The K Wire Project: removal of percutaneous kirschner wires from children without general anaesthetic

2008 ◽  
Vol 2 (2) ◽  
pp. 66-76 ◽  
Author(s):  
Mary Lucy Moreton ◽  
Ishbel Proctor ◽  
Annette Henderson ◽  
JE Robb
Keyword(s):  
General Anaesthetic ◽  
Kirschner Wires

Migration of Kirschner Wires after Surgical Stabiliziation of Shoulder Injuries - Four Case Reports

Swiss Surgery ◽  
1999 ◽  
Vol 5 (6) ◽  
pp. 281-287 ◽  
Author(s):  
Schindele ◽  
Hackenbruch ◽  
Sutter ◽  
Schärer ◽  
Leutenegger
Keyword(s):  
Case Reports ◽  
Shoulder Injuries ◽  
Kirschner Wires ◽  
Klinische Symptome

Häufige Frakturen im Bereich der Schulter betreffen je nach Alter die Clavicula oder den proximalen Humerus. Die Indikation zur operativen Stabilisierung ist bei Luxationsfrakturen des lateralen Claviculaendes und bei instabilen und dislozierten Frakturen des proximalen Humerus grosszügig zu stellen. Werden Kirschner-Drähte zur Osteosynthese eingesetzt muss in hohem Masse mit Drahtwanderungen oder Drahtbrüchen gerechnet werden. In mehreren Fällen wird in der Literatur auf diese Komplikation hingewiesen. Anhand von vier Fallbeispielen möchten wir Ursachen und technische Voraussetzungen aufzeigen, die bei dieser operativen Variante zu lebensbedrohlichen Komplikationen durch eine sekundäre Migration führen können. Dies unter Umständen nach Jahren und ohne klinische Symptome. Die Indikation zur Kirschnerdraht-Osteosynthese muss vor allem bei vorliegender Osteoporose zurückhaltend gestellt werden. Regelmässige Kontrollen in der postoperativen Phase werden empfohlen, die Entfernung der Drähte sollte bei konsolidierter Fraktur frühzeitig geplant werden.

scholarly journals Bedtime Oral Hygiene Behaviours, Dietary Habits and Children’s Dental Health

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 416
Author(s):  
George Kitsaras ◽  
Michaela Goodwin ◽  
Michael P. Kelly ◽  
Iain A. Pretty
Keyword(s):  
Oral Hygiene ◽  
Dietary Habits ◽  
Dental Health ◽  
Cross Sectional Study ◽  
Study Data ◽  
General Anaesthetic ◽  
Dental Disease ◽  
Cross Sectional ◽  
Important Relationship ◽  
Bedtime Routine

Background: Oral hygiene behaviours as well as dietary habits before bed can affect children’s dental health resulting in higher prevalence of dental disease. Dental disease can affect children’s health, development and even school performance. If left untreated, dental disease can progress and it can lead to extractions under general anaesthetic causing further distress for children and families. Consistent and appropriate oral hygiene behaviours and dietary habits can prevent dental diseases from occurring in the first place. Objective: This cross-sectional study examines the relationship between oral hygiene behaviours, dietary habits around bedtime and children’s dental health. Methods: A total of 185 parents with children between the ages of 3 and 7 years from deprived areas participated in the study. Data on bedtime routine activities were collected using an automated text-survey system. Children’s dental health status was established through examination of dental charts and dmft (decayed, missed, filled teeth) scores. Results: In total, 52.4% of parents reported that their children’s teeth were brushed every night. The majority of children (58.9%) had dmft scores over zero. In total, 51 (46.7% of children with dmft score over 0 and 27.5% of all children) children had active decay. The mean dmft score for those experiencing decay was 2.96 (SD = 2.22) with an overall mean dmft score of 1.75 (SD = 2.24). There were significant correlations between frequency of tooth brushing, frequency of snacks/drinks before bed and dmft scores (r = −0.584, p < 0.001 and r = 0.547, p = 0.001 respectively). Finally, higher brushing frequency was associated with a lower likelihood of a dmft score greater than 0 (Exp(B) = 0.9). Conclusions: Despite families implementing oral hygiene behaviours as part of their bedtime routines those behaviours varied in their consistency. Results of this study highlight the need for additional studies that consider bedtime routine-related activities and especially the combined effects of oral hygiene practices and dietary habits due to their potentially important relationship with children’s dental health.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

scholarly journals 907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Crotty ◽  
M Corbett ◽  
T Hussain ◽  
A Diaconescu ◽  
N Patil
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Effective Alternative ◽  
General Anaesthetic ◽  
Single Centre ◽  
Pain Scores ◽  
Single Centre Experience ◽  
Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

