https://www.drchristygraff.com https://www.drchristygraff.com/research-paper-refractures-of-the-paediatric-radius-and-or-ulna <div data-rss-type="text"> <p> <span> Dr Graff and her team investigated the literature in a systematic review regarding why some children refracture their forearm after their initial fracture. Published in the Australian and New Zealand Journal of Surgery, the team found that the risk of refracture increases in diaphyseal fractures (fractures in the middle of the bone) and greenstick fractures (incomplete fractures). Fractures that have healed in a bent position and incomplete healing in greenstick fractures may also have a higher risk of refracture. Refractures can occur up to 9 months after the initial injury. <br/> </span> </p> </div> Tue, 08 Jul 2025 01:15:00 GMT https://www.drchristygraff.com/research-paper-refractures-of-the-paediatric-radius-and-or-ulna orthopaediceducation,footandanklesurgeon,Research Paper thumbnail main image https://www.drchristygraff.com/understanding-orthopaedic-normal-variants-in-children <div data-rss-type="text"> <h3> <span> Attention all GPs: you are invited to a free  </span> <a href="https://www.instagram.com/explore/tags/gpeducation/" target="_blank"> #GPeducation </a> <span>  event to discuss everything you wanted to know about orthoapedic 'normal' variants in children. Please register on the details provided. Look forward to seeing you there! </span> </h3> <p> <br/> </p> <p> <strong> Tuesday 22 July 2025 </strong> </p> <p> <strong> 6pm - 9:30pm </strong> </p> <p> <strong> Dinner provided </strong> </p> <p> <strong> Chianti, Hutt Street </strong> </p> <p> <strong> Level 1 Gallo Nero </strong> </p> <p> <span> <br/> </span> </p> <h2> <span> To Register: </span> </h2> <p> <span> <span> Email </span> </span> <a href="mailto:admin@christygraff.com" target="_blank"> admin@christygraff.com </a> <span> <span> or call </span> </span> <a href="tel:0493 461 133" target="_blank"> 0493 461 133 </a> </p> </div> Tue, 24 Jun 2025 01:15:01 GMT https://www.drchristygraff.com/understanding-orthopaedic-normal-variants-in-children orthopaediceducation,Events,footandanklesurgeon thumbnail main image https://www.drchristygraff.com/understanding-conditions-of-the-foot-and-ankle <div data-rss-type="text"> <p> <span> Thanks to everyone who came to ‘ </span> <strong> Understanding Conditions of the Foot and Ankle </strong> <span> ’ and made it a great education event. </span> </p> </div> Tue, 10 Jun 2025 07:48:03 GMT https://www.drchristygraff.com/understanding-conditions-of-the-foot-and-ankle orthopaediceducation,Events,footandanklesurgeon thumbnail main image https://www.drchristygraff.com/understanding-orthopaedic-foot-and-ankle-conditions Attention all GPs: you are invited to a free #GPeducation event to discuss everything you wanted to know about foot and ankle conditions. <div data-rss-type="text"> <h2> <span> Understanding orthopaedic foot and ankle conditions </span> </h2> <p> <span>   </span> </p> <p> <span> Join orthopaedic surgeon Dr Graff and her guests for an interactive discussion regarding all things foot and ankle </span> </p> <p> <span>   </span> </p> <p> <strong> Tuesday 13 May 2025 </strong> </p> <p> <strong> 18:00 pm to 21:00pm </strong> </p> <p> <strong> Orso 36 Kensington Road </strong> </p> <p> <strong> Dinner and drinks provided </strong> </p> <p> <br/> </p> <h3> <span> **Free for all GPs** <span>  </span> </span> </h3> </div> <div> <img src="https://irp.cdn-website.com/d36040d2/dms3rep/multi/CG+Logo+Central+White.jpg" alt=""/> </div> <div> <img src="https://irp.cdn-website.com/d36040d2/dms3rep/multi/CPD+Approved+Activity-+Hybrid.jpg" alt=""/> </div> <div data-rss-type="text"> <p> <strong> To Register: </strong> <span> <span> Email </span> </span> <a href="mailto:admin@christygraff.com "> admin@christygraff.com </a> <span> <span> or call </span> </span> <a href="tel:0493 461 133"> 0493 461 133 </a> </p> </div> Fri, 25 Apr 2025 06:11:48 GMT https://www.drchristygraff.com/understanding-orthopaedic-foot-and-ankle-conditions orthopaediceducation,Events,footandanklesurgeon thumbnail main image https://www.drchristygraff.com/tibial-eminence-fractures-in-the-paediatric-population-a-systematic-review Dr Graff (nee Coyle) and her team