Biomedical subjects
Publications and source records attributed to T F Beattie.
We present a rare case of avulsion fracture of the reflected head of rectus femoris. This occurred in a 13-year-old male footballer. Diagnosis was made with pelvic radiology and treatment was bed rest and analgesia.
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We report a survey of telephone calls to an Accident and Emergency Department. Telephone calls form a significant part of the workload of an Accident and Emergency Department. The differences between telephone advice from an Accident and Emergency Department and general practice are highlighted. In general telephone advice from the Department is a useful adjunct to the service provided by the NHS. The possibility of medico-legal implications is discussed.
This paper documents hand injuries in the paediatric population presenting to a Paediatric Accident and Emergency Department over a two month period. Unlike other childhood accidents, they showed no marked male preponderance, nor age pattern. While most injuries were relatively minor and were able to be managed in the Accident and Emergency Department, a small minority were referred for specialist treatment.
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The incidence of Radial Head Subluxation in young children in the Aberdeen City Area was ascertained by retrospective review to be 1.2% per year. One hundred and sixty-two cases were recorded, in children aged between 5 and 66 months. The epidemiological features of the condition are reviewed. Extrapolation of these figures to the population of England, Scotland and Wales would suggest an annual incidence of 50,000 cases. This is a condition treatable in general practice, provided of course that the patient is not taken direct to an Accident and Emergency Department.
This study was undertaken to assess the accuracy of clinical examination in predicting significant injury following blunt chest trauma and to determine whether more selective use of frontal chest radiography could be achieved.
A prospective study was performed to establish definitive guidelines for selective use of radiography in the assessment of inversion ankle injuries. Five hundred patients were included, representing 3.2% of the workload of the department during the study period. There were 379 soft tissue injuries, 56 malleolar fractures, 40 avulsion fractures, 21 fractures at the base of the fifth metatarsal, and four calcaneal fractures. Multiple logistic regression identified distal fibular tenderness, age, and ability to bear weight as the most important clinical variables in predicting important fractures (p less than 0.001). A policy of requesting x ray examination of only those patients with distal fibular tenderness or inability to bear weight or aged over 60, with a further proviso that no foot radiographs should be obtained, would produce a 60% reduction in ankle radiography in this centre without detriment to patient care.
Two methods of reduction for anterior dislocation of the shoulder were compared in 111 patients. Milch's technique was found to be atraumatic and relatively painless. Greater success with Milch's technique was experienced in patients under 40 years of age in whom the dislocation had been present for less than 4 hours. Milch's technique should be tried initially in patients fulfilling these criteria. In other cases Kocher's technique should be used first, especially in those of heavy build.
This paper describes two patients with posterior dislocation of the elbow in whom the dislocation was reduced atraumatically by a modified hanging arm method not previously described. Further research is recommended to evaluate this method.