Nando Ferreira

Nando Ferreira
Stellenbosch University | SUN · Division of Orthopaedic Surgery

BSc, MBChB, HDip Orth, FC Orth, MMed Orth, PhD

About

151
Publications
33,890
Reads
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692
Citations
Citations since 2016
103 Research Items
631 Citations
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2016201720182019202020212022020406080100120140
2016201720182019202020212022020406080100120140
2016201720182019202020212022020406080100120140
Additional affiliations
March 2016 - present
Tygerberg Hospital
Position
  • Head Clinical Unit: Tumour, Sepsis and Reconstruction
March 2016 - present
Stellenbosch University
Position
  • Head Clinical Unit: Tumour, Sepsis and Reconstruction
January 2011 - March 2016
University of KwaZulu-Natal
Position
  • Lecturer
Education
January 2013 - February 2016
University of KwaZulu-Natal
Field of study
  • Orthopaedic Surgery
July 2006 - October 2008
Colleges of Medicine of South Africa
Field of study
  • Orthopaedic Surgery
July 2006 - October 2010
Colleges of Medicine of South Africa
Field of study
  • Orthopaedic Surgery

Publications

Publications (151)
Article
Full-text available
IntroductionLarge segmental long bone defects are notoriously difficult to manage. Treatment is resource-intensive due to the complexity, cost, and specialized skills required. Truss designs are known for their triangular shapes organized in web configurations. This allows for maximal mechanical strength, the least mass, and a lattice that can be f...
Article
Full-text available
Purpose To assess the outcome of surgically fixated femur shaft and distal femur fractures following low-velocity civilian gunshot injuries over a 4-year period. Methods A retrospective review was conducted on all patients who sustained femur shaft and distal femur fractures from civilian low-velocity gunshot injuries that required definitive surg...
Article
Full-text available
Purpose Dead space management is critically important during the treatment of chronic osteomyelitis. Many dead space management strategies are available, each with their respective advantages and shortcomings. This study aims to present the outcomes and complications of dead space management strategies employed in the treatment of chronic osteomyel...
Article
Full-text available
BACKGROUND: Burnout is epidemic among physicians, with the orthopaedic speciality displaying one of the highest rates of burnout in international studies. The burnout rate of the South African orthopaedic community is unknown. This study aimed to determine the prevalence and causes of burnout, as well as the coping mechanisms and associations with...
Article
Background Temporary spanning fixation aims to provide bony stability whilst allowing access and resuscitation of the traumatised soft-tissue envelope. Conventional monolateral fixators are prone to half-pin morbidity in feet, variation in construct stability and limited weight-bearing potential. This study compares traditional delta-frame monolate...
Article
Introduction: The radius and ulna are commonly fractured bones. The restoration of the native anatomy is the primary surgical objective but can be difficult due to a mismatch between the bones' shape and available implants. A thorough understanding of the underlying anatomical relationships between the radius and ulna could allow for a more accurat...
Article
Introduction: Dead space management following intramedullary debridement and reaming can be challenging and several alternatives have been described. The main objective of this study was to investigate the clinical outcome and resolution rate in patients treated for fracture-related Cierny and Mader anatomical type 1 intramedullary chronic osteomye...
Article
Background: Pin site infection is a common complication with external fixation, with a reported incidence of 26%-71% in the context of limb reconstruction. The Checketts and Otterburn (C&O) classification is frequently used, with minor infections (C&O I-III) treated with pin site care and enteral antibiotics. Major infections (C&O IV-VI) require re...
Article
Background: Intramedullary limb lengthening has become more popular in the past two decades. This study aimed to investigate the mechanical properties of the various intramedullary lengthening devices currently available to orthopedic surgeons. Materials and Methods:
Article
Background Segmental femur fractures often pose management challenges regarding the optimal fixation choice and sequence of surgical events. Methods Retrospective review of clinical records and radiographic data of adult patients with segmental femur fractures treated by a conceptual radiographic cover-up test to determine the ideal fixation metho...
Article
Full-text available
In low and middle-income countries (LMICs), individuals suffer from a disproportionately higher number of musculoskeletal (MSK) injuries compared with those living in a high-income setting. However, despite the higher burden of death and disability from MSK injuries in LMICs, there has been little policy, research, and funding invested in addressin...
Article
Full-text available
Background Current orthopaedic practice requires a forearm nail that is length and rotationally stable and which can restore functional anatomy. A forearm nailing system was designed based on clinical need. This nailing system features unique designs and locking holes that offer a larger approach and escape angle for ease of interlocking. The aim o...
