Objectives. This review aims to summarize the outcomes used to describe effectiveness of treatments for paediatric
Background. Despite the known multifactorial nature of scaphoid
The aim of this study was to explore parents’ experience of their child’s recovery, and their thoughts about their decision to enrol their child in a randomized controlled trial (RCT) of surgery versus non-surgical casting for a displaced distal radius fracture. A total of 20 parents of children from 13 hospitals participating in the RCT took part in an interview five to 11 months after injury. Interviews were informed by phenomenology and analyzed using thematic analysis.Aims
Methods
The aim of this study was to develop a core outcome set of what to measure in all future clinical research on hand fractures and joint injuries in adults. Phase 1 consisted of steps to identify potential outcome domains through systematic review of published studies, and exploration of the patient perspective through qualitative research, consisting of 25 semi-structured interviews and five focus groups. Phase 2 involved key stakeholder groups (patients, hand surgeons, and hand therapists) prioritizing the outcome domains via a three-round international Delphi survey, with a final consensus meeting to agree the final core outcome set.Aims
Methods
In-office surgeries have the potential to offer high quality medical care in a more efficient, cost-effective setting than outpatient surgical centers for certain procedures. The primary concerns with operating on patients in the office setting are insufficient sterility and lack of appropriate resources in case of excessive bleeding or other surgical complications. This study serves to investigate these concerns and determine whether in-office hand surgeries are safe and clinically effective. A retrospective review of patients who underwent minor hand operations in the office setting between December 2020 and December 2021 was performed. The surgical procedures included in this analysis are needle aponeurotomy, trigger finger release, mass/foreign body removal and reduction of hand/
Aims:. 1) To determine the predictive value of a simple stability test in children’s
Outcome following
Distal radius fractures (DRF) are very common injuries. National recommendations (British Orthopaedic Association, National Institute for Health and Care Excellence (NICE)) exist in the UK to guide the management of these injuries. These guidelines provide recommendations about several aspects of care including which type of injuries to treat non-operatively and surgically, timing of surgery and routine follow-up. In particular, current recommendations include considering immobilizing patients for 4 weeks in plaster for those managed conservatively, and operating on fractures within 72 hours for intra-articular injuries and 7 days for extra-articular fractures. With increased demands for services and an ageing population, prompt surgery for those presenting with distal radius fractures is not always possible. A key factor is the need for prompt surgery for hip fracture patients. This study is an audit of the current standard of care at a busy level 2 trauma unit against national guidelines for the management of DRFs. This retrospective audit includes all patients presenting to our emergency department from June to September 2018. Patients over 18 years of age with a diagnosis of a closed distal radius fracture and follow-up in our department were included in the study. Those with open fractures were excluded. Data was retrieved from clinical coding, electronic patient records, and IMPAX Client (Picture archiving and communication system). The following data was collected on patients treated conservatively and those managed surgically:- (1)Time to surgery for surgical management; (2)Period of immobilization for both conservative and operative groups. 45 patients (13 male, 32 female) with 49 distal radius fractures (2 patients had bilateral injuries) were included. Patients had mean age 63 years (range 19 to 92 years) 30 wrists were treated non-operatively and 19 wrists treated surgically (8 K-wires, 10 ORIF, 1 MUA). Mean time to surgery in the operative group was 8 days (range 1 – 21 days, median 7 days). Mean time to surgery for intra-articular fractures was 7 days (range 1 – 21) and 12 days for extra-articular fractures (range 4 – 20). Mean immobilization period in those treated in plaster is 6 weeks (range 4 – 13 weeks, median 5.6 weeks). At busy level 2 trauma units with limited theatre capacity and a high volume of hip fracture admissions, time to surgery for less urgent injuries such as
The December 2012 Wrist &
Hand Roundup. 360. looks at: the imaging of scaphoid fractures; splinting to help Dupuytren’s disease; quality of life after nerve transfers; early failure of Moje thumbs; electra CMCJ arthroplasty; proximal interphalangeal joint replacement; pronator quadratus repair in distal radius fractures; and osteoporosis and
