Deborah M Eastwood

Royal National Orthopaedic Hospital NHS Trust | RNOH · Department of Orthopaedics

Unlabelled: In unilateral Developmental Dysplasia of the Hip (DDH), avascular necrosis (AVN), femoral or pelvic osteotomy, and residual dysplasia causing subluxation of the proximal femur may influence Leg Length Discrepancy (LLD). This can lead to gait compensation, pelvic obliquity, and spinal curvature. The aim of this study is to determine the...

Purpose To study the physical, emotional and social impact of clubfoot on the lives of affected children and their families. Methods A purposive sample of children with treated idiopathic clubfoot and their parents was recruited from two geo- graphical locations—the United Kingdom (UK) and India. Children were divided into age groups of 5–7 and 8–1...

Aim: Dual tension-band plates are used for temporary epiphysiodesis and longitudinal guided growth. The study aim was to assess rate of correction, to identify development of femoral and tibial intra-articular deformity during correction and to document resumption of growth after plate removal. Materials and methods: A retrospective study of 34...

Aims This international study aimed to assess: 1) the prevalence of preoperative and postoperative COVID-19 among patients with hip fracture, 2) the effect on 30-day mortality, and 3) clinical factors associated with the infection and with mortality in COVID-19-positive patients. Methods A multicentre collaboration among 112 centres in 14 countrie...

Background: Dynamic supination is a well-recognized cause of congenital clubfoot deformity relapse. However, there is no consensus on how to diagnose it and there are varied approaches in its management. This study aims to define dynamic supination and indications for treatment by presenting consensus from an international panel of experts using a...

Aims Osteofibrous dysplasia (OFD) is a rare benign lesion predominantly affecting the tibia in children. Its potential link to adamantinoma has influenced management. This international case series reviews the presentation of OFD and management approaches to improve our understanding of OFD. Methods A retrospective review at three paediatric terti...

The outcomes of idiopathic congenital talipes equinovarus: a core outcome set for research and treatment Yael Gelfer, Donato G. Leo, Aisling Russell, Anna Bridgens, Daniel C. Perry, Deborah M. Eastwood Published Online:27 Jan 2022

The aim of this study is to define a core outcome set (COS) to allow consistency in outcome reporting amongst studies investigating the management of orthopaedic treatment in children with spinal dysraphism (SD). Relevant outcomes will be identified in a four-stage process from both the literature and key stakeholders (patients, their families, and...

Orthopaedic societies, with their diverse membership from across the world, serve a mission to endorse the progress and innovation in the field of orthopaedics and traumatology with a focus on improving patient care, as well as to encourage and develop education, teaching and research. Such organizations, whether small or large, have been successfu...

Aims To identify the minimum set of outcomes that should be collected in clinical practice and reported in research related to the care of children with idiopathic congenital talipes equinovarus (CTEV). Methods A list of outcome measurement tools (OMTs) was obtained from the literature through a systematic review. Further outcomes were collected f...

Background: Pavlik harness (PH) treatment is successful in treating over 90% of newborns with developmental dysplasia of the hip (DDH). There is a need for close supervision, frequent adjustments, size changes, and monitoring of complications. This paper aims to provide a safe criterion for remote follow-up of DDH patients treated in a PH to reduc...

Bracing is considered a gold standard in treating Developmental Dysplasia of the Hip (DDH) in infants under 6 months of age with reducible hips. A variety of braces are available that work on similar principles of limiting hip adduction and extension. This paper summarises the current evidence regarding bracing in DDH. Most of the literature pertai...

Introduction: Nosocomial COVID-19 increases morbidity and mortality in patients undergoing surgical procedures. This study assesses the consenting process in patients admitted for surgical procedures with regard to risks of contracting nosocomial COVID-19 infection during the three lockdown periods in the United Kingdom. Methods: Retrospective revi...

Aims Perthes’ disease (PD) often results in femoral head deformity and leg length discrepancy (LLD). Our objective was to analyze femoral morphology in PD patients at skeletal maturity to assess where the LLD originates, and evaluate the effect of contralateral epiphysiodesis for length equalization on proximal and subtrochanteric femoral lengths....

