Evaluating postcranial macromorphoscopic traits to estimate population variation among modern South Africans.

Population overlap and the variation within and among populations have been globally observed but is often difficult to quantify. To achieve this, numerous different methods need to be explored and validated to assist with the creation of an accurate biological profile. The current lack of databases for postcranial macromorphoscopic traits indicates the need to further investigate if the method can be employed repeatably in a forensic context. The current study aimed to assess the prevalence of eleven postcranial macromorphoscopic traits in a South African sample. A total of 271 postcrania of adult black, coloured, and white South Africans were assessed. The intra- and inter-observer agreement ranged from fair to almost perfect except for the accessory transverse foramen of C1, which had poor agreement between observers. Only seven traits differed significantly between at least two of the groups. Univariate and multivariate random forest models were created to test the positive predictive performance of the traits to classify population affinity. The classification accuracies for the univariate models ranged from 33.3% to 53.0% and ranged from 54.6% to 62.1% for the multivariate models. Based on the variable importance, the traits assessing spinous process bifurcation were the most discriminatory variables. The results indicate that the postcranial MMS approach does not outperform current methods employed to estimate population affinity. Further research needs to be done for the method to have practical applicability for medicolegal casework in South Africa.

Door to relocation time for dislocated hip prosthesis: multicentre comparison of emergency department procedural sedation versus theatre-based general anaesthesia.

BACKGROUND: Dislocation of a hip prosthesis is a painful event which has an incidence of 4% for primary total hip arthroplasty. Relocation is traditionally performed under general anaesthesia in the operating theatre, but relocation using sedation in the emergency department (ED) has been reported, with a limited success rate of 62%. A study was undertaken to compare door to relocation times for ED sedation and theatre general anaesthesia. METHODS: The notes of all patients attending five centres in the south west of England with prosthetic hip dislocation over a 12-month period between 2005 and 2006 were retrospectively reviewed using standardised data collection forms. RESULTS: Successful ED reduction was significantly quicker than failed ED reduction and theatre-based general anaesthesia (2 h 21 min vs 8 h 32 min; p<0.001). No statistical difference was found between failed ED reduction and theatre general anaesthesia. CONCLUSIONS: Reduction of dislocated hip prostheses in the ED saves nearly 6 h compared with theatre-based general anaesthesia and is therefore advocated.