The purpose of this study was to evaluate the relationship between radiological and functional results in patients with extra-articular fractures of the distal radius. We conducted a prospective study of radiological and functional assessment in 95 consecutively selected extraarticular distal radius fractures. There were two patient groups: more than 60 and less than 60 years of age. The final fracture union radiographs were analysed for their functional outcome using the Michigan Hand Outcomes Questionnaire (MHQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. In patients with acceptable radiological results, 62% (MHQ group) and 72% (DASH group) of patients had satisfactory functional outcome. Analysing patients with satisfactory functional results, 56% (MHQ group) and 59% (DASH group) had satisfactory radiological results. There was a higher proportion of patients with better functional results, despite poor radiological results, in both of the age groups. There was a statistically significant correlation between satisfactory radial tilt and functional outcome in the younger patients. In the older age group, patients with satisfactory radiological results had satisfactory functional outcome (p<0.05). However, in the older age group, satisfactory functional results were achieved, despite unsatisfactory radiological results.Résumé Le propos de cette étude est d'évaluer les relations entre les résultats radiologiques et fonctionnels des patients ayant présenté une fracture extra articulaire de l'extrémité distale du radius. Une étude prospective et radiologique a été menée chez 95 patients consécutifs présentant ce type de fractures. Ils ont été divisés en deux groupes, le groupe de plus de 60 ans et le groupe de moins de 60 ans. La consolidation finale, radiographique, a été analysée de même que le résultat fonctionnel en utilisant le score de Michigan et le questionnaire DASH. Si l'on prend les patients présentant un résultat radiologique acceptable, 62% selon le score Michigan et 72% selon le score DASH, ceuxci ont un résultat fonctionnel satisfaisant. Si l'on analyse les patients à partir du score fonctionnel : 56% ayant un score Michigan satisfaisant et 59% un score DASH satisfaisant ceux-ci ont une consolidation radiologique également satisfaisante. Les résultats montrent qu'il existe une proportion élevée de patients ayant un score fonctionnel satisfaisant en dépit d'un résultat radiologique peu satisfaisant dans chaque groupe d'âge. De même il existe une relation statistiquement significative entre la bascule de l'extrémité distale du radius et le résultat fonctionnel chez les patients jeunes. Dans le groupe des patients âgés de plus de 60 ans ceux qui ont un résultat radiologique satisfaisant ont également un résultat cliniquement satisfaisant (p<0.05). Cependant dans le groupe des patients les plus âgés les résultats fonctionnels satisfaisants sont observés malgré des résultats radiologiques peu satisfaisants.

The purpose of this study was to evaluate the benefits of suction drainage following primary total joint arthroplasty. We reviewed primary total hip and knee replacements separately and together in 126 consecutive patients. There were 63 patients each in the drainage and no drainage groups. Sex distribution and anticoagulant use were similar in the two groups. All patients underwent the same operative technique and method of closure. The mean postoperative fall in haemoglobin was 3.2 and 3.3 gm/dl in the drainage and no drainage groups respectively. There was no statistically significant difference between the two groups with regard to blood transfusion requirements, rehabilitation time, postoperative complications such as hypotension and wound infections (p>0.05). The average rehabilitation time in both groups was 8-9 days. The routine use of a suction drain is unnecessary after an uncomplicated total joint arthroplasty.

There was no correlation between delay in surgery and outcome. Modified Weaver-Dunn procedure with mersilene tape is a valuable method of treatment in patients with persistent painful acromioclavicular joint dislocations and have low incidence of postoperative complications. However, it should be undertaken after adequate clinical assessment and trial of conservative treatment of painful Type III injuries.

Traumatic neurapraxia in digital nerve injuries of the hand are not uncommon, as previously thought, following lacerated injuries to hand and have favourable prognosis. This information is important for clinicians in getting more informed consent and patient education. The classification of digital nerve injuries into traumatic neurapraxia and neurotemesis appears logical for its practical application in routine clinical practice.

The purpose of this study was to evaluate the changes in alignment during the course of treatment for extra-articular distal radius fracture and the relationship of initial and intermediate radiographs, with the final radiograph taken at fracture union. A cohort of 96 consecutive patients who were conservatively managed for extra-articular distal radius fracture in an 18-month period was undertaken. The radiographs analysed were taken at prereduction, postreduction, a week later and at fracture union. The radiological parameters analysed were radial tilt, radial length, radial inclination, dorsal comminution and ulnar styloid fracture. There was a significant change in radiographic alignment between initial and immediate postreduction radiographs, and between postreduction 1 week later radiographs (p < 0.05), but the number of patients in the 1 week later and fracture union groups remained similar (p > 0.05). All patients with poor radiological outcome had ulnar styloid fractures. This was also associated with dorsal comminution in 86% of patients. Patients with satisfactory radiological outcome had ulnar styloid fracture and comminution in 34% and 43% of patients respectively. The final radiological outcome was not found to be influenced by initial unsatisfactory alignment of radial tilt, radial length and radial inclination individually or in combination. We suggest that two clinic visits after initial reduction of the fracture should be sufficient to manage such injuries; the first visit 1 week after manipulation to detect unacceptable displacement and if found satisfactory, the last visit at fracture union for final review, advice and referral to physiotherapy.