Background: Congenital deficiency of the femur remains uncommon, with a wide spectrum of presentation from simple hypoplasia to complete absence. In cases of severe deformity and leg length discrepancy, prosthetic use remains the preferred management strategy. The aim of this study was to assess this group's functional outcome and evaluate the infl...

Duchenne muscular dystrophy (DMD) is an incurable disease caused by out-of-frame DMD gene deletions while in frame deletions lead to the milder Becker muscular dystrophy (BMD). In the last decade several antisense oligonucleotides drugs have been developed to induce a partially functional internally deleted dystrophin, similar to that produced in B...

Background/aims Outpatient physical therapy is the mainstay of treatment in shoulder instability, but lack of motivation and intermittent monitoring of progress is associated with poor compliance. ‘Exergames’ (a combination of videogames and physical exercise) may provide an additional or alternative motivational factor. The aim of this study was t...

Introduction: Leg-length difference (LLD) is common in patients with developmental dysplasia of the hip (DDH). LLD of > 1 cm at skeletal maturity is reported in > 40% of patients, with the majority related to ipsilateral overgrowth. A longer DDH leg might lead to excessive mechanical loading at the acetabular margin, resulting in compromised aceta...

Skeletal dysplasia is one of the most challenging fields in paediatric orthopaedic practice. It requires a multidisciplinary approach and dedicated team with special interest in this subspecialty. The aim of this chapter is to help you understand the language around skeletal dysplasias and the common threads they present, whilst highlighting specif...

Equinus contracture is the most common deformity at clubfoot relapse and causes pain and functional limitation. It presents a challenge to the orthopaedic surgeon throughout childhood. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies included were: (i) ori...

Aims This study aims to define a set of core outcomes (COS) to allow consistent reporting in order to compare results and assist in treatment decisions for idiopathic clubfoot. Methods A list of outcomes will be obtained in a three-stage process from the literature and from key stakeholders (patients, parents, surgeons, and healthcare profession...

British Limb Reconstruction Society virtual conference 2021 Introduction Leg length discrepancy (LLD) in patients with unilateral developmental dysplasia of the hip (DDH) can be problematic for both patients and surgeons. Patients can acquire gait asymmetry, back pain, and arthritis. Surgical considerations include timing of correction and arthro...

Background Post-operative wound reviews constitute an essential part of care for children undergoing surgery, allowing prompt identification of post-operative complications.Until now it has been routine practice in the orthopaedic department to delegate wound reviews to community services. However, departmental follow-up may have significant benefi...

Background Congenital Talipes Equinovarus (CTEV) deformity affects 1:1000 new-borns. Since the Ponseti technique became popular, the need for operative intervention beyond tenotomy has reduced. However, mid-long term results remain poorly reported. This prospective case series describes our patient population and outcomes since 2011 with an innovat...

Purpose: To de!ne the volume of paediatric orthopaedic surgical work requiring re-prioritisation and resourcing at two major hospitals following the COVID-19 pandemic. Methods: All patients on the waiting list as of 23rd March 2020 at two institutions were reviewed. The data recorded included demographics, diagnosis and treatment needed. As advised...

Background Meta-analysis of simulation teaching has shown to be an effective teaching methodology. The Association for Simulated Practice in Healthcare (ASPIH) annual international, multidisciplinary conference is recognised as the leading UK meeting for simulation-based education. We hypothesise that simulation-based research presented at this con...

Purpose This study was designed to review the diagnostic yield of single photon emission computed tomography-computed tomography (SPECT/CT) in children with complex foot/ankle pain. Methods We reviewed the records of 33 patients with complex foot and ankle pain referred for SPECT/CT (36 scans) performed between 1st September 2009 to 30th September...

Aims To analyze outcomes reported in studies of Ponseti correction of idiopathic clubfoot. Methods A systematic review of the literature was performed to identify a list of outcomes and outcome tools reported in the literature. A total of 865 studies were screened following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA...

