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Hand Surgery

Both surgeons at the Cape Joint Surgery maintain a keen interest in hand surgery, a sub-speciality in orthopedics which overlaps with plastic surgery to some extent and requires meticulous technique and soft-tissue management. Dr Engela was involved with the Groote Schuur Hospital hand clinic for many years and was the driving force behind the establishment Read on … !

Adult Elbow Conditions

Fractures around the elbow

Adult Elbow injuries or fractures can range from undisplaced crack fractures, which he can definitely be treated in splints with a view to early movement of the elbow joint, to severely shattered fractures into the joint, which require meticulous reconstruction in order to prevent severe elbow stiffness. A fact that is Read on … !

Elbow Injuries in Children

Elbow injuries in children are extremely complicated orthopaedic problems to deal with and the diagnosis requires extensive experience as well as insight into the x-ray findings at various stages of a child’s elbow growth. In children, the injured elbow is often too painful and swollen to examine and the diagnosis rests with special investigations. Fractures Read on … !

Subacute Osteitis

Subacute osteitis is a rare condition, which may occur around the hip in young children. This usually results after a bone infection has been partially treated with antibiotics, which were discontinued too early. The diagnosis may not have been made in this case is often when antibiotics were prescribed empirically for a child which was Read on … !

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis consists of a spectrum of inflammatory arthropathys which affects children (girls in the early teenage years more often than boys). The patients present with synovitis of various joints (usually a polyarthropathy (more than one joint involved), although initial presentation may be in the form of a monoarthropathy). The wrist-, knee-, and ankle Read on … !

Tennis Elbow

Tennis elbow syndrome ( Lateral epicondylitis ) causes pain on the outer aspect of the elbow during activities that require a strong grip. The pain will only be present during activity in the early phase of the disease but may cause pain at rest or at night in more advanced disease. The initial treatment includes Read on … !


Bursitis is an inflammation of the fluid-full space, which is present around many of the bony prominence is in the body, such as for example the elbow or the kneecap. While bursitis may develop due to systemic inflammatory conditions and/or infective agents, by far the most common cause is repetitive trauma, hence the colloquial names Read on … !


Muscles are connected to bones via tendons and these structures are often placed under tremendous strain during physical activity, especially during sporting activities. Some of these structures, such as the tendons of the rotator cuff in the shoulder run over bony ridges or through bony canals, which may cause friction or impingement, leading to recurrent Read on … !