Showing papers in "Journal of orthopaedic surgery (Hong Kong) in 2007"
TL;DR: Surgeons should treat paediatric supracondylar humeral fractures based on an assessment of the degree of displacement rather than by employing the Gartland classification, because of the reproducibility of the classification.
Abstract: Purpose. To evaluate the intra- and inter-observer reproducibility of the Gartland radiographic classification for supracondylar humeral fractures in children. Methods. Anteroposterior and lateral radiographs of 50 supracondylar humeral fractures in children were graded on 2 separate occasions by 4 orthopaedic surgeons according to the Wilkins modification of the Gartland classification. Data were analysed by calculating the Kappa values for intra- and interobserver agreement to indicate the reproducibility of the classification. Results. There was moderate inter-observer agreement, except for poor agreement over type I fractures. Type II fractures only showed fair to moderate agreement. Type III fractures and the flexion group
40 citations
TL;DR: It is concluded that one-stage combined surgery without preoperative traction is effective in the treatment of developmental dislocation of the hip in older children, by virtue of a lower complication rate.
Abstract: I read with interest the article by Tezeren et al.1 They concluded that one-stage combined surgery without preoperative traction is effective in the treatment of developmental dislocation of the hip in older children, by virtue of a lower complication rate. However, the method of traction was not described. Divarication traction has been reported to increase the risk of avascular necrosis because of the extreme abduction.2 The authors further Letters to the Editor Locking compression plate in treatment of forearm fractures: a prospective study
32 citations
TL;DR: Modern designs of posterior stabilised prostheses with right and left femoral components were superior to older designs and related to better postoperative flexion.
Abstract: Purpose.To identify factors related to knee flexion after total knee arthroplasty in a Chinese population.Methods.Records of 242 total knee arthroplasties were retrospectively reviewed. The paramet...
28 citations
Journal Article•
21 citations
TL;DR: To test the bacterial penetrability of disposable non-woven drapes used specifically for total hip arthroplasty, six brands of disposable drape were tested and some were more impenetrable than others and some remained so or allowed passage of fewer than 100 colony-forming units at 90 minutes.
Abstract: Purpose. To test the bacterial penetrability of disposable non-woven drapes used specifically for total hip arthroplasty. Methods. 12 round agar plates were inoculated with 107 colony-forming units/ml of coagulase-negative staphylococci (CNS) and incubated in air at 37oC for 18 hours to obtain a semi-confluent growth of organisms. Six brands of disposable drapes were tested; each was assigned to 2 plates. Each disposable drape was placed between a round agar plate and an inverted square agar plate filled with blood agar. After 30 and 90 minutes, the square agar plates were removed and incubated for 48 hours and inspected for growth of CNS. Results. Bacterial penetration was time dependant. Certain brands of drapes were more impenetrable than others; none was impenetrable at all time points, but most remained so or allowed passage of fewer than 100 colony-forming units at 90 minutes. Conclusion. It is recommended that drapes be rigorously tested with regard to their resistance to bacterial penetration.
20 citations
TL;DR: A Malaysian family with congenital insensitivity to pain with anHydrosis was diagnosed based on clinical symptoms of chronic ulcers, joint deformities, malunited fractures, anhydrosis, and learning disabilities and detected a compound heterozygous mutation in exon 16: V709L from the mother and G718S from the father.
Abstract: A Malaysian family with congenital insensitivity to pain with anhydrosis was diagnosed based on clinical symptoms of chronic ulcers, joint deformities, malunited fractures, anhydrosis, and learning disabilities. We detected a compound heterozygous mutation in exon 16: V709L from the mother and G718S from the father. Two novel mutations were identified: at amino acid 709, a change of G to C at nucleotide 2209 (approximately 2209G to C) causing a valine to leucine substitution (V709L), and at amino acid 718, a change of G to A at nucleotide 2236 (approximately 2236G to A) causing a glycine to serine substitution (G718S). Polymorphisms identified were at nucleotides approximately 2113G to C and approximately 2176T to C.
14 citations
TL;DR: Initial clinicoradiological results of uncemented total hip arthroplasty are promising in younger patients with good bone quality and a trumpet-shaped femur, and intra-operative stability of the implants could fairly predict outcome.
