Injury
-
Patient feedback is increasingly important to inform and develop effective healthcare within the United Kingdom. In order to optimise patient experience of ankle fracture care in our unit, we sought to identify elements of practice associated with poor patient experience and low levels of satisfaction. ⋯ Efforts to improve the healthcare experience of patients with ankle fractures should be focused on improving processes that minimise cancellation of surgery and the communication around delay management.
-
Malalignment of syndesmosis is generally associated with a poor outcome, yet occurs at a high rate in malleolar ankle fractures. In this study, we examine whether malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view. ⋯ The results of our study show that malreduction of syndesmosis can be avoided by careful interpretation of intraoperative perspective mortise views based on Weber's three indexes. To increase the diagnostic accuracy further, it is important to detect anteroposterior deviation of the fibula in intraoperative lateral views.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Nadroparin or fondaparinux versus no thromboprophylaxis in patients immobilised in a below-knee plaster cast (PROTECT): A randomised controlled trial.
The immobilisation of the lower leg is associated with deep vein thrombosis (DVT). However, thromboprophylaxis in patients with a below-knee plaster cast remains controversial. We examined the efficacy and safety of nadroparin and fondaparinux to ascertain the need for thromboprophylaxis in these patients. ⋯ Thromboprophylaxis with nadroparin or fondaparinux significantly reduces the risk of DVT in patients with an ankle or foot fracture who were treated in a below-knee cast without any major adverse events.
-
There has been very little analysis of the epidemiology of adult fall-related fractures outwith the osteoporotic population. We have analysed all in-patient and out-patient fall-related fractures in a one-year period in a defined population and documented their epidemiology. The overall prevalence of non-spinal fall-related fractures is 63.1% with 40.7% and 82.7% occurring in males and females respectively. ⋯ In females the greatest increase in incidence is in 16-19year females but all age ranges show a significant increase up to 60-69 years. There is a decreased incidence in 90+ females. The reasons for the increase in the incidence of fall-related are multifactorial but they are probably contributed to by the inherently weaker bone of younger females and by the increased incidence of conditions such as obesity and diabetes.
-
The incidence of geriatric acetabular fractures continues to increase due to demographic changes. In the elderly, anterior column fractures are common, and standard approaches are associated with a considerable risk for surgery-associated complications. Therefore, a minimally invasive approach was developed in our department. The aim of this study was to examine early and mid-term results regarding the use of this novel two-incision minimally invasive (TIMI) approach in patients aged over 55 years with acetabular fractures. ⋯ Therapeutic Level II (Prospective cohort study).