The importance of anatomical reduction in the functional outcome of open ankle fractures.

Introduction: Whilst closed ankle fracture injuries are common, well characterized and have treatment guidelines derived from the literature, open ankle fractures are rare and are not well studied. The few studies that exist are from the developed First World and these well resourced circumstances are not available in most parts of the world. The purpose of this prospective study was to assess the functional outcomes of open ankle fractures and the factors associated with their outcome in an adult population in rural South Africa.

Delayed implants sepsis in HIV-positive patients following open fractures treated with orthopaedic implants.

Background: There has been concern that HIV-positive patients may be more susceptible to delayed infection (>1 month) after treatment of open fractures with orthopaedic implants. To date, the longest published follow-up for such patients is 6 months.

Aim: Long-term follow-up to identify rates of delayed implant sepsis in open fractures treated with internal fixation, in HIV positive patients and controls.

Severity of upper-limb panga injuries and infection rates associated with early v. late tendon repair.

Background: Panga or machete attacks are a common cause of significant upper-limb trauma in South Africa. Pangas are a multipurpose household tool used predominantly for foraging and agricultural purposes and are highly contaminated. While some centres advocate immediate primary repair if no concern exists regarding the risk of infection, others delay definitive repair until satisfied there is no evidence of infection.

Does human immunodeficiency virus status affect early wound healing in open surgically stabilised tibial fractures?: A prospective study.

We compared early post-operative rates of wound infection in HIV-positive and -negative patients presenting with open tibial fractures managed with surgical fixation. The wounds of 84 patients (85 fractures), 28 of whom were HIV positive and 56 were HIV negative, were assessed for signs of infection using the ASEPIS wound score. There were 19 women and 65 men with a mean age of 34.

Chromosome 9 ALS and FTD locus is probably derived from a single founder.

We and others have recently reported an association between amyotrophic lateral sclerosis (ALS) and single nucleotide polymorphisms on chromosome 9p21 in several populations. Here we show that the associated haplotype is the same in all populations and that several families previously shown to have genetic linkage to this region also share this haplotype. The most parsimonious explanation of these data are that there is a single founder for this form of disease.

The effect of HIV on early wound healing in open fractures treated with internal and external fixation.

There are 33 million people worldwide currently infected with human immunodeficiency virus (HIV). This complex disease affects many of the processes involved in wound and fracture healing, and there is little evidence available to guide the management of open fractures in these patients. Fears of acute and delayed infection often inhibit the use of fixation, which may be the most effective way of achieving union.

Massive bilateral tarsal ankylosis and surgical correction: a case report.

Tarsal ankylosis is described as a feature of advanced juvenile or rheumatoid arthritis. Ankylosis involving more then one tarsal segment is uncommon. Incidental reports of massive tarsal ankylosis have been described in a case of juvenile spondyloarthropathy, a case of familial tarsal ankylosis, and, more recently, it was discovered in a prehistoric skeleton dating back to the Iron Age.

Femoral torsion in patients with Blount's disease: a previously unrecognised component.

In 1937 Blount described a series of 28 patients with 'Tibia vara'. Since then, a number of deformities in the tibia and the femur have been described in association with this condition. We analysed 14 children with Blount's disease who were entered into a cross-sectional study.

Haematogenous pyogenic bone and joint sepsis--reducing avoidable morbidity.

Background And Objectives: Delayed presentation of haematogenous bone and joint sepsis is common in our childhood population and leads to a large burden of avoidable morbidity extending into adult life. We set out to determine causative factors in these delays.

Design: A prospective study was undertaken over a 1-year period.

A prospective study of pyogenic sepsis of the hip in childhood.

Between September 2004 and December 2005 we carried out a prospective study of all cases of sepsis of the hip in childhood at a South African regional hospital with a large local population, and which also took referrals from nine rural hospitals. The clinical, radiological, ultrasound and bacteriological features were assessed. All the hips were drained by arthrotomy and the diagnosis was confirmed microbiologically and histologically.

Reduction of shoulder dislocations by the hanging method.

Over a 2-year period, 23 cases of anterior dislocation of the shoulder were managed by the hanging method, combined with a supraclavicular block. Reduction was easily accomplished in all but 2 of these cases. The technique is described.

Cytological assessment of knee effusions.

Effusion fluid from 80 knee joints was obtained from patients prior to arthroscopy and arthroscopic surgery and submitted to independent physicochemical analysis and cytological examination. The majority of the effusions were secondary to osteoarthrosis and traumatic mechanical derangement. These two conditions gave nonspecific findings on physicochemical analysis and cytology, and the cytologist diagnosed on 13% of these correctly.

Hydatid disease of bone. A case report.

A patient presented with a pathological fracture of the femur; on biopsy of the lesion the characteristic grapeskin cysts of hydatid disease poured out of the bone. The patient was treated conservatively.