Abstract: Purpose. To analyse the 3 to 6 years’ clinicoradiological outcome of 45 uncemented total hip arthroplasties performed in 37 patients using cementless Spotorno stem and St Nabor cup. Methods. The main indications for surgery were avascular necrosis of the femoral head and rheumatoid arthritis. Younger patients with good bone quality and a trumpet-shaped femur were eligible. A single surgeon performed all the operations using a posterolateral approach. Patients were reviewed at 6 weeks, 3 months, 6 months, and yearly thereafter. The clinical status was recorded using the Harris Hip Score. All radiographs were analysed by 2 independent blinded observers on 2 separate occasions. Results. The mean follow-up period was 49 months and the mean Harris Hip Score at the latest followup was 94. Osseointegration in the form of trabeculae running from the endosteum to the prosthesis surface along with tropism of the calcar was evident in 73%
11 citations
TL;DR: Dermatitis at sites remote from the operative site may be a contributing factor in implant infection and full antiseptic measures were taken.
Abstract: We report 2 cases of implant infection with Staphylococcus aureus associated with dermatitis. In both cases, the skin at the surgical site was normal and full antiseptic measures were taken. One patient had a history of chronic asteatotic eczema complicated by cellulitis; the other had generalised exfoliative dermatitis with an atopic aetiology. Dermatitis at sites remote from the operative site may be a contributing factor in implant infection.
11 citations
TL;DR: A 28-year-old man with a valgus injury of his left knee joint after a fall from a motorcycle is reported, revealing complete avulsion of the superficial MCL from both its femoral and tibial insertions.
Abstract: The medial collateral ligament (MCL) is the most commonly injured ligament of the knee joint Proximal MCL tears occur more frequently than do distal ones We report a 28-year-old man with a valgus injury of his left knee joint after a fall from a motorcycle Magnetic resonance imaging of the affected knee joint revealed complete avulsion of the superficial MCL from both its femoral and tibial insertions The meniscofemoral portion of the deep part of the MCL was also torn and the medial meniscus was subluxated Such a pattern, an MCL tear with subluxation of the medial meniscus, is rare
9 citations
TL;DR: A 15-month-old boy presented with a 2-day history of a wry neck (bent to the left side) with no definite trauma and underwent an emergency right-sided C3 to T8 hemi-laminectomy and haematoma evacuation.
Abstract: A 15-month-old boy presented with a 2-day history of a wry neck (bent to the left side) with no definite trauma. He had bilateral upper limb weakness and was afebrile, conscious, and stable. There was no spontaneous movement in both upper limbs. Magnetic resonance imaging of the cervical and thoracic spine demonstrated an extensive spontaneous spinal epidural haematoma from C3 to T8. 23 hours after admission, the patient underwent an emergency right-sided C3 to T8 hemi-laminectomy and haematoma evacuation. The patent's strength gradually recovered and he attained full power 3 weeks after operation. Spontaneous spinal epidural haematoma is a rare disease in children. A high index of suspicion is essential for its effective management as the interval to operation is the most important prognostic factor.
4 citations
TL;DR: Although occipitocervical fixation is technically challenging and there are risks of serious neurologic or vascular complications, it remains a viable option with favourable results in patients requiring stabilisation of the craniocervicals junction.
Abstract: Purpose. To report on 14 consecutive cases of occipitocervical fixation. Methods. Records of 8 men and 6 women aged 40 to 81 (mean, 57) years who underwent occipitocervical fixation and were followed up for a minimum of 2 years were retrospectively reviewed. Neurological grading was assessed before and after surgery using the Ranawat grade. Intra-operative somatosensory evoked potentials were monitored. Results. The main indications for surgery were rheumatoid arthritis (n=6) and cervical metastasis (n=4). 77% of the patients demonstrated neurological improvement. Four out of the 5 non-ambulatory patients (Ranawat grade IIIB) regained ambulatory status postoperatively. No patient had neurological deterioration or evidence of vertebral artery or spinal cord injury. One endured a superficial wound infection and 2 had implant breakage. Conclusion. Although occipitocervical fixation is technically challenging and there are risks of serious neurologic or vascular complications, it remains a viable option with favourable results in patients requiring stabilisation of the craniocervical junction.
TL;DR: There are several definitions for bony nonunion, but the one that defines it as no clinical, radiographic, or scintigraphic evidence of healing 12 months after injury and by the need for secondary surgery is used.
Abstract: There are several definitions for bony nonunion. We use the one that defines it as no clinical, radiographic, or scintigraphic evidence of healing 12 months after injury and by the need for secondary surgery. Delayed union is defined as the completion of union Letter to the Editor Immediate interlocking nailing versus external fixation followed by delayed interlocking nailing for Gustilo type IIIB open tibial fractures