ABSTRACT
Clinical governance is the structured approach to maintaining and improving the quality of patient care and is a vital part of global surgery. BFIRST and BSSH closely collaborate with local doctors on a number of overseas projects, seeking to strengthen and develop local knowledge and skills, aiming for an independent local practice in reconstructive and upper limb surgery. Thoughts on essential requirements, improvements and pitfalls in the ethical approach to global collaboratives are presented.
Subject(s)
Medical Missions/organization & administration , Plastic Surgery Procedures/standards , Quality Assurance, Health Care/organization & administration , Aftercare , Capacity Building/organization & administration , Global Health , Humans , Informed Consent , Quality Assurance, Health Care/methodsABSTRACT
This paper describes the presence of tenodesis effects in normal physiology and explores the uses of operative tenodesis in surgery of the upper limb.
Subject(s)
Tendons/surgery , Tenodesis/methods , Upper Extremity/surgery , Humans , Tendons/physiology , Trapezium Bone/surgerySubject(s)
Bone Plates/adverse effects , Fracture Fixation, Internal/adverse effects , Osteophyte/etiology , Radius Fractures/surgery , Wrist Injuries/diagnosis , Wrist Injuries/etiology , Adult , Female , Fracture Fixation, Internal/instrumentation , Humans , Osteophyte/diagnosis , Osteophyte/surgery , Radius Fractures/complications , Range of Motion, Articular , Wrist Injuries/surgerySubject(s)
Median Neuropathy/etiology , Nerve Compression Syndromes/etiology , Radius Fractures/complications , Tendon Entrapment/etiology , Adult , Fracture Fixation, Internal , Humans , Male , Median Neuropathy/surgery , Nerve Compression Syndromes/surgery , Radius Fractures/surgery , Skiing/injuries , Tendon Entrapment/surgeryABSTRACT
This paper entails a clinical review of outcomes and complications of 19 consecutive paediatric patients having undergone elastic stable intramedullary nailing for diaphyseal forearm fractures over a one year period. The mean age of patients was 9 years. The majority were male with a ratio of 17:2. In this group there were two patients with grade 1 open fractures. Four of the fractures required open reduction due to difficulty in reduction and soft tissue interposition. All fractures went on to osseous union with minimal deformity and full recovery. There were three complications which included one EPL rupture requiring delayed repair, one EPB partial rupture repaired at time of surgery, and one superficial radial nerve injury. Two patients also presented with nails penetrating the skin prior to removal. Elastic stable intramedullary nails offer good fixation to control deformity in midshaft forearm fractures for paediatric patients. However there is a high rate of possible complications around the radial insertion point.
Subject(s)
Bone Nails , Forearm Injuries/surgery , Fractures, Bone/surgery , Internal Fixators , Orthopedic Procedures/methods , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Forearm Injuries/physiopathology , Fracture Healing/physiology , Fractures, Bone/diagnostic imaging , Humans , Male , Orthopedic Procedures/adverse effects , Orthopedic Procedures/instrumentation , Radiography , Recovery of Function/physiology , Retrospective StudiesABSTRACT
We report a case of carpal tunnel syndrome as a result of an extraosseous chondroma in a 47-year-old gentleman. This case demonstrates the importance of clinical examination and occasional radiographs in this not uncommon condition. We also highlight that this well known entrapment syndrome is not only caused by the common causes that we all know, but also any space-occupying lesion in the carpal tunnel compressing the median nerve.
Subject(s)
Carpal Tunnel Syndrome/etiology , Chondroma/complications , Wrist , Carpal Tunnel Syndrome/surgery , Chondroma/surgery , Humans , Male , Middle AgedABSTRACT
The AO/ASIF proximal femoral nail (PFN) is a new device designed for the treatment of the unstable trochanteric femoral fracture. This study reports the outcome in such fractures treated using the PFN at a District General Hospital. All patients presenting to our department with unstable trochanteric femoral fractures were treated operatively using the PFN. A total of 76 patients were included in the study and were followed up to fracture union or fixation failure. A case documentation form and follow-up form were used to collect the data which included the Salvati and Wilson assessment of hip function. The majority of the procedures were reported by the operating surgeon as "easy" or "usual". Distal locking was difficult in three patients. In one patient, the fixation failed because the screws were wrongly positioned and was revised to a THR. Mortality rate, during the first 3 months, was 27%. Of the surviving patients, screws cut through the femoral head in four patients (8%), however, fractures united in all the patients. There was one incidence of fracture around the tip of the nail. Seventy-eight percent of the patients at the final follow-up scored >20 points (out of 40 points), using the Salvati and Wilson hip function scoring system. According to the patients and/or their carers, outcome was described as good or very good in 94% of the patients and the level of function was similar to pre-injury level in 50% of the patients. We conclude that the PFN is a useful device in the treatment of the unstable trochanteric femoral fracture. It is a relatively easy procedure and a biomechanically stable construct allowing early weight bearing. Femoral neck screws positioning is critical.