Article
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Background This review aims to collate all published work on the management of transarticular gunshot injuries to better inform decision-making when managing these injuries. Methods A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) was undertaken. A literature search of major electronic datab...
Article
Full-text available
Introduction: Limb salvage and reconstruction are often challenging and even more so in the limited resource setting. The purpose of this narrative review is to explore the strategies for addressing the unique obstacles and opportunities of limb reconstructive surgery in resource-limited environments globally. Methods: We review (1) the global b...
Article
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Objectives: Due to ongoing concern about femur anatomy-implant mismatches, this cross-sectional study aimed to create a geometric femur profile and used it to identify and quantify possible mismatches between femur anatomy and cephalomedullary nail dimensions. The work further aimed to assess whether patient demographics affect anatomy-implant coh...
Article
Full-text available
BACKGROUND: Orthopaedic surgery often benefits from innovation in biomedical engineering, with 3D printing being one of the latest examples. Proving cost-effectiveness and improved clinical outcomes remains challenging. Because of the reduced cost and increased accessibility, it has been possible to start an orthopaedic 3D-printing laboratory in a...
Article
Background: Lengthening nails (ILN) are an established method of limb reconstruction for leg length discrepancy (LLD). Literature on these nails is predominantly from developed countries, with more accessible resources for the procurement of devices and post-operative therapies. This paper aims to present the results and lessons learned from four t...
Article
Full-text available
Objectives The Radiographic Union Score for Tibia (RUST) scoring system has been validated in multiple studies assessing the healing of tibial fractures. Our objective was to assess the interobserver and intraobserver reliability for the RUST in diaphyseal femoral fractures treated with intramedullary (IM) nailing.Patients and methodsA total of 60...
Article
Full-text available
Background: The accuracy of physical examination to exclude arterial injury in penetrating trauma to extremities has been well established. Objectives: To determine whether the accuracy of physical examination to exclude arterial injury is similar to that of a computed tomography arteriogram (CTA) for different anatomical regions and mechanisms...
Article
Introduction Tibia fractures are the most common long bone injuries encountered in the trauma population. The majority are treated successfully but non-union remains a common complication. A systematic review of current evidence regarding the management for aseptic diaphyseal tibial non-unions was undertaken. Methods A systematic review using the...
Article
Full-text available
Citation: Pretorius HS, Ferreira N, Burger MC. A computer tomography-based anthropomorphic study of forearm osteology: implications for prosthetic design. SA Orthop J 2021;20(3):162-166. http://dx.doi.
Article
Background: The accuracy of hexapod circular external fixator deformity correction is contingent on the precision of radiographic analysis during the planning stage. The aim of this study was to compare the SMART Taylor spatial frame (TSF) in suite radiographic analysis methods with the traditional manual deformity analysis methods in terms of accu...
Article
Background: Orthopedic surgeons are invariably faced with situations where contemporary surgical techniques and implants are not satisfactory for a specific clinical scenario. One such scenario frequently arises around the lack of implant choice for intramedullary fixation of radius and ulna fractures. We will describe our experience designing and...
Article
Full-text available
Purpose Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assist with evidence...
Article
Full-text available
The incidence of civilian gunshot injuries is on the rise worldwide.Unfortunately, there is a lack of high-level evidence guiding management. The treatment of orthopaedic injuries from gunshots is complex and requires consideration of multiple aspects, including energy transfer to the tissue, severity of the wound, possible contamination, presence...
Article
Full-text available
Background: South Africa (SA) has one of the highest gun-related mortality rates in the world - 20 people per day. The available data, however, do not reflect the substantial number of patients suffering non-lethal firearm injuries. Gunshot-related injury has been recognised as a highly costly healthcare problem by individual treating centres in S...
Article
Full-text available
Background: Empirical antibiotic strategies in the treatment of chronic osteomyelitis should ideally be based on local microbiological antibiograms. Objectives: To review the antibiogram profiles of bacterial isolates of patients undergoing surgical treatment for chronic osteomyelitis and identify the most appropriate empirical antibiotic strate...
Article
Introduction: Tibia fractures are the most common long bone injuries encountered in the trauma population. The majority are treated successfully but non-union remains a common complication. A systematic review of current evidence regarding the management for aseptic diaphyseal tibial non-unions was undertaken. Methods: A systematic review using the...
Article
Full-text available
Background: Human immunodeficiency virus (HIV) reduces bone mineral density, mineralisation and turnover, and may impair fracture healing. Setting: This prospective cohort study in South Africa investigated whether HIV infection was associated with impaired fracture healing following trauma. Methods: All adults with acute tibia and femur fract...
