International orthopaedics
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Arthroscopy of the knee was carried out under local anaesthesia in 313 outpatients, with arthroscopic surgery in 81. The procedure had to be abandoned because of apprehension in only 0.9%. ⋯ The method was particularly valuable in the assessment of patello-femoral pain since dynamic evaluation of patellar alignment, and the localisation of sensitive structures by palpation, was possible. The method is a safe, reliable and inexpensive alternative to the use of spinal or general anaesthesia for arthroscopy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of isotonic saline, distilled water and boiled water in irrigation of open fractures.
A prospective randomised study was carried out on 86 patients with first, second and third degree open fractures in order to compare the effect of isotonic saline, distilled water and boiled water as irrigating fluids. The standard management consisted of emergency surgical toilet, use of broad spectrum antibiotics and fracture immobilization. The results show that the outcome was not affected by the type of irrigating fluid used.
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Synovial oedema is a frequent complication in arthroscopic procedures performed with normal saline as the irrigating fluid. The authors have studied the effect of saline solution, Ringer lactate, 5% Dextran and 10% Dextran in normal saline on 12 specimens of human synovial membrane. They found that 10% Dextran in normal saline decreases the water content of the synovium without causing damage, and recommend this solution for procedures lasting longer than 30 minutes.
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Case Reports
Intraspinal, extradural stab injury of the spine without neurological deficit. A case report.
There are many reports of stab wounds of the spinal cord with neurological deficit, but here we report an intraspinal, extradural stab injury of the spine with no neurological injury. The broken blade was removed eight months later.