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Biomedical subjects

P H Brakenbury

Publications and source records attributed to P H Brakenbury.

8 recordsLinked to original sources
PubMed1989

A comparative double blind study of amoxycillin/clavulanate vs placebo in the prevention of infection after animal bites.

The value of prophylactic antibiotics in the treatment of animal bites is uncertain. A prospective double blind stratified trial was performed comparing a broad spectrum antibiotic amoxycillin/clavulanate with placebo in full thickness animal bite wounds in a series of 185 consecutive patients. In wounds less than 9 h old, no significant benefit was found with the antibiotic. In older wounds, presenting 9-24 h after injury, the infection rate was reduced significantly (P = 0.023), although the numbers were small. We recommend the use of such an antibiotic on wounds 9-24 h old and query its use in more recent injuries, unless tendons or joints are likely to be involved.

Adult↗
PubMed1985

Accident and emergency services--the contribution of the community hospital.

A survey of attendances in one year at a community hospital accident and emergency department in Redcar was undertaken to determine the clinical conditions treated and their severity, the number of cases referred to the major accident centre or to an appropriate specialist, and the reasons why patients chose to attend for treatment at the community hospital. Minor trauma accounted for many of the 7,557 attendances (4,916 patients); 5% were medical and non-traumatic surgical cases. One third of the patients had hand injuries. There were 1,765 patients (36%) referred for specialist care or follow-up. Nearly half of the patients gave no reason for choosing to seek treatment at the community hospital and most of the remainder attended because of difficulty in getting access to their general practitioner or practice surgery when the injury/illness occurred.

Adolescent↗
PubMed1981

The treatment of isolated fractures of the ulnar shaft in adults.

This study of 254 cases of isolated fractures of the ulnar shaft in adults is the largest series to date. The methods of treatment employed are analysed. Conservative treatment and the indications for, and technique of operation are discussed. A plan of management is proposed for these fractures.

Adolescent↗
PubMed1981

Non-union of the isolated fracture of the ulnar shaft in adults.

Twenty-one cases of non-union of the isolated fracture of the shaft of the ulna were reviewed. The factors which have been shown to predispose to non-union include the site of the fracture, its initial displacement, comminution, the presence of multiple injuries and early mobilization. The use of rigid fixation and the delay of one week in operation reduced the incidence of non-union in those internally fixed. No evidence was found that internal fixation reduced the incidence of delay in union, compared with closed treatment. Fourteen of the fractures later united. Plating the fracture of internal fixation with bone grafting secured union in 11 out of 12 cases. These were the only satisfactory methods of treatment.

Adolescent↗
PubMed1981

Dislocation following total hip replacement.

An analysis of 142 dislocations from a multicentre study of 6774 total hip replacements is reported. The incidence of dislocation was 2.1 per cent. Patients with neuromuscular disorder, those in a confused mental state, and those undergoing revision operations are at special risk. The commonest surgical error, present in nearly half the patients, was placing the acetabular cup too vertically or too anteverted. A less common fault was placing the femoral component too anteverted. Neither the original pathology nor the approach to the hip appeared to affect the likelihood of dislocation. The dislocations were divided into early and late, single and recurrent, and the success rate of treatment is described in these groups. One hundred and eleven patients (78.2 per cent) eventually obtained stability. Of those with a single dislocation, 62 per cent remained stable after a single manipulation. Thirty-four per cent of the patients required an open operation to achieve stability and it is suggested that, in many cases, open reduction alone is not enough; the mechanical fault needs to be corrected.

Acetabulum↗
PubMedDate not supplied

Objective verification of tetanus immune status in an apparently non-immune population.

Patients who are not known to be immunised to tetanus are considered to be non-immune. The appropriate treatment is the commencement of active immunisation with a course of three tetanus toxoid inoculations; if the wound is considered to be tetanus-prone, 250 IU of human anti-tetanus immunoglobulin is given concurrently. This study determined the true immune status of 166 patients who were considered to be non-immune on the basis of the available history. The majority (90 of 166) had protective levels of immunoglobulin (greater than 0.06 IU/ml) and further treatment was not indicated. Only two patients were non-immune. The remainder had protective levels (between 0.01 and 0.06 IU/ml) and required a tetanus toxoid booster.

Aged↗