Our specialist
Prof Len Marais
Specialist Orthopaedic Surgeon
Specialities
Orthopaedic Infections, Orthopaedic Oncology, Hand, Limb Reconstruction
Orthopaedic Infections
Bone and joint infections are complex conditions that are challenging to treat and necessitate specialised care. One common type of bone and joint infection is a Fracture-Related Infection, which occurs following an open fracture or following fracture fixation surgery. Infection can occur after any orthopaedic operation. Examples of post-operative infections include Periprosthetic Joint Infection which is an infection in a joint that has been replaced (for example a hip or knee replacement). Acute bone and joint infections need to be treated urgently, as they may result in permanent or chronic functional impairment or systemic sepsis.
Orthopaedic Oncology
Orthopaedic oncology is a specialised field which focuses on the diagnosis and treatment of tumours and tumour-like conditions which affect bones, joints, muscles and soft tissues of the limbs, pelvis, and shoulder girdles. These conditions can range from benign bone tumours and dysplastic bone disorders to malignant bone cancers and soft tissue tumours which occur in the limbs and limb girdles. Metastatic tumours, myeloma and lymphoma are systemic cancers that can involve bone. Metabolic bone disorders also need treatment, as they affect bone strength and structure. A multidisciplinary team approach is taken when considering the diagnosis and treatment plan for these conditions.
Surgery of the hand
Optimal hand and wrist function is vital for our activities of daily living. Injuries such as fractures of bone, joint injuries or dislocations, tendon and nerve injuries, as well as all other soft tissue and nail trauma necessitate specialist care to prevent permanent impairment. Hand and wrist trauma can also result in chronic pain and disability that may require treatment. Degenerative and inflammatory conditions, such as osteoarthritis or rheumatoid arthritis also commonly effect the joints of hand and wrist, causing pain and stiffness. Other common pathologies encountered in the hand and wrist are carpal tunnel syndrome (presenting as pain and abnormal sensation in the hand), trigger fingers (with catching of a finger with movement), Dupuytren’s disease (characterised by thickening and contraction of the fascia in the hand), and inflamed painful tendons due to overuse.
Limb reconstruction
A variety of postoperative orthopaedic complications can affect the healing and functioning of bones and limbs. These include delayed union or non-union of bones (when bone fails to heal properly within the expected time frame); malunion (bones which fail to heal in the correct position) which could cause deformity and impaired function. Trauma or infection can result in bone defects which may require reconstruction techniques such as bone grafting or the use of prosthetics which are designed to replace extensive bone loss. Leg length discrepancies could be a result of a congenital condition or may be acquired through an injury. This is often managed by bone lengthening procedures which use gradual distraction techniques. Deformities of bones and joint can be corrected using circular external fixation devices that are programmed using complex computer algorithms that allow the deformities to be corrected gradually and very accurately. In some instances, amputation may be necessary which requires specialised management.