Publications by authors named "Daniel Westacott"

Flat-top talus (FTT) is a complication well-known to those treating clubfoot. Despite this, it receives little attention in textbooks, so our knowledge and understanding can be limited to anecdote and hearsay. In particular, its association with different treatments, especially the Ponseti method, is not well understood.

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Background: Paediatric traumatic elbow dislocation occurs in 6 per 100,000 children per year and if not treated promptly can result in a poor outcome. Despite this, the long-term clinical and functional outcome of these injuries has not been well described using modern patient-reported outcome tools. The aim of our study was present the outcome of these injuries in the long term.

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Purpose: To understand the variation in the management of hip dysplasia identified from the United Kingdom neonatal selective screening programme.

Methods: Having been designed and tested by the research committee of the British Society for Children's Orthopaedic Surgery (BSCOS), a nationwide online survey was conducted of BSCOS members to ascertain their treatment strategies for neonatal hip dysplasia.

Results: There were 111 responses (60% of members), which illustrated wide variation in care.

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Background: The proposed association between osteofibrous dysplasia and adamantinoma has led some to advocate resection of the entire lesion, which can require major subsequent reconstruction. However, this link remains unproven and there is some support in more recent literature for a less aggressive approach. This study aims to describe our experience managing pediatric tibial osteofibrous dysplasia with such an approach and to report functional outcomes in children treated thus.

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A total of 28 068 infants were studied to investigate whether universal ultrasound screening for developmental dysplasia of the hip results in fewer delayed presentations than selective screening, and whether the screening protocol affects subsequent treatment. The rate of delayed presentation was not lower with selective screening compared with universal screening but all cases of delayed presentation in this cohort were administrative errors. There were no sonographic errors (false-negatives).

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Background: There are limited data on injuries sustained during men's lacrosse. As the sport gains popularity, practitioners will be more likely to treat lacrosse players.

Purpose: To analyze data from the 2010 World Lacrosse Championships.

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Objective: Our study analyzes the impact of becoming a major trauma centre (MTC) on paediatric trauma workload in a centre outside a major city without specialist paediatric surgical services.

Methods: Paediatric 'trauma calls' presenting between 1 April 2010 and 31 March 2013 were retrospectively reviewed. As our centre became an MTC on 1 April 2012, our study population was split into 'pre-MTC' and 'post-MTC' groups.

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Outcomes of nonoperative treatment for developmental dysplasia of the hip were compared between two centres. Eighty children in Centre A underwent staged weaning of the Pavlik harness once three consecutive weekly ultrasounds showed Graf Grade I hips, whereas in 48 children in Centre B, the harness was removed immediately. No statistically significant difference was found in the rate of reintervention (repeat harness treatment, closed or open reduction), avascular necrosis or acetabular index between the two methods, although there was a nonsignificant trend towards higher reintervention rate and lower avascular necrosis rate with immediate harness removal.

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Purpose: The orientation of the acetabular component in metal-on-metal hip resurfacing arthroplasty affects wear rate and hence failure. This study aimed to establish if interpretation of pelvic radiographs with TraumaCad software can provide a reliable alternative to CT in measuring the acetabular inclination and version.

Methods: TraumaCad was used to measure the acetabular orientation on AP pelvis radiographs of 14 painful hip resurfacings.

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Background: Early diagnosis in neck of femur fractures has been shown to improve outcome. The National Institute for Clinical Excellence recommends if an occult hip fracture is suspected then an MRI should be performed and if not available within 24h a CT should be considered. At our centre, emergency MRI is rarely available and so CT is commonly used.

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Purpose: Unstable paediatric diaphyseal both-bone forearm fractures requiring fixation have traditionally been treated with rigid internal fixation with plate and screws. Intramedullary stabilisation has grown in popularity over the last 25 years but may be associated with rotational deformity and subsequent loss of pronosupination. This systematic review aims to establish which treatment method provides better functional outcome.

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The close interaction between community practitioners and young families provides an invaluable opportunity for prevention, education, support and even diagnosis in cases of developmental hip dysplasia. This article provides a brief overview of the condition, including clinical findings, screening protocols, 'hip safe' practices, and common treatments that may be encountered in the community.

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Unstable paediatric diaphyseal both-bone forearm fractures that fail conservative management are usually treated with fixation of both radius and ulna. This systematic review aimed to establish if single-bone fixation achieves results comparable to both-bone fixation and which bone should be fixed and by what method. A systematic review of the published literature was performed, searching Medline for English language studies that reported functional or radiographic outcome following single-bone fixation of either bone by any method.

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A systematic review of the literature was performed to establish whether direct repair of the pars defect or intervertebral fusion achieves better Oswestry Disability Index scores in adolescent spondylolysis or low-grade spondylolisthesis. Nine studies fulfilled the inclusion criteria, reporting a minimum total of 80 direct repairs and 108 fusions because of presumed replication of data between studies. Little statistically or clinically significant difference could be established between the two interventions.

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Gluteal tendon tears are one of the many pathologies causing pain around the greater trochanter that are often labelled as trochanteric bursitis. We systematically reviewed the peer-reviewed literature to establish the accuracy of magnetic resonance imaging and ultrasonography in the diagnosis of gluteal tendon tears in patients with persistent lateral hip pain or Greater Trochanteric Pain Syndrome (GTPS). 7 studies met the inclusion criteria, comparing either imaging modality with a reference standard of surgical findings.

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The results of a series of 36 elderly patients with proximal femoral fracture distal to the intertrochanteric line treated with the third generation long Gamma nail are presented. Outcome was comparable with the second generation nail in terms of 1-year mortality, length of stay, surgical complications and re-operation rate. No patients required reoperation for construct failure.

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In order to identify specific factors associated with prolonged inpatient stay following surgical correction of acute ankle fracture, we conducted a retrospective cohort study of patients who underwent acute ankle fracture repair, comparing length of hospital stay to the reason for delay of surgery (logistical versus clinical), type of fracture, and age. Our findings showed that delay in surgical repair beyond 24 hours following presentation to the emergency department was associated with a statistically significant overall longer length of stay, in comparison to patients who underwent surgery within the first 24 hours (P = .022).

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