Antimicrobial resistance is an important patient safety issue. Antibiotic Stewardship is one of the key strategies in tackling this problem. We present our data over a two year period from October 2011 to December 2013. A multidisciplinary, consultant led antibiotic ward round was implemented in October 2011. This involved the consultant orthopaedic surgeon, microbiologist, pharmacist and antibiotic prescription nurse. Data from the meetings was collected prospectively over a 118 week period using a standard data form. The case notes, prescription kardex, laboratory results including microbiology data and clinical information of patients was available at the time of the Ward round. The indications for, choice of antibiotics, duration and further treatment plan were made and a note for the case notes was dictated immediately. Changes to prescriptions were also made at the time.Introduction:
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The patella is an important component of the extensor mechanism of the knee. Patellar fractures need to be fixed if displacement occurs more than 2 mm. Transverse fractures comprise the largest category. Several different techniques for internal fixation have been employed. The aim of this work was to evaluate the results of treatment of transverse patellar fractures with figure of eight wiring through cannulated screws. Twenty patients were included in the study, all suffering from displaced transverse patellar fractures. All were treated by open reduction and internal fixation with figure of eight tension band wire through 4.0 mm cannulated screws. All patients were assessed after 1 month, 3 months and 6 months according to a modified Hospital for special surgery (HSS) knee scoring system. Because varus and valgus knee alignment and stability are not affected by patellar fracture fixation, the ten points assigned to these functions are eliminated, making the highest score ninety points. Excellent results are considered with points from 75 to 90, good from 60 to 74, fair from 50 to 59 and poor with points below 50. The final results of the study showed fourteen patients (70%) had excellent results, five (25%) good result, one (5%) fair result and no patient had a poor result. There was a statistically significant improvement of the patients' score throughout the follow up period. The complications occurred included knee pain in one patient (5%), loss of terminal flexion of knee occurred in three patients (15%), one patient lost 30 degrees, another lost 20 degrees while the last lost 10 degrees. There were no cases with extension lag in this series. Treatment of patellar fractures using figure of eight wiring through cannulated screws is an easy technique which gives good stability leading to good results with a low complication rate.
