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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_13 | Pages 4 - 4
1 Sep 2014
Dachs R Roche S Chivers D Fleming M
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Aim

To compare radiological and clinical outcomes between triceps-detaching and triceps-sparing approaches in total elbow arthroplasty, with specific focus on cementing technique and post-operative range of motion.

Methods

A retrospective review was completed of medical records and radiographs of 56 consecutively managed patients who underwent a primary total elbow arthroplasty between 2000 and 2012 at a tertiary hospital. Rheumatoid Arthritis was the predominant pathology (47/56). Data analysed included patient demographics, range of motion pre-operatively and at various stages post-operatively, approach utilized, operative time and complications. Cementing technique was graded as adequate, marginal or inadequate according to Morrey's criteria.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_29 | Pages 74 - 74
1 Aug 2013
Fleming M Dachs R du Plessis J Vrettos B Roche S
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Purpose:

To review the union rates, outcomes and complications of angular stable plating of lateral third clavicle fractures.

Method:

Between 2007 and 2010 angular stable plates were used in the fixation for seventeen patients with displaced lateral third clavicle fractures (Allman Group II, Type 2). These were identified from surgical log books and operation codes. The surgical and clinical notes as well as X-rays were reviewed. The patients were contacted telephonically. An Oxford Shoulder Score and questions relating to plate removal, scar pain and return to activities were asked. Three patients were not contactable.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_14 | Pages 25 - 25
1 Mar 2013
Fleming M Dunn R
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Purpose

To determine whether MRI done prior to reduction altered the surgeon's choice of reduction method.

Method

One hundred and four patients were included in this retrospective review. The first component of this study identified the presence of uncontained, herniated discs in this patient group. The MRI scans were reviewed by two teams including a radiology team and orthopaedic team. These scans were assessed without clinical information and the teams did not have access to the patient notes. An Interrater agreement assessment was applied to the data and the most reliable inter-observer variables of disc injury were chosen to identify the presence of a herniated uncontained intervertebral disc. The second part of this study entailed a detailed clinical note review specifically looking at type of reduction, whether it was intended and the reason why a certain type of reduction was chosen. These naturally divided the 104 patients into 5 cohorts including; closed reduction, Intended open reduction due to the documented presence of a ‘dangerous disc’, open reduction following failed closed reduction, open reduction with no documented reason and open reduction due to delay in presentation. Since closed reduction would not be considered in delayed presentations this cohort was removed from data analysis. Additionally the pre and post reduction neurological status was noted.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_14 | Pages 26 - 26
1 Mar 2013
Fleming M Westgarth-Taylor T Candy S Dunn R
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Purpose

To perform an Interrater reliability study determining the agreement between an Orthopaedic team and a Radiology team on the MRI features of prolapsed uncontained cervical discs in Flexion-Distraction injuries of the cervical spine. This leads us to determine how many patients demonstrated evidence of a ‘dangerous’ disc: an uncontained disc herniating posteriorly that may be drawn into the spinal canal during closed reduction.

Methods

One hundred and ten patients who had pre-reduction MRI scans managed during the last 10 years were included. Variables were chosen and defined by the senior Author and explained to both teams prior to reviewing the scans. The review was performed by each team independently and without any access to clinical information. Data collection and interpretation was designed by a statistician to reduce risk of data entry errors. Interrater reliability/agreement was determined using the Cohen Kappa value.