Article
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Background: South Africa has a high burden of traumatic injuries that is predominantly managed in the public healthcare system, despite the relative disparity in human resources between the public and private sectors. Because of budget and theatre time constraints, the trauma waiting list often exceeds 50 - 60 patients who need urgent and emergent...
Conference Paper
Full-text available
Introduction Purpose: Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assis...
Conference Paper
Introduction The aim of this radiographic study was to define the anatomical axis joint centre distance (aJCD) and anatomical axis joint centre ratio (aJCR) of the distal femur in the coronal plane for skeletally mature individuals. Materials and Methods A cross-sectional radiographic study was conducted to calculate the horizontal distances bet...
Article
Full-text available
Background This study aimed to determine the prevalence of pathological neck of femur (NOF) fractures at a tertiary referral hospital through histological examination of specimens in all NOF fracture patients undergoing hip arthroplasty. A secondary aim was to determine whether the current practice of sending all femoral heads for histological eval...
Article
Full-text available
Background This study presents the outcomes of the management of chronic osteomyelitis of the appendicular skeleton according to an integrated approach at a dedicated bone infection unit in South Africa. Methods A retrospective record review identified 80 patients who were treated between January 2016 and December 2018. Results Sixty patients (75%)...
Article
Adamantinoma-like Ewing sarcoma is a rare variant of Ewing sarcoma with histologic and immunohistochemical evidence of squamous differentiation. This variant most commonly occurs in the head and neck region with a few cases reported in the long bones of the limbs. It may be associated with poorer clinical outcome and could pose a diagnostic challen...
Article
Full-text available
Background Tibial shaft fractures (TSFs) are among the most common long bone injuries often resulting from high-energy trauma. To date, musculoskeletal complications such as fracture-related infection (FRI) and compromised fracture healing following fracture fixation of these injuries are still prevalent. The relatively high complication rates prov...
Article
Full-text available
Background: Bone defects remain challenging to manage. The wide array of treatment options is a testament no single strategy works in every patient. This is more complex if consideration is given to the status of the host and the soft tissues. The choice of treatment should be based on specific patient requirements after taking all variables into a...
Article
Full-text available
BACKGROUND: The aim of this retrospective longitudinal study was to describe the overall burden and outcomes of surgically managed gunshot tibia fractures at a major trauma centre. Secondary objectives were to identify possible risk factors for complications including non-union and infection and to highlight any differences in outcomes between trea...
Article
Full-text available
BACKGROUND: The aim of this study was to accurately establish the variability in the anatomy of the radius and ulna in the context of the design of an intramedullary nail for both bones METHODS: Forearm computed tomography scans were used to measure the specific internal and external anatomy of the radius and ulna in adult patients. Patients with f...
Article
Full-text available
BACKGROUND: Malignant tumours commonly metastasise to bone. When this occurs in the femur, surgical intervention is required to reduce pain and restore mobility post fracture, or as a prophylactic measure when fracture is anticipated. This is typically in the form of replacement with hemi- or total arthroplasty or stabilisation with an intramedulla...
Chapter
Malalignment around the knee may harbour cosmetic, biomechanical and joint longevity complications [1]. Current literature is inconclusive regarding the long-term implications of angular deformities of the lower limb [1–3]; however, long-bone nonunions have shown a reduction in quality of life that is greater than diabetes, stroke and HIV [4]. Fort...
Article
Purpose: Orthopedic surgeries are still dependent on the human factor and more specifically the human eye to gauge the end result. Thus, the planned result and the final surgical result may differ at times. Our hypothesis was that the human eye would not be able to distinguish any angulational difference <3° from the planned trajectory. Materials a...
Article
Background: The aim of this radiographic study was to define the anatomic axis joint center distance (aJCD) and anatomic axis joint center ratio (aJCR) of the distal femur in the coronal plane for skeletally mature individuals. Methods: A cross‐sectional radiographic study was conducted to calculate the horizontal distances between the anatomical a...
Article
Abstract Objectives: To investigate, in patients suffering from fracture blisters, the time to surgical readiness in those treated with silver impregnated fibrous hydrocolloid (SFH) dressings compared to those treated with topical silver sulfadiazine (SS) cream, and to determine the direct costs associated with both treatments. DesignL: A sin...
Article
Full-text available
BACKGROUND: The management of femoral neck fractures in the younger patient remains contentious, with high failure rates being reported in the literature. Patient age usually plays a major role during decision-making with regard to head-sparing versus head-sacrificing surgical strategies. The aim of this study was to review the outcomes of fixation...
