The aim of this study was to find out whether distal radius fractures treated by K wire fixation loose reduction after wire removal and analyze the variables may influence this. Patients who underwent K wire fixation for unstable fractures of distal radius over a period of 3 years were included in this retrospective study. Fractures were classified according to AO classification. Radiographs taken just prior to removal of K wires and radiographs taken at least 1 month after wire removal were analyzed to study three radiological parameters; Palmar or dorsal tilt, radial inclination and ulnar variance. Loss of these angles was analyzed statistically against variables like age, sex, AO classification, type of K wires used, delay in fixation and duration of fixation. 59 fractures were analyzed with mean age of 56 years and male to female ratio of 1:2. Average loss of radial tilt was 2.6 deg, loss of palmar tilt was 2.6 deg and loss of ulnar variance was 1.3 mm. We found that distal radius fractures treated by percutaneous K wire fixation, do not suffer significant loss of reduction of fracture position after removal of wires. This remains true regardless of age, sex, fracture type according to AO type, type of wires used, delay in fixation or duration of wire fixation.

The purpose of this study was to find out whether routine post operative check radiographs after DHS (Dynamic Hip Screw) fixations are contributing to patient management. In a random selection of 50 NHS hospitals in England, 18 orthopaedic units were found to be ordering formal check radiographs after DHS. In our department check radiographs were routinely being done even though image pictures were printed in theatre. We reviewed 174 DHS fixations, assessed adequacy of image intensifier pictures and compared them with post operative radiographs. 115 stable fractures showed no change in position of fracture or screw. In 59 unstable fractures 14 showed medialisation of femoral shaft. 132 case notes were reviewed and none of these patients have had a change in post operative mobilization status based on check radiographs. The 14 unstable fractures which showed change in position too continued with mobilization.

We conclude that routine check radiographs are unnecessary after DHS fixations if adequate image pictures are obtained at surgery. It has important implications like manpower and cost, patient discomfort and unnecessary radiation.

Aim: To identify the variables associated with poor radiological outcome in the distal radius fractures stabilized with K wires.

Materials & Methods: All the patients who underwent K wire fixation of distal radius fracture in last 3 years were included in this retrospective study. AO Classification was used to classify the fracture. Immediate post fixation radiographs and radiographs taken just prior to removal of K wires (5–6 weeks) were analyzed to study three radiological parameters (dorsal tilt, radial tilt, ulnar variance). Changes in these parameters were recorded. Results were graded as excellent, good, fair and poor according to the Stewart classification. The results were analyzed against variables like age, sex, AO classification, associated ulnar fracture, number of k wires used, delay in fixation and duration of fixation. Statistical tests were performed to find out variables associated with the poor radiological outcome.

Results: 113 distal radius fractures were analyzed in total. Average age of patients was 56.2 years (standard deviation-19.9) with male to female ratio of 1:2.1. Average loss of radial tilt was 4.12 deg, loss of dorsal tilt was 8.07 deg and change in the ulnar variance was 3.12 mm. We found excellent results in 23.9 %, good result in 56.6%, fair results in 15 % and poor results in 4.4 % of patients.

Age more than 65 years (p value 0.006), comminuted distal radius fracture [A3 or C3 in AO classification] (p value 0.049) and associated ulnar fracture (p value 0.013) were the variables found to have statistically significant correlation with poor radiological outcome.

Conclusion: Age more than 65, comminuted distal radius fracture and associated ulnar fracture are the variables associated with poor stability of K wire fixation in distal radius fracture. Alternative mode of stabilization should be considered to improve the stability of the fracture fixation in these patients.

We report a prospective study of the factors associated with acute urinary retention after total hip replacement in 103 consecutive male patients. Eleven patients (10.7%) developed retention after operation. Of the factors investigated before operation three had predictive value: inability to pass urine into a bottle whilst lying in bed, urinary peak-flow rates indicative of obstruction, and a history of previous bladder outflow problems. This study suggests that patients showing one or more of these factors should be assessed and if necessary treated by a urologist before arthroplasty, so as to avoid the need for catheterisation, and the consequent risk of deep infection.