ABSTRACT
Malunions of forearm fractures in adults can present with limitation of forearm rotation, or as distal radioulnar joint instability with functional impairment. This contrasts with paediatric patients in whom malunions of similar severities are often better tolerated. We did a retrospective review of six adult patients after corrective forearm osteotomy for symptomatic malunited forearm shaft fractures. The corrective operations were done between 7 and 168 months after initial injury, using oblique or wedge osteotomies. Median follow-up was 22.5 months. The patients recovered well, with statistically significant improvement in forearm rotation and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. No significant complications occurred.
Subject(s)
Fractures, Malunited/surgery , Osteotomy/methods , Radius Fractures/surgery , Radius/surgery , Ulna Fractures/surgery , Adolescent , Adult , Elbow Joint/physiopathology , Female , Fractures, Malunited/physiopathology , Humans , Male , Middle Aged , Range of Motion, Articular , Ulna/surgery , Wrist Joint/physiopathology , Young AdultABSTRACT
INTRODUCTION: This study determines the accuracy of reading a Polaroid retinal photograph in the diabetic retinal photography programme as compared to a clinical fundal examination in the diagnosis of diabetic retinopathy. METHODS: A prospective study recording the additional findings obtained from clinical examination of the eye using indirect ophthalmoscopy and slit lamp biomicroscopy in a restructured tertiary hospital serving an urban community was performed. RESULTS: Seventy-eight eyes in 39 diabetic patients were reviewed by an ophthalmologist for diabetic changes seen on fundus photography. The sensitivity of diabetic retinal photography in diagnosing diabetic eye conditions was 91.6 percent, with a specificity of 99.8 percent and a positive predictive value of 95.6 percent. The degree of agreement kappa was 0.94. CONCLUSION: The use of diabetic retinal photographs to screen for diabetic eye disease achieved a high sensitivity by capturing diabetic retinal lesions. It was comparable to an examination performed by the ophthalmologist. With appropriate training, the person reading the diabetic retinal photographs can accurately diagnose diabetic eye conditions.
