Irish journal of medical science
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Survival and mortality outcomes for trauma patients admitted to Liverpool Hospital, Sydney were analysed to determine the adequacy of trauma care. TRISS and ASCOT survival probabilities and peer review were utilised to determine if deaths were avoidable. Evaluation methods were compared for assessment of care. ⋯ The Effectiveness (E) value for outcome was 0.91. Poor communication within the Area Trauma System was the greatest contributor to avoidable deaths. All trauma deaths need peer review rather than solely relying upon ASCOT and TRISS probabilities to identify "unexpected" deaths for detailed review.
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Ankle arthroscopy has grown in popularity over the past decade as a diagnostic and therapeutic procedure. We assessed 24 patients who underwent ankle arthroscopy during the two year period 1991-1993. In 18 cases a mini-arthrotomy was performed based on the arthroscopic findings. ⋯ There were no neurovascular complications. This series represents an initial experience and illustrates that ankle arthroscopy provides a safe and effective method of diagnosis and treatment with few complications. Further advances in instrumentation and distraction techniques will reduce the need for open arthrotomy and should expand the indications for the procedure.
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Ninety-three consecutive treadmill exercise stress test were performed for the assessment of peripheral vascular function. Thirty-one were for atypical claudication-like symptoms including pain on standing, relief on sitting and back pain. Pedal pulses were palpable in 24 patients. ⋯ Of the original 31 patients with atypical symptoms, spinal stenosis was present in 13 (42%). Atypia- in the common syndrome of intermittent claudication should alert the surgeon to the possibility of spinal canal disorders. Further investigation may identify significant pathology spinal stenosis in particular.