Admission proforma significantly improves the medical record.

The authors worked in a busy regional fracture unit, where it was noted that important data was being omitted from medical notes. In an attempt to improve on this, an admission proforma was formulated. This was designed to be easily and quickly completed. Notes were audited on two separate weeks, the first before, and the second after introduction of the proforma. The overall results demonstrate statistically significant improvements in documentation with a proforma, and concur with the limited previous literature in this area.

Osteoid osteoma of the scapular neck: a case report.

Osteoid osteoma localised in the scapula are very rare. We report the case of an 11-year-old girl, who presented with an osteoid osteoma at the neck of the glenoid. This was excised en bloc after being located accurately by computed tomography. This case report demonstrates the difficulty in the approach to the excision of this unusually located lesion.

Supracondylar nail failure: two case reports.

We describe two case reports of supracondylar nail failure in young patients who had sustained high energy, closed, comminuted supracondylar femoral fractures. These injuries had been successfully treated using retrograde intramedullary nails which failed several months later because of excessive activity on the part of the patient without the presence of full flexion at the knee. The failed implants were removed and dynamic condylar screws were inserted with bone graft to the fracture site. This revision procedure produced solid bony union. We recommend that these patients should not fully weight bear, or engage in strenuous physiotherapy after nailing, until the fracture has consolidated and a functional range of knee motion has been obtained. Failed implants should be managed by nail removal, bone grafting and insertion of a dynamic condylar screw.

Chronic sclerosing osteomyelitis. An unusual case.

An unusual case of bilateral chronic sclerosing osteomyelitis of the clavicles is reported. A culture of resistant Staphylococcus aureus was obtained. Curettage of the lesions resulted in healing and symptomatic relief. There has been no recurrence on follow-up at one year.

Brain abscesses in Northern Ireland: a 30 year community review.

One hundred and seventy-two cases of intracranial abscesses, obtained from Neurosurgical and Centralised Autopsy Records for Northern Ireland for the 30 years, 1947--1976, have been reviewed. The incidence of the disease has fallen from five to three per million of population per year over the past three decades. Intracranial abscesses were three times as common in males as in females. Twenty-nine per cent of the abscesses were in the temporal lobe, 25% frontal, 10% parietal, 6% cerebellar, 3% occipital, and 7% were either subdural or in deep sites such as the thalamus; the remainder (20%) were multiple. Multiple and occipital abscesses were all fatal, temporal and parietal abscesses were associated with a 65% mortality, and 45% of patients with frontal abscesses died. Chronic suppurative otitis media was the single largest cause, and it was the only aetiological factor to have shown a progressive decline over 30 years. For those seen and treated in the neurosurgical unit the mortality was 53%, but if those obtained from the necropsy records were included the overall mortality was 70%.