The aim of the study was to analyze the results of primary tendon
reinsertion in acute and chronic distal triceps tendon ruptures
(DTTRs) in the general population. A total of 28 patients were operated on for primary DTTR reinsertions,
including 21 male patients and seven female patients with a mean
age of 45 years (14 to 76). Of these patients, 23 sustained an acute
DTTR and five had a chronic injury. One patient had a non-simultaneous
bilateral DTTR. Seven patients had DTTR-associated ipsilateral fracture
or dislocation. Comorbidities were present in four patients. Surgical
treatment included transosseous and suture-anchors reinsertion in
22 and seven DTTRs, respectively. The clinical evaluation was performed
using Mayo Elbow Performance Score (MEPS), the modified American
Shoulder and Elbow Surgeons Score (m-ASES), the Quick Disabilities
of the Arm, Shoulder and Hand score (QuickDASH), and the Medical
Research Council (MRC) Scale.Aims
Patients and Methods
We report the results of performing a pronating osteotomy of the radius, coupled with other soft-tissue procedures, as part of an upper limb functional surgery programme in tetraplegic patients with supination contractures. In total 12 patients were reviewed with a mean follow-up period of 60 months (12 to 109). Pre-operatively, passive movement ranged from a mean of 19.2° pronation (−70° to 80°) to 95.8° supination (80° to 140°). A pronating osteotomy of the radius was then performed with release of the interosseous membrane. Extension of the elbow was restored postoperatively in 11 patients, with key-pinch reconstruction in nine. At the final follow-up every patient could stabilise their hand in pronation, with a mean active range of movement of 79.6° (60° to 90°) in pronation and 50.4° (0° to 90°) in supination. No complications were observed. The mean strength of extension of the elbow was 2.7 (2 to 3) MRC grading. Pronating osteotomy stabilises the hand in pronation while preserving supination, if a complete release of the interosseous membrane is also performed. This technique fits well into surgical programmes for enhancing upper limb function.
We report the results of six trauma and orthopaedic
projects to Kenya in the last three years. The aims are to deliver both
a trauma service and teaching within two hospitals; one a district
hospital near Mount Kenya in Nanyuki, the other the largest public
hospital in Kenya in Mombasa. The Kenya Orthopaedic Project team
consists of a wide range of multidisciplinary professionals that
allows the experience to be shared across those specialties. A follow-up
clinic is held three months after each mission to review the patients.
To our knowledge there are no reported outcomes in the literature
for similar projects. A total of 211 operations have been performed and 400 patients
seen during the projects. Most cases were fractures of the lower
limb; we have been able to follow up 163 patients (77%) who underwent
surgical treatment. We reflect on the results so far and discuss
potential improvements for future missions.
