Single-rod technique for the treatment of scoliosis - 5 years experience

Scliosis is a complex 3-dimensional and segmental deformity of the spine. Surgical treatment is indicated mainly for a growing child with increasing curve or in an already present severe deformity. Multi- segmental 3 dimensional correction gave better correction and fixation than the older systems. But it increased significantly the cost and difficulty of the procedure. To assess the results of using multisegmental fixation with a single rod for the treatment of scoliotic deformities. Subjects: There were 120 patients treated in this study by single rod technique for scoliosis of different aetiologies. There were 120 patients [Age: 5 to 18 years] treated by the single rod technique. The angle of the preoperative curve ranged from 45° to 110° with a mean of 61.4°. The curve flexibility ranged from 21% to 78% with a mean of 47.8%. The postoperative correction ranged from 47.4% to 85.7% with a mean correction of 64.7%, which was maintained until the final follow up [10-60 months, average = 42.6] without implant failure or pseudarthrosis. The use of a single rod for multisegmentalfixation for scolio tic deformities reduced the operative time, blood loss and cost. The implant was less bulky with increased surface area available for grafting which gives better fusion mass. The correction obtained was comparable with double rod technique

Augmentation of single rod with sublaminar wiring in treating adolescent idiopathic scoliosis

To evaluate the effects of single rod augmented with sublaminar wiring in correcting scoliosis. Special attention was. 25 adolescent patients with mean age of 12.9 years. These included 9 boys and 16 girls. All cases were examined clinically and radiologically before and after surgery. Surgery in all cases included the use of single rod fixed with transpedicular screws [except one case where kooks were used in the upper part of the curve]. Sublaminar wires were used to supplement the fixation. Moreover at the sites intended for screw fixation these openings were extended a bit laterally to facilitate screw fixation. The mean thoracic curve preoperatively was: 54.7 degrees, while that of the lumber was 37.3 degrees. Flexibility of the thoracic curve had a mean of 48.1% while that of the lumbar was 46.7%. The mean number of vertebrae included was 10.7 vertebrae. The mean number of screws was 5.1 screws and a mean of 4.4 sublaminar wires was used. The mean correction of thoracic curve was 59.9% that of lumbar was 55.5%. The factors that was significantly affecting the correction were the flexibility of the thoracic curves, the number of vertebrae included in instrumentation, number of screws used. The number of sublaminar wires used were positively but insignificantly correlated to the degree of correction

outcome of fracture neck femur in children: a long-term follow up

This is a long-term follow up study of forty nine children with fracture of the neck of the femur who were treated and followed up at Hadra University Hospital. The age of these children at the time of injury ranged from 3 to 17 years [average of 10.2 years]. The follow up period averaged 9.3 years [range 5 to 19 years]. There were 23 males and 26 females. Thirty eight fractures [77.5%] were caused by major violence. There was a single transepiphyseal fracture, 25 transcervical fractures, 21 basicervical fractures and 2 intertrochanteric fractures. Five fractures were undisplaced. According to the method of treatment, the cases were grouped into 4 categories; five patients [10.2%] were treated by immobilisation in a hip spica; skeletal traction was used for treating two patients [4.1%]; internal fixation was the line of treatment in 36 fractures [73.5%]; and subtro chant eric osteotomy was the line of treatment in 6 cases [12.2%]. The overall results were good in 46.9%, fair in 24.5% and poor in 28.6% of patients. Better results were obtained in undisplaced fractures and in those displaced fractures where early anatomical reduction could be achieved and maintained throughout the treatment. Furthermore, the quality of reduction appeared to influence the occurrence of delayed complications such as avascular necrosis and non-union. Many early and delayed complications were encountered and reported. Avascular necrosis occurred in 40.8%, coxa vara in 38.8%, non union in 38.8%, premature epiphyseal closure in 40.8%, shortening in 59.1%, arthritic changes in 36.7%, coxa valga in 10.2%, coxa magna in 2% and post operative infection in 24.4% of patients