Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_ Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Poster Topic: Trauma - Forearm Abstract number: 26212 REMANIPULATION OF PAEDIATRIC FOREARM FRACTURES Prakash JAYAKUMAR 1 , Saket TIBREWAL 2 , Nirav SHAH 1 , John WHITE 2 , Krishna VEMULAPALLI 2 1 Queens Hospital Romford, Romford (UNITED KINGDOM), 2 Queen's Hospital Romford, Kent (UNITED KINGDOM) Our aims were to identify the re-manipulation rate in the common setup of a district general hospital (DGH). We also examined the influence of the experience of the operating surgeon and the timing of procedure upon the re-manipulation rate of these fractures.We undertook a retrospective study of all clinical notes of children admitted to Oldchurch (now Queens) district general hospital with a forearm fracture treated by closed reduction over a five-year period.We were unable to show an association between the age of the child and chance of re-displacement, nor between redisplacement and sex or type of injury. In our study there was no significant difference between the experience of the surgeon at the index procedure and a remanipulation being required. We also found that there was no significant difference with regards to the time of day the index manipulation was performed and a subsequent re-manipulation being required.Our study reveals the overall remanipulation rate at a district general hospital is comparable to the national and international published results at specialized paediatric centres. Our results also show that above-elbow casts are not better at preventing re-displacement. We can conclude that in the district hospital setting the seniority of surgeon and time of day of index surgery do not have an affect on the outcome with regards to the need for remanipulation of forearm fractures in children. 534
Poster Topic: Trauma - Hand/Wrist Abstract number: 23372 SYSTEMATIC REVIEW AND METANALYSIS OF THE TREATMENT OF ACUTE SCAPHOID FRACTURE Sattar ALSHRYDA 1 , Amit SHAH 2 , SR MURALI 2 , S ODAK 2 , B ILANGO 3 1 University Hospital of North Tees and Hartlepool, Stockton-On-Tees (UNITED KINGDOM), 2 Wrightington Hospital, Wigan (UNITED KINGDOM), 3 Fairfield General Hospital, Bury, Lancs (UNITED KINGDOM) Background The scaphoid fractures account for 50% to 80% of all carpal bone fractures in young and active individuals. Non union of the fracture occurs in approximately 5% to 10% of undisplaced scaphoid fractures. Current management varies significantly among different places and surgeons.Objectives The purpose of this review is to investigate the evidence of the effectiveness and safety of various treatments of acute scaphoid fractures. Methodology: Systematic review and metanalysis of all the randomised and quasi-randomised trials comparing different treatments of acute scaphoid fractures. Results: Seventy six potential papers have been reviewed for eligibility of inclusion criteria. Thirteen RCTs ( Published 18 times) have met our inclusion criteria. The followings have been investigated:1.Colles cast versus scaphoid cast:2.Above elbow versus below elbow scaphoid cast:3.Colles cast with the wrist in flexion versus Colles cast with the wrist in extension.4.The effect of adjunct ultrasound treatment with standard scaphoid cast.5.Operative versus nonoperative treatment.Union rate ( subgroup and sensitivety analysis for displaced vs undisplaced, open vs. percutaneous techniques) Complications ROM Grip strength. Cost. 6.Union rate versus time to union:Conclusion: Scaphoid fracture can be treated by Colles cast for up to 12 weeks. The wrist should not be in flexion. There is no advantage of an above elbow cast over a below elbow cast. Operative treatment for undisplaced scaphoid does not provide a higher union rate , but may do in displaced fractures. Open approach seems to be superior to percutaneous fixation. 535
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Poster<br />
Topic: Trauma - Hand/Wrist<br />
Abstract number: 23372<br />
SYSTEMATIC REVIEW AND METANALYSIS OF THE TREATMENT OF ACUTE<br />
SCAPHOID FRACTURE<br />
Sattar ALSHRYDA 1 , Amit SHAH 2 , SR MURALI 2 , S ODAK 2 , B ILANGO 3<br />
1 University Hospital of North Tees and Hartlepool, Stockton-On-Tees (UNITED<br />
KINGDOM), 2 Wrightington Hospital, Wigan (UNITED KINGDOM), 3 Fairfield General<br />
Hospital, Bury, Lancs (UNITED KINGDOM)<br />
Background The scaphoid fractures account for 50% to 80% of all carpal bone<br />
fractures in young and active individuals. Non union of the fracture occurs in<br />
approximately 5% to 10% of undisplaced scaphoid fractures. Current management<br />
varies significantly among different places and surgeons.Objectives The purpose of<br />
this review is to investigate the evidence of the effectiveness and safety of various<br />
treatments of acute scaphoid fractures. Methodology: Systematic review and<br />
metanalysis of all the randomised and quasi-randomised trials comparing different<br />
treatments of acute scaphoid fractures. Results: Seventy six potential papers have<br />
been reviewed for eligibility of inclusion criteria. Thirteen RCTs ( Published 18 times)<br />
have met our inclusion criteria. The followings have been investigated:1.Colles cast<br />
versus scaphoid cast:2.Above elbow versus below elbow scaphoid cast:3.Colles cast<br />
with the wrist in flexion versus Colles cast with the wrist in extension.4.The effect of<br />
adjunct ultrasound treatment with standard scaphoid cast.5.Operative versus nonoperative<br />
treatment.Union rate ( subgroup and sensitivety analysis for displaced vs<br />
undisplaced, open vs. percutaneous techniques) Complications ROM Grip strength.<br />
Cost. 6.Union rate versus time to union:Conclusion: Scaphoid fracture can be treated<br />
by Colles cast for up to 12 weeks. The wrist should not be in flexion. There is no<br />
advantage of an above elbow cast over a below elbow cast. Operative treatment for<br />
undisplaced scaphoid does not provide a higher union rate , but may do in displaced<br />
fractures. Open approach seems to be superior to percutaneous fixation.<br />
535
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