Introduction: Scoliosis Nursing service was introduced at the Cardiff Spinal Unit in 2003 as part of a multi-disciplinary team to improve quality of care for the patients and their families.

Background: This nurse is a point of contact at pre-admission and discharge. She co-ordinates the peri operative care and liases with other team-members including physiotherapists, occupational therapists and dieticians. Information regarding type of surgery, pain management, wounds/dressings, investigations is offered.

Aims and Objectives: To assess patients’ and families perception and satisfaction with the various aspects of care provided by the Scoliosis Nurse.

Methods and Materials: From 2005 to 2006, 30 consecutive patients and families who had seen the Scoliosis Nurse filled a questionnaire. 25 questionnaires were completed. Response was collated by an independent observer.

Results: All (100%) respondents felt that the presence of a nurse in clinic was beneficial. (100%) reported that they had received adequate information and literature. 66% of the patients felt a pre admission ward visit would be beneficial. 63% felt that further information about discharge and aftercare would be helpful.

Conclusion: Thus the Scoliosis Nurse was perceived to be beneficial by the patients and the family. Based on the abovefeedback the patient Information booklet has been updated.

Background data: Previous studies have questioned the quality of information available on the internet. Internet research has proven to more prevalent among scoliosis patients as compared to other orthopaedic conditions.

Aim: Scoliosis websites identified by commonly used search engines were assessed for quality and medical accuracy.

Methods: The word scoliosis was entered into top six search engines and Websites ranked according to frequency. Five websites from the worldwide web and five from the UK only search were evaluated by medical professionals – 4 spinal consultants, 2 registrars, 3 nurses and 1 physiotherapist. 10 patients/carers who had scoliosis surgery also assessed these sites. A scale of 1 to 5 was used for ease of understanding, reliability, clinical correlation, adequacy and links and average score calculated.

Results: None of the top five UK websites figured in the top 5 WWW searchs. Scoliosis research society (SRS) and American Academy of Orthopaedic Surgeons (AAOS) website scored the highest by clinicians and patients in the www list. From the UK list, SAUK website scored the highest with both groups followed by Great Ormond Street Hospital (GOSH) website. We compared the assessment of websites by a healthcare professionals and by patients who had undergone treatment and showed no statistical difference in the scoring.

Conclusion: As treating clinicians it is necessary to educate patients by guiding them to reliable internet sites like SAUK and SRS.

We retrospectively reviewed thirty-six patients who had undergone dorsal opening wedge osteotomies using cancellous bone graft and plate fixation for symptomatic healed angulated distal radius fractures.

Average improvement of the distal radius dorsal articular tilt was 28° and the ulna variance 2.7mm. The final average range of motion was flexion 46°, extension 62°, pronation 79°and supination 75°. The range of supination and pronation was not significantly different from the unaffected limb (p> 0.115).

For healed angulated distal radius fractures, dorsal opening wedge osteotomy combined with cancellous bone grafting and plate fixation, is a reliable technique allowing significant deformity correction.

We retrospectively reviewed thirty-six patients with symptomatic healed angulated distal radius fractures who had undergone dorsal opening wedge osteotomies using cancellous bone graft and plate fixation by a single surgeon. Twenty-five patients were reviewed both clinically and radiologically with an average follow-up of forty-seven months. The radiographs of a further eleven patients were reviewed.

Average age at surgery was fifty years with an interval from injury of twenty-nine months. All osteotomies united. 20% required plate removal.

Preoperatively the average distal radius articular tilt was 25° dorsal, and ulna variance +4.3mm. Following correction, average articular tilt was 3° volar, and ulna variance +2mm. These changes were highly significant (p< 0.0005). There was no significant loss of correction of the deformity between the immediate postoperative radiographs and those following union (p> 0.33).

The average range of motion was flexion 46°, extension 62°, pronation 79°and supination 75°. The range of pronation and supination was not significantly different from the unaffected limb (p> 0.115).

The average Patient Rated Wrist Evaluation Score was thirty, indicating residual pain and disability greater than that for an age matched cohort of patients with uncomplicated distal radius fractures (PRWE=15), previously reported by our laboratory. Patients reported that they were satisfied with the cosmetic appearance and had regained 73% of wrist use – these values had a significant negative correlation with the final ulna variance (p< 0.05).

For healed angulated distal radius fractures, dorsal opening wedge osteotomy combined with cancellous bone grafting and plate fixation, is a reliable technique allowing significant deformity correction.