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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXIX | Pages 252 - 252
1 Sep 2012
Morgan A Lee P Batra S Alderman P
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Background

Despite studies into patient consent and their understanding of the potential risks of trauma surgery, no study has looked at the patient's understanding of the procedure involved with neck of femur fracture surgery.

Method

Prospective analysis of 150 patients who had operative fixation of neck of femur fractures in a district general hospital. Patients were asked on the third post-operative day to select which procedure they had undergone from a diagram of four different neck of femur surgeries (cannulated screws, cephalomedullary nail, dynamic hip screw and hemiarthroplasty). Exclusion criteria for patient selection - mini mental score of < 20 and confusion secondary to delirium.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 286 - 286
1 Mar 2004
West S Andrews J Bebbington A Ennis O Alderman P
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Aims: To show that the treatment of buckle fractures in children in a soft bandage, rather than a plaster cast, is an effective and safe method of treatment. Methods: In order to determine the difference between the two groups it was decided to compare the range of movement at three weeks. Power calculations were performed. This gave a required sample size of 23 for each group. The project was submitted for ethical approval in July 1999. Patients enter the trial after parents agree and sign the consent form. Allocation to either plaster or bandage is random and parents draw previously sealed envelopes themselves. Patients are seen each week and measurements taken of their range of movement. Results: Thirty seven patients have completed the study. 17 have been allocated to bandage the rest to cast. Those in bandage show an excellent range of movement at the þrst week with no reported problems on their questionnaires. One patient has transferred from bandage to plaster at the request of the parents. Conclusion: Results suggest a positive result for treatment in bandage with no reported adverse effects and, a highly desirable result for the patient. We would hope to suggest a change in treatment policy for such fractures.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 276 - 276
1 Mar 2003
West S Andrews J Alderman P
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Objectives: To show that the treatment of buckle fracture in children in a soft bandage, rather than a plaster cast, is an effective and safe method of treatment, with an earlier return to normal function.

Methods: In order to determine the difference between the two groups it was decided to compare the range of movement at three weeks. Power calculations were performed using the minimum difference for a two-sample t-test method and assuming a non-central distribution. The calculation was performed on Minitab release version 12.1 Assuming a required difference of 5 degrees and a standard deviation of 5 degrees also with a required power of 0.9(90%) this gave a required sample size of 23 for each group i.e a total of 46 patients. Guidelines for the parents, consent forms, doctor and nurse protocols, a guidance poster for the A& E, treatment profiles for each patient and a questionnaire for parents were written. The project was submitted for ethical approval in July 1999 and granted at the end of that month. Patients enter the trial after parents agree and sign the consent form. Allocation to either plaster or bandage is random and parents draw previously sealed envelopes themselves. Those allocated to bandage are seen each week and measurements taken of their range of movement.

Results: Thirty seven patients have completed the study. 17 have been allocated to bandage the rest to cast. Those in bandage show an excellent range of movement at the first week with no reported problems on their questionnaires. One patient has transferred from bandage to plaster at the request of the parents. Problems encountered have been compliance of those in bandage to return for follow up after two weeks and, ensuring all patients enter the trial and attend the right clinic.

Conclusion: Results suggest a positive result for treatment in bandage with no reported adverse effects and, a highly desirable result for the patient. We would hope to suggest a change in treatment policy for such fractures.