ABSTRACT
A survey is presented that contradicts the often quoted teleologic argument that restricted mobility is the limiting factor in weight reduction in overweight patients needing a total hip arthroplasty. One hundred fifty patients were reviewed at 1 year after arthroplasty. All reported improved mobility, but there was no evidence of a trend toward weight loss. More complications with overweight patients were observed. This is useful information in encouraging overweight people to lose weight prior to hip arthroplasty, and could be extrapolated to other procedures.
Subject(s)
Body Weight , Hip Prosthesis , Obesity/epidemiology , Postoperative Complications/epidemiology , Body Mass Index , Follow-Up Studies , Humans , Risk Factors , Time FactorsSubject(s)
Heart Transplantation , Hip Prosthesis , Adult , Female , Femur Head Necrosis/etiology , Femur Head Necrosis/surgery , HumansABSTRACT
Carpal and tarsal synostoses are uncommon. We report a rare combination of bilateral carpal and tarsal synostoses, including fusion across the carpal and tarsal rows, and review the literature.
Subject(s)
Carpal Bones/abnormalities , Synostosis/diagnostic imaging , Tarsal Bones/abnormalities , Adult , Carpal Bones/diagnostic imaging , Flatfoot/complications , Humans , Male , Radiography , Synostosis/epidemiology , Tarsal Bones/diagnostic imagingSubject(s)
Cysts/etiology , Tibial Meniscus Injuries , Cysts/surgery , Humans , Menisci, Tibial/surgery , RuptureABSTRACT
Although limb exsanguination prior to tourniquet inflation is usually accomplished using mechanical devices, elevation alone may still be employed under circumstances where mechanical means are contraindicated. The rather confusing advice within the literature as to duration of elevation, stimulated a study in the arm which revealed the optimal duration of elevation to be 5 min, a period somewhat longer than generally advised. Because the pattern of venous drainage within the leg is slightly different to that of the arm, we undertook a similar study to ascertain if our findings for the arm also held true for the leg. Volume changes in the calves of seven male volunteers during elevation at 45 degrees and 90 degrees were assessed using strain gauge plethysmography. To achieve maximal exsanguination it is recommended that the leg should be elevated at an angle of 45 degrees for 5 min. Higher angles of elevation produce slower and less complete exsanguination.
Subject(s)
Leg/blood supply , Posture/physiology , Tourniquets , Adult , Humans , Male , Plethysmography , Regional Blood Flow/physiology , Time FactorsABSTRACT
Limb exsanguination before tourniquet inflation is usually accomplished using mechanical devices although, where their use is contraindicated, exsanguination by elevation alone may be employed. Advice regarding duration of elevation within the literature is a little confusing with recommendations ranging from 20 s to 5 min. Volume changes, during elevation at 45 degrees and 90 degrees, were measured using strain gauge plethysmography in seven male volunteers. In addition, the superimposed effect of brachial arterial compression on elevation at 90 degrees was investigated. To achieve maximal exsanguination it is recommended that the arm should be elevated for 5 min at 90 degrees before tourniquet inflation. Supplementary brachial arterial compression is not recommended as this tends to attenuate changes in volume.
