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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_10 | Pages 42 - 42
1 Jun 2023
Bridgeman P Heeley E
Full Access

Introduction

Introduction: Pin site infection is a common complication during treatment with a circular frame external fixator and increases time and support patients require from the limb reconstruction team. Wound swabs were not routinely sent by the clinical nurse specialists prior to this study, with most pin site infections treated as Staphylococcus aureus with flucloxacillin (clindamycin in penicillin allergy). The aim of this study was to ascertain whether routine sending of wound swabs in pin site infection would change antibiotic treatment.

Materials & Methods

Materials and Method: Patients presenting at clinic or physiotherapy with clinical signs of pin site infection were assessed using the Maz Oxford Nuffield (MON) Pin Site Infection Grading System© (OUH, 2021). Antibiotics were commenced as per unit guidelines and swabs sent for microscopy, culture and sensitivity.


Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_10 | Pages 41 - 41
1 Jun 2023
Bridgeman P Carter L Heeley E
Full Access

Introduction

Introduction: Pre-operative counselling to prepare patients for frame surgery is important to ensure expectations of recovery and rehabilitation are realistic and anxiety is reduced. The aim of the study was to ascertain whether the current clinical nurse specialist frames counselling session (CNS FCS) prepared patients adequately for life with a frame as well as to explore information patients felt was missing.

Materials & Methods

Materials and Method: Patient reported questions were used to assess frames patient views on the CNS FCS. Thirty frames patients were asked about the CNS FCS information, involvement in decision making, factors influencing frames surgery decision and patient experience.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_5 | Pages 16 - 16
1 Apr 2022
Dent E Raven M Thompson M Cole K Bridgeman P
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Introduction

Traditionally, limb reconstruction physiotherapy consisted of face to face group rehabilitation. During the COVID-19 pandemic OP physiotherapy service provision was significantly reduced and delivery methods limited due to staff redeployment, service prioritisation and restriction of footfall within the hospital. A virtual exercise group for acute limb reconstruction patients was set up to maintain contact and clinical support.

Materials and Methods

A small single centre study was performed over two 4 week periods capturing the experience of 35 patients. A patient reported questionnaire was used and revised post-pandemic to gather quantitative and qualitative data about the patients experience of the Limb Reconstruction Physiotherapy Service at each point in time. The qualitative data was analysed using an inductive thematic analysis.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_8 | Pages 27 - 27
1 May 2018
Bridgeman P Raven M Fischer B Bose D Fawdington R Fenton P
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Background

Many patients undergo frame removal in the outpatient setting and nitrous oxide is frequently used, but has varying effects. The aim of the study was to ascertain whether pain levels during frame removal are improved with local infiltration of local anaesthetic (LA) and to assess the effect of LA and nitrous oxide compared to nitrous oxide alone.

Methodology

This was a small single centre study using patient reported questions to assess pain levels during frame removal. The test group received 5–20ml 2% lidocaine infiltrated into tissues surrounding half pins and olive wire exit sites. All patients were asked to complete a questionnaire to assess pain levels and patient satisfaction following the procedure. Patients were asked to mark their pain level on a 100mm visual analogue scale giving a final pain score out of 100.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_8 | Pages 41 - 41
1 May 2018
Battaloglu E Budair B Bridgeman P Warner R Baden J Bose D Fenton P
Full Access

Introduction

Managing open tibial fractures according to national guidelines is a primary focus for major trauma centres, however pressures of capacity and expertise limit the capability to achieve all of these standards for every patient. Debate remains over the impact of particular aspects of guidance, especially in relation to the timing of surgical interventions. Evaluation of these tenants of care predominantly hinge on trends derived from low level scientific evidence, mainly due to the difficulty in completing high level studies. The aim of this study is to assess the complication rates and the associations with difficulties in achieving the national guidance standards.

Methods

Retrospective analysis of the 2015/2016 cohort of 3B open tibial fractures treated at the Queen Elizabeth Hospital Birmingham. Data collected, through the use of the patient electronic records, cross referenced against hospital coding and trauma injury database, included patient demographics, injury details, clinical interventions, surgical management, complications and time to bony union.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_23 | Pages 4 - 4
1 May 2013
Noor S Bridgeman P David M Humm G Bose D
Full Access

Introduction

Infection following traumatic injury of the tibia is challenging, with surgical debridement and prolonged systemic antibiotic therapy well established. Local delivery via cement beads has shown improved outcome, but these often require further surgery to remove. Osteoset-T is a bone-graft substitute composed of calcium sulphate and 4%-Tobramycin, available in pellets that are packed easily into bone defects. Concerns remain regarding the sterile effluent produced as it resorbs, along with the risk of acute kidney injury following systemic absorption.

Purpose

We present outcomes of 22 patients treated with Osteoset-T.