A prospective randomized trial of external fixation and plaster cast immobilization in the treatment of distal radius fractures.
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Biomedical subjects
Publications and source records attributed to G Horne.
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Indoor cricket is a popular winter sport, but injuries sustained in the game have not been previously reported. The Accident Compensation Corporation statistics showed that in 1987 520 injuries were sustained in indoor cricket. This paper reports 33 finger and thumb injuries sustained in two seasons of indoor cricket. The majority of patients had some residual stiffness, deformity or loss of function as a result of the injuries.
Daily s.c. injections of buserelin were commenced in the mid-luteal phase of the preceding cycle in 118 women undergoing in-vitro fertilization (IVF) and embryo transfer. Ovarian and pituitary suppression was said to have been adequately achieved when serum oestradiol was less than 50 pg/ml, serum LH less than 2.0 IU/l, no ovarian cysts greater than or equal to 10 mm diameter were present and menstruation had occurred. Nine groups of women were retrospectively identified after the administration of buserelin for 12 days according to whether pituitary and ovarian suppression had been achieved or not, and the reason for extended buserelin treatment prior to ovarian stimulation. Upon adequate suppression, patients were grouped in terms of the duration of exposure to buserelin, and ovarian stimulation was then started by daily injections of human menopausal gonadotrophin. There appeared to be no differences in the ovarian response for women down-regulated by day 12, 19 or greater than or equal to 26 days; those women requiring extended buserelin treatment did equally well compared to those women down-regulating quickly, in terms of number of oocytes recovered and fertilization rate. Clinical pregnancy rates per embryo transfer were 27/68(40%), 8/33(26%) and 4/17(24%) for those women down-regulated by days 12, 19 or greater than or equal to 26 respectively, and were not significantly different.
The occurrence of pain following a technically satisfactory cemented total hip arthroplasty is of concern for both the orthopedic surgeon and the patient. In order that the source of the pain be accurately located, a scientific approach is required. We present an algorithm for the evaluation of pain following an apparently satisfactory hip arthroplasty which, if followed, results in the correct diagnosis.
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A patient with osteomyelitis of the superior pubic ramus is reported. Computed tomography was helpful in making the diagnosis.
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A bioassay procedure is described for quality control testing of various disposable items used in routine IVF procedures. This bioassay is performed over 4 days and uses the survival of human sperm in vitro at room temperature to assess which products are suitable for use. New products were tested for cytotoxicity using a general screening method and subsequent batches of every suitable item tested to detect interbatch variation. Products were considered suitable or unsuitable for use depending upon a calculated sperm survival index. Two main types of product were found to be cytotoxic, namely certain brands of syringe and surgical gloves, the common feature of both being the presence of rubber components. The bioassay was also used to investigate further the cytotoxic effect of the powdered and starch-free surgical gloves. The cytotoxic substances from both types of surgical glove were readily transferred to an embryo replacement catheter by touch, and washing of the gloves reduced this effect only moderately. The bioassay has proved inexpensive and convenient but more importantly it has been invaluable for detecting potential sources of cytotoxicity before they are introduced into a standard IVF protocol.
Revision of failed cemented total hip arthroplasties represents a major technical challenge to orthopaedic surgeons. One of the problems encountered is loss of femoral bone stock, making restoration of prosthetic stability difficult. Revision with uncemented components may allow healing of bone defects.
The potential for femoral head rotation occurring during insertion of a compression hip screw has been investigated. Rotation to up to 30 degrees has been demonstrated, and was not visible on an image intensifier. The insertion of a guide-wire parallel to a hip screw does not control rotation adequately. Small threaded pins do not cause femoral head rotation.
Little has been written on the outcome of the survivors of major trauma accidents. The Glasgow outcome scale has been used to assess outcome following neurotrauma. This study of 90 patients reviewed at an average of 3.2 years post-injury used a modified form of the Glasgow outcome scale expanded to include all abbreviated injury score body areas. The average injury severity score was 23.3. The majority of patients had a satisfactory outcome.
One hundred oblique distal first metatarsal osteotomies (Wilson's) were reviewed at an average of five years and two months following surgery. In 96 feet there was pain over the bunion or first metatarsophalangeal joint preoperatively. This pain was eliminated in 85 feet and improved in nine feet. Second metatarsalgia present preoperatively was relieved in five of seven feet, but 19 feet developed second metatarsalgia following surgery. The majority of patients were pleased with the outcome of the surgery. No significant complications were noted. The surgical technique of Wilson's first metatarsal osteotomy for hallux valgus is straight-forward and produces a predictably excellent result.
Two patients having subarachnoid haemorrhage due to cerebral aneurysms were given betamethasone postoperatively. Both developed avascular necrosis of the head of the femur, three and four years later.
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