No abstract

We describe a surgical technique for ankle arthrodesis using an anterior approach to the ankle and internal fixation with an anteriorly-placed AO T plate.A total of 33 patients who had ankle arthrodeses have been followed retrospectively. Thirty-one (94%) of the ankles fused although two patients developed tibial stress fractures. Four patients had a superficial infection which did not prevent union.The surgical technique is simple, easily reproducible and gives excellent clinical results with a high rate of union.J Bone Joint Surg [Br] 1999;81-B:113-6.

We describe a surgical technique for ankle arthrodesis using an anterior approach to the ankle and internal fixation with an anteriorly-placed AO T plate.A total of 33 patients who had ankle arthrodeses have been followed retrospectively. Thirty-one (94%) of the ankles fused although two patients developed tibial stress fractures. Four patients had a superficial infection which did not prevent union.The surgical technique is simple, easily reproducible and gives excellent clinical results with a high rate of union.J Bone Joint Surg [Br] 1999;81-B:113-6.

Background: Scoliosis has been shown to affect quality of life of young people. There can be a lengthy wait for surgery. We aim to assess whether the length of time waiting for surgery has an impact on quality of life and surgical outcomes. Methods: Patients who were waiting for or had completed surgery for paediatric spinal deformity in the last 3 years were contacted and asked to complete the Scoliosis Research Society-30 (SRS-30) questionnaire as well as a questionnaire designed to specifically assess the impact of waiting for surgery. Hospital records and X-rays were reviewed to determine surgical outcomes. Results: Longer waiting time was associated with both lower SRS scores (0.13 points per 6 months, P = 0.01) and lower wait time questionnaire values (0.12 points per 6 months, P < 0.01). Within the SRS-30 questionnaire, pain, satisfaction with management and self-image domains showed a statistically significant decrease with increasing wait time (P = 0.02, 0.05, >0.01 respectively). Cobb angles progressed with increased waiting time, but progression was not statistically significant. No correlation was found between waiting times and the other surgical outcomes measured (surgical duration, hospital stay, blood transfusion, return to theatre or other complications). Conclusion: Increased waiting time for surgery has a negative impact on quality of life of patients with scoliosis.

This case emphasizes the need to consider the presence of lumbosacral nerve root anomalies in cases in which neurologic findings exceed what would be anticipated. Preoperative identification of these anomalies allows for their existence to be considered in the surgical plan.