To clarify the true association with pathological DDH and ASC (asymmetrical skin crease). Between 1st January 1995 and 31st December 2015 all paediatric referrals with suspected hip instability were assessed in a one-stop DDH clinic. All patients had clinical and sonographic assessment with results prospectively recorded onto a database.Purpose
Method
Advances in surgical and anesthetic technique have resulted in a reducing length of stay for lumbar decompression, with the first day case procedure published in the literature in 1980. Current evidence suggests day case surgery is associated with improved patient satisfaction, faster recovery, reduced infection rates and financial savings. Following the introduction of a locally agreed day case protocol for lumbar microdiscectomy, we reviewed our 30-day postoperative complication rates. To review postoperative complication rates for patients who underwent day case primary lumbar microdiscectomy.Background
Aims
PROMs have become an integral assessment tool of clinical effectiveness and patient satisfaction. To date, PROMs for lumbar discectomy are not an NHS requirement, although voluntary collection via the British Spine Registry is encouraged. Despite this, PROMs for day case microdiscectomy is scarcely reported. We present PROMs for day case microdiscectomy at Lancashire Teaching Hospitals.
To review PROMs to quantify leg pain, back pain, EQ5D and ODI scores. Evaluate PROMs data collection compliance.Background
Aims
Accurate knowledge of the normal shoulder range of movement (ROM) is imperative for evaluating pathology and clinical success. However, in orthopaedic texts, the quoted normal shoulder ROM has significant variation. Furthermore we suspect there is a high incidence of intra and inter observer error during shoulder ROM examination. The aims of our study were thus: To perform a literature review and record the published values for normal shoulder ROM. Subsequently, to calculate the average of these published values. To perform visual and goniometer measurement of shoulder ROM in 10 volunteers and assess the agreement between the two methods. A literature search of textbooks, Pub Med and scoring systems was undertaken. Statistical analysis was performed to identify the average value of shoulder movements. Two researchers (specialist trainees in T&O) prospectively assessed 20 shoulders in 10 healthy volunteers. Second observations were made after two weeks. Visual estimation and goniometry assessments were conducted. Bland Altman analysis was performed.Aims
Methods
To assess concordance between hospital coding and clinician coding for patients undergoing spinal instrumentation procedures and determine if our coding systems result in accurate financial reimbursement from the primary care trust (PCT). We conducted a one year retrospective review of 41 patients who underwent spinal instrumentation procedures. Data collected from IT systems included: operation description, clinician procedure code, hospital procedure code, Hospital Health Resource grouping (HRG), clinician HRG, instrumentation costs and PCT reimbursement fees. From this data we compared coding based re-imbursement fees and actual surgical costs, taking into account exact instrumentation prices. In all cases the primary hospital and clinician coding values differed. Using the clinician code would have altered the HRG group in 16 patients. Using solely clinician coding would have generated less financial reimbursement than using hospital coding. In 23 patients undergoing complex spinal procedures, instrumentation costs represented a significant proportion of the final fee obtained from the PCT, thus leaving a small proportion for the associated hospital stay costs. This suggests instrumentation costs are inadequately reimbursed from the PCT. Hospital coding appears more accurate than clinician coding and results in greater financial reimbursement. On the whole, we found there to be insufficient reimbursement from the PCT. The variable and sometimes substantial cost of spinal instrumentation procedures results in inadequate reimbursement for many procedures. We feel the payment by results (PBR) scheme is suboptimal for such procedures and adequate reimbursement can only be achieved by direct billing on an individual case basis.
The correlation between the results of NCS and the subsequent outcome from surgery Compare these results with a similar group of patients that underwent decompressive surgery without NCS.
