Orthopedic disability and socioemotional functioning.

BACKGROUND: The major aim of the study was to examine self-concept, emotional stability, and sociability of Turkish adolescents with orthopedic disability, and the links between these domains and sport participation. METHOD: Participants of the study were 95 students in grades 5-12 (mean age, 15.44 +/- 2.40 years). They were recruited from two boarding schools established for youth with orthopedic disabilities. Parents of the adolescents participated in the study by completing a form to provide information about the child, his/her condition (e.g. first appearance, severity, treatment), and the household in general. Adolescents filled in self-report scales that were developed to measure self-concept, emotional stability, and sociability. RESULTS: Hierarchical multiple regression indicated that regular engagement in sports significantly predicted self-concept of adolescents with orthopedic disability, and the predictive value of playing sport was significant even after differences in participant age, sex, and severity of the disability were taken into account. Emotional stability and sociability of adolescents with disability were predicted by sports playing but to a low degree. CONCLUSION: Study findings underline the importance of understanding social aspects of disability, and the positive association between playing sports and an individuals positive beliefs about oneself.

[Cementless total hip replacement in patients with high total dislocation: the results of femoral shortening by subtrochanteric segmental resection]. / Yüksek kalça çikikli hastalarda çimentosuz total kalça artroplastisi: Subtrokanterik segmental rezeksiyon ile femoral kisaltma sonuçlari.

OBJECTIVES: We evaluated the results of femoral shortening by subtrochanteric segmental resection in patients who underwent total hip replacement (THR) for high total dislocation of the hip. METHODS: We performed THR in 19 hips of 16 patients (15 females, 1 male; mean age 41 years; range 22 to 55 years) with high total dislocation of the hip. All the patients had severe hip pain. In all cases, femoral shortening by subtrochanteric segmental resection and an anatomical reconstruction of the acetabulum were performed with the use of cementless femoral components and cementless acetabular components with screws, respectively. The Harris hip scoring system was used for functional assessments. Radiologic assessments were based on the DeLee and Charnley criteria for the acetabular component, and on the Gruen zones and the Engh criteria for the femoral component. The mean follow-up period was 44 months (range 22 to 79 months). RESULTS: Union was achieved in all cases in a mean of 14 weeks (range 11 to 15 weeks). The mean leg length discrepancy decreased from 4 cm to 1.5 cm postoperatively. A positive Trendelenburg sign was found in 13 patients and four patients before and after surgery, respectively. The mean Harris hip score improved from 37 to 83 postoperatively. None of the patients developed deep infection, dislocation, sciatic nerve palsy, or nonunion at the osteotomy site. No clinical and radiologic signs of loosening were observed and no revisions were required. CONCLUSION: Femoral shortening with subtrochanteric segmental resection in THR is a safe technique in patients with high total dislocation of the hip, leading to satisfactory functional results.

Which one is at risk in intraoperative fluoroscopy? Assistant surgeon or orthopaedic surgeon?

BACKGROUND: Orthopaedic surgeons use intraoperative portable fluoroscopy and roentgenography. The present study was an attempt to find out if there is a difference between the occupational radiation exposure to the orthopaedic surgeon and assistant surgeon in the operating room while using intraoperative fluoroscopy or radiographic control and to measure it. METHODS: During a 3-month period, 107 consecutive operations were monitored for radiation exposure. At monthly intervals, the radiation doses were measured in millirem and recorded. The distance of the orthopaedic surgeon and the assistant surgeon from the X-ray source were noted in every fluoroscopic check. The orthopaedic surgeon was always at a safe distance (more than 90 cm), but the assistant surgeon always stood nearby (10 cm) the X-ray source for positioning of the patient. RESULTS: The radiation exposure according to the badge on the shoulder was consecutively 3, 4, 3 mrem for the orthopaedic surgeon and 20, 19, 22 mrem for the assistant surgeon. The radiation exposure according to the badges on the anaesthetic machine, in the room and under the apron of the orthopaedic surgeon were all zero, whereas the readings of the badge under the apron of the assistant surgeon were 7, 6, 5 mrem consecutively. CONCLUSION: Our findings show that although the radiation exposure during orthopaedic operations is below the recommendations of the European Committee on Radiation Protection, there is a higher risk of exposure for the assistant surgeon. It has to be kept in mind that there could be morphological and functional damage in cells exposed to radiation. Therefore, we should continue to use appropriate shielding precautions in view of the unknown long-term risks.