during her time at the Royal London Hospital investigated the literature for evidence on the best management of tibial eminence fractures in children. <div data-rss-type="text"> <p> <span> Dr Graff (nee Coyle) and her team during her time at the Royal London Hospital investigated the literature for evidence on the best management of tibial eminence fractures in children. </span> </p> <p> <br/> </p> <p> <span> Tibial eminence fractures in children often occur instead of an anterior cruciate ligament (ACL) rupture in children, because the bone in children is weaker than the ACL. In adults, the ligament is weaker than bone, and therefore they often have an ACL rupture rather than a fracture. </span> </p> <p> <br/> </p> <p> <span> If the ACL has avulsed the tibial eminence in children, it can sometimes be managed non operatively if the bone hasn’t moved. If the bone has moved, management in the literature is controversial. The literature is summarised by Dr Graff and her team in this paper.  </span> </p> <p> <br/> </p> <p> <span> The literature is not comprehensive, and management in a long leg cast may yield good results. However, arthroscopic or open reduction and internal fixation for fractures in which the bone has moved is advocated in more current literature. Benefits of this management include clearance of soft tissue structures (ie. cartilage or ligaments) trapped under the bony fragment, early range of movement and less chance of stiffness and pain. Most children will have increased knee laxity in that knee, but this has not shown to have any impact in the long term. <span>  </span> </span> </p> </div> Mon, 20 Jan 2025 08:04:50 GMT https://www.drchristygraff.com/tibial-eminence-fractures-in-the-paediatric-population-a-systematic-review Research thumbnail main image https://www.drchristygraff.com/outcomes-of-early-versus-delayed-weight-bearing-with-intramedullary-nailing-of-tibial-shaft-fractures The tibia, also known as the shinbone is the most commonly fractured long bone in the body. Tibial shaft fractures account for 1.9% of all fractures. Intramedullary nailing (IMN) – where a specially designed metal rod is inserted inside the bone to stabilise the fracture and allow healing, is the gold standard for the treatment of these fractures in adults. <div data-rss-type="text"> <p> <span> The tibia, also known as the shinbone is the most commonly fractured long bone in the body. Tibial shaft fractures account for 1.9% of all fractures. Intramedullary nailing (IMN) – where a specially designed metal rod is inserted inside the bone to stabilise the fracture and allow healing, is the gold standard for the treatment of these fractures in adults. Initially, most of the load in walking on the leg is transferred through the nail. As the fracture heals the load is gradually transferred to the bone. </span> </p> <p> <br/> </p> <p> <span> The process of recovery and healing can take up to 4-6months and many different factors can affect this timeline. One of these factors is the timing and extent of weight bearing post operatively. Given there are no universal guidelines for weight bearing after surgery, we wanted to analyse and compare the different approaches in regard to their outcomes such as, the time to fracture healing (union), rates of fractures not healing correctly or not healing at all. We analysed all possible literature on this topic, extracting data from trials to compare the outcomes of early weight bearing (EWB) - walking on the leg before 6 weeks post surgery, versus delayed weight bearing (DWB) - walking on the leg after 6 weeks post surgery. </span> </p> <p> <span> <span>  </span> </span> </p> <p> <span> Based on the results of our study, EWB after IMN for tibial shaft fractures may produce faster healing and fewer total complications in certain patient groups. More research and evidence is required, especially in patient subgroups who have significant comorbidities or are at higher risk of complications. Click the link below if you would like to read the full article which was published in the European Journal of Trauma and Emergency Medicine. </span> </p> </div> Mon, 13 Jan 2025 08:00:41 GMT https://www.drchristygraff.com/outcomes-of-early-versus-delayed-weight-bearing-with-intramedullary-nailing-of-tibial-shaft-fractures