INTRODUCTION: Epidermoid inclusion cysts (EIC) of the terminal phalanx are a rare but relevant cause of lytic lesions, particularly in the context of previous trauma to the finger. We report the first known case of late recurrence, occurring almost three decades after the incident surgery METHODS: A 56-year-old female patient presented to us with what proved to be a...
BACKGROUND: Resection of aggressive benign or malignant tumours of the proximal fibula are difficult due to the high number of surrounding anatomical compartments and close association with many important neurovascular and functional structures. For the same reasons malignant tumours behave differently in this area. Before the 1980s results were poor. With the introduction of...
The ultimate goal of management of proximal humeral fractures in the elderly patient is to get the patient independently mobile. This article will review the current literature regarding this cohort of patient. Recent Cochrane reviews and a large multicentre randomised study question the role of surgical intervention. Implant design is evolving rapidly, and many elderly patients...
AIMS: To describe the epidemiology and injury severity of patients with extremity gunshot injuries in an area with a high rate of interpersonal violence PATIENTS AND METHODS: This is a prospective cohort study of patients who presented with an extremity gunshot injury and were recorded as part of a trauma registry at a large tertiary care hospital in Cape Town, South Africa...
BACKGROUND: Literature supports early decompression of low energy cervical spine dislocations. Closed reduction can safely and rapidly achieve this; however, its use and acceptance among specialists is poorly described. This study aimed to assess the training, experience and decision-making of trainees and surgeons who manage cervical spine dislocations with the goal of...
INTRODUCTION: Patients with kyphosis and myelopathy have traditionally been managed by combined anterior and posterior surgery with associated morbidity and long theatre episodes. The posterior vertebral column resection (pVCR) technique allows circumferential apical decompression with instrumented correction and stabilisation through a single extra-pulmonary approach. The...
SOUTH AFRICAN ORTHOPAEDIC ASSOCIATIONThe South African take on the America-British-Canadian FellowshipHeld MI; Walmsley PII; Baker PIII; Ramasamy AIV; Sandiford AV; Johnson LVI; Rosenfeldt MVIIIMD, PhD FC Orth(SA); Consultant orthopaedic surgeon; Knee Unit, Groote Schuur Hospital and Orthopaedic Research Unit, University of Cape Town, South Africa IIMD, FFSTEd, FRCS(Tr&Orth...
EDITORIAL Tuning stem cells Leonard MaraisPhD, Editor-in-Chief, South African Orthopaedic Journal Orthopaedic surgeons, particularly trauma surgeons, spend a considerable amount of time trying to get bone to heal. While it is certainly a natural process, we aim to guide and manipulate the process to ensure that it is achieved as fast as possible, with the lowest chance of...
BACKGROUND: Conditions associated with catabolism of bone are common and progress sub-clinically with devastating skeletal consequences. Over the past two decades, bisphosphonates have become increasingly popular for the preventative management of the skeleton in these conditions METHODS: Recent literature pertaining to the mechanisms of action, clinical indications and...
BACKGROUND: This study sought to determine the incidence of extended post-operative length of stay (EPLoS) and its associated risk factors in South African primary hip arthroplasty patients METHODS: This was a retrospective chart review study of 185 adults who underwent primary hip arthroplasty at a quaternary South African hospital. Data related to patient, clinical, and...
BACKGROUND: The management of osteoid osteoma (OO) and other small primary benign lesions of bone has evolved over the past 50 years from open surgery with wide resection margins to less invasive surgical techniques such as image-guided intralesional excision and percutaneous radiofrequency ablation. We aim to evaluate the outcomes of patients treated with computerised tomography...
BACKGROUND: Spinal pathology in the Western Cape is managed at three tertiary level hospitals, including Tygerberg Hospital. The Tygerberg Hospital Orthopaedic Spinal Unit is responsible for the management of spinal pathology for the 3.4 million people in the hospital's catchment area. However, the unit's overall burden of disease and associated resource use is currently unclear...
BACKGROUND: The aim of the study is to determine the prevalence of HIV infection among adult patients with reactivation of haematogenous chronic osteomyelitis METHODS: A retrospective analysis of prospectively collected data from 143 adult patients with chronic osteomyelitis RESULTS: A total of 143 patients were included in the study group, with a mean age of 38 years (range 14...
BACKGROUND: Blount's disease is a developmental disorder of the proximal tibia with progressive varus, flexion and internal rotation deformity. It is often seen in overweight children and strongly associated with obesity. As the prevalence of childhood obesity is increasing worldwide, the incidence of Blount's disease has been noted to be on the increase as well. In the South...
MESSAGE FROM THE PRESIDENT Big data and medicine Leon RajahFCS(SA)Orth President: SA Orthopaedic Association 'We are on the verge of a digital revolution across every aspect of this sector, from the lab bench to the patient's bed side'.1,2It is predicted that three emerging technologies will drive the next wave of medical innovation:1. Internet of things: For example, wearable...
EDITORIAL Imperfect regulation of implants JA ShipleyMMed Orth UFS, FC Orth SA, Emeritus Professor of Orthopaedics, University of the Free State, Bloemfontein, South Africa; [email protected] Towards the end of last year, a prominent UK newspaper carried a leading article 'Revealed: faulty medical implants harm patients around the world'.1 This was followed shortly after by a...
BACKGROUND: Conditions associated with catabolism of bone are common and progress sub-clinically with devastating skeletal consequences. Over the past two decades, bisphosphonates have become increasingly popular for the preventative management of the skeleton in these conditions METHODS: Recent literature pertaining to the mechanisms of action, clinical indications and...
BACKGROUND: This study sought to determine the incidence of extended post-operative length of stay (EPLoS) and its associated risk factors in South African primary hip arthroplasty patients METHODS: This was a retrospective chart review study of 185 adults who underwent primary hip arthroplasty at a quaternary South African hospital. Data related to patient, clinical, and...
BACKGROUND: The management of osteoid osteoma (OO) and other small primary benign lesions of bone has evolved over the past 50 years from open surgery with wide resection margins to less invasive surgical techniques such as image-guided intralesional excision and percutaneous radiofrequency ablation. We aim to evaluate the outcomes of patients treated with computerised tomography...
BACKGROUND: Spinal pathology in the Western Cape is managed at three tertiary level hospitals, including Tygerberg Hospital. The Tygerberg Hospital Orthopaedic Spinal Unit is responsible for the management of spinal pathology for the 3.4 million people in the hospital's catchment area. However, the unit's overall burden of disease and associated resource use is currently unclear...
BACKGROUND: The aim of the study is to determine the prevalence of HIV infection among adult patients with reactivation of haematogenous chronic osteomyelitis METHODS: A retrospective analysis of prospectively collected data from 143 adult patients with chronic osteomyelitis RESULTS: A total of 143 patients were included in the study group, with a mean age of 38 years (range 14...
BACKGROUND: Blount's disease is a developmental disorder of the proximal tibia with progressive varus, flexion and internal rotation deformity. It is often seen in overweight children and strongly associated with obesity. As the prevalence of childhood obesity is increasing worldwide, the incidence of Blount's disease has been noted to be on the increase as well. In the South...