Aims. Elective operating was halted during the COVID-19 pandemic to increase the capacity to provide care to an unprecedented volume of critically unwell patients. During the pandemic, the orthopaedic department at the Aneurin Bevan University Health Board restructured the trauma service, relocating semi-urgent ambulatory trauma operating to the isolated clean elective centre (St. Woolos’ Hospital) from the main hospital receiving COVID-19 patients (Royal Gwent Hospital). This study presents our experience of providing semi-urgent trauma care in a COVID-19-free surgical unit as a safe way to treat trauma patients during the pandemic and a potential model for restarting an elective orthopaedic service. Methods. All patients undergoing surgery during the COVID-19 pandemic at the orthopaedic surgical unit (OSU) in St. Woolos’ Hospital from 23 March 2020 to 24 April 2020 were included. All patients that were operated on had a telephone follow-up two weeks after surgery to assess if they had experienced COVID-19 symptoms or had been tested for COVID-19. The nature of admission, operative details, and patient demographics were obtained from the health board’s electronic record. Staff were assessed for sickness, self-isolation, and COVID-19 status. Results. A total of 58 surgical procedures were undertaken at the OSU during the study period; 93% (n = 54) of patients completed the telephone follow-up. Open reduction and internal fixation of ankle and
Aim. Fixation of distal radial fractures via the volar approach has become a commonly performed procedure over the past few years. This study is to highlight potential pitfalls with this ‘everyday’ procedure and to perhaps temper over-enthusiasm for plating all
Introduction and Objectives: Volar osteosynthesis with plates with angular stability in dorsal fractures has revolutionized the treatment of
Introduction and aims: Minimal trauma fractures may be the first indication of osteoporosis [OP]. Available data suggests that the continuum of care [EDorthopaedic service-GP] is breaking down with respect to identification and treatment of osteoporosis. Our aim was to determine the extent of this breakdown in the Australasian context. Methods: Observational retrospective cohort study of patients aged 50 years or over who were treated and discharged with
Introduction and Aims: Locking plates represent a major change in the way we stabilise fractures. The distal radius Locking Compression Plate (LCP, Synthes) theoretically enables palmar plating of dorsally comminuted and intra-articular
Introduction and Aims: Osteoporotic fractures, especially hip fractures, represent a major health problem in terms of morbidity, mortality and cost. Since the availability of new treatments for osteoporosis, a better understanding of the disease is needed to define the indications for treatment. Method: A descriptive study of osteoporotic fractures and the evaluation of the relative risk of hip fracture following a minor fracture were done on a population aged 45 years old and older from 1980 to 1997 (2.5 million individuals, 1997). Results: During the follow-up period, 220,120 fractures (hip, wrist, proximal humerus and ankle) were recorded. The incidence rate of fractures was stable over time. The
Osteoporosis investigation following a low-trauma fracture is often missed. The aim of this study was to (i) measure the current rate of osteoporosis investigation and (ii) to test a simple intervention that seeks to increase patient awareness and physician alerting following these sentinel events. Our study showed that 92% of the intervention group was investigated compared to 18% of the control group. This study suggests that a simple inexpensive intervention can increase the rate of osteoporosis investigation in an at risk population. National guidelines (1–3) emphasize that low-trauma fractures should prompt to investigate for osteoporosis but more than 80% of “at risk” people are not investigated. To measure the rate of diagnosis of osteoporosis when patients with low-trauma
My talk concentrates on the practical management of
Aims: The aim of our study was to compare relative risk of hip fracture after wrist or spine fracture, in both men and women. Methods: We performed a systematic literature review of cohort studies reported since 1982 that included low-trauma wrist or spine fracture as a risk factor for subsequent hip fracture among (white) women and men aged 50 years or older. A fixed effects meta-analysis was used to calculate a common relative risk (RR) with 95% confidence interval (95% CI). Results: Ten cohort studies (six from the U.S.A. and four from Europe) contributed to this meta-analysis. Among postmenopausal women, RRs for future hip fracture after wrist and spine fracture were 1.53 (95% CI 1.34–1.74, p<
0.001) and 2.22 (95% CI 1.95–2.52, p<
0.001), respectively. The RR was significantly higher after spine fracture than after
A descriptive study of osteoporotic fractures and the evaluation of the relative risk of hip fracture following a minor fracture were done on 2.5 million individuals from 1980 to 1997. People aged forty-five years old and older have a risk for hip fracture after a minor fracture of 2.3–17.3 time the risk of people without previous fracture. Given the availability of pharmaceuticals that decrease the fracture risk dramatically within the first 18 months of therapy, the average four to six years time between minor and hip fracture represents a perfect window of opportunity for preventive treatment. Osteoporotic fractures, especially hip fractures, represent a major health problem in terms of morbidity, mortality and cost. Since the availability of new treatments for osteoporosis, a better understanding of the disease is needed to define the indications for treatment. A descriptive study of osteoporotic fractures and the evaluation of the relative risk of hip fracture following a minor fracture were done on a population aged fortyfive years old and older from 1980 to 1997 (2.5 million individuals). During the follow-up period, 220,120 fractures (hip, wrist, proximal humerus and ankle) were recorded.