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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 14 - 14
1 Jan 2013
Hill R
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Aims

Meningococcal septicaemia can result in growth arrest and angular deformities. The aim of this case series was to review the pattern of involvement in the lower leg.

Patients and Methods

The notes and radiographs of all patients presenting with a growth arrest or deformity affecting the lower leg following meningococcal septicaemia between 1995 and 2010 were reviewed. There were fourteen patients, eight girls and six boys. The mean age of the patients at the time of presentation was 9.6 years.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 3 - 3
1 Jan 2013
Hill R
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This study retrospectively reviews all forearm lengthenings carried out by the author in order to assess results and complications and determine the efficacy of this treatment in children with various pathologies. The records of all patients who had undergone a forearm lengthening between 1995 and 2009 were reviewed. 23 forearm lengthenings in 20 patients were identified but in one case there was insufficient information for the study. The study is therefore based on 22 lengthenings. The patients were divided into two groups, Group A in whom the purpose of treatment was to restore the length relationship between the radius and ulna and Group B in whom the purpose was to gain forearm length. In Group A patients the aim was to protect the radial head against dislocation by lengthening the ulna (with if necessary a corrective radial osteotomy) or to protect the wrist from subluxation by a radial lengthening. In Group B patients the aim was to improve function and cosmesis.

The average age of the patients at time of surgery was 9.78 years, average follow up was 26 months post frame removal. There were 11 patients in Group A with an average radio ulnar discrepancy of 2.34 cms and 11 patients in Group B. In Group A patients the average length achieved was 2.69 cms i.e. overcorrection and in Group B the average lengthening was 3.84 cms. In Group A patients lengthening was only partially successful at preventing subluxation or dislocation of the radial head. Common complications were pin site infection and poor regenerate formation. Forearm lengthening by distraction osteogenesis is a worthwhile procedure in paediatric patients with improved cosmesis and function particularly in Group B patients.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 13 - 13
1 Jan 2013
Sanghrajka A Murnaghan C Simpson H Bellemore M Hill R
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Introduction

We report 3 cases from different centres of infantile tibia vara in which the deformity was due to slippage of the proximal tibial epiphysis on the metaphysis; the aim of this study was to define the features of this previously unreported condition, and their implications for management.

Method

Three cases of tibia vara secondary to atraumatic slippage of the upper tibial epiphysis on the metaphysis were identified from three different centres. The case notes and imaging studies were retrospectively reviewed to distinguish common clinical and radiographic features.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIV | Pages 9 - 9
1 May 2012
Ghassemi A Nicolaou N Hill R
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PURPOSE

To report the experience and evolution of treatment of Congenital Pseudarthrosis of the Tibia in a single surgeon, consecutive series of 19 patients.

METHODS

A retrospective case series review, with radiological assessment and functional outcome scores including the Activity Scale for Kids (ASK) and the Oxford Ankle Foot Questionnaire (OAFQ) Child & Teenager version. Patients were classified as per Boyd & Andersen. Alteration in the Tibial mechanical axis was compared pre-treatment and at last review.