RESUMO
Partial wrist fusions are commonly performed for various degenerative conditions. In this series 30 wrists had a scaphoidectomy and midcarpal arthrodesis performed with a new plate. The most common indications were SLAC and SNAC wrists. In 24 cases a four-corner arthrodesis was done and in the other six the triquetrum was not included. Mean follow-up was 3 years. Mean flexion was 31° and extension 35°. Union was achieved in all wrists despite movement being commenced early. The plates proved straightforward to use, allowing some latitude in placement. This series confirms that scaphoidectomy and midcarpal arthrodesis is a useful salvage procedure and that these plates are suitable for that purpose.
Assuntos
Artrodese/instrumentação , Ossos do Carpo/cirurgia , Articulação do Punho/cirurgia , Adulto , Idoso , Artrodese/métodos , Placas Ósseas , Parafusos Ósseos , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Amplitude de Movimento Articular , Estudos Retrospectivos , Osso Escafoide/cirurgia , Resultado do Tratamento , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/fisiopatologiaRESUMO
Nurse practitioner-based/Traditional Hawaiian Lomi-Lomi clinics were funded with grant money and matching funds to provide medical services to uninsured Native Hawaiians. The clinics proved to be successful through the outreach efforts of local outreach workers, satisfaction with Lomi-Lomi (Hawaiian massage with a spiritual component), and the primary and preventive services of nurse practitioners. Western medicine and Lomi-Lomi are practiced in the same clinic setting cooperatively. Nurse practitioners refer to other community-based programs for nutrition education and weight control and to physicians as needed. Nurse practitioners must be aware of administration and fiscal issues to maintain such nontraditional clinics and services.
Assuntos
Centros Comunitários de Saúde/organização & administração , Serviços de Saúde do Indígena/organização & administração , Pessoas sem Cobertura de Seguro de Saúde , Medicina Tradicional , Profissionais de Enfermagem/organização & administração , Havaí , Humanos , Pesquisa em Avaliação de Enfermagem , Avaliação de Programas e Projetos de Saúde , Encaminhamento e ConsultaRESUMO
Intraarticular fractures of the base of the middle phalanx are difficult to treat, especially if the fragments are comminuted. A spring dynamic traction device is described and the results in the first 14 patients presented. Patient acceptance has been high and the results comparable to other methods of treatment.
