Little is known about the forces carried by the Taylor Spatial Frame (TSF) hexapod fixator. Our aim was to measure the TSF resultant force and how this changed during the consolidation phase. Five patients undergoing correction of tibial deformities were recruited. Measurements were taken at 2, 4, 8 and 12 weeks post-correction during various activities. Instrumented struts incorporating strain gauges measuring axial force were temporarily used each time. Strut forces and lengths were used to determine frame kinetics. The resultant axial fixator forces and moments were calculated relative to sitting. Ground reaction forces (GRF) were measured using the treadmill force plates.Background:
Method:
Pin site care in external fixation remains a major challenge. The ideal dressing regime still remains controversial as does the type of dressing. We present an audit following the use of a sponge compression dressing in comparison to previously used sterile gauze. All pins and wires were inserted using a standardised technique. Dressings were applied during surgery to prevent haematoma formation. The new sponge dressing was applied to the wire or half-pin sites and compressed to the skin by either pierced tubing over the wire or clips at the end of the procedure. Dressings were changed weekly unless the pin sites were discharging serous fluid or frankly infected, when they were changed as required. The pin sites were evaluated for evidence of infection or irritation using the good, bad or ugly grading system. Each evaluation was performed by two of the authors on two separate occasions to assess the inter- and intra-observer error. The results were compared to those previously reported using sterile gauze as the pin site dressing. 1035 pin sites were assessed. 985 pin sites were graded as “good” (95.2%), 49 “bad” (4.7%) and 1 “ugly”. The kappa values demonstrated excellent inter- and intra-observer correlation, 0.892 and 0.905 respectively. The previous study using gauze reported 600 pin sites with 514 graded “good” (85.7%), 80 “bad” (13.3%) and 6 “ugly” (1%). The use of compression sponge dressing appears to reduce the rate of pin site irritation and infection. Further anecdotal evidence by patients who have undergone surgical treatment using both techniques demonstrated a preference for the sponge dressings due to ease of dressing change and general comfort once applied. We therefore would recommend this type of dressing in the use of external fixation.
In recent years, there has been an increase in using self- admistrated questionnaires to accurately assess intervention outcomes in hand surgery to determine the quality of healthcare. This study aims to evaluate whether the Manchester Modified Disabilities of the Arm, Shoulder and Hand (M2DASH) questionnaire is a valid, reliable, responsive, and unbiased outcome measure for Carpal Tunnel syndrome compared to the Disability of Arm, Shoulder, and Hand (DASH) questionnaire, Boston questionnaire (BQ), and Nerve Conduction Studies (NCS). 48 patients with CTS confirmed by NCS completed the M2DASH, original DASH, and the BQ, at least twice at different time intervals. The scores obtained from M2DASH were compared and correlated with the DASH, BQ, and NCS to assess validity, reliability, responsiveness, and bias of the questionnaires. Validity analysis for M2DASH showed strong positive correlations with the Original DASH and BQ. No significant correlation was obtained from correlating with NCS. Reliability testing confirmed that the M2DASH is internally consistent and reproducible outcome. Significant results for responsiveness were noted in BQ symptom severity scale only. There was no age, gender, hand dominance, or side affected bias in all three questionnaires.Method
Results
To study the outcomes of DVR plating for distal radius fractures. We prospectively studied all patients managed with a DVR plate, over a twelve-month period in 2006/07. All patients were seen in our dedicated research clinic at 2, 6, 12 and 26 weeks post-operatively. Physiotherapy started at 2 weeks post-operatively. Active range of motion (ROM) of the injured wrist was recorded at 6, 12 and 26 weeks and compared with the normal side. Standardised radiographs were taken at 2 and 6 weeks and compared with pre- and post-operative films for radial and volar angulations, relative radial length, ulnar variance and implant position. Patient satisfaction was measured with the Patient Rated Wrist Evaluation score (PRWE) at 6, 12 and 26 weeks.Aims
Methods
