ABSTRACT
We describe the use of proximal stacked wires for the removal of an intramedullary nail in the context of difficult extraction and failed attempts by conventional methods. This percutaneous technique is particularly useful for the extraction of narrow cannulated or solid intramedullary nails after failure of removal by extraction bolt devices.
Subject(s)
Bone Nails , Bone Wires , Device Removal/methods , Femur Neck/surgery , Orthopedic Procedures/methods , Adult , Female , Femoral Neck Fractures/surgery , Fracture Fixation, Intramedullary/methods , HumansABSTRACT
By implementing collaborative care for patients with alcohol misuse and alcohol-related liver disease, the Royal Bolton Hospital aimed to improve and coordinate their care by recruiting a multidisciplinary team and placing the patient at the centre of all efforts. There has been a marked improvement in the accuracy of the drinking histories taken, detoxification, dietary documentation, and patient and staff attitudes and confidence, with enhanced satisfaction in patients, their families and staff and improved accessibility and communication. We observed a considerable increase in the number of inpatient and outpatient referrals and believe that it is more effective to work together in a joint gastroenterology/psychiatry team. There is a critical national need to establish steering groups of key clinical, managerial and commissioning personnel to address the growing problem of alcohol misuse. The appointment of dedicated alcohol health workers is central to this strategy.
