The effect of excising fifty sural nerves from the legs of forty-five patients undergoing nerve grafting are described. Forty-two per cent of patients complained of tenderness in the calf, likely to be due to neuroma formation. Ten per cent of patients had other minor complaints. One would haematoma and one deep vein thrombosis occurred. Overall patient satisfaction was high when the functional result of the nerve grafting was taken into account.
We report a prospective study of the factors associated with acute urinary retention after total hip replacement in 103 consecutive male patients. Eleven patients (10.7%) developed retention after operation. Of the factors investigated before operation three had predictive value: inabifity to pass urine into a bottle whilst lying in bed, urinary peak-flow rates indicative of obstruction, and a history of previous bladder outflow problems. This study suggests that patients showing one or more of these factors should be assessed and if necessary treated by a urologist before arthroplasty, so as to avoid the need for catheterisation, and the consequent risk of deep infection. Deep infection is a serious complication of hip joint replacement, and usually results in removal of the prosthesis
Objective-To assess the management of elderly patients presenting to the accident and emergency (A&E) department with a proximal femoral fracture. Methods-A retrospective audit carried out on 30 patients with proximal femoral fracture showed an unacceptably long waiting time in the A&E department. A new "fast track" system for managing these patients, involving the use of a flow chart for expediting admission, was devised. A prospective study of 100 patients > 60 years of age with proximal femoral fracture admitted by fast track system was then carried out.
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