Mkhululi Lukhele

University of the Witwatersrand | wits · Department of Surgery

Background. Osteosarcoma is the most common primary malignant bone tumour. There is a high incidence of late presentation in the developing world, posing additional challenges in the treatment of this aggressive disease. Objective. To evaluate clinical outcomes of patients with osteosarcoma at Charlotte Maxeke Johannesburg Academic Hospital (CMJ...

Background. Osteosarcoma is the most common primary malignant bone tumour. There is a high incidence of late presentation in the developing world, posing additional challenges in the treatment of this aggressive disease. Objective. To evaluate clinical outcomes of patients with osteosarcoma at Charlotte Maxeke Johannesburg Academic Hospital (CMJ...

There is emerging evidence that total hip arthroplasty (THR) can be safely practiced in developing countries but scant evidence of safety of total knee replacement (TKR). The purpose of this study is to evaluate the outcomes of these procedures focusing on procedure related complications. This is a retrospective study of the frst 100 arthroplasties...

PurposeTotal hip and knee joint arthroplasty (TJA) rank among the most successful orthopaedic operations. Several developing countries in Africa have started to perform these procedures that are routine in developed countries. The aims of this study were to measure the incidence and assess the determinants of in-hospital mortality after elective pr...

Bilateral simultaneous fractures of Neck of Femur (NOF) are rare. They result amongst others from trauma, metabolic disease, electro-convulsion and simple falls. We report two cases of 40-year-old and 74-year-old females who presented with bilateral simultaneous fractures of NOF post simple falls. Both patients had staged bilateral fracture xation;...

Bilateral simultaneous fractures of Neck of Femur (NOF) are rare. They result amongst others from trauma, metabolic disease, electro-convulsion and simple falls. We report two cases of 40-year-old and 74-year-old females who presented with bilateral simultaneous fractures of NOF post simple falls. Both patients had staged bilateral fracture xation;...

Bilateral simultaneous fractures of Neck of Femur (NOF) are rare. They result amongst others from trauma, metabolic disease, electro-convulsion and simple falls. We report two cases of 40-year-old and 74-year-old females who presented with bilateral simultaneous fractures of NOF post simple falls. Both patients had staged bilateral fracture xation;...

Background: Surgical complications are common and most of them are preventable, especially if one considers that 53% to 70% of surgical errors occur outside theatre. Recent studies have shown that pre-operative checklists are associated with improved patient outcome. We hypothesize that in our institution there will be an improvement in patient ou...

Background: Surgical complications are common and most of them are preventable, especially if one considers that 53% to 70% of surgical errors occur outside theatre. Recent studies have shown that pre-operative checklists are associated with improved patient outcome. We hypothesize that in our institution there will be an improvement in patient ou...

Bilateral simultaneous fractures of Neck of Femur (NOF) are rare. They result amongst others from trauma, metabolic disease, electro-convulsion and simple falls. We report two cases of 40-year-old and 74-year-old females who presented with bilateral simultaneous fractures of NOF post simple falls. Both patients had staged bilateral fracture xation;...

Telangiectatic osteosarcoma is a rare variant of osteosarcoma accounting for 3%-11% of all primary osteosarcomas.¹ It has well described distinctive radio-pathological features. Radiographically, these tumours appear as purely lytic destructive lesions located in the metaphyses of long bones. On gross clinical examination, it presents as a soft and...

Giant lipomas of hand are rare lipomas that are larger than 5 cm. Comprehensive history and clinical examination is usually sufficient to make the diagnosis of lipoma but with giant lipoma, liposarcoma cannot be excluded. We report a case of giant lipoma in which we excluded liposarcoma by MRI and proceeded to do excisional biopsy. The histology co...

High-pressure injection injuries of the hand are relatively rare but potentially devastating injuries. We highlight a clinical case that presented to the Chris Hani Baragwanath Academic Hospital Hand Unit. The pathophysiology of this phenomenon, as well as the risk factors associated with a poor prognosis, is discussed. Management strategies are ex...

The prevalence of HIV-positive patient is high in the sub-Saharan region. This is a report of two unknown asymptomatic HIV carriers presenting with major thoracolumbar fractures for emergency management. The patients' results were complicated by delayed infection. The cases demonstrate the need to know the HIV status in a major orthopaedic trauma s...

AIM: The aim of the study was to establish the human immunodeficiency virus (HIV) seroprevalence in an acute orthopaedic trauma setting in an urban teaching hospital. METHODS: All patients admitted at the Orthopaedic Trauma Unit of the academic hospital during a six-month period from 1 July 2008 to 31 December 2008 were counselled and an informed c...

Lumbar disc herniation is very uncommon in children under the age of 10 years. We report on a lumbar disc herniation in a 9 year old. The patient presented with spontaneous onset of back pain and right leg pain which had failed to respond to 6 months of conservative treatment at a primary health care facility. Examination revealed severe lumbar bac...

The coexistence of idiopathic scoliosis and Graves' disease is not an established phenomenon. Bilateral pneumothoraces as a complication of posterior pedicle screw correction of scoliosis is an uncommon finding. Thyroid storm as initial presentation in Graves' disease is also uncommon. Surgery and stress are known precipitants of thyroid storm in u...

INTRODUCTION: Atlantoaxial instability is not uncommon and its management can be a challenge. Several stabilisation techniques have been described. All have their challenges because of the paucity of some osseous elements, the neural and vascular structures found in that region. Lateral mass screw fixation is one of the techniques which has been de...

INTRODUCTION: In scoliosis management the five stages of the Risser sign on the iliac crest have been widely used as a tool to assess skeletal age and remaining spinal growth. However, as with other markers of skeletal age, it is under the influence of genetic and environmental factors. Proof of this was given by Risser, who observed that children...

In 2007, approximately 33 million people were living with human immunodeficiency virus (HIV) infection worldwide. Sub-Saharan Africa has been hardest hit by the HIV pandemic. In this chapter the impact of HIV infection on bone and joint surgery is reviewed. The management of orthopaedic trauma and diseases specific to HIV infection (such as osteone...

Unlabelled: A consensus forum was convened to evaluate the economic considerations associated with prophylaxis against thrombo-embolic disease in patients undergoing hip replacement therapy in South Africa. This forum consists of orthopaedic surgeons, vascular surgeons and a statistician. Methods: The forum was instructed to evaluate the economi...

To analyse the causes of atlanto-axial rotatory fixation (AARF) and discuss the diagnosis and treatment. Retrospective case studies. Medical University of Southern Africa-Ga-Rankuwa referral hospital. A total of 10 patients admitted to and treated in the Department of Orthopaedics, Ga-Rankuwa Hospital, between July 1989 and June 1993. Dynamic compu...

Tuberculosis of the cervical spine is rare, comprising 3-5% of cases of tuberculosis of the spine. Eight patients with tuberculosis of the cervical spine seen during 1989-1992 were reviewed. They all presented with neck pain. The 4 children presented with a kyphotic deformity. In all the children the disease was extensive, with a large prevertebral...

Unifacet and bifacet dislocations of the lower cervical spine are very common injuries. Occasionally these injuries may be associated with fractures of the lamina which, in the absence of computed tomography, are often discovered in theatre. The presence of a fracture of the lamina makes the standard posterior wiring and fusion biomechanically unst...