Browsing by Subject "Orthopedic surgery"
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- ItemOpen AccessIntra-operative pneumatic tourniquet – perceptions of use and complications in the orthopaedic community of South Africa(1996) Gibson, A St Clair; Lambert, M I; Milligan, J; Merwe, W van der; Walters, J; Noakes, T DOBJECTIVES: To assess views on use, maintenance and side-effects of the pneumatic tourniquet in the South African orthopaedic community. METHODS: A census-type questionnaire study was conducted of all 475 orthopaedic surgeons registered with the Orthopaedic Association of South Africa during 1993/94. The chi-square test was used to determine statistical significance between different groups of respondents. RESULTS: Seventy-seven per cent of the questionnaires were returned. Ninety-nine per cent of respondents used a pneumatic tourniquet. Eighty-four per cent believed that the tourniquet may damage underlying tissue both as a result of applied pressure effects and ischaemic consequences. Fifty-four per cent of respondents personally checked the calibration of the pneumatic tourniquet, although 76% of respondents believe that the apparatus needs to be checked at least once per month. More respondents who did not check the tourniquet apparatus than respondents who did check it believe that applied pressure does not cause tissue damage (P < 0.001), that the operating room technician or hospital engineer should be responsible for checking equipment (P < 0.001), and that equipment did not need to be checked more than once every 6 months (P < 0.001). CONCLUSIONS: Although most orthopaedic surgeons are aware of the pneumatic tourniquet's side-effects, a minority appear to be unaware of the hazards of excessive applied pressure alone or excessive applied pressure caused by use of faulty equipment. It needs to be emphasised to these surgeons that regular checking of the pneumatic tourniquet apparatus is necessary in order to prevent postoperative complications ascribed to use of the tourniquet.
- ItemOpen AccessA systematic review of the effects of single-event multilevel surgery on gait parameters in children with spastic cerebral palsy(Public Library of Science, 2016) Lamberts, Robert P; Burger, Marlette; Toit, Jacques du; Langerak, Nelleke GBACKGROUND: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). Purpose The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. METHODS: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies. RESULTS: Except for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention. DISCUSSION: The current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can't be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.