Advertisement for orthosearch.org.uk
Results 1 - 8 of 8
Results per page:
Applied filters
Content I can access

Include Proceedings
Dates
Year From

Year To
Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_19 | Pages 40 - 40
1 Dec 2014
Lourens P Ngcelwane M Sithebe H
Full Access

Introduction:

Measurement of ankle brachial pressure index is an easy screening test to perform in patients presenting with an acute knee injury. According to Nicardi et al recognition of vascular injury is particularly challenging because vascular compromise may not be immediately associated with clinical signs of ischemia.

The aim of the study is to correlate the values of ABPI measurements to CT angiograms and clinical outcome in high energy knee trauma.

Materials and Methods:

We reviewed the records of patients admitted to our unit following high energy knee trauma during the period Nov 2012 to Dec 2013. The orthopaedic injuries sustained were 11 knee dislocations, 5 supracondylar femur fractures, 3 high energy tibia plateau fractures (Schatzker 5 and 6) and 4 gunshot injuries.

From the records we recorded the nature of the orthopaedic injury, the ABPI, the CT angiogram and the clinical outcome. We excluded all patients with insufficient records and previous vasculopathy. After these exclusions, 23 patients were enrolled for the study.

Analysis of the data involved calculating of basic descriptive statistics, including proportional and descriptive measures. T-tests (one-sample and independent) and chi-square tests of independence were employed to investigate the relationship between ABPI and CT angiogram and clinical outcomes. Throughout the statistical analysis cognisance is taken of the relative small sample, and relevant test adjustments made.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_19 | Pages 4 - 4
1 Dec 2014
Viljoen J Ngcelwane M Kruger T
Full Access

Introduction:

Cervical spondylotic myelopathy (CSM) is a degenerative condition that results in a non-traumatic, progressive and chronic compression of the cervical spinal cord.

Surgery is indicated for patients with moderate to severe myelopathy or progressive myelopathy. Literature shows that decompressive surgery halts progression of the condition. We undertook this study to see if there is a worthwhile improvement in function in patients who had spine decompression for cervical spondylotic myelopathy.

Material and Method:

From a retrospective review of our medical records, a total of 61 patients had decompressive surgery for cervical myelopathy during the period between January 2008 and January 2014. 11 Patients were excluded because their cervical myelopathy was due to compression from tuberculosis or a tumour. 33 patients had incomplete records. We are reporting on the 17 patients who had complete records.

From the patients' notes we recorded the detailed preoperative neurologic examination usually done for these patients in our clinic. This was compared to the neurological examination done at 6 months, 12 months and at more than 2 years follow-up. Where this examination was not adequate, patients were called in for the neurologic examination.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_19 | Pages 5 - 5
1 Dec 2014
Rangongo R Ngcelwane M Suleman F
Full Access

Introduction:

The anterior column of the spine is often destroyed by trauma or disease. It is reconstructed by using autograft, allograft, or synthetic cages. The fibula strut graft provides good strength, incorporates quickly and has less risk of disease transmission, which is a big advantage in communities with high incidence of HIV. Various authors cite that its major drawback is the size of its foot print. We could not find any literature that measures its size. We undertook a study to measure the size of the footprint of the fibular in relation to the surface area of the endplate. The clinical relevance is that it may guide the surgeon in deciding how many struts of fibular are required in reconstructing the anterior column, and also quantifies the statement that the fibular strut has a small footprint.

Material and Method:

CT angiograms are done frequently for peripheral vascular diseases. These angiograms also show CT scans of the lumbar and thoracic vertebrae, and fibulae of the same patient. We retrospectively examined the first 35 scans done during the year 2012 at Steve Biko Academic Hospital. From the CT we measured the surface area of the endplate of the vertebral bodies T6, 8, 12, L2, and the surface area of the cut surface of the proximal, middle and distal thirds of the fibular, all in square millimetres. We then compared the areas of the vertebral measurements to the area of the fibular measurements.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_13 | Pages 32 - 32
1 Sep 2014
Ngcelwane M Mandaba M Niazi J
Full Access

Aim

To evaluate efficacy of a one stage posterior approach in decompression and eradication of infection in TB spine.

