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Posters, Which Were Displayed on All Orthopaedic Wards and Emailed Individually to All Orthopaedic Trainees and Consultants Abstract no.: 36413 PATHOLOGICAL INFLUENCES OF CONNECTIVE TISSUES DYSPLASTIC DISORDERS ON SURGICAL TREATMENT RESULTS OF PECTUS EXCAVATUM IN CHILDREN Iskandar KHODJANOV, Sherali KHAKIMOV, Khatam KASYMOV Scientific Research Institute Traumatology and Orthopedics, Tashkent city (UZBEKISTAN) Recently, several complications associating with the instability of the installed bar, PC deformity occurrence and the PE relapse have been occurred in more than 20% after surgery. Purpose was the determination of the role of the connective tissues dysplastic disorders for remodeling processes of the anterior chest wall in children with PE in post- operative periods. Investigation performed on 40 children, who underwent operative treatment by the D. Nuss procedure in Clinic of SRITO RUz, with PE. Genetic assessment was carried out by the T. Milkovska-Dmitrova and A. Karakeshev classification (1985). Good results were obtained in 35 cases in the nearest postoperative periods, 5 cases were with the severe pain and in long-term periods was occurred the PC deformity in 2 cases, secondary atypical deformation in 1, the relapse of PE till I degree in 1 and in 1 case was saved the neuralgic pain. The connective tissues dysplasia is a congenital character genesis, characterized by metabolic disorders in the stroma tissues and several enzymopathy. The osseo-cartilaginous structural system growth processes were not behavioral in the necessary age norm of locomotors apparatus and with the delaying of ossification processes also in the adolescent's age and the sterno-costal complex became most pliable. These changes complicated the correction method of PE, extended the period of immobilization. It is hard to determine the outcome operative results of the patients with severe degrees of conjunctive tissues dysplasia. Abstract no.: 36416 EPIPHYSEAL OSTEOMYELITIS: A REPORT OF THREE CASES AND REVIEW OF LITERATURE. Nanjundappa S. HARSHAVARDHANA1, Vaibhav BAGARIA2, Amit NEMADE3 1ORIGYN, Gourock (UNITED KINGDOM), 2CARE hospital & ORIGYN Clinic, Nagpur (INDIA), 3LMC & ORIGYN CLINIC, NAGPUR (INDIA) Haematogenous osteomyelitis has classically been associated with the metaphysis or the diaphysis involvement. Involvement of the epiphysis is rare entity which poses a diagnostic and management dilemma. The differential diagnosis include chondroblastoma, chondromyxoid fibroma, enchondroma, osteoid osteoma, eosinophillic granuloma, foreign body granuloma. Treatment in the literature remains controversial. Here we present three cases:. Cases 1 presented as chronic pain in the knee with a radiologic picture of radiolucency in the distal femoral epiphysis. The diagnosis was confirmed in MRI and she underwent a curettage of the lesion. Case 2 1yr infant presented with a septic knee, at that point of time the x ray did not show any bony abnormality. He underwent an arthrotomy and after 6 weeks of parental therapy he developed an osteolytic lesion, but the knee was asymptomatic hence we continued conservative management. The patient was doing well till the last follow up. Case 3: 3 yr toddler presented with history of tying a holy thread around the wrist 6 months back. Few days later due to swelling the thread got buried in the subcutaneous tissues cutting through the skin which was partially removed. X ray pictures showed a lucent area adjacent to the distal radial physis. He was managed conservatively but the sinuses persisted hence a curettage was planned. The sinus tracts were curetted and the remaining thread was removed. Patient is doing well till the last follow up. The last case classically demonstrates the foreign body granulaoma presenting as epiphyseal osteomyelitis. Abstract no.: 36417 THE INCIDENCE OF SYNDESMOTIC INJURY Turner VOSSELLER, John KARL, Justin GREISBERG Columbia University Medical Center, New York, NY (UNITED STATES) Introduction: Injury to the tibio-fibular syndesmosis can occur with ankle sprain or fracture. The incidence of syndesmotic injury has not been specifically sought at a population level. Methods: Data on syndesmotic injury was obtained from the Healthcare Cost and Utilization Project (HCUP), a federal-state-private partnership. It is administered by the Agency for Health care Research and Quality (AHRQ), a division of the Unites States Department of Health and Human Services (HHS). Two HCUP databases were queried for eight states: the State Inpatient Database (SID) and the State Emergency Department Database (SEDD). The first six ICD-9 code diagnoses were searched for codes that are used for syndesmotic injury (i.e. 845.03). These data, along with data from the 2010 US Census, were used to yield incidence rates for syndesmosis injury, as well as for various