Preprint
Full-text available
Background: Adamantinoma-like Ewing sarcoma is a rare variant of Ewing sarcoma known to have cytokeratin expression and squamous differentiation. It occurs more commonly in the head and neck region with only a few cases reported in long bones of the limbs. It also harbours EWSR1-FLI1 gene fusion which is required for the diagnosis of Ewing sarcoma....
Preprint
Full-text available
Adamantinoma-like Ewing sarcoma is a rare variant of Ewing sarcoma known to have histologic and immunohistochemical evidence of squamous differentiation. This variant most commonly occurs in the head and neck region with a few cases reported in long bones of the limbs. It may be associated with poorer clinical outcome and could pose a diagnostic ch...
Article
Full-text available
Background: Violence and injuries are a significant global public health concern, and have a substantial emotional, physical and economic impact on society. In South Africa (SA), the Western Cape Injury Mortality Profile shows that homicides increased from 38 deaths per 100 000 in 2010 to 52 deaths per 100 000 in 2016. This increase is directly re...
Article
PurposeThe aim of this study was to quantify the overall burden of orthopaedic gunshot-related injuries at our institution over a four year period. Secondary aims included identifying complications from gunshot-related injuries and the additional burden it places on healthcare services.MethodsA retrospective review was conducted on all patients wit...
Article
Dynamization of fixation has long been used as a strategy to promote fracture healing. Which clinical scenarios would benefit from dynamization, how and when to introduce it and its effectiveness remains to be elucidated. A systematic review of the literature reporting on the use of dynamization in fracture healing using the Preferred Reporting Ite...
Article
Fracture-related infections (FRIs) are among the most common complications following fracture fixation, and they have a huge economic and functional impact on patients. Because consensus guidelines with respect to prevention, diagnosis, and treatment of this major complication are scarce, delegates from different countries gathered in Philadelphia...
Article
Full-text available
Synovial chondromatosis and osteochondromas are frequently encountered benign cartilaginous lesions. The concomitant occurrence of these lesions is rare. We report one such case in an 11-year-old female patient and speculate on the common underlying pathogenetic mechanisms which might be involved.Level of evidence: Level 5
Article
Full-text available
Nonunions are a relevant economic burden affecting about 1.9% of all fractures. Rather than specifying a certain time frame, a nonunion is better defined as a fracture that will not heal without further intervention. Successful fracture healing depends on local biology, biomechanics and a variety of systemic factors. All components can principally...
Article
Full-text available
BACKGROUND: Peri-articular infiltrations (PAI) in total knee arthroplasty (TKA) offer effective analgesia, and are cost effective, safe and easy to perform. Currently there is no gold standard technique based on evidence-based medicine; described methods are based on consensus recommendations. The latest literature supports PAI including complex an...
Article
Full-text available
Open tibia fractures are associated with an increased risk of infection, delayed union, non-union and wound complications. Management is aimed at mitigating the risk of infection while optimising the biological and biomechanical environment to encourage soft tissue and bone healing. With ongoing clinical trials and research, our knowledge around be...
Article
Stiff nonunions represent a unique subgroup of nonunions which pose distinct management challenges. Distraction of stiff nonunion, although seemingly counterintuitive, has long been shown to provide predictable results. Potential advantages of such a management protocol include gradual correction of deformity and limb length; noninvasive nature wit...
Article
Full-text available
Distal interlocking of intramedullary nails can be challenging if not done regularly and can be associated with a prolonged operating time and excessive radiation exposure. Multiple techniques have been developed to overcome these problems but all still rely on conventional distal locking methods. Between December 2011 and March 2013, 18 patients w...
Article
Full-text available
Background: The increase of orthopaedic surgical interventions has given rise to an increased prevalence of chronic osteomyelitis. The principles of management of chronic osteomyelitis are well defined and include a thorough debridement, dead space management followed by an adequate period of appropriate antibiotics. Bioactive glass has garnered in...
Article
Background Chronic osteomyelitis is a challenging condition to treat and although no exact treatment guidelines exist, the surgical management strategy includes wide resection of necrotic and infected bone followed by dead space management. This study evaluates the use of bioactive glass as a single-stage procedure for dead space management followi...
Article
The use of hexapod circular external fixation in acute tibia fracture care is increasing as more general orthopaedic surgeons are gaining expertise with the use of this treatment modality. Limited data is currently available on the complications that may be encountered with this treatment strategy. Aim: To review the complications and outcomes of...
Article
Full-text available
Introduction: High energy fractures like gunshot-related injuries or high velocity road traffic accidents are often complex to treat and have been associated with a higher non-union rate, especially when there is extensive bone loss. Fractures with severe comminution may not heal due to bone loss and an inability to achieve adequate fracture stabil...