Background

The classic operation for TB spine is anterior spine debridement. This involves a trans-thoracic, or retroperitoneal approach, thus increasing morbidity in an already compromised patient. The anterior procedure in the form of the Hong Kong operation is aimed at decompressing the spine, and debridement of necrotic tissue. If kyphosis is a major problem, its correction requires a posterior procedure, often not at the same sitting.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_14 | Pages 76 - 76
1 Mar 2013
Ngcelwane M Kruger T Bomela L
Full Access

Background and objectives

Positron emission tomography (PET) is a technology widely used in oncology. It is now being increasingly used in orthopaedics, especially in diagnosing bone infection. Diagnosis of bone infection is still a challenge, especially after surgery. Bone scintigraphy, Gallium-67 scintigraphy, and radiolabelled leucocyte scintigraphy are not specific. MRI has problems with definition in the presence of metal. PET uses 18-F Fluoro deoxyglucose(FDG) as a radiotracer. Inflammatory cells use glucose for energy, and the 18F-Fluoride component of FDG is a positron-emitting radionucleotide. We undertook this study to show our experience with the FDG-PET –CT in diagnosing bone infection and to highlight its superiority in diagnosing infected spine implants.

Material and Methods

Medical records of orthopaedic patients referred to the nuclear medicine department in our hospital were retrospective reviewed. We looked at the clinical records, radiographs, bone scintigraphs, MRI and FDG-PET, assessing their diagnostic accuracy, and their value in helping the surgeon plan treatment.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_14 | Pages 18 - 18
1 Mar 2013
Ngobeni R Mandizvidza V Ngcelwane M Matela I
Full Access

Objective

To investigate the relationship between the pattern of pelvic or acetabular fracture, and bladder injuries.

Methods

A total of 173 patients admitted at our Academic Hospital from January 2006 to March 2012 with cystograms done for pelvic or acetabular fractures were studied retrospectively. Records of pelvic X-Rays, CT scans and cystograms were reviewed. Tile's classification and Young & Burgess classification were used for pelvic fractures and Judet & Letournel classification system for acetabular fractures.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 290 - 290
1 Sep 2005
Ngcelwane M Bam T Sanchez L
Full Access

Introduction and Aims: Recurrent disc herniation or sciatica is one of the major complications of discectomy, often leading to a cascade of surgical procedures of increasing magnitude, but decreasing surgical outcome. We undertook a study to see if prolapsed disc fragment type can predict the possibility of recurrence of disc herniation or sciatica.

Method: We looked at the records of patients who had a discectomy operation during a 10-year period from 1992–2002. We excluded from the study patients who had a concomitant fusion operation, patients with multiple level disc operations and those who have diabetes. We went through the operation records, looking for the type of the disc fragment, i.e. whether it was contained, extruded or sequestrated disc. In the follow-up notes we recorded the patients that complained of leg pain, starting three months after the operation and continuing despite treatment. We recorded the length of follow-up.

Results: Sixty-five patients were entered for the study. There were 31 males and 34 females. The age range at surgery was 16–61 years (average 42.1 year). The follow-up ranged from 18 months to 10 years (average 30 months). We divided the patients into two groups. Group A, those patients with recurrent leg pain; and group B, those patients with no leg pain.

There were 18 patients in group A – they were all subjected to further examination with MRI scan. In five of the patients, the scan showed recurrence of disc herniation. It was an ipsilateral reherniation in four patients and contralateral in one patient. Eight of these 18 patients required repeat surgery.

In the five patients with reherniation (7.69% of whole series), the repeat surgery was a discectomy. In another three patients the surgery was a wide decompression and fusion. On further analysing the pathology found at the initial discectomy, in the group A patients, six (33%) had extruded discs and 12 (66%) had contained discs. In group B, 34 (72%) had extruded discs and 13 (27%) had contained discs. The statistical significance in this small series is debatable.

Conclusion: Patients with extruded discs do much better than those with contained discs. Recurrent disc herniation is more common in contained discs and less common in extruded discs. If we could select pre-operatively those patients with contained disc herniations, we could elect to persist with conservative treatment for longer in this group.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_I | Pages 16 - 16
1 Mar 2005
Ngcelwane M Bam T
Full Access

The aim of this study was to assess whether the pro-lapsed disc fragment type was predictive of recurrent disc herniation or sciatica after discectomy. The records of 39 patients treated by lumbar discectomy only were reviewed. Within two months of surgery, the type of disc fragment prolapse and state of the annulus were assessed on CT scans or MRI. Patients who presented later with recurrent sciatica or disc prolapse were reviewed with MRI. All other patients were contacted and asked whether they had had recurrent sciatica or had undergone repeat surgery elsewhere. The follow-up period was three years.

The results suggest that patients in whom discs required annulotomy at surgery had poorer results than those with extrusion through an annular fissure. The degree of annular competence can be used to assess the risk of recurrence of herniation or sciatica.