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PubMed1999

Face to face

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Journal Article↗
PubMedDate not supplied

Face-to-face and hands-on: assumptions and assessments in the physiotherapy clinic.

Drawing on findings from physiotherapy practice, this article discusses several interrelated concerns that are highly relevant for health care research: How do professionals constitute their very object--"the body"--and what are the connections between professionals' views of the body, their approaches to it, and patient participation? By providing a comparative analysis of two first encounters in physiotherapy, where patients' musculoskeletal disorders are assessed, I show how variously physiotherapists can practice and reason. One therapist is guided by assumptions deriving from the biomedical sciences, the other by an understanding of the body as the center of experience and field of expression. I show that the status clinicians ascribe to the body has important implications for what kind of information they regard as relevant, and I argue that the diversities accounted for provide unequal possibilities for collaboration and patient participation. I sum up by calling for more comprehensive studies of clinical practice in natural settings.

Attitude of Health Personnel↗
PubMed2000

"Face to face": a new method for the treatment of polydactyly of the thumb that maximises the use of available soft tissue.

Some patients with distal phalangeal polydactyly of the thumb have severe hypoplastic pulps that are difficult to make sufficiently large with either the fillet flap method or a symmetrical combination, the Bilhaut-Cloquet method. We have devised a new method to reconstruct the largest possible pulp by resecting only a minimum amount of soft dorsal skin tissue with one nail and not resecting any of the palmar skin of the thumbs. By contrast, other procedures require some resectioning of soft tissue of both the dorsal and the palmar skin. We have treated 13 cases with distal phalangeal polydactyly of the thumb since 1988 in this way. All the thumbs were successfully reconstructed with a sufficiently large pulp. The only problem was slight instability of the skin of the pulp after the operation, but this condition gradually improved during a five-year follow up. We think that this method facilitates the reconstruction of a sufficiently large pulp when both bifid pulps are hypoplastic.

Child, Preschool↗