Purpose. To evaluate the effects of perioperative information for wrist arthroscopy on postoperative pain, return to daily activities, and patient satisfaction. Methods. 34 women and 21 men aged 19 to 54 (mean, 35) years underwent diagnostic wrist arthroscopy to explore the radiocarpal and midcarpal joints. They were randomised to receive specific preoperative information on the procedure (pictures of the wrist joint anatomy, portal entry sites, and the arthroscope) and written instructions on postoperative care (n=28) or only standard preoperative information and verbal instructions on postoperative care (n=27). The visual analogue score (VAS) for pain and the Quick Dash score for return to daily activities of each patient were recorded before and after wrist arthroscopy. Analgesic intake after wrist arthroscopy was recorded. Results. The mean post-arthroscopic VAS from days 2 to 6 was significantly lower in the experimental group than controls. This was reflected by the decrease 2011;19(1):85-8 in analgesic intake. The mean post-arthroscopic Quick Dash score was significantly lower in the experimental group than controls (40 vs. 47, p=0.02), indicating earlier return to daily activities. Conclusion. Patients who received specific preoperative information on the procedure and written instructions on postoperative care experienced less pain, consumed less analgesics, and had an earlier return to daily activities.

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Here, we report a case of a distal femoral fracture in a 23-year-old male army cadet who presented to the Accident and Emergency department following a twisting injury while participating in a routine military marching exercise. A pathological fracture was considered but this suspicion was put to rest following thorough investigations, leaving only a diagnosis of a nontraumatic spontaneous femoral fracture.To our knowledge, there have been no reported cases of distal femoral fractures associated with nontraumatic military exercises, with the majority of injuries instead related to stress fractures. A vigilant literature search yielded no cases of similar injury nature, which is the primary reason we believe that those interested in orthopaedics or military doctors would find themselves drawn to this case.The patient presented with severe pain in his left thigh and on examination there was a deformity of his left thigh.In terms of investigations, a bone profile, plain film radiographs, C-reactive protein, erythrocyte sedimentation rate, and tumor markers were all preformed and proved unremarkable. The definitive treatment was by open reduction and internal fixation.Femoral fractures often require significant amounts of force, particularly in young, healthy individuals. Generally, these injuries in this demographic follow high-energy traumas, with the lion's share occurring following a road traffic accident or other high-speed impact. More often than not, the treatment is surgical. Given the extraordinary manner of this such, one must be attentive and exhaustive in their investigation of such presentations.