Treating buckle fractures in children with a soft cast and home removal: a quality improvement initiative.

Buckle fractures of the distal radius are unique to children and a frequent presentation in the emergency department (ED). In University Hospital Waterford, Ireland, the treatment of buckle fractures followed the traditional method involving a rigid cast and a follow-up hospital appointment. However, the latest literature indicates that buckle fractures are stable and heal without complication, so a minimalist approach to treatment is recommended. Therefore, the advanced nurse practitioners in the ED introduced a change in protocol at the hospital. This involved the use of a soft cast for removal at home, with verbal and written discharge information and no follow-up appointment. An audit was conducted to ensure that this new protocol was safe and effective, and the time and distance saved by patients through avoiding a return hospital visit was estimated. Treatment in a soft cast with verbal and written discharge information revealed a successful outcome for all 88 patients included in the audit. Avoiding return hospital visits resulted in significant travel time and distance savings for patients and families.

Evaluation of Functional Outcomes for Adult Patients After Distal Radius Fracture Treated With Volar Plate Fixation Versus Nonsurgical Care.

Distal radius fractures are one of the most common fractures patients experience. Although there are a variety of treatments, there is a lack of standardization as it relates to treatment of such fractures. The purpose of this study was to compare treatment outcomes between surgical and nonsurgical care of distal radius fractures to inform evidence-based guidelines for the management of distal radius fractures. A retrospective chart analysis was performed in the public university hospital setting on a sample of 60 patient health records divided equally into those treated surgically and nonsurgically. Data were analyzed related to specific variables in those patients who met specific inclusion/exclusion criteria. Analysis identified that patients treated surgically experienced improved healing and return of range of motion. There was no statistical significance comparing pain in both the surgical and nonsurgical groups. Diabetes and smoking were found to have a negative impact on healing and clinical outcomes. Despite limitations, this pilot project serves as a baseline for future research regarding best practices in the treatment of distal radius fractures. It also demonstrates the negative impact that diabetes and smoking can have on clinical outcomes.

Effect and nursing study of traditional Chinese medicine preparation huayu zhitong powder in the treatment of distal radius fracture.

This paper aims to discuss the effect of traditional Chinese medicine preparation Huayu Zhitong powder in the treatment of distal radius fracture. In this paper, 200 patients with distal radius fracture were randomly divided into treatment group and control group. Patients in treatment group orally took Huayu Zhitong powder, while patients in control group were treated with traditional Shangke Jiegu tablets with traditional Chinese medicine composition. After fixed in a cast plaster, patients in the two groups were supervised the disappearance time of pain by adopting NRS (Numerical rating scale) from scale 0 to 10. Besides, they returned at day 5 and day 8 respectively, and then they were observed the swelling affected part. At day 14, day 28, and day 56 after reduction they respectively took an x-ray. Then they would be graded according to the growth of osteotylus and the clinical effects were evaluated based on the grade. Finally, the treatment group worked better in relief effect than the control group. At day 8, the treatment group worked better in detumescence than the control group. At day 28, the recovery effect in treatment group was found to be better than the other. From these, it is shown that the traditional Chinese medicine works much better in the treatment of distal radius fracture than traditional treatment medicine. Thus it is of great worth spreading for use.

Distal radius fracture in adults: self-reported physical functioning, role functioning, and meaning of injury.

PURPOSE: To identify physical function, role function, and meaning of injury in adults with a distal radius fracture. SAMPLE: Convenience sample of 60 adults with an isolated distal radius fracture. METHOD: Repeated measures of analysis of variance were used to test the relationship of gender, age, education, hand dominance, preinjury physical health, and treatment modality to physical function, role function, and meaning of illness/injury. The independent variable is time and the dependent variables are physical function, role function, and meaning of illness/injury. FINDINGS: Although improvement occurred with time, older adults had significantly lower physical functioning than younger adults while their wrist was immobilized, and middle-age adults had significantly lower role functioning compared to younger and older adults. Physical function was influenced by age, and role function was influenced by both age and education. CONCLUSION: The identified need for additional guidance and physical and emotional support with the standard treatment of distal radius fractures highlights the need for nursing care during the early recovery period.

The effects of technology on triage in A & E.

Within the specialty of Accident and Emergency (A & E) nursing, triage is a term meaning to classify or sort patients according to their need for care (Blythin 1988). Burgess (1992) views this process as a means of prioritizing patients in order, so that the more seriously ill or injured are seen first (Table 1). Triage performance is measured in the author's department by computer. This technological source is used to record the patient's arrival time and the time at which the patient is triaged. Technology is defined by the Oxford Dictionary (1996) as 'the study of mechanical arts and science, their application in industry'. This paper explores the impact of this technology and the related issues on the A & E triage nurse, and will focus on issues related to the Patients' Charter (1991), resource implications, safety and staff training. In conclusion, the quality of a patient's total care, in which the author participated, is discussed with reference to the related issues and implications for future practice.