In a retrospective survey of patients with fractures and dislocations attending the Accident department of a District General hospital, comparison was made between patients with fractures and dislocations in the hand and fractures and dislocations of other sites. Patients with hand injuries accounted for 28% of the total patients seen. They were more likely than other fracture patients to be male and between the ages of 10 and 40 years. Almost a quarter of hand injuries attended on Monday. Leisure activities outside the home formed the commonest aetiological factor. Only 66% of patients with hand injuries attended the Accident department within 24 hours of injury. The little finger was the commonest site of injury. This survey emphasizes the differences between hand injuries and injuries of other sites, identifies the risk factors for hand injuries and has implications for the management of hand injuries in a District General Hospital.
AObjectives: Snapping hip syndrome has been a known entity for long, but has only recently been studied in detail. It however remains poorly understood and infrequently diagnosed due to the paucity of the condition. As a result, the literature remains scarce and scattered about the management, with most series limited to less than 15 patients. We present our experience in operative and conservative management of this condition in a series of 20 patients. We describe an out patient operative approach involving release and anterior transposition of the posterior half of the iliotibial band. Methods: Review of results in 20 patients [25 hips] treated operatively over last 12 years after failed conservative treatment.Results: Dramatic reduction in average visual analog scale and clicking score from 6 and 9 to 0.7 and 0.6, respectively. Significant improvement in quality of life score from 5 to 9 postoperatively [out of a maximum of 10]. All the patients reported good to excellent relief in symptoms postoperatively and walking distance was no longer limited by hip pain or clicking. Five patients had bilateral surgery and the rest replied in affirmative when asked if they would prefer this procedure in future if the other hip became symptomatic. Conclusions: We did not have any major complications after the procedure and had a high satisfaction rate of 95 percent. None of the patients have needed a repeat surgery yet. Most patients reported impressive relief in their snapping symptoms, but pain relief was variable. This approach has yielded satisfactory and reproducible results and we would recommend this approach in snapping hip refractory to conservative treatment.
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