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Classification*

Peer Review ; Review ; Publications

Current ; trends ; Coronary Arteriosclerosis

Forty children treated non operatively for fractures of the femoral shaft were reviewed with regard to differences in limb length after treatment. Follow up duration ranged from two to seven years. The average femoral overgrowth was 0.85cm (range 0 2.5cm) and was influenced by age at the time of fracture. We were not able to find any association between the quantity of overgrowth and race, gender, level or configuration of the fracture.

Objective: To review the presentation and outcome of developmental dysplasia of the hip (DDH) cases in the last 6 years. Methodology: We retrospectively reviewed the presentation as well as short and mid term outcome of 17 children (18 hips) with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness, closed or open reduction depending on age at presentation and the individual needs of each patient. Results: The average age at presentation was 31.1 months, and the male t
Orthopaedic

Introduction: Hip spica casting is an important component of treatment for developmental dysplasia of the hip (DDH) and popular treatment method for femur fractures in children. Breakage at the hip region is a relatively common problem of this cast. We have developed a three-slab technique of hip spica application using fibreglass as the cast material. The purpose of this review was to evaluate the physical durability of the spica cast and skin complications with its use. Methodology: A retrospective review of children with various conditions requiring hip spica immobilisation which was applied using our method. Study duration was from 1st of January 2014 until 31st December 2015. Our main outcomes were cast breakage and skin complications. For children with hip instability, the first cast would be changed after one month, and the second cast about two months later. Results: Twenty-one children were included, with an average age of 2.2 years. The most common indication for spica immobilisation was developmental dysplasia of the hip. One child had skin irritation after spica application. No spica breakage was noted. Conclusion: This study showed that the three-slab method of hip spica cast application using fibreglass material was durable and safe with low risk of skin complications.
Hip Fractures

Missed Monteggia fracture leading to chronic radial head dislocation is a known complication. The surgical treatment options remain challenging. The aim of treatment is to reduce the radial head and to maintain the stability of the elbow in all ranges of motion. A few surgical techniques have been described with complications. We report the case of a 13 years old boy with chronic radial head dislocation as a result of an unrecognised Monteggia fracture-dislocation for eight years. We successfully reduced the radial head and corrected the cubital valgus from 45 degrees to 10 degrees with a proximal ulna osteotomy and gradual distraction with 2-pin Monotube external fixator. The correction was uneventful with good functional outcome.

We report a case of end stage renal failure in a patient who presented with acute cord compression and extensive brown tumour involving the spine, distal femur and patella. Brown tumours of the long bone, spine and pelvis have been documented previously. However, the occurrence of brown tumour in sesamoid bones such as the patella is extremely rare and is indicative of widespread lesions and severe secondary hyperparathyroidism. These tumours typically respond poorly to medical treatment alone. The acute c
Orthopaedic

Extension distraction injury of the spine is rare. A majority of these cases occur in the cervical region and at an isolated level. Rare instances of this injury have been described in an ankylosed or fused spine. This case report describes a rare two level extension distraction thoracic spine injury in an otherwise healthy adult resulting from a motor vehicle accident.
Orthopaedic