Aims To analyze outcomes reported in studies of Ponseti correction of idiopathic clubfoot. Methods A systematic review of the literature was performed to identify a list of outcomes and outcome tools reported in the literature. A total of 865 studies were screened following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...

Introduction In response to the COVID-19 pandemic, there was a rapidly implemented restructuring of UK healthcare services. The The Royal National Orthopaedic Hospital, Stanmore, became a central hub for the provision of trauma services for North Central/East London (NCEL) while providing a musculoskeletal tumour service for the south of England, t...

Introduction In response to the COVID-19 pandemic, there was a rapidly implemented restructuring of UK healthcare services. The The Royal National Orthopaedic Hospital, Stanmore, became a central hub for the provision of trauma services for North Central/East London (NCEL) while providing a musculoskeletal tumour service for the south of England, t...

Background Delivering local teaching programmes equally relevant to all senior house officer (SHO) equivalent junior doctors within a tertiary level specialist hospital is challenging. This study aimed to establish the views of SHOs within a specialist orthopaedic hospital on the value of the current local teaching programme to their educational ne...

Aims: Open fractures are at greater risk of infection and delayed bone healing. Guidelines to reduce these risks exist for adult open fracture management but not for paediatric open fractures, where there is considerable practice variability. This systematic review evaluates the quality of the evidence and clinical outcomes for paediatric open frac...

Introduction: Idiopathic toe walking (ITW) is an exclusionary diagnosis resulting in a child walking on the balls of their feet. Preferred treatment options may be due to the severity of the toe or the health professional preference There are limited guidelines supporting consistent treatment recommendations for this condition. This research aimed...

Background In all patients with mucopolysaccharidosis type I (MPS I), skeletal disease (dysostosis multiplex) is a prominent, debilitating, condition related complication that may impact strongly on activities of daily living. Unfortunately, it is not alleviated by treatment with hematopoietic cell transplantation (HCT) or enzyme replacement therap...

Purpose The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti met...

Rett syndrome is a neurodevelopmental disorder first described in 1966 (Rett, Wien Med Wochnschr 116:723–6, 1966). The characteristic picture includes a regression in learnt motor and social skills often with the later development of increased tone, muscle imbalance and subsequent joint contractures leading to scoliosis and hip subluxation. In the...

The muscular dystrophies (MD) are a group of inherited conditions characterized by a progressive muscle weakness and increasing disability. The most common and well-known is Duchenne muscular dystrophy (DMD). DMD is essentially the only MD associated with hip problems.

Background Idiopathic toe walking (ITW) is an exclusionary diagnosis and varies in severity, from those children with full range of ankle motion, to those with associated ankle equinus. In the absence of a consensus in the treatment for this gait pattern, many clinicians are faced with challenges in understanding available evidence-based treatment...

Aims The Ponseti method is the benchmark treatment for the correction of clubfoot. The primary rate of correction is very high, but outcome further down the treatment pathway is less predictable. Several methods of assessing severity at presentation have been reported. Classification later in the course of treatment is more challenging. This system...

X-linked hypophosphataemia (XLH) is the most common cause of inherited phosphate wasting and is associated with severe complications such as rickets, lower limb deformities, pain, poor mineralization of the teeth and disproportionate short stature in children as well as hyperparathyroidism, osteomalacia, enthesopathies, osteoarthritis and pseudofra...

Level III Introduction and Objective: The Ponseti method of clubfoot correction is the “gold standard”. A variety of methods assessing severity at presentation have been reported. Classification later in the treatment course is more challenging. Reporting standards vary widely with often a complete absence of definition of the corrected or relapse...

Abstract Background: In all patients with mucopolysaccharidosis type I (MPS I), skeletal disease (dysostosis multiplex) is a prominent, debilitating, condition related complication that may impact strongly on activities of daily living. Unfortunately, it is not alleviated by treatment with hematopoietic cell transplantation (HCT) or enzyme replacem...

