Abstract No.: 39063 COMPARISON BETWEEN HIP SPIKA AND PLATING IN TREATMENT OF FRACTURE OF SHAFT OF FEMURE IN CHILDREN Boujaylah Aqwuyidir, 11 children presented with fracture of shaft of femur treated by hip spika , Following data collected about them; Sex, age, hospital stay, postoperative period. They are followed for period range from 3 to 12 months, mean follow up is 8 months. 12 boys presented with fracture femur fixed by plate, Following data collected about them; Sex, age, hospital stay, postoperative period. Range of follow up is 4 to 12 months, its mean is 6 months. 8 boys and 3 girls , their age range (2-8) years, its mean 4.5 years.treated by application of hip spika under general anaesthesia. Hospital stay range (3-11) days its mean 4 days. Postoperative period range (1-9) days, its mean 2 days. Only one case admitted after 3 weeks for one day . 12 boys presented with femoral fracture fixed by plate. Their age range (7-14 )years , its mean 11 years. Hospital stay range 6-17 days , its mean 8 days. Postoperative period range 3-8 days, its mean 5 days, No case readmitted to hospital. Both plate and hip spika can lead to good result if case selected properly. Abstract No.: 39065 DIAGNOSIS AND TREATMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD IN CHILDREN WITH EPIPHYSES DYSPLASIA Kamola VALIEVA, Achrarbek Djuraev, Guzala Kasimova, Khayrulla Rakhmatullaev, Ruziev Norpulat, Rakhimjon Djabborov, Gulrukh Umarova Objective of research: To improve the diagnosis and effective treatment of avascular necrosis of the femoral head in children with epiphyses dysplasia. Materials and Methods: 46 patients were examined with epiphyses dysplasia from 2 to 15 years. The criteria for a diagnosis of epiphyses dysplasia is a violation of enchondral ossification of two or more pairs of epiphysis and the absence of signs suggesting other types of nosology. Criteria for the identification of avascular necrosis of the femoral head on the background of the epiphyseal dysplasia is the determination to review radiographs of typical signs of the hip joints of avascular necrosis of the femoral head (condensation, subchondral line of enlightenment, followed by fragmentation of the pineal gland) on the one hand on the background of bilateral dysplastic or structural changes in femoral head. Clinical manifestations of avascular necrosis of the femoral head on the background of the epiphyseal dysplasia were similar to symptoms of typical Perthes' disease. It was required for all the children to maintain with orthopedic regime, including a moderate limitation of motor activity of the child, limitation of weight load on the hip and knee joints with therapeutic measures directing to the improving the microcirculation and metabolism of cartilage. Results: 21 patients from 46 (45.6%) during the epiphyses dysplasia were complicated by progress of avascular necrosis of the femoral head. Conclusions: Thus, multiple epiphyses dysplasia is often complicated by avascular necrosis of the femoral head (often double-sided) and requires prompt treatment. Abstract No.: 39076 FALSE POSITIVE OR EQUIVOCAL SCAN RESULTS IN EARLY ULTRASOUND SCREENING FOR DDH Breanna Winger, Nicholas Green, Philip Henman Ultrasound screening for DDH in ‘at risk’ groups is a national programme. In our unit babies are scanned at the next available appointment, which has led to a large range of ages at time of scan. The NIPE guidelines for screening advises scanning at 6-8 weeks for at risk with the age reduced to 2 weeks in babies with any abnormal post natal hip examination findings. It is suggested that a high proportion of very young babies will need a second scan as their hips appear immature at the time of initial scanning. We identified all babies scanned for DDH over 2 years (2012-2013, n=777). Of these, 48 babies required treatment for DDH (eg harness) and 64 (8.2%) were rescanned following an equivocal first ultrasound. Of these 6 were treated. 257 babies were under the age of 4 weeks at the time of their first scan. Of these babies 48 (18.7%) were referred for a further scan compared to 22 (4.2%) of those over 4 weeks(n=520). Of the babies who were rescanned 23 of 64 (35.9%) had a normal alpha angle at the time of initial scan. Babies are perhaps scanned too early leading to false positive or equivocal scans. Delaying ultrasound screening (with the exception of babies with abnormal examination) until 4 weeks may save resources and parental concern. Babies with normal alpha angles at the time of the first scan could be discharged regardless of immaturity however, this is contentious as there are rarely missed diagnoses. Abstract No.: 39078 PRIMARY TOTAL HIP ARTHROPLASTY WITH A NEW FEMORAL SHORT STEM Jaime Morales, Carolina Lopez, Cristian Gordo INTRODUCTION: Conservative stems retain a larger amount of bone and biomechanical effect due to Their, They allow higher compression forces on the lateral column of the femur and reduce stress shielding. They retain Since metaphyseal bone, short stems allow the use of conventional stems Becomes Necessary When Revision surgery. To show the early results of the study on the conservative stem GTS-Biomet. MATERIAL: The 81 cases in 80 patients Comprised 55 men and 25 women (1 in Both hips) with a mean age of 64.85 years (range 43- 78) at time of surgery. Mean follow-up was 16 months (range 6-24 month). METHODS: The clinical results of 81 arthroplasties Performed Were Assessed by one surgeon using the Merle D'Aubigné scale; a radiologic assessment was made and the findings and Complications Were described. RESULTS: We had one calcar fracture, Which required a fixation with a screw. No cases of clinical or radiologic loosening Were Reported. CONCLUSIONS: Conservative hip arthroplasty With The GTS-Biomet stem has proven to be an excellent medium for femoral hip replacement, with expectations That It May Exceed the durability of other types of implants without harming the femoral diaphysis. This May Facilitate stem Abstract No.: 39081 3D PRINTING IN HIP REPLACEMENTUSE OF 3D PRINTED POST IN PLANNING COMPLEX ARTHROPLASTY Vaibhav Bagaria, Amit Nemade, Sameer Raghatate, Shalini Jain, Shirish Deshpande Three Dimensional printing is transforming the way we used to plan complex hip replacement in past. The technology called as additive manufacturing or layered manufacturing involves creating a physical model from the axial cuts derived from the CT scan of the patients. Having a model ensures that the surgeon can plan their surgery on a physical structure, do a thoughtful inventory planning, perform surgical simulation and also use the same as an intraoperative reference. The group of technologies were called as 3D Patient Optimised Surgical Tools (3D POST) and were used in 15 cases of difficult primary hip. The surgeons who used them were asked to fill in a questionnaire evaluating their experience with the technology and if it made a difference to the surgical procedure. The results were analysed to rate the technology. Most surgeons believe that the technology altered their surgical planning, helped reduce intraopertaive time and errors and overall did improve the patient outcome. 3D Printing technology derived patient optimised surgical tools ( 3D POST) are likely to have a major impact in surgical practice in coming days. It is likely to become a standard part of pre operative planning. Patient customised jigs and implants would be universally available and used of for the benefits of the patient. Abstract No.: 39083 MANAGEMENT OF TYPE III AND TYPE V ACROMIO-CLAVICULAR JOINT DISRUPTIONS: LESSONS WE LEARNT FROM OUR EXPERIENCE OF 17 CASES Aditya Krishna Mootha, Raghuveer Chander Alluri Introduction: Acromioclavicular joint (A-C Joint) dislocation is a common injury, which accounts for about 9% of all shoulder injuries. Spectrum of management options for type III and V injuries vary depending upon the presentation. Here we present a prospective series of 17 cases of type III or V A- C joint injuries surgically treated at our center. Material and Methods: All cases of type III or V A-C joint injuries surgically managed at our centre from 2011 June to 2014 January are prospectively included in the present series. The treatment methods included K-wire fixation, Coraco clavicular screw fixation, dynamic coraco-clavicular stabilisation with Ethibond or coraco-clavicular ligament reconstruction with semitendinosus auto graft in chronic neglected cases. Results: Out of 17 cases 8 cases are acute injuries while 9 cases are chronic injuries. 2 of the acute are operated by k wires alone. Coraco clavicular screw fixation is done in 4 acute cases and 2 chronic cases. In 1 acute case and 3 chronic cases dynamic coraco-clavicular stabilisation with Ethibond is done. In 6 chronic cases coraco-clavicular ligament reconstruction with semitendinosus auto graft is done. In 6 of the 9 chronic cases excision of lateral end of clavicle is also performed. Complications included pin tract infection in 1 case, screw back out in 2 cases. Mild subluxation of the joint persisted in 4 cases. Conclusion: Dynamic fixation of the A-C joint has far better results in comparison to rigid fixation and in neglected cases biological augmentation is strongly recommended with hamstrings auto graft. Abstract No.: 39085 BACTERIAL CULTURES OF SUSPECTED INFECTED OPEN TENDO ACHILLES LACERATION WOUNDS Abduljabbar Alhammoud, Mohammed Nader Said, Ghalib Ahmed, Mahmood Ali Arbash Introduction: Open tendon Achilles lacerations were reported to have high incidence in Qatar. In the majority of cases the cause is slippage on bathroom floors.This study aims to audit clinically infected wounds for the bacterial culture. Methods: A retrospective study of open tendon Achilles patients operated and followed up in the orthopedic department in Hamad Medical Corporation. The time period Jan 2011 to Dec 2013. Patient’s data and files were revised and investigated for clinical infection.