Industry-driven research: Have we reached a crisis point?

We know that all academic and private units are cash strapped. Money for research is dwindling and it is diffi- cult to obtain new funds. Big industry is reluctant to donate money for research for various reasons, and new rules from the Department of Justice make it difficult to donate money direct- ly to a […]

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Spinal schistosomiasis in the era of tuberculosis

Spinal schistosomiasis although rare is a well-described entity. We report an unusual manifestation of ectopic spinal schistosomiasis involving T6/T7 with spinal cord compression in a patient on treatment for a suspected TB of the spine. The patient had T6/T7 vertebral destruction with complete paraplegia. This patient was treated at a rural hospital for spinal tuberculosis […]

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Bilateral pneumothoraces and thyroid storm in undiagnosed Graves’ disease following posterior fusion scoliosis surgery: A case report

The coexistence of idiopathic scoliosis and Graves’ disease is not an established phenomenon. Bilateral pneumothoraces as a complication of posterior pedicle screw correction of scoliosis is an uncommon finding. Thyroid storm as initial presentation in Graves’ disease is also uncommon. Surgery and stress are known precipitants of thyroid storm in untreated Graves’ disease. We report […]

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Hippocrates revisited: Opening address at the European Hip Society Meeting, Athens, 2010

Hippocrates – born on the island of Kos in 460BC – was an ancient Greek physician of the age of Pericles. He is credited with establishing medicine as a profession distinct from the other fields it had traditionally been associated with, notably theurgy and philosophy. He is considered the father of clinical medicine. Download

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Prevalence of agenesis of flexor digitorum superficialis of the fifth digit in East Africa through clinical examination

Introduction The flexor digitorum superficialis (FDS) is a flexor of the digits of the hand and has been reported to have vary- ing rates of agenesis. We conducted a study to determine the prevalence of agenesis of the FDS in an East African population by clinical examination. Materials and methods A prospective study was conducted […]

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EXPERT OPINION ON PUBLISHED ARTICLES

Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial There is a large volume of literature published on the man- agement of stable thoracolumbar burst fractures; however the ideal management of these common injuries remains debated. A variety of treatment options […]

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Canterbury index: An accurate predictor of fracture re-displacement?

Purpose Paediatric forearm fractures are commonly seen and treated by closed reduction and plaster cast application in theatre. Historically cast application has been subjectively evaluated for its adequacy in maintaining fracture reduction. More recently emphasis has been placed on objectively evaluating the adequacy of cast application using indicators such as the Canterbury index (CI). The […]

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Spondylolytic spondylolisthesis: Surgical management of adult presentation

Retrospective review of 27 patients presenting as adults with spondylolytic spondylolisthesis. The average age at surgery was 42.9 years. Most patients (21/27) had long standing tolerable axial back pain with symptoms present for up to 156 months. It was however the radicular pain that brought them to surgery. Posterior transforaminal lumbar interbody fusion (TLIF) was […]

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Periprosthetic fractures of the femur associated with hip arthroplasty

Periprosthetic fractures following total hip or knee arthroplasty have become more common as the indications and age distribution for these procedures have increased in the last few years. Revision surgery in these patients holds a very high complication rate and therefore measures should be taken to prevent these fractures. Osteolysis with subsequent component loosening has […]

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Low grade chondrosarcoma: Is long-term follow-up necessary?

Introduction: Currently, the follow-up regimen for patients treated for low-grade chondrosarcoma is similar to that of all chondrosarcomas. It is possible that low-grade chondrosarcoma may have a far more benign course than other chondrosarcomas and, if treated adequately, may require a far less vigorous follow-up regimen. Patients and methods: A retrospective study was performed on […]

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Anterior-only transthoracic surgery for adult spinal tuberculosis

Historically, anterior decompression followed by posterior fusion has been the surgical management of choice in spinal tuberculosis. Due to theatre time being at a premium, we have evolved to anterior only debridement, allo- graft strut reconstruction and instrumentation for tuberculosis in the adult thoracic spine. The aim of this study was to review the safety […]

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Obesity and total joint replacement

Orthopaedic practice in our country faces many chal- lenges. The latest challenge is that some medical aid funders do not want to cover their overweight members for total joint replacement (hip and knee). The reason given is that the complication rate in these individuals is too high. Download

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Lumbar disc herniation in a 9-year-old child

Lumbar disc herniation is very uncommon in children under the age of 10 years. We report on a lumbar disc her- niation in a 9 year old. The patient presented with spontaneous onset of back pain and right leg pain which had failed to respond to 6 months of conservative treatment at a primary health […]

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The orthopaedic management of myelomeningocoele

EB Hoffman Associate Professor, Department of Orthopaedic Surgery, University of Cape Town GT du Toit Founders Lecture, SAOA Congress, September 2010 Reprint requests: Prof EB Hoffman 7 Marne Avenue 7700 Newlands Cape Town Myelomeningocoele is the commonest congenital birth defect.1 The Cape Town prevalence has been reported as 2.5 per 1 000 births in the […]

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Musculoskeletal trauma – are we winning?

The management of musculoskeletal trauma in South Africa is indeed a losing battle with over 70 000 South Africans dying every year, and a further 3.5 million seeking health care, as a result of trauma. Approximately 9 000 people are killed on South Africa’s roads every year, and more than 33 000 seriously injured. Our […]

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Overtreatment of cruciate ligament injuries

Once an unvalidated surgical procedure has become common,  (narrowly defined) activity level or type had been included. widely known in the general population, and popular among ‘celebrities’, it is regarded as too late to evaluate its efficacy. Patients will be unwilling to risk control treatment, and doctors will be unwilling to recruit. To challenge […]

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Orthopaedic litigation in South Africa: A review of the Medical Protection Society data base involving orthopaedic members over the last 10 years

Background Medical litigation, especially against orthopaedic surgeons, is a worldwide phenomenon with a marked upward trend in the developed nations. There has been a 20% increase over the last five years in South Africa alone. The purpose of the study was to review the cases involving Medical Protection Society (MPS). members in RSA, identify trends […]

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Anatomical classification and surgical considerations: Primary spinal tumours An overview

Abstract Primary spinal tumours make up 11% of primary musculoskeletal tumours, and 4.2% of spinal tumours.1 Six per cent of these spinal tumours are to be considered malignant.2 The intrinsic rarity of these tumours therefore make it very difficult for a single spinal surgeon to amass a large enough number of surgical cases to string […]

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Management of post-operative hypotony

Dr Bayanda N Mbambisa Registrar, Division: Ophthalmology, Department of Neurosciences, University of the Witwatersrand Introduction Patients with uveitic glaucoma are at an increased risk of post-operative hypotony following filtration surgery. The risk of this complication can be reduced by adequate control of inflammation pre-operatively, careful surgical technique and appropriate post-operative management of hypotony. Case study […]

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ophthalmology

President’s Report

It is the start of a challenging two years for me as I have been preceded by extremely competent presidents in Dr Harold König and Dr Chris Gouws, who did duty during the period that I have been on OSSA EXCO. Luckily, I have learnt a lot from them and the other members, especially Dr […]

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