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The results of 46 extensor tendon repairs performed by junior accident and emergency doctors were assessed, with a minimum follow up of 6 months. Based on Miller's assessment, 80 per cent of the proximal injuries achieved excellent or good results. Only 18 per cent of distal injuries achieved excellent or good results. Neither grip or fingertip pinch strength were significantly reduced. Sixty-seven...
Monitoring of postoperative wound healing is important for the early diagnosis of postoperative infective complications in order to decrease morbidity. The purpose of this study was to search for a discriminatory time point between uneventful wound healing and early wound infections after operations for orthopaedic trauma using PMN elastase. This proteolytic enzyme is a biochemical marker for pathological...
This study tested different methods of internal fixation of a symphyseal disruption, in comparison with the mechanics of the intact pelvis. Unembalmed cadaveric pelves were tested in simulated bilateral stance in a servohydraulic materials-testing machine. Motion of the superior and inferior pubic symphysis, and at two levels of the posterior sacroiliac complex, was measured using high resolution...
A routine audit revealed that in 25 per cent of patients with proximal femoral fracture, hospital stay was complicated by urinary tract infection (UTI). A prospective study was undertaken to investigate the relationship of UTI to fracture type, timing of surgery and the effect of perioperative antibiotics. Eighty-eight patients were investigated over a 4-month period with urine specimens obtained...
We report the effect of dynamization timing on healing rates when treating tibial fractures with the Dynamic Axial Factor (Orthofix, registered trademark). Sixty-nine patients with 71 fresh tibial fractures were grouped retrospectively for age, Gustilo and Anderson wound grading, site of tibial fracture and presence of an intact fibula or stable fibular fracture. Pairs were then generated chronologically...
Various mechanisms of injury have been hypothesized for each of the common elbow fractures, but few have been proved. This paper describes cadaveric experiments demonstrating some fracture mechanisms. Tests were performed at different angles of flexion, with impacts around the elbow or along the forearm bones. A range of fractures occurred. Radial head and coronoid fractures followed impact along...
The choice of which decision to use for open reduction and internal fixation of complex acetabulum fractures depends on several variables. We report on 26 patients in whom a lateral extension of the ilioinguinal incision was used to achieve fracture reduction and stabilization. The lateral extension allowed visualization of the lateral ilium, in some cases passage of cerclage wires around the anterior...
The experience of one institution in the use of the Seidel locking intramedullary nail in 23 patients with humeral shaft fractures is reported. The device was used only for cases involving failure of previous treatment, pathological fractures or multiple injuries. Acceptable results were achieved in patients with pathological fractures, but the results in other patients were disappointing with unacceptably...
In ten mature rabbits two cerclage wires were placed 9 mm apart on one femur. The contralateral femora were sham-operated and served as controls. The animals were killed after 99 days and the femora subjected to four-point bending tests. All wires were embedded in callus. Strength slightly increased and stiffness was unchanged in the wired femur compared with the contralateral femur. Provided...
The triple reamer is a convenient tool for reaming the proximal femur when using a sliding screw and plate device, but unnecessarily high temperatures may be generated within the femoral head while the lateral cortex is being reamed. Nineteen female patients over 60 years old were randomized to either the standard or a modified reaming technique with the triple reamer during internal fixation of...
Four cases of impalement injury are described. The principles of management are discussed, these being minimal manipulation of the object before and during transport, preoperative planning, a multidisciplinary approach, and wound care.
An easy to make skin model has been developed using commonly available materials. It allows simple wound closure to be practised safely on a medium which attempts to simulate the properties of soft tissue.
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