When compared with the long gamma nail, the sliding hip screw should remain the gold standard for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur because it is associated with similar outcomes with less expense.

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INTRODUCTION ‘Have I got a fracture or a break doctor?’ remains a commonly posed question in fracture clinics, suggesting that patients frequently feel a ‘fracture’ and a ‘break’ are two separate entities. This apparent misconception amongst fracture clinic patients may result in confusion and occasionally anger that doctors appear to have inconsistent views on the severity of their injury. Compliance and outcome of patient care can also be affected by poor communication. PATIENTS AND METHODS Our questionnaire-based study was conducted in two stages. The initial objective was to establish whether this misconception surrounding the words ‘fracture’ and ‘break’ is commonly held amongst our out-patient trauma patients. The second stage of the audit was to determine whether a patient information leaflet on fractures/broken bones could help reduce this misconception. RESULTS The preliminary audit involving 50 new patients attending our fracture clinic showed that 84% thought there was a difference between a ‘fracture’ and a ‘break’, with 68% believing a ‘break’ to be worse than a ‘fracture’. Following the introduction of an information leaflet, a re-audit of 61 new patients took place. This time 67% felt there was a difference between a ‘fracture’ and a ‘break’, with 65% believing a ‘break’ to be worse than a ‘fracture’. Only 21% had read the supplied information leaflet, and 69% of those still believed there was a difference between a ‘fracture’ and a ‘break’. CONCLUSIONS The majority of patients believed that there was a difference between a ‘fracture’ and a ‘break’. Access to information leaflets did not appear to alter this misconception. Verbal communication and explanation may be more beneficial and practical than visual aids and leaflets in overcoming this problem.

1 S u m m a r y : E n d o m e t r i o s i s is a c o m m o n g y n a e c o l o g i c a l c o n d i t i o n / characterised by the presence and proliferation of ectopic endometrial tissue. A wide variety of sites have been reported but endometriosis within the inguinal canal is uncommon [Clausen 1987]. The majority of reported cases have described the endometrial tissue as lying in the extraperitoneal portion of the round ligament or within an inguinal lymph node [Clausen 1987]. We report a rare case of endometriosis presenting within the sac of an indirect inguinal hernia.

Objectives. To review of outcome following delay in surgery in patients with hip fracture taking clopidogrel (Plavix bisulphate) on admission.Methods. Retrospectively studied patients with hip fractures on clopidogrel admitted to our trauma unit between January 1, 2006 and May 31, 2007.Results. We report the results of a retrospective study of 15 patients taking clopidogrel on admission.The mean preoperative haemoglobin levels were 12.4 (range 9.9 to 14.1), the mean postoperative haemoglobin level were 9.7 (range 8 to 12.3). Four patients required blood transfusions. The mean delay in surgery was 9.1 days (range 7 to 14 days). The mean duration of hospital stay was 21 days (range, 8 to 45 days). Three patients died secondary to cerebrovascular complications.Conclusion. In summary, we found that there is increase mortality and requirement for blood transfusion in patients on clopidogrel in whom surgery were delayed.