Journal of the Royal College of Surgeons of Edinburgh
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The risks of occupational radiation exposure for orthopaedic surgeons has not been well documented. The use of fluoroscopy in orthopaedics has reduced morbidity and by reducing operative time and by reducing the invasiveness of procedures. Increasingly procedures requiring the use of fluoroscopy are being developed. ⋯ The exposure levels are well below the maximum dose limits for ionizing radiation as recommended by European Economic Communities EURATOM directives. Experimentally using a phantom patient it was shown that the exposure to ionizing radiation during the insertion of a dynamic hip screw was minimal. Despite the low level of exposure care should be exercised when using fluoroscopy.
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A classification of cervical spine injuries based upon Dunn's concept of stable and unstable fractures is presented. The role of conservative treatment using Halo-body fixation is outlined along with the various approaches to the cervical spine and their method of ensuring stability.
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Thoracotomy has long been the conventional surgical approach in dealing with chylothorax due to thoracic duct injury which has been refractory to conservative treatment. The development of thoracoscopic access provides an alternative means of dealing with thoracic duct injuries thereby reducing the morbidity from thoracotomy and prolonged chylous leak. It will encourage earlier intervention in thoracic duct injury.
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The incidence of stabbings in the United Kingdom has not been determined. We audited all cases of stabbings presenting to the Accident and Emergency Department of the Cardiff Royal Infirmary over an 18-month period from 1 January 1991. ⋯ There was a high incidence of self-inflicted stab wounds accounting for a significant proportion of the expenditure. This has not been reported previously.