Nicholas M. P. Clarke

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BACKGROUND Clinical screening aims to identify and treat neonatal hip instability associated with increased risk of hip displacement, but risks failures of diagnosis and treatment (abduction splinting), iatrogenic effects, and costs to parents and health services. Our objectives were to assess clinical effectiveness and net cost of ultrasonography compared(More)
The treatment for most patients with slipped capital femoral epiphysis (SCFE) is well established but controversy remains as to how to manage the more difficult cases. The advent of fixation by a single cannulated screw has made this the operation of choice. The morbidity is considerably less than that with any of its predecessors , but the optimum timing(More)
BACKGROUND Residual acetabular dysplasia is one of the most common complications after treatment for developmental dysplasia of the hip. The acetabular growth response after reduction of a dislocated hip varies. The options are to wait and add a redirectional osteotomy as a secondary procedure at an older age, or to perform a primary acetabuloplasty at the(More)
Osteoarthritis (OA) is generally a disease of the elderly population, but can occur in young patients in exceptional cases. This study compares the cellular and epigenetic features of primary old-age OA with those of secondary OA in a 23-year-old patient with developmental dysplasia of the hip. In addition, control cartilage from a 14-year-old was compared(More)
BACKGROUND Existing radiographic classification schemes (eg, Tönnis criteria) for DDH quantify the severity of disease based on the position of the ossific nucleus relative to Hilgenreiner's and Perkin's lines. By definition, this method requires the presence of an ossification centre, which can be delayed in appearance and eccentric in location within the(More)
Historically infant swaddling was almost a universal practice. It involved binding or bundling babies in blankets with the arms restrained and the lower limbs extended. It remains common in the Middle East 1 and in some ethnic groups with or without a board or cradle. 2 There has been a recent resurgence of swaddling because of its perceived palliative(More)
Transient neonatal radial nerve palsy manifests at birth by wrist drop and intact elbow and shoulder function. Spontaneous resolution is universal. We present a case series, including two bilateral cases, and a review of the cases found in the English literature, hypothesizing how this condition is probably misdiagnosed as brachial plexus injury.
INTRODUCTION Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site(More)
BACKGROUND Improved management of clinicians' time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual(More)
PURPOSE Developmental dysplasia of the hip (DDH) is common, and the term encompasses a spectrum of anatomical abnormalities of the hip in which the femoral head displaces from the acetabulum. These abnormalities may be congenital or develop during infancy and/or childhood. Neither the prenatal and postnatal factors that predispose to hip instability nor the(More)