3D-printed cable tie-assisted static progressive splints for fixed flexion contractures of the proximal phalangeal joint: a proof of concept study
In South Africa, hand injuries account for one-third of all traumatic injuries seen in the state hospital setting. Proximal interphalangeal joint (PIPJ) injury is one of the most common injuries to the hand, and these injuries regularly complicate with flexion contracture and stiffness. The maximal joint volume is found at a position of 30–40º of flexion; this position is passively assumed by unsplinted patients to minimise the pain of capsular stretch from the increased pressure of inflammatory infiltrate influx. At this degree of flexion, the volar plate check rein ligament complex is slack, and so when fibrosis and scarring ensues in this shortened position, it results in limitation of extension.
Let’s talk business: a public-private partnership in soft tissue knee surgery
There is a worldwide challenge of high patient volumes and limited resources, independent of gross domestic product (GDP), which is even greater in developing countries. A possible solution to increase capacity in South Africa is considered in a National Health Insurance (NHI), which is a large-scale model combining public and private health resources to improve equity to healthcare. For orthopaedic care, such public-private partnerships (PPPs) in the form of outreach programmes is one of the main goals of the South African Orthopaedic Association for upcoming years. To date, various studies have focused on the feasibility of such partnerships, as public and private sectors are driven by different goals and principles with mixed outcomes.
The use of a mobile software application to improve the management of open tibia fractures in a resource-constrained environment
Open fractures represent an orthopaedic emergency due to the risk of infection secondary to contamination, devitalised bone segments and compromised soft tissues. The goals of open fracture management are fracture union, prevention of infection and restoration of function. These goals are best achieved by prompt and appropriate early treatment and timely referral to a centre equipped with the necessary infrastructure and expertise required for definitive management.
Unexpected high prevalence of Gram-negative pathogens in fracture-related infection: is it time to consider extended Gram-negative cover antibiotic prophylaxis
Fracture-related infection (FRI) is a dreaded complication following orthopaedic trauma. Extensive pre-, intra- and postoperative care is taken to minimise the risk of infection. One of these strategies is the use of prophylactic systemic antibiotics, primarily aimed at Gram-positive organisms.
The role of bioceramics in the management of osteomyelitic voids
Fracture-related infection and chronic osteomyelitis are common problems following musculoskeletal trauma, orthopaedic surgery, and the sequelae of acute haematogenous osteomyelitis. Following surgical debridement, bone and soft tissue defects or dead space need to be managed to prevent recurrence of infection. Multiple dead space management strategies are available; however, choosing the appropriate strategy is controversial.
A case of tenofovir-induced extreme osteopaenia
Complications and morbidity in patients infected with HIV may arise from the disease itself or as side effects of the antiretroviral (ARV) agents used to treat it. Many first-line treatment regimens for HIV and post-exposure prophylaxis include tenofovir disoproxil fumarate (TDF) as the primary nucleoside reverse transcriptase inhibitor (NRTI).