Background The decision to recommend either reconstructive or ablative surgery to the parents of children with fibular hemimelia is difficult and debatable in the orthopaedic literature.
Background
Transverse olecranon fractures are commonly fixed using a tension band wiring technique. This technique has a high rate of complications because of the prominent metalwork, frequently resulting in further surgery to remove the hardware. We investigated a new technique using two metal screw in bone anchors double loaded with Orthocord.
Methods
A tension band suture technique was employed in 22 patients (14 Mayo type IIA fractures and 8 olecranon osteotomies) using two double Orthocord loaded bone anchors in a standardised fashion. Twenty‐one patients started mobilisation at 1 week. Patients were followed up until both clinical and radiological union was evident. Any problems with fixation hardware and complications were all recorded.
Results
The mean time of union was 6.4 weeks (range 5 weeks to 9 weeks). One patient developed an asymptomatic fibrous non‐union and 20 achieved complete anatomical union. At a mean of 14.2 months, no patient had developed any hardware problem or required further surgery.
Discussion
Tension band suturing is a safe, easy and quick technique that avoids the risks associated with other methods of fixation. It provides a comparable union rate without any complications as a result of the hardware. In our series, no patients required further surgery.
The present study supports the use of HD as a first line treatment for AC regardless of the underlying cause, and also demonstrates that the volume injected does appear to influence the outcome.
Many junior doctors feel cardiac arrests are unsatisfactorily managed and experience high levels of stress during the procedure, often feeling they are inadequately trained for the task. Juniors also regard ‘do not resuscitate’ orders as decisions for teams, not individuals.
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