Aust Fam Physician
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Bennett fracture dislocation is an intra-articular fracture of the base of the first metacarpal with resultant dislocation of the first carpometacarpal joint. The fracture is unstable, and with inadequate treatment leads to osteoarthritis, weakness and/or loss of function of the first carpometacarpal joint. ⋯ Bennett fractures usually result from falling on an extended or abducted thumb or an impact onto a clenched fist. The patient presents with pain and loss of function of the first carpometacarpal joint. Management can involve closed reduction, with or without percutaneous Kirschner wire fixation, or open reduction and internal fixation, with adequate reduction and the maintenance of reduction being the key to a successful outcome. Due to the difficulty of management it is recommended that patients be referred to a specialist hand surgeon.
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Patient initiated aggression toward general practice staff can cause distress among staff, however, it is unknown how frequently practice staff experience patient aggression in the workplace. The aim of this study is to determine the national prevalence of patient aggression toward general practice staff. ⋯ This study provides some national evidence of the prevalence of patient aggression toward general practice staff. This may inform the development of policy and procedures.
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A man, 43 years of age, presents to his general practitioner with a 6 day history of sore throat. There are no other symptoms of an upper respiratory tract infection. In passing, the patient mentions that 6 days ago he experienced an episode of exertional chest pain. ⋯ He has no cervical lymphadenopathy. His lungs are clear on auscultation and his heart sounds are dual with no murmur. His electrocardiogram is shown in Figure 1.