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Immediate weight-bearing in surgically treated ankle fractures

This study aims to understand how well surgery works for broken ankles when the person puts weight on that foot immediately after surgery to improve their mobility.

Ankle fractures are fairly common injuries with about 169 out of every 100,000 people breaking their ankle each year. They're the third most common type of fracture that people are admitted to hospital for in New Zealand. The fractures that need surgery to fix them, tend to happen more often in two main groups: younger men and older women, most often young rugby players and middle-aged women who slip or trip at home, especially on stairs or grass.

Because ankle fractures can keep people from returning to work and requiring help with their activities of daily living, it's really important to help them mobilise as soon as possible.

The results will help surgeons decide if it is safe for patients to weight bear immediately following surgery, allowing early mobilisation, independently and safely. This may shorten their hospital stay and reduce support with their activities of daily living.

This is a study in collaboration with the Department of Anatomy at the University of Otago.

We will look at the stability of the bones across the fracture after it has been fixed and put in a plaster cast or a boot.

First, we will create an ankle break (using embalmed leg specimens) and perform a fixation with metal plates and screws, mimicking a standard surgical procedure.  Then we will measure the relative movement of the broken bones when weight is applied through the limb by using a biomechanics machine that tests how stable the fixed bones are.

The team

Further information

This project has been reviewed and approved by the University of Otago Human Ethics Committee (Health). Reference: H23/118.

Osteoarthritis and surgery versus non-surgery

Osteoarthritis is a common long-term condition and is a frequent presentation in primary care (16,000 new cases recorded per year in Aotearoa).

Initial management (patient education, exercise, and weight management) often does not reach patients as recommended and this results in long-term use of pain-relieving medications before joint replacement surgery.

This type of surgery dominates the public health system costs for osteoarthritis.

Results will provide insight into:

  • How to most effectively select patients who will benefit most from surgery
  • Demonstrate the unmet need for surgery
  • Make the case to funders and decision makers for funding and resourcing to increase capacity to undertake surgery

This is a study of patients coming to see a surgeon for the first time whether they have a total joint replacement or receive non-surgical treatments for late-stage osteoarthritis.

We will look at the patients’ experiences over a period of two years from the first appointment at Dunedin Hospital and examine the impact of rationing surgery by evaluating the effectiveness and cost-effectiveness of total joint replacement compared to non-surgical care.

We will invite patients who attend an orthopaedic surgeon clinic appointment and those who have been seen in the past two years at Dunedin Hospital. We will collect patients’ perceptions of how pain affects their quality of life and functioning.

We are inviting all patients at their first specialist appointment to complete two questionnaires. Patients will be contacted again to repeat the same questionnaire:

  • Six months following this appointment
  • 12 months after the appointment
  • 24 months after the appointment

These can be completed online with the link being sent via email, through a brief telephone call from one of the research team or posted out to be completed on paper.

The team

Further information

Further details can be found on this information sheet

This project has been reviewed and approved by the University of Otago Human Ethics Committee (Health). Reference: H24/0081

Patient reported and clinical outcomes following surgery for proximal humerus fractures

Breaks (fractures) of the upper arm are the most common osteoporotic fractures after wrist and hip fractures in the elderly population. Multiple breaks can occur following an everyday fall on an outstretched arm.

This project is about studying this common shoulder injury, where doctors want to clarify the best way to do surgery.

By adding this information to what has already been learned from a similar study done at Christchurch Hospital, we plan a bigger study involving multiple hospitals in different cities. The future study will look at different surgeries for this type of fracture to determine which works best.

We are looking back at past cases where people had surgery for this type of fracture in Otago and Canterbury.

We have already checked records of patients at Dunedin Hospital for some clinical information, with approval from the hospital, and we will now ask these patients about their experiences after surgery of their pain, and activities of daily living.

We will invite patients to attend a clinic to assess their shoulder range of movement and to complete two questionnaires. The clinic can be in person at Dunedin Hospital or virtually via a video call.

The team

Further information

Further information can be found on this information sheet

This project has been reviewed and approved by the University of Otago Human Ethics Committee (Health). Reference: H24/0085

A clinical audit of patients listed for total hip replacement to ascertain presence of developmental dysplasia of the hip

Developmental dysplasia is when the hip joint does not sit smoothly together. Finding and treating a hip problem early in babies can reduce the risk of the development of hip osteoarthritis later in life.

Different countries use different tests to check babies' hips.

In New Zealand, they often use something called the Ortolani and Barlow Test when a baby is a few days old. An ultrasound scan may also be done.

In Europe, using ultrasound scans is routine practice and is a no-radiation scan.

We want to know how often diagnosis is missed in New Zealand to determine if a new approach would work better. This is important because osteoarthritis affects:

  • How much pain people have
  • Their lifestyle
  • Increases the cost to the healthcare system in New Zealand

Checking how many people had this problem missed who either need or have had hip surgery, will give us evidence to develop ways to better find and treat a misshaped hip in infancy to reduce the risk of osteoarthritis.

We are going to look at records and X-rays from the past five years in southern New Zealand of patients waiting for or have had a hip replacement.

We will look at things like:

  • Age
  • Sex
  • Ethnicity
  • and we will measure things that show if there is a misshaped hip

The patients will not be involved, and our study will not change how they are treated.

Clinicians will take measurements on the x-ray and this information will be analysed to determine if developmental dysplasia is present. We will analyse the age, sex and ethnicity to determine if particular groups of patients are affected.

The team

  • Associate Professor Sebastian Lippross
    Email sebastian.lippross@otago.ac.nz
  • Professor J Haxby Abbott
  • Mr Fraser Harrold
  • Dr Ross Wilson
  • Jane Terry
  • John Clemance

Further information

This project has been reviewed and approved by the University of Otago Human Ethics Committee (Health). Reference: H24/0084

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