OBJECTIVES: To assess hip abductor function, strength and complaints following insertion of a femoral intramedullary nail. DESIGN: Retrospective clinical review. SETTING: Department of Orthopaedics, Adelaide Women's and Children's Hospital, Adelaide. Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia. PATIENTS: 1. 32 of 37 patients who had an intramedullary nail inserted for an isolated femoral shaft fracture at the Royal Adelaide Hospital between 1987 and 1990. 2. 14 of 18 patients who had closed femoral shortening for leg length discrepancy, at the Adelaide Women's and Children's Hospital between 1985 and 1987. Patients with pathology involving the abductor mechanism were excluded. 3. 40 asymptomatic controls. INTERVENTION: Intramedullary fixation for femoral shaft fractures or as part of closed femoral shortening. All procedures were performed on a traction table via a gluteal splitting approach with reamed nails. MAIN OUTCOME MEASUREMENTS: Complaints included, pain, stiffness, limp and diminished walking distance. Examination of abductor function and measurement of abductor strength. Radiological assessment at followup. RESULTS: Complaints included trochanteric pain (40%, 40%), thigh pain (10%, 8%) and limp (13%, 42%) in the femoral fracture and closed femoral shortening groups respectively. There was significant difference in the abduction strength (p < 0.01) and abduction ratio (p < 0.01) between the control and each treatment group. Abductor weakness correlated (r = 0.30) with the incidence of complaints. CONCLUSION: Pain, limp and weakness are common following insertion of a femoral intramedullary nail. Agluteal retracting approach may minimize abductor weakness.

Adult↗

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Tibiofibular torsion in normal and treated clubfoot populations.

Tibiofibular torsion was measured in normal and clubfoot populations. A gradual increase, up to skeletal maturity, was demonstrated in normal legs. Lateral tibiofibular torsion was reduced in patients at the completion of clubfoot treatment, and it was concluded that derotation braces did not influence this result.

Adolescent↗

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Statistical analysis of the incidence of physeal injuries.

The incidence of physeal injuries in nearly 2,000 bony injuries was 18%. They were commoner in adolescents and specifically more frequent in the upper limbs. The incidence of growth arrest was just over 1%, whereas the incidence of serious complication was less than 1%. The prognosis depends more on the site than the Salter-Harris classification. The proximal tibia is a common site for growth disturbance.

Adolescent↗

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Three-dimensional imaging of a juvenile Tillaux fracture.

The juvenile Tillaux fracture is an injury involving the articular surface of the ankle joint. The fracture sometimes requires open reduction and internal fixation. The decision to adopt an operative or nonoperative policy in each case can only be made with precise imaging of the anatomy which can be provided by three-dimensional reformation of computed tomography (CT) scanning.

Adolescent↗

PubMedDate not supplied

Remodeling in slipped capital femoral epiphysis: sonographic assessment after pinning.

Twenty-one children and 26 hips with recent slipped capital femoral epiphysis (SCFE) underwent serial sonographic examination after operative fixation. The initial sonographic step at the anterior outline of physis decreased as a result of metaphyseal resorption. The first signs of resorption were evident 3 weeks after onset of symptoms; thereafter, the rate of resorption was 2 mm for each 3 weeks of follow-up. Finally, the physeal step was smooth and the anterior aspect of the femoral neck was straight. Sonography is accurate and free of projectional errors in assessment and classification of remodeling in SCFE.

Bone Remodeling↗

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Long-term follow-up of anterior tibial eminence fractures.

Most children who have sustained a tibial eminence fracture have objective evidence of anterior cruciate ligament (ACL) laxity at long-term follow-up, but few have subjective complaints. Clinical signs of anterior instability were noted in 64% of patients (32 of 50) examined at an average follow-up of 4 years. Objective evidence of laxity determined with a KT-1000 arthrometer was noted in 74% of patients (37 of 50). Five patients (10%) complained of pain, but no patient complained of instability at follow-up. Assessment of long-term stability showed that the method of management (open vs. closed methods) had no bearing on eventual outcome.

Adolescent↗

PubMedDate not supplied

Innominate osteotomy. Its role in the treatment of congenital dislocation and subluxation of the hip joint.

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Australia↗

PubMedDate not supplied

Bone formation and impedance of electrical current flow.

The impedance to current flow to an electrically stimulated cathode did not change appreciably over a 12-week measurement period and did not support the hypothesis of a temporal relationship between bone formation and impedance to current flow in the region of the cathode. The use of an electrically stimulated titanium cathode at a current density of 0.33 microA/mm2 in this model of canine delayed union resulted in a significant bone formation when analyzed by quantitative and qualitative methods. Sequential quantitative radionuclide scanning correlated well with histologic appearance of bone formation and was a sensitive indicator of electrically induced osteogenesis.

Animals↗