The use of the simple designed bone awl to facilitate the bankart operation.

This study reviews the results of using the simply designed bone awl to simplify the Bankart operation. The awl is characterized by a handle connected to the curved part in a bayonet position. The curve is 2.5 cm. In diameter, 2-3 mm. thick, with a sharp tip, as in a trocar point. During 1987-1989, this instrument was used to perform the Bankart operation in 13 patients with recument dislocation of the shoulder. The patient’s ages ranged from 18-31 years, twelve were males and one was female. Eleven patients suffered dislocation of the right shoulder and two of suffered dislocation of the left. In the operation, the awl could perform 3 holes at the edge of the glenoid. Three millimeters from the glenoid edge was the proper area to make the inlet hole. The canal was curve and 2 mm. in diameter. The outlet hole through the articular suface was 2 mm. below the glenoid edge. The time spent boring one hole was about 2 minutes and the hole could provide adequate strength to suture the anterior capsule to the glenoid edge without breakage of the hole. The use of the awl minimizes the duration of the operation and decreases the surgical trauma. The clinical results of five year follow-up showed that the patients could move the shoulder joint in full range of motion in two and a half months, and could do heavy duty work and play the sport in about three and a half months with no re-dislocation.

Effect of inspiratory flow waves to the patient.

To study the effect of inspiratory flow, we gave 30 postoperative ventilated patients (ASA 1-2) aged 20-60 years old three kinds of inspiratory wave forms as I (square), II (decelerated) and III (sine) were. Each patient received all 3 kinds of wave in on particular order by random. We found these effects on the cardiovascular system. Sine wave: decreased blood pressure more than the others but not significantly (p > 0.01). The best oxygenation was from sine waves than decelerated and finally square (not significant). Ventilation: PaCP2 decreased least with decelerated wave and most with square wave a significantly change comparing the two (p < 0.01). There was no significant change in pH. Airway pressure; PIP, increased significantly in I more than III and II, P plateau was highest in III then I and II and P maw the difference was not significant in I, II and III nut highest in III.