ABSTRACT
Patients who report ongoing adverse symptoms following trapeziectomy may require revision surgery. We present a series of 10 patients who underwent revision surgery using a Silastic interpositional finger joint arthroplasty. Mean age was 60 (range 48-70) years, with a mean interval between primary and revision surgery of 34 (range 12-84) months. Review was performed at an average of 53 (range 21-136) months. Nine of the 10 patients reported improvement in pain, and all patients reported improvement in pinch grip, activities of daily living, and satisfaction at having undergone revision surgery. There were no complications. We found good medium-term results and high satisfaction rates. We advocate this technique as an effective treatment option in these difficult cases, provided other treatable causes of poor outcome are excluded.
Subject(s)
Arthroplasty/methods , Carpometacarpal Joints/surgery , Thumb/surgery , Trapezium Bone/surgery , Activities of Daily Living , Aged , Female , Hand Strength , Humans , Male , Middle Aged , Pain Measurement , Patient Satisfaction , Recovery of Function , Reoperation , Treatment OutcomeABSTRACT
OBJECTIVES: The aim was to monitor the inhospital progress of 170 patients sustaining proximal femoral fractures. The extent of delay in discharge was recorded and what effect this prolonged hospitalisation had on nosocomial infection rates. SETTING: A regional trauma centre. DESIGN: A prospective observational study. PATIENTS AND PARTICIPANTS: All consecutive patients sustaining proximal femoral fracture over 60 years of age. INTERVENTION: The same clinician monitored each patient throughout their inhospital stay. Factors recorded included nosocomial infection acquired and when, mobility scores, loss of independence, delay in discharge amongst others. MAIN OUTCOME: Delay in discharge, incidence of nosocomial infection and mobility scores. RESULTS: Nosocomial infection occurred in 58% of patients (99 patients) when discharge was delayed beyond 8 days (after surgery). Eighty-five per cent of patients (145 patients) achieved their maximum mobility score by the 8th, and 95% (162 patients) by the 10th postoperative day. CONCLUSIONS: Patients with proximal femoral fracture derive no benefit from acute hospital admission of more than 8 days and the majority acquire nosocomial infection after this.
