RP-Department of Surgery & Orthopaedics
Permanent URI for this collection
Browse
Browsing RP-Department of Surgery & Orthopaedics by Author "Ndeleva, B.M."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item The Anterior Curve of the Adult Femur in a Kenyan Population and its Mismatch with Available Intramedullary Nails(AJOL, 2016) Lakati, K.C.; Ndeleva, B.M.Background: There are currently no studies which have documented the anterior femoral curvature in Kenya or elsewhere in Africa, and compared it to the curvature of the available intramedullary nails. Objective: To determine the anterior femoral curvature in cadaveric femora and to compare this with the curvatures of locally available femoral intramedullary nails. Methods: We determined the radii of 66 cadaveric femora by the method described by Karakas and Harma. The radii of locally available femoral intramedullary nails were also obtained from the respective product monographs. Results: We found that the radius of the curvature ranged from 52.02cm to 165.82cm with a mean of 96.4cm and standard deviation of 25.61cm. The radii of locally available intra-medullary nails ranged from 127cm to 200cm. Conclusion: The radius of curvature of the adult femora in Kenyans is less than that of other populations. There was a large mismatch between the available intramedullary nails and the femoral curvature. Further study of the complications resulting from this mismatch and a review of the design of the nails for local use is recommended.Item OSCEs for Undergraduate Clinical Examination in Orthopaedics: Inter-Examiner Variability(AJOL, 2016) Ndeleva, B.M.Background: The traditional clinical examination has fallen into disfavour on account of considerable inter-examiner variability. The OSCE is gaining popularity as it is perceived to be less prone to this. Objective: To establish whether inter-examiner variability is still a significant factor for the undergraduate orthopaedic clinical examination in our institution. Method: Thirty three final year students were randomly divided into two groups of 17 and 16 students. Two standardized OSCE questions were administered to each student by four examiners with each group being examined by one lecturer for each of the questions. For the first question, students in Group 1 were examined by Examiner A while those in Group 2 were examined by Examiner B. For the second question, students in Group 1 were examined by Examiner C while those in Group 2 were examined by Examiner D. The scores for each student were tabulated and the range, mean, and pass rate determined for each of the examiners. The Student’s t-test was calculated to determine if there was statistically significant interexaminer variability. Results: For Question 1, the mean score for students examined by Examiner A (Group 1) was 7.47 marks while that for Examiner B (Group 2) was 5.59 marks. The p-value was 0.01367 (95% confidence interval). For Question 2, the mean score for students examined by Examiner C (Group 1) was 7.32 marks while that for Examiner D (Group 2) was 8.625. The p-value was 0.001148 (95% confidence interval). Conclusion: There was statistically significant inter-examiner variability. We recommend that for all OSCE exams, examiners be paired with a deliberate attempt to pair a “Hawk” with a “Dove”. Statistical correction of biases is also recommended