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Biomedical subjects

C E Ackroyd

Publications and source records attributed to C E Ackroyd.

35 records · Page 2Linked to original sources
PubMed1991

Internal fixation of forearm fractures in the 1980s: lessons to be learnt.

A series of 156 diaphyseal forearm fractures in 108 patients were treated by internal fixation between 1980 and 1985. These cases have been critically reviewed in the light of the present knowledge and expertise of internal fixation. A total of 122 fractures were fixed with ASIF compression plates. An analysis of results shows that 17 patients (15.7 per cent) had a poor clinical symptom result, 29 patients (26.9 per cent) had a poor functional score, 14 (13 per cent) had a poor subjective and employment score, and 40 fractures (32 per cent) united after 18 weeks. Non-union rate was 10.3 per cent, the infection rate was 5.5 per cent and there were three cases (2.7 per cent) of synostosis. Only six patients had primary cancellous bone grafting. A statistical analysis of the variables which may affect the result shows that the most important factors are accurate reduction of the fracture, correct use of interfragmentary screw fixation and rigid fixation. Failure to observe these rules will produce a poor result. Fracture complexity and comminution, especially if combined with a butterfly fragment, predispose to a poor result.

Adolescent↗
PubMed1990

Late lengthening of the fibula for malaligned ankle fractures.

We describe a technique of lengthening osteotomy of the fibula for the late treatment of symptomatic malaligned or malunited fractures of the ankle. Good results at two to three years were achieved in five of six cases despite delays of up to four years from the original injury. The method can prevent progressive instability and degenerative arthritis.

Adult↗
PubMed1990

Removal of forearm plates. A review of the complications.

We studied 55 patients who had undergone elective removal of forearm plates between 1980 and 1986; 44 plates were removed from the radius and 37 from the ulna. Before removal only 20 patients (36%) had definite symptoms attributable to the plates, but 44 patients (80%) were advised by the surgeon to have the plates removed. In 22 cases (40%) the operation was followed by a significant complication. The complication rate was higher with junior surgeons and was permanent in 50% of cases. It is recommended that forearm plates should be removed only if they are causing significant symptoms, and that the operation should not be delegated to the most junior surgeon.

Adolescent↗
PubMed1990

The fixation and prognosis of trochanteric fractures. A randomized prospective controlled trial.

A randomized prospective controlled trial of 155 patients with trochanteric fractures compared the AO dynamic hip screw and the Jewett nail plate. The dynamic hip screw showed significantly less evidence of mechanical failure and a lower incidence of reoperation. The implant had no effect on mortality or success of rehabilitation. Mortality was significantly associated with social dependence before fracture and the hospital attended. Capacity to return home and walk again were associated with mobility before fracture and age. While the fate of the majority of patients appeared to be determined by their state before fracture, hospital differences appear to offer the greatest potential for influencing the outcome of this condition.

Activities of Daily Living↗
PubMed1985

Pyogenic infection of the sacro-iliac joint. A report of 11 cases.

We report 11 patients who, over a five-year period, were treated for pyogenic infection of the sacro-iliac joint. This condition is uncommon and difficult to assess, so that diagnosis is liable to be delayed and morbidity increased. Skeletal scintigraphy, with perfusion phase imaging, is usually positive in early lesions and prompt antibiotic treatment reduces complications.

Acute Disease↗
PubMed1985

The use of a microcomputer for inpatient audit in an orthopaedic department.

A microcomputer has been used to assist in the inpatient audit of an orthopaedic unit in a district general hospital. The aims were to provide a more detailed, accurate audit, more rapidly than previous manual methods had allