The aim of this study was to assess the injury pattern of patient’s 60 years plus who have required acute orthopaedic admission and the influence this population group will have on orthopaedic services in the future. A retrospective analysis of orthopaedic patients obtained from our database covering a three-year period (2001–2003) was conducted. We identified those that had been treated with surgical and non-surgical procedures. The demographic injury pattern and length of stay was in-turn assessed in relation to anticipated changes in the population from projected data obtained from Statistics New Zealand. A review of 1209 orthopaedic patients (60% males) indicated that the majority (92%) required acute orthopaedic admission. Within this group, the most common injury type was a fracture, experienced particularly in the lower limb. Length of hospital stay ranged from 0–188 days. Racial distribution incorporated a number cultures including New Zealand European, New Zealand Maori, Pacific Island, Asian, Middle Eastern, and Indian. Orthopaedics like many other services should already have begun planning for this population group. Relevant specifications may include increased follow up visits, imbalance between males and females, and the percentage of urban-based patients. With regards to orthopaedic staffing and their skill base services need to look at the possible inclusion of an aged care specialist as part of the orthopaedic hospital team and enhancement of communication between orthopaedics and staff from the geriatric ward. Training packages for orthopaedic staff, in relation to healthcare of the elderly should also be made available.
The aim of this study was to determine the outcome of patients treated with Achilles tendon rupture randomized to surgical or non-surgical treatment where both groups received the same early motion and weight bearing rehabilitation protocol. Fifty patients between the ages of 18 and 50 years with a clinical diagnosis of Achilles tendon rupture were randomized to surgical or conservative treatment. All injuries had occurred within ten days. Both groups received the same rehabilitation program with initial cast immobilization then splintage in a removable orthosis with ankle motion commencing at two weeks. Patients completed the MFAI, a validated outcome questionnaire and clinical assessment including range of motion and calf squeeze response at 2, 6 and 12 weeks, 6 months and one year. There was no difference between the surgical and non-surgical groups for difference in dorsiflexion and plantar flexion between the injured and non-injured sides. There was no difference in the MFAI quality of life scores for either treatment group. There was the same number of re-ruptures in both groups. There were no infections in the operated patients. Early motion rehabilitation after Achilles tendon rupture results in similar functional results and patient satisfaction in both surgically and non-surgically treated patients.