Complications Following Tension-Band Fixation of Patellar Fractures with Cannulated Screws Compared with Kirschner Wires

2013 ◽  
Vol 95 (7) ◽  
pp. 653-659 ◽  
Author(s):  
C. Max Hoshino ◽  
Wesley Tran ◽  
John V. Tiberi ◽  
Mary Helen Black ◽  
Bonnie H. Li ◽  
...  
Keyword(s):  
Tension Band ◽  
Cannulated Screws ◽  
Kirschner Wires ◽  
Patellar Fractures

741 Manipulation and Reduction of Paediatric Forearm Fractures in The Emergency Department Using Intranasal Diamorphine and Entonox

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kapoor ◽  
A Valand ◽  
J Dartnell
Keyword(s):  
Emergency Department ◽  
Patient Discharge ◽  
General Anaesthetic ◽  
Forearm Fractures ◽  
Distal Radial Fractures ◽  
Access To Treatment ◽  
Early Access ◽  
The Mean ◽  
Salter Harris

Abstract Background Paediatric forearm fractures are commonly encountered in Trauma and Orthopaedics. Currently most forearm fractures are manipulated in theatre the following day, increasing resource burden and delays in management. The aim of this project was to introduce guidelines to reduce fractures in the Emergency Department (ED) using intranasal Diamorphine and Entonox. Method 197 cases were identified over a 6-month period in 2018 and 2019. 74 distal radial fractures and 123 mid shaft forearm fractures were analysed. Fractures with an intact periosteal hinge or a Salter Harris type 2 were reduced in ED. The pre manipulation and post manipulation radiographs were compared with particular attention to the post reduction angles. Results 67% of fractures were reduced in the correct setting. A number of fractures reduced in ED required re-manipulation or internal fixation. Overall, there was a 56% reduction in patients undergoing general anaesthetic. There was a reduction in the mean length of stay from 36 hours to 3.5 hours. Conclusions Intranasal Diamorphine and Entonox offer a safe method for managing paediatric forearm fractures in ED. Implementation of this method facilitates early access to treatment and early patient discharge. Manipulation in ED offers significant financial savings and reduces demands on the Trauma Theatres.

Minimally Invasive Reduction of Intraarticular Calcaneal Fractures With Percutaneous Fixation Using Cannulated Screws Versus Kirschner Wires: A Retrospective Comparative Study

2021 ◽  
pp. 193864002098775
Author(s):  
Ahmed Shams ◽  
Osama Gamal ◽  
Mohamed Kamal Mesregah
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Comparative Study ◽  
Operative Time ◽  
Cannulated Screws ◽  
Kirschner Wires ◽  
Calcaneal Fractures ◽  
K Wires ◽  
Retrospective Comparative Study ◽  
Minimally Invasive Reduction

Background Several minimally invasive techniques were developed for management of intraarticular calcaneal fractures. This study aimed to compare the functional and radiological outcomes of 2 minimally invasive reduction and fixation techniques using cannulated screws or Kirschner wires (K-wires) for fixation. Methods This study was a retrospective comparative review of patients with displaced intraarticular calcaneal fractures, who were treated with cannulated screws or K-wires techniques. Clinical and radiological data were collected and compared between both groups. Functional outcomes and patient satisfaction using the Maryland Foot Score (MFS) and the visual analogue scale (VAS) of pain, in addition to the complications, were compared between both groups. Results In total, 70 patients were included in the study: 34 in the cannulated screws group, with a mean age of 35.2 ± 4 years, and 36 in the K-wires groups, with a mean age of 33.4 ± 3 years. The operative time was shorter in the K-wires group (40.5 ± 5.6 minutes) compared to the cannulated screw group (49.5 ± 4.5 minutes), P < .001. There were no statistically significant differences between both groups regarding the radiological parameters, including Bohler’s angle, angle of Gissane, calcaneal width, height, or length. The mean MFS, mean VAS, and complications were not different between the 2 groups. Conclusion Treatment of displaced intraarticular calcaneal fractures with minimally invasive reduction and fixation using either cannulated screws or K-wires can achieve similar excellent functional and radiological outcomes, with high patient satisfaction. The use of K-wires has the advantage of reduced operative time than cannulated screws. Levels of Evidence: Level III: Retrospective comparative study

ETHYL CHLORIDE AS A GENERAL ANAESTHETIC

BMJ ◽  
1906 ◽  
Vol 1 (2361) ◽  
pp. 771-772
Author(s):  
G. A. H. Barton
Keyword(s):  
Ethyl Chloride ◽  
General Anaesthetic
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