ILLUSTRATION OF SOME CASES AT CSC

An Old Elbow Fracture

Many trauma cases seen by the Orthopaedic Surgeon at CSC are usually 2 to 3 months old from the time of injury.
A 28-year old lady working as a farmer sustained the closed injury to her forearm whilst working in the field 3 months prior to be seen at CSC.

The ulna was fractured at the junction of middle and proximal third with dislocation of the radial head. This left the patient unable to flex the elbow which was an essential part of her job. The management plan for the clinical condition is to fix the ulna, relocate the radial head and attempt to reconstruct the annular ligament, which wraps around the radial neck. The intra-operative picture shows the ulna plated, relocation of the radial head and reconstruction of the annular ligament, using a strip of triceps fascia (Bells Tawse procedure). The strip of fascia is stitched onto itself thus providing a sling around the radial neck.

The annular ligament is being reconstructed using triceps fascia

Lateral Xray showing relocation of radial head AP       Xray showing ulnar fracture fixation

The wire through the radial head and capitellum was left in situ for 4 weeks.
The patient at 8 weeks post op regained full motion of her elbow and is back at work providing for her family.

Equinus Ankle Contracture

22 year old with left ankle contracture causing him difficulty in walking but no abnormality of the ankle joint 

A ring fixator was applied and gradual correction of the deformity performed, thus allowing the soft tissues to stretch and regain a plantar grade foot. Its important to insert wires in the toes to stop any flexion contractures from occuring.

After 3 months of gradual correction, the final result was acceptable to the patient who could now fully weight bear and return to work. Xrays show good joint preservation.