Browsing by Author "Hoffman, E B"

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    Epiphyseal fractures of the distal humerus
    (1990) De Jager, L T; Hoffman, E B
    This dissertation discusses distal humeral epiphyseal injuries in children, i.e. lateral condylar fractures, medial condylar fractures, fracture-separation of the distal humeral epiphysis and T-condylar fractures. Medial and lateral epicondylar fractures, being apophyseal, are excluded. The research was done at the Red Cross Children's Hospital Trauma Unit. It was based on two clinical retrospective studies and one case report: a: 60 lateral condylar fractures presenting from 1984 to 1987 -were reviewed. b: 12 fracture-separations of the distal humeral epiphysis presenting from 1984 to 1989 were reviewed. c: One case report of a medial condylar fracture with associated elbow dislocation The distal humeral epiphysis is the second most commonly injured epiphysis in the body, after that of the distal radius (Peterson 1972). Supracondylar fractures are the most common fractures around the elbow in children, making up 65% of the total (Canale 1987). Lateral condyle fractures have an incidence of 17.4%, compared to 3.2% for medial condylar fractures and 0.8% for T-condylar fractures (Canale 1987). At the Red Cross Children's Hospital, 60 displaced supracondylar fractures, 20 lateral condylar fractures and 2 to 3 fracture-separations of the distal humeral epiphysis are seen every year. Medial condylar fractures are rare.
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    Four decades of conjoined twins at Red Cross Children's Hospital - lessons learned
    (Health and Medical Publishing Group, 2006) Rode, H; Cywes, S; Lawrenson, J; Numanoglu, A; Fieggen, A G; Brown, R A; Davies, M R Q; Hewitson, J P; Hoffman, E B; Jee, L D; Mann, M D; Matthews, L S; Millar, A J W; Peter, J C; Thomas, J; Wainwright, H
    Conjoined twins represent a rare but fascinating congenital condition, the aetiology of which remains obscure. Over the past four decades, the paediatric surgeons at Red Cross Children's Hospital have been involved in the management of 46 pairs of conjoined twins, of which 33 have been symmetrical and 12 asymmetrical. Seventeen symmetrical twins have undergone separation with 22 children (65%) surviving; all of the live asymmetrical twins survived separation. We describe the important features of this unique cohort, outline our approach to management and present the results of this approach. We consider some of the ethical and moral dilemmas we have confronted, and discuss the prenatal diagnosis, obstetric implications and postnatal care of these children, including the relevant investigations and anaesthetic and surgical management. Specific aspects related to the cardiovascular system, hepatobiliary and gastrointestinal tracts, urogenital tract, central nervous system and musculoskeletal system are highlighted.
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    French osteotomy for cubitus varus in children: a long term study over 27 years
    (2016) North, David Martin; Hoffman, E B
    Background: Cubitus varus is a cosmetically unacceptable complication of supracondylar fractures of the elbow in children. We have performed the lateral closing wedge (French) osteotomy to correct the varus for 27 years. More complex osteotomies have been described to correct the associated hyperextension and internal rotation deformities and to prevent a prominent lateral condyle. Methods: We retrospectively reviewed 90 consecutive patients (1986-2012). The mean age of the patients at surgery was 8.2 years (3 to14 years). The varus angle (mean 21.4°, range 8°- 40°) was assessed pre-operatively with the humero-elbow-wrist (HEW) angle. The postoperative carrying angle (mean 10.4) and the pre- and postoperative range of movement were assessed clinically. The lateral condylar prominence index (LCPI) was retrospectively measured at union. Results: Seventy five (93.3%) of the patients had a good or excellent result. Six (6.7%) had a poor result (residual varus, loss of >20°of pre-operative range of flexion or extension or a complication necessitating repeat surgery). There were no neuro-vascular complications. The mean LCPI was +0.14. Conclusions: The results of the French osteotomy are comparable to the more technically demanding dome, step-cut translation and multi-planar osteotomies, with a lower complication rate. The literature reports adequate remodelling of the hyperextension deformity ( ≤ 10 years) patient. Level of evidence: Level IV: Case series
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    Neonatal osteomyelitis
    (1989) Knudsen, C J M; Hoffman, E B
    This dissertation is based largely on an original study performed by myself and Dr EB Hoffman on 34 neonates with bone and joint sepsis. Our experience of 19 septic hips is the largest in the literature. The study was performed at the Red Cross Children's Hospital in 1987 and 1988. The paper has been accepted for publication in the Journal of Bone and Joint Surgery (September 1990). The literature has been reviewed in depth and compared with our findings. In order to avoid repetition, I have not included a separate literature review in my dissertation. I have however incorporated the literature review in the introduction and especially in the discussion.