ABSTRACT
To evaluate the benefit of the Pacific Island Health Care Project (PIHCP) to our orthopedic graduate medical education program, we performed a retrospective review of our 8-year operative experience with patients referred through this program. Between July 1994 and June 2002, 69 patients underwent 79 orthopedic operative procedures. Patients were categorized by primary diagnosis, anatomic site involved, and surgical treatment rendered. Because many of the patients referred from the PIHCP with tumors were noted to have either unusually large lesions or advanced-stage disease, further analyses of tumor stage and pathologic grade were made. Seven of the 14 oncologic cases surgically treated in our department in the past 8 years were referrals from the PIHCP. Unique operative procedures performed for these tumor patients included one forequarter amputation, one hip disarticulation, one hemipelvectomy, two partial scapulectomies, and one distal ulna excision. We conclude that the PIHCP referrals provide an important and relatively unique contribution to the clinical and operative experience of our orthopedic residents. These patients from the Pacific basin also enhance our orthopedic graduate medical education program by exposing our residents to the special socioeconomic and cultural issues related to caring for people from developing insular countries.
Subject(s)
Hospitals, Military/statistics & numerical data , Internet , Military Medicine/education , Orthopedic Procedures/statistics & numerical data , Orthopedics/education , Referral and Consultation , Remote Consultation , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Education, Medical, Graduate , Female , Hawaii , Health Services Accessibility , Humans , Male , Middle Aged , Pacific Islands , Program Evaluation , Retrospective Studies , Transportation of PatientsABSTRACT
The Maisonneuve fracture consists of a proximal fibular fracture with associated syndesmotic ligament disruption and injury to the medial ankle structures. The accepted mechanism of injury is an external rotation force applied to the ankle with the foot in either supination or pronation. Because most Maisonneuve fractures involve complete syndesmotic disruption, operative treatment is usually indicated. A case report is presented of an unusual fracture pattern-i.e., that of a distal fibular fracture with lateral ankle dislocation associated with a Maisonneuve fracture. To our knowledge, only two other similar cases are reported in the English literature.