Research thumbnail main image https://www.drchristygraff.com/management-of-iatrogenic-ulnar-nerve-palsies-after-cross-pinning-of-paediatric-supracondylar-humerus-fractures-a-systematic-review Supracondylar humerus fractures in children are common, and severe unstable fractures are managed with surgery. This involves using X-ray to straighten the bone and put wires in to hold the bone still. The most stable configuration of wires is one on the outside of the elbow and one on the inside of the elbow. <div data-rss-type="text"> <p> <span> Supracondylar humerus fractures in children are common, and severe unstable fractures are managed with surgery. This involves using X-ray to straighten the bone and put wires in to hold the bone still. The most stable configuration of wires is one on the outside of the elbow and one on the inside of the elbow. However, putting a wire on the inside of the elbow puts the ulnar nerve (the ‘funny bone nerve’) at risk, as it is very close by. </span> </p> <p> <br/> </p> <p> <span> All literature on this complication was reviewed for this paper. The quality of literature was poor and difficult to summarise. In total, only 179 incidences of this complication were reported in regard to recovery.  </span> </p> <p> <span> <span>  </span> </span> </p> <p> <span> We found that the current literature reports that when the ulnar nerve is damaged from a wire on the inside of the elbow, 9 out of 10 nerves recover without any problems, even if the wire is left in place for 3 weeks. The current literature does not support early wire removal and/or exploration of the nerve, likely because the damage is done at the time of wire placement. Reporting and long term follow up of this complication, however, is poor. </span> </p> </div> Mon, 06 Jan 2025 07:58:05 GMT https://www.drchristygraff.com/management-of-iatrogenic-ulnar-nerve-palsies-after-cross-pinning-of-paediatric-supracondylar-humerus-fractures-a-systematic-review Research thumbnail main image https://www.drchristygraff.com/antibiotic-impregnated-cement-coated-intramedullary-nail-accin-using-bronchoscopy-tubing-technical-tips-case-series-and-a-review-of-the-literature Open fractures of the tibia can sometimes lead to bone infection, called osteomyelitis. This is difficult to treat, as the fracture will not heal without getting rid of the infection, but also needs to be stable. If the fracture does not heal, this is called delayed union or 'non-union'. <div data-rss-type="text"> <p> <span> Open fractures of the tibia can sometimes lead to bone infection, called osteomyelitis. This is difficult to treat, as the fracture will not heal without getting rid of the infection, but also needs to be stable. If the fracture does not heal, this is called delayed union or 'non-union'.  </span> </p> <p> <span> <span>  </span> </span> </p> <p> <span> Antibiotic-impregnated cement wrapped around a titanium rod has been shown to be a good way to help eradicate infection and allow stability of the fracture. Dr Graff and her team developed a novel technique using tubing usually used for lungs to prepare the antibiotic-impregnated cement rod, and published it as a surgical technique for other surgeons to use. In her paper, she has presented examples of her patients successfully treated with her new technique. </span> </p> </div> Mon, 30 Dec 2024 07:45:22 GMT https://www.drchristygraff.com/antibiotic-impregnated-cement-coated-intramedullary-nail-accin-using-bronchoscopy-tubing-technical-tips-case-series-and-a-review-of-the-literature Research thumbnail main image https://www.drchristygraff.com/understanding-injuries-of-the-foot-and-ankle <div data-rss-type="text"> <h2> <span> Join orthopaedic surgeons Dr Graff, Dr Fisher and Dr Gieroba for an interactive discussion and lots of education </span> </h2> <p> <strong> Saturday 23 March 2024 </strong> </p> <p> <strong> 11am to 4pm </strong> </p> <p> <strong> Cathedral Hotel </strong> </p> <p> <span> Level 1 Torrens Room </span> </p> <p> <span> Lunch provided </span> </p> <p> <span> Free for all GPs <br/> </span> </p> </div> Thu, 01 Feb 2024 08:03:19 GMT https://www.drchristygraff.com/understanding-injuries-of-the-foot-and-ankle Events thumbnail main image