A Virtual Clinic for DDH Pavlik Harness Monitoring

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rajiv M. Merchant ◽  
Shehzaad A. Khan ◽  
Christine Douglas ◽  
Penina Edel ◽  
Tahir Khan ◽  
...  
2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Westley ◽  
H Creasy ◽  
R Mistry

Abstract Introduction The Queen Victoria Hospital (QVH) was designated a cancer and trauma hub during the COVID-19 pandemic. With this, a new virtual hand trauma clinic was set up. We assess accuracy of assessment within this virtual set-up with comparison to pre COVID-19 face-to-face assessment. Method Two weeks of clinic sessions during and pre lockdown were analysed. Initial assessment was compared with the patient's operation note. Results In the pre COVID-19 two-week period 129 face-to-face appointments were analysed. Of 99 patients that required surgery 77 (78%) had an accurate assessment. 6 were overestimated, 12 were underestimated. 189 patients were seen over two weeks during lockdown via telephone or video call. Accuracy of assessment increased with seniority of the clinician. Of 126 patients that required an operation 109 (87%) had an accurate assessment; all structures injured were correctly predicted. 12 were overestimated, 5 had their injury underestimated. Conclusions The new virtual clinic allowed patients to be remotely assessed during lockdown, reducing footfall and unnecessary journeys. We found that virtual clinic assessments are accurate, and no patient underwent an unnecessary procedure. Using a telephone call plus photo gave similar accuracy as a video call. Virtual assessment was more accurate than face-to-face assessment.


Author(s):  
Elizabeth Vogel ◽  
Thomas Leaver ◽  
Fiona Wall ◽  
Ben Johnson ◽  
Michael Uglow ◽  
...  

Abstract Objective There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy. Methods Patients who had completed 5 years’ follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs. Results All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6–9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11–0.46, SD: 0.07). This is far lower than the annual ‘safe’ limit for healthcare workers of 20 mSv and is categorised as “Very Low Risk”. Conclusion Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is “Very Low Risk”. Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.


2009 ◽  
Vol 29 (7) ◽  
pp. 661-665 ◽  
Author(s):  
Andrzej Borowski ◽  
Dinesh Thawrani ◽  
Leslie Grissom ◽  
Aaron G. Littleton ◽  
Mihir M. Thacker
Keyword(s):  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pan Gou ◽  
Yuan Zhang ◽  
Jun Wu ◽  
Jun Li ◽  
Xiang Li ◽  
...  

2018 ◽  
Vol 38 (6) ◽  
pp. 297-304
Author(s):  
Alex L. Gornitzky ◽  
Emily K. Schaeffer ◽  
Charles T. Price ◽  
Wudbhav N. Sankar
Keyword(s):  

2017 ◽  
Vol 225 (4) ◽  
pp. S112 ◽  
Author(s):  
Paul Healy ◽  
Liam F. McCrone ◽  
Emer Flannery ◽  
Roisin Tully ◽  
Karen McNamara ◽  
...  

2006 ◽  
Vol 30 (5) ◽  
pp. 348-351 ◽  
Author(s):  
Károly Pap ◽  
Sándor Kiss ◽  
Tamás Shiha ◽  
Gábor Marton-Szücs ◽  
György Szöke

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