Acta Orthop Belg
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Comparative Study
Comparison of glove donning techniques for the likelihood of gown contamination. An infection control study.
The creation of an optimal environment, whenever major joints are opened or metal is implanted into bone, is important to reduce infection following orthopaedic surgery. Following normal hand washing protocols, it is possible that pathogenic bacteria can remain on the skin. These bacteria may inadvertently be transferred to the surgical gown during the glove donning procedure and therefore contamination of the surgical wound could follow. ⋯ There were no contamination patches in the scrub staff assisted technique. Glove donning, using the scrub staff assisted technique can minimise the possibility of gown contamination. This is important in surgical procedures where the results of infection can be devastating.
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Open reduction and internal fixation has been shown to be effective in the treatment of unstable distal radius fractures. When a dorsal approach is used, extensor tendons rupture or irritation are frequent and well known complications. Complications associated with volar plate fixation have not been studied to the same extent. ⋯ In this study, volar plate fixation appeared as a safe procedure in the management of unstable distal radius fractures, with a low rate of complications. Accurate placement of the plate and exact measurement of the screws may further minimize the incidence of complications. When radiographs reveal conditions that may predispose to tendon attritional lesions (prominent edge of the plate, dorsal protrusion of the screw tips) we strongly recommend early removal of the fixation device.
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Type III Acromio-Clavicular Joint dislocations can be treated successfully by surgical stabilisation in situ, with or without reconstruction of the coracoclavicular ligaments. The authors describe a simple and reliable mode of fixation, performed arthroscopically. ⋯ No hardware removal is necessary. Concomitant glenohumeral pathology can be treated simultaneously.
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We report on a patient who developed persistent low back pain, pyrexia and neurological deficit soon after she underwent a laparotomy under combined general and epidural anaesthesia. The diagnosis of lumbar vertebral osteomyelitis, discitis, epidural and psoas abscesses was made one month later when she was referred to our institution. The patient was successfully treated with posterior decompression, drainage of the epidural abscess and fusion in combination with percutaneous, computed tomography-guided needle aspiration of the psoas abscesses.
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Randomized Controlled Trial Comparative Study
A randomized trial of 'soft cast' for distal radius buckle fractures in children.
A buckle fracture is a stable fracture where there is a dorsal cortex compression of the distal radius. A total of 117 children with buckle fracture treated at our institution were randomised prospectively into two treatment groups: soft cast or rigid cast. The rigid cast group attended clinic after three weeks for removal of the cast. ⋯ Only one patient in the soft cast group had a problem as compared to 5 in the rigid cast group (p = 0.035, using chi square test). When given a choice, parents of children in both groups opted for future treatment with a soft cast (p < 0.01 using chi square test). Our study showed that buckle fractures of the distal radius can safely be treated with a soft cast without the need for more than one fracture clinic appointment.