Background: Bilateral developmental dysplasia of the hip (DDH) is believed to have a worse outcome than unilateral DDH with the optimal treatment unclear. To define indications for treatment we report a retrospective series of 92 hips (46 patients) who underwent closed reduction (CR) and/or open reduction (OR). Methods: A total of 58 hips in 29...

Purpose To summarize recent developments and provide recommendations as to whether universal or selective programmes are advisable. Methods A literature review was performed and preference given to studies with higher levels of evidence. All programmes reviewed included clinical screening. Results Recent studies underline the need for high qualit...

Purpose To summarize recent developments and provide recommendations as to whether universal or selective programmes are advisable. Methods A literature review was performed and preference given to studies with higher levels of evidence. All programmes reviewed included clinical screening. Results Recent studies underline the need for high qualit...

Study design: Retrospective case series OBJECTIVE.: To review clinical and radiological outcomes of craniovertebral surgery in children with Morquio A syndrome (Mucopolysaccharidosis type IVA) and develop an evidence-based management algorithm. Summary of background data: Myelopathy secondary to craniovertebral pathology is a common cause of neu...

Developmental dysplasia of the hip (DDH) is the most common skeletal developmental disease. However, its genetic architecture is poorly understood. We conduct the largest DDH genome-wide association study to date and replicate our findings in independent cohorts. We find the heritable component of DDH attributable to common genetic variants to be 5...

Introduction and Objectives The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post- correction bracing can affect lower limb function and age of independent standing and walking. This study investigates the age at which infants with idiopathic clubfoot treated using...

Purpose To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total o...

Paediatrics for The FRCS (Tr + Orth) Examination is a comprehensive revision resource providing candidates with over 200 high-quality questions to prepare for this challenging subject. Written and edited by consultant paediatric orthopaedic surgeons and senior fellows, this book provides comprehensive coverage of both paediatric trauma and orthopae...

Table S1. Identification of SALL1FL and SALL1p.Arg276∗ Interactors by Proximity Proteomics

Despite preventative screening programmes in some countries, hip dislocation is still a common problem in many severely affected, non-ambulant patients with cerebral palsy. There are two scenarios where pain and stiffness affect all aspects of patient comfort and care and where a proximal femoral excision with an interpositional arthroplasty (myopl...

A comprehensive revision source providing candidates with over 200 high quality questions to prepare for this challenging subject. This book provides comprehensive coverage of both paediatric trauma and orthopaedic topics. Split into 3 parts, this source contains over 100 single best answer questions, 50 extended matching questions and 50 viva topi...

Purpose Fractures of the lateral condyle of the humerus in children are a common injury. If displaced or unstable they may require surgical reduction and fixation with Kirschner wires (K-wires). K-wires are placed using either an open or closed technique. The decision to bury or leave the ends extending through the skin is surgeon-dependent and bas...

The mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders with clinical manifestations relevant to the orthopaedic surgeon. Our aim was to review the recent advances in their management and the implications for surgical practice. The current literature about MPSs is summarised, emphasising orthopaedic complications and th...

Purpose Mucopolysaccharidoses (MPS) are a group of rare lysosomal storage disorders associated with involvement of multiple organs along with a generalised skeletal dysplasia. Both haematopoetic stem cell transplant and enzyme replacement therapy have improved the outlook for patients while surgery remains high-risk and there is little information...

Background Many patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child. Methods Since 2005, 24 patients with X-LHPR hav...

Purpose Complete fibula absence often presents with significant lower-limb deformity. Parental counselling regarding management is paramount in achieving the optimum functional outcome. Amputation offers a single surgical event with minimal complications. This study compares outcomes with an amputation protocol to those using an extension prosthesi...

Study design: Systematic Review OBJECTIVE.: To determine the indications and outcomes for surgical treatment of thoracolumbar kyphosis in patients with mucopolysaccharidoses (MPS) in order to define future studies. Summary of background data: Improvements in the medical treatment of MPS have increased lifespan and improved quality of life for ma...