduces significant cost and peri-operative morbidity. The purpose of this paper is to report the radiographic and clinical outcomes of posterior-based circumferential arthrodesis using a novel expandable interbody cage.

Methods:

A prospective pilot clinical trial with one year follow-up of the only expandable cage approved by the FDA for interbody application. Clinical outcomes measured include ODI and VAS for back and leg. Radiographic outcomes include arthrodesis rates based upon CT scan. Statistical significance for change in health status was calculated using Student's t-test.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 316 - 317
1 Jul 2008
Corner J Rawoot A Parmar H
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Introduction: The Thrust Plate Prosthesis (TPP) is a neck preserving femoral component in total hip arthroplasty (THA), allowing direct load transfer to the medial cortex of the femoral neck. We present an evaluation of its use in young patients with hip arthritis.

Methods: A consecutive series of patients were reviewed at a minimum of 5 years after THA using the TPP. Harris Hip Score (HHS) and Oxford Hip Score (OHS) were recorded pre-operatively and at the last clinical review. Radiographic analysis was performed and patient satisfaction levels and complications were recorded.

Results: Between 1996 and 2000 we implanted 41 prostheses in 38 consecutive patients (3 bilateral). The mean age at time of surgery was 56 years (41–67) and the mean length of follow up was 71 months. The HHS improved from a mean of 42 points pre-operatively to 88 points at the last clinical review and the mean OHS also improved from 40 points to 18 points. 83% of patients expressed that they were ‘very satisfied’ with the procedure. Three cases have since required revision surgery secondary to peri-prosthetic fracture, early deep infection and aseptic loosening (1 case each). Only one other case has radiological evidence of loosening or poor cortical contact with the collar of the TPP. Two patients have experienced sub-luxation or dislocation of the prosthesis. Eight patients suffer discomfort when lying on the operated side.

Discussion: These are the first results of the TPP from the United Kingdom. Whilst many of these young patients treated with the TPP show excellent improvement in clinical outcome scores and a high level of patient satisfaction, the complication rate gives some concern. We support the selective use of the TPP to treat young patients with hip osteoarthritis.