A case of post-traumatic pseudoaneurysm of the peroneal artery is presented. This occurred after standard open reduction and internal fixation of a Weber type C trimalleolar fracture of the left ankle in a 33-year-old man. The pseudoaneurysm was diagnosed 12 weeks post-operatively when the patient attended the pre-assessment clinic for the removal of the syndesmosis screw. Diagnosis was confirmed on ultrasonography, and the anatomical site was confirmed by a digital subtraction angiogram. The pseudoaneurysm was coiled successfully, and the syndesmosis screw was removed in theatre the next day, without any post-operative complications. We explore the aetiology of post-traumatic peroneal pseudoaneurysms, with emphasis on the pathoanatomy and management as described in literature. This is a rare complication, but is easily manageable provided an index of suspicion is maintained.
Nurses represent the largest single resource in terms of numbers of staff employed as well as the revenue cost within the National Health Service. As trainee nurses constitute about 30% of the nursing staff and in some cases provide more than 60% of the bedside care, the effective design of nurse training programmes must receive considerable analytic attention. A computer-aided interactive procedure is described which enables senior nursing administrators to evaluate and improve, from service point of view, a given nurse training programme.
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