The aim of this study was to evaluate the epidemiology and treatment of Perthes’ disease of the hip. This was an anonymized comprehensive cohort study of Perthes’ disease, with a nested consented cohort. A total of 143 of 144 hospitals treating children’s hip disease in the UK participated over an 18-month period. Cases were cross-checked using a secondary independent reporting network of trainee surgeons to minimize those missing. Clinician-reported outcomes were collected until two years. Patient-reported outcome measures (PROMs) were collected for a subset of participants.Aims
Methods
The aim of this study was to inform the epidemiology and treatment of slipped capital femoral epiphysis (SCFE). This was an anonymized comprehensive cohort study, with a nested consented cohort, following the the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) framework. A total of 143 of 144 hospitals treating SCFE in Great Britain participated over an 18-month period. Patients were cross-checked against national administrative data and potential missing patients were identified. Clinician-reported outcomes were collected until two years. Patient-reported outcome measures (PROMs) were collected for a subset of participants.Aims
Methods
We would like to present this case series of 10 adolescent patients with displaced, closed diaphyseal tibial fractures managed using the Taylor Spatial Frame. Management options for these injuries include non-operative treatment, antegrade nailing, flexible nailing systems, plating and external circular fixation. External circular fixation allows anatomical reduction avoiding potential complications such as growth arrest associated with antegrade nailing and retained metal work with plating. Flexible nailing system and cast immobilisation are unreliable for precise anatomical reduction. With limited evidence as to the extent of post-traumatic deformity that is acceptable, combined with the limited remodeling potential that this patient group possess, the precision of percutaneous fixation with the Taylor Spatial Frame system has clear advantages. This is a retrospective analysis of 10 adolescent patients with a mean age of 14.5 years (range 13 to 16 years). Data collected includes fracture configuration, deformity both pre and post operatively compared to post frame removal, length of time in frame and complications. The data was gathered using the patient case notes and the Picture Archiving and Communications System. The mean time in frame was 15.5 weeks (range 11 to 22 weeks). One non-union in a cigarette smoker was successfully managed with a second Taylor Spatial Frame episode. Our conclusion was that with careful patient selection the Taylor Spatial Frame allows successful treatment of closed tibial fractures in adolescents, avoiding complications such as growth arrest and post-traumatic deformity as well as avoiding retained metalwork.
