Advertisement for orthosearch.org.uk
Results 1 - 3 of 3
Results per page:
Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_29 | Pages 17 - 17
1 Aug 2013
Peters F Frey C Greeff R
Full Access

Acetabular cup placement in total hip replacement surgery is often difficult to assess, especially in the lateral position and using the posterior approach. On table control X-Rays are not always accessible, especially in the government sector. Conventional techniques and computer assisted surgery (CAS), are currently the two most popular methods for proper placement of the acetabular cup in Lewinnek's safe zone of orientation (anteversion 15°–10° and lateral inclination 40°±10°). We developed a simple way to get accurate cup placement using Smartphone technology.

Methods:

A spirit level application was downloaded to the Smartphone. The acetabulum inclination was measured on the pre-operative X-Rays. The phone is placed in a sterile bag and then used intra-operatively, to measure and set our acetabular cup orientation to our pre-operative measurements. The inclination level was measured before and after final placement of the acetabular cup. This was compared to the acetabular cup inclination in our post-operative X-Rays.

Results:

In our series of 50 cup placements we found high accuracy. The results show less than 5° deviation between our pre-, intra- and post-operative measurements.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 466 - 466
1 Aug 2008
Ferrao P Mohideen M Frey C
Full Access

Liquiband is a new tissue adhesive: It works like super glue – it is attached to the wound edges, it sets within seconds and lasts for about two weeks. The glue then flakes off automatically as the skin regenerates. There is no need for suture removal. A second step forms a waterproof layer over the wound. We compared in a prospective randomized trial the Liquiband glue to skin staples.

Over a 9 month period (May 2005 to January 2006) we enrolled a total of 80 patients, 40 in each group. The patients were booked for elective limb surgery and agreed to participate in the study. The surgical wounds were closed in layers. The skin was then either closed with Liquiband or skin staples. A follow up was a weeks 2, 6 and 18. The wound healing was photographically documented. The wounds were assessed according to the Hollander wound scoring system and a patient satisfaction score. Ethical approval was obtained.

The two groups were matched for sex, age, body-mass index and smoking. There was a similar total wound length in both groups. All wounds healed. In the Liquiband group 4 superficial infections occurred, one dehiscence due to glue removal by the patient. In the skin staples group we had 6 superficial infections. The patient satisfaction score was lower in the skin staple group (7.0 compared to 8.3 in the Liquiband group) and on the Hollander wound scoring system there were 10% more step-off borders and 12% more edge inversions in the skin staple group. The glue did not stain the skin or leave visible marks.

The authors conclude that the Liquiband skin glue is safe and effective for elective surgery. The Liquiband skin glue does not require staple removal after wound healing and the waterproof closure of the wound provides additional safety.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 276 - 276
1 Sep 2005
Frey C Preddy J Sinevici V
Full Access

In a prospective study from October 2002 to December 2003, we evaluated 102 femoral fractures treated with the new Synthes antegrade femoral nail. It is a titanium femoral nail with a recon locking option, distal dynamisation slot and trochanteric entry point.

There were 99 patients (76 males and 23 females), three of whom had bilateral fractures and 42 polytrauma. The mean age was 36 years (13 to 87). The mean Injury Severity Score was 42 (23 to 65). Motor vehicle accidents were the cause of 44 fractures and gunshot injuries the cause of 37. There were 25 transverse fractures (AO 32-A), 37 wedge type fractures (AO 32-B) and 40 complex (AO 32-B) fractures. There were 38 Gustilo type-II and type-III open fractures. Surgery was performed within 24 hours in 80% of the fractures. Nine required open reduction. Unreamed nails were inserted in 38 patients.

All fractures united. However, 11 showed angulations greater than 5°. Two patients had shortening of more than 1 cm, one of them requiring reoperation. One patient sustained a iatrogenic fracture, four developed fat embolism syndrome and three had DVT. Three patients had early superficial wound infection and two had late infections with a draining sinus. One locking screw broke.

We found this to be a reliable femoral nail with a safe entry point.