ABSTRACT
INTRODUCTION: The preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients were reviewed. As it is currently only a limited release product, we describe to potential users early complications and negative outcomes. METHODS: Patients were assessed using pain levels, ranges of motion, grip strength, type of and time to return to work as well as pre-operative and post-operative DASH (Disabilities of the Arm, Shoulder and Hand) scores. Radiographs were taken and patient satisfaction was recorded. RESULTS: All six patients were contacted. One was not satisfied. Three had reduced motion. None experienced squeaking. There were no immediate or late post-operative complications. There was one early volar displacement of an implant. CONCLUSIONS: Although our early results are somewhat encouraging, further and longer studies are warranted before supporting the use of this particular pyrocarbon implant as a primary procedure.
Subject(s)
Carbon , Joint Prosthesis , Osteoarthritis/surgery , Wrist Joint/surgery , Adult , Aged , Arthroplasty, Replacement , Biocompatible Materials , Female , Humans , Male , Middle Aged , Prospective Studies , Range of Motion, Articular , Treatment OutcomeABSTRACT
From a clinical audit of the treatment given to 1005 patients suffering from ankle fractures, 507 patients of 626 taken randomly from 15 hospitals were contacted and asked to complete a questionnaire describing and evaluating their experiences. The design of the study aimed in a number of ways to reduce respondents' tendency towards a positive response in completing satisfaction scales. The very high response rate, commentaries and variations in opinions about specific service criteria indicate that the results have a high degree of validity. The generally high rates of satisfaction reported here reflect very well on existing NHS provision for a specific procedure, with the exception of certain hospitals' arrangements for waiting, and the provision of certain types of information. Against general indicators of satisfaction with the management of pain relief in hospitals, that in ankle fracture treatments appears to be exceptionally high. However, it would be valuable to discover why younger patients appear to be strikingly more critical than older patients across the entire range of issues. The inquiry aims to compare findings with studies of other orthopaedic services using a similar elementary methodology as a routine component of clinical audit.
Subject(s)
Ankle Injuries/therapy , Fractures, Bone/psychology , Fractures, Bone/therapy , Patient Satisfaction/statistics & numerical data , Quality of Health Care , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Ankle Injuries/psychology , Child , Communication , Female , Health Personnel , Humans , Male , Middle Aged , Patient Education as Topic , Professional-Patient Relations , State Medicine/standards , Time Factors , United KingdomABSTRACT
Foot drop resulting from subluxation of the superior tibio-fibular joint is described in a female dancer. Spontaneous resolution of the nerve injury occurred over two months with no residual joint instability. Expectant management is recommended for this injury. The potential for this unusual injury, in a wide variety of sports, is pointed out.
Subject(s)
Athletic Injuries/etiology , Dancing , Joint Dislocations/etiology , Knee Injuries/etiology , Adult , Athletic Injuries/diagnostic imaging , Female , Humans , Joint Dislocations/diagnostic imaging , Knee Injuries/diagnostic imaging , RadiographyABSTRACT
From August 1981 to February 1982 postoperative infections due to different strains of penicillin-resistant Staphylococcus aureus occurred in 20 of 467 patients (4.3%) undergoing elective cranial and spinal operations. These infections were not attributable to defects in procedures or the theatre environment, therefore chemoprophylaxis was instituted. In the following 8 months, when patients were given penicillin G and sulphadiazine for 5 days commencing immediately postoperatively, S. aureus infections occurred in five of 579 patients (0.9%). In a subsequent randomized uncontrolled study, infections occurred in six of 265 patients receiving penicillin (2.3%), three of 270 receiving penicillin and sulphadiazine (1.1%) and one of 45 receiving erythromycin (2.2%) immediately postoperatively for 5 days. In a further study in which 587 patients received penicillin for 5 days commencing immediately preoperatively, infections due to S. aureus occurred in six (1.1%). Infections due to gram-negative organisms were seen in five (0.4%) of 1167 patients in the two uncontrolled studies.
