Purpose. To compare the visual analogue score (VAS) for pain in patients with femoral neck fracture who received standard preoperative analgesia with or without fascia iliaca compartment block (FICB). Methods. In patients with femoral neck fracture, 69 patients who received standard preoperative analgesia (regular paracetamol 1g 4 times a day, codeine 60 mg 4 times a day, and opioid 10 mg 2 hourly as required) were compared with 50 patients who received standard preoperative analgesia plus FICB. VAS for pain at rest and on movement (hip flexion) was assessed before FICB and 15 minutes, 2 and 8 hours after FICB. The amount of additional opioid required and the incidence of opioid overdose (necessitating administration of naloxone) were determined. Results. VAS for pain was significantly lower after standard analgesia plus FICB than standard analgesia alone (p=0.001). The analgesic effect (pre-score minus post-score) of standard analgesia plus FICB did not differ between genders (p=0.57) or fracture patterns
Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified.
Whilst the costs of physical products were well estimated by our cohort of patients, the costs of less tangible products, such as radiology and operations, were poorly estimated. Our study shows that there is a poor public perception of the true cost for investigation and operative treatment of common trauma and orthopaedic conditions.
Statistically significant inter-observer values in both rounds were noted with the three-column classification, making it statistically an excellent agreement. The intra-observer reproducibility for the three-column classification improved as compared with the Schatzker classification. The three-column classification seems to be an effective way to characterise and classify fractures of tibial plateau.
Introduction
Ankle sprains are among the most common of bone and joint injuries. Historically, distal tibiofibular syndesmotic injuries have been treated using syndesmotic metal screws to prevent diastasis. However, the use of screws meant that physiological micro-movement between the tibia and fibula was lost which often results in loosening and breaking of the screws. Tightrope fixation was a new technique that has been developed to overcome these complications and allowed some degree of flexibility similar to that offered by natural ligaments. The aim of our study was to evaluate such injuries.
Materials and methods
We conducted a retrospective study reviewing all clinical records of cases of patients with injuries of the distal tibofibular syndesmosis treated with the ankle tightrope (Arthrex Inc) in our institution between January 2008 and January 2011.
Results
A total of 42 patients were reviewed. We encountered five cases with complications (12%). Of those: three required removals due to prominent knot, one soft-tissue irritation and one with uncomplicated wound infection.
Conclusion
Our study, one of the largest so far evaluating complications of tightrope fixation, demonstrates that one in eight patients treated with tightrope will experience complication.
How to cite this article
Al-azzani WAK, Sabah T, Paringe V, O'Doherty D. Evaluation of Ankle Tightrope Syndesmosis fixation. J Foot Ankle Surg (Asia-Pacific) 2014;1(1):1-4.
During the COVID-19 pandemic, there has been worldwide cancellation of elective surgeries to protect patients from nosocomial viral transmission and peri-operative complications. With the unfolding situation, there is a definite need for an exit strategy to reinstate elective services. Therefore, more literature evidence supporting exit plans for elective surgical services is imperative to adopt a safe working principle. This study aims to provide evidence for safe elective surgical practice during the pandemic.
MethodologyThis single centre, prospective, observational study included adult patients who were admitted and underwent elective surgical procedures in the trust's COVID-free environment at the Birmingham Treatment Centre between May 19 and July 14, 2020. Data were collected on demographic parameters, perioperative variables, surgical specialities, COVID-19 reverse transcription polymerase chain reaction (RT-PCR) testing results, post-operative complications and mortality. The study also highlighted the protocols it followed for the elective services during the pandemic.
ResultsA total of 303 patients were included with mean age of 49.9 years (SD 16.5) comprising of 59% (178) female and 41% (125) male. They were classified according to the American Society of Anaesthesiologist Grade, different surgical specialities and types of anaesthesia used. Ninety-six percent (96%) of patients were discharged on the same day. Hundred percent (100%) compliance with pre-operative COVID-19 RT-PCR testing was maintained. There was no 30-day mortality or major respiratory complications.
ConclusionCareful patient selection, simultaneous involvement of the pre-assessment and anaesthetic team, strict adherence to peri-operative protocols and delivering vigilant post-operative care for COVID-19 infection can help provide safe elective surgical services if the community transmission is under reasonable control. However, it is particularly important to maintain COVID-free safe environment for such procedures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.