header advert
Results 1 - 2 of 2
Results per page:
Applied filters
General Orthopaedics

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XVII | Pages 12 - 12
1 May 2012
Brennan S Khan F Walls R O'Byrne J
Full Access

Abduction braces are commonly prescribed following the closed reduction of a dislocated prosthetic hip joint. Their use is controversial with limited evidence to support their use. We have conducted a retrospective review of dislocations in primary total hip replacements over a nine year period and report redislocation rates in patients braced, compared to those who were not. 67 patients were identified. 69% of those patients who were braced had a subsequent dislocation. Likewise 69% of those who did not receive a brace re-dislocated. 33% of patients that were braced dislocated whilst wearing the brace. Bracing was associated with patient discomfort, sleep disturbance, skin irritation and breakdown. Small femoral head size, monoblock femoral components and poor biomechanical reconstruction was prevalent amongst dislocators. Abduction bracing following closed reduction of a total hip replacement is costly(e950), does not prevent redislocation and may be the cause of considerable morbidity to the patient.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XVII | Pages 29 - 29
1 May 2012
Brennan S Walls R Murphy D Kenny P Keogh P O'Flannagan S
Full Access

Conservative management remains the gold standard for many fractures of the humeral diaphysis with union rates of over 90% often quoted. Success with closed management however is not universal.

Phase 1

A retrospective review of all conservatively managed fractures between 2001 and 2005 was undertaken to investigate a suspected high non-union rate and identify possible causes. The overall non-union rate was 39.2% (11 of 28 cases). There was no difference in axial distraction at presentation, however following application of cast there was significantly more distraction in the non-union group (1.2 v 5.09mm, p<0.01).

Changes to practise

All humeral fractures were admitted, lightweight U-slabs were applied by a technician, distraction was avoided, patients abstained from NSAIDS, consultant reviewed radiographs before discharge and patients were converted early to functional brace.