demographic groups. National estimates of injury totals were also calculated. Results: In the eight states there were a total of 1,821 syndesmotic injuries. Given the population of these states, the incidence rate of syndesmotic injury was 2.09 syndesmotic injuries per 100,000 person years. This incidence correlates to an estimated 6,445 syndesmotic injuries per year in the US. Conclusions: This data provides some baseline numbers as to the incidence of syndesmotic injury in the US. Although the incidence was low relative to some other injuries, the fact that syndesmotic injuries tend to occur in younger patients may have greater impact in terms of productive years of life lost. Abstract no.: 36420 CLINICAL CHARACTERISTICS OF ATYPICAL FEMORAL FRACTURES IN PATIENTS WITH OSTEOPOROSIS TREATMENT Joon-Soon KANG1, Kee Haeng LEE2, Jong Oh KIM3, Kyeong Ho MOON1 1Inha university hospital, Incheon (SOUTH KOREA), 2Catholic University of Korea, College of Medicine, Buchoen St. Mary’s Hospital, Bucheon (SOUTH KOREA), 3Ewha university hospital, Seoul (SOUTH KOREA) Background: We investigated the relationship between taking bisphosphonate and clinical characteristics of atypical femoral fracture throughout Korean multicenter studies. Object and Method: We retrospectively analyzed the bone mineral density, prodromal symptoms before femoral fracture, medication history of osteoporosis and union period of femoral fracture in 76 cases of atypical femoral fracture. Result The mean age of cases is 71.4 years old. The mean follow up period was 24.5 months. The mean BMD of femur is -1.9 ± 1.4(range, -4.8 - 2.3). Prodromal symptoms including thigh pain before femoral fracture appeared in 28.9%. The period of taking bisphosphonate before fracture is 36.8 months. The delayed union is developed in 43 (56.5 %) of 76 patients. The group of taking osteoporosis medication more than three years showed relatively longer union period compared to those for a short period medication group (p=0.017). The delayed union was developed in 43(56.5%) of 76 patient and in group with long term therapy showed significantly high incidence. (p=0.021) The bilateral femoral fracture was developed in 23 (30.2%) of 76 patients and in groups with medicated more than three years showed high incidence. (p=0.039). Conclusion Medical and surgical strategy should be considered in the clinical setting for the acceleration of fracture healing, especially in patients on long term bisphosphonate therapy who present with atypical femoral fracture. Careful observation is required for contralateral femur due to high incidence of bilateral femoral fracture. Abstract no.: 36421 THE EFFECT OF ORTHOPAEDIC SURGERY ON THE INTRINSIC PROPERTIES OF SURGICAL GLOVES Ali ABDULKARIM, Andrew MORIARITY, Eoin SHEEHAN Midland Regional Hospital Tullamore, Tullamore , Co Offaly (IRELAND) Introduction: Surgical gloves function as a mechanical barrier that reduces transmission of body fluids and pathogens. The effectiveness of this barrier is dependent upon the integrity of the glove. Methods: A total of 20 unused sterile surgical gloves (neoprene and latex) were exposed to blood, bone shavings and cement over 15, 30 and 60 minute intervals. Following each time point, the palmar surface and finger tips of each glove was analyzed under the scanning electron microscope (SEM), and were tested for changes in contact angle and tensile properties. Results: Exposure to cement caused a significant increase in both the neoprene and latex glove porosities at 15 min but no significant further changes at any later time points. The latex gloves had a greater increase in pore diameter than the neoprene gloves. Exposure to cement for 15 min duration significantly decreased the tensile strength of both latex and neoprene gloves. Exposure to either blood or bone shavings did not cause any significant changes in the latex or neoprene glove properties. Conclusions: This study provides evidence that exposure to cement, a common orthopaedic material, can disrupt the intrinsic properties of the surgical gloves worn in the operating theatre. Abstract no.: 36423 CHILDHOOD OBESITY AS A RISK FACTOR FOR UPPER EXTREMITY FRACTURES Ali ABDULKARIM, Andrew MORIARITY, Javaria AHMED, Dorothy NIALL, Eoin SHEEHAN Midland Regional Hospital Tullamore, Tullamore , Co Offaly (IRELAND) Introduction:to investigate the relationship between BMI and upper extremity fractures in children and adolescents of different ages and genders. Methods: We prospectively collected data on 280 children and adolescents between 2 to 19 years of age who presented to hospital with upper extremity trauma. We determined BMI and BMI-for-age percentiles for each patient. Fracture types were classified and the management was recorded.The associations among the BMI class and specific upper extremity fractures were estimated using
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