RESUMO
This audit reviewed the trauma theatre time utilisation during April 2000 to March 2001. Instead of a scheduled 8 30 am start, first patient was on the table by only 9 40 am because of various reasons. To use this redundant time carpal tunnel release was started under local anaesthesia, as first case. On re-auditing, it was found that the patient for carpal tunnel release was on the table at 8 44 am. The first trauma case was on the table at 9 46 am. This simple idea has helped in the performing of an additional case every day with a delay to the trauma list of only six minutes (p<0.05).
Assuntos
Síndrome do Túnel Carpal/cirurgia , Descompressão Cirúrgica/métodos , Inglaterra , Hospitais Gerais/estatística & dados numéricos , Humanos , Tempo de Internação , Auditoria Médica , Fatores de Tempo , Centros de Traumatologia/estatística & dados numéricosRESUMO
INTRODUCTION: This study analyses the results of 50 displaced diaphyseal forearm fractures in children treated with flexible intramedullary nailing. METHODS: Between 1999 and 2002 we treated 50 children aged between 5 and 15 years, with diaphyseal fractures of the forearm using Flexible intramedullary nailing (FIN). Both bones were fractures in 45 patients, radius only in 4 and ulna only in 1. The indications for fixation were instability (26), re-displacement (20), and open fractures (4). RESULTS: 24 patients were reduced closed, followed by nailing, while 26 fractures required open reduction of either one bone(16 cases) or both bones(10 cases) prior to nailing. Bony union of all fractures was achieved by an average of 7 weeks (range 6 weeks to 4 months) with one delayed union. Pronation was restricted by an average of 20 degrees in 9 patients. Two patients developed post operative compartment syndrome requiring fasciotomy. Three patients were lost to follow-up. INTERPRETATION: FIN led to early bony union with acceptable bony alignment in all 47 patients available at final follow-up. We therefore recommend FIN for the treatment of unstable diaphyseal forearm fractures in children.
Assuntos
Fixação Intramedular de Fraturas/métodos , Fraturas do Rádio/cirurgia , Fraturas da Ulna/cirurgia , Adolescente , Pinos Ortopédicos , Criança , Pré-Escolar , Síndromes Compartimentais/etiologia , Diáfises/lesões , Diáfises/cirurgia , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/instrumentação , Consolidação da Fratura , Humanos , Masculino , Radiografia , Fraturas do Rádio/diagnóstico por imagem , Resultado do Tratamento , Fraturas da Ulna/diagnóstico por imagemAssuntos
Atlas Cervical/lesões , Fraturas da Coluna Vertebral/diagnóstico por imagem , Acidentes por Quedas , Atlas Cervical/diagnóstico por imagem , Humanos , Lactente , Masculino , Movimento , Fraturas da Coluna Vertebral/fisiopatologia , Fraturas da Coluna Vertebral/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Dor nas Costas/etiologia , Osteoma Osteoide/complicações , Neoplasias da Coluna Vertebral/complicações , Adolescente , Dor nas Costas/diagnóstico por imagem , Feminino , Humanos , Osteoma Osteoide/diagnóstico por imagem , Radiografia , Cintilografia , Neoplasias da Coluna Vertebral/diagnóstico por imagemRESUMO
We describe a patient with fractures of both bones of the forearm in whom flexible intramedullary nail fixation of the radius alone led to ulnar malunion and a symptomatic distal radio-ulnar joint subluxation. This was successfully treated by ulnar osteotomy.
Assuntos
Fixação Intramedular de Fraturas/efeitos adversos , Fraturas Mal-Unidas/etiologia , Luxações Articulares/etiologia , Fraturas do Rádio/cirurgia , Traumatismos do Punho/etiologia , Criança , Feminino , Humanos , Fraturas do Rádio/complicações , Fraturas da Ulna/complicações , Fraturas da Ulna/terapiaRESUMO
Vascular malformations involving the muscles around the knee can be a cause of knee pain. We studied ten such cases. All underwent magnetic resonance (MR) imaging which confirmed the diagnosis. Eight cases underwent wide surgical excision of the lesion, histology of which showed a vascular malformation with predominantly venous element. There was no recurrence in any of the operated cases at the last follow-up. We believe that most of these lesions can be treated successfully by careful preoperative planning aided by MR imaging and a wide-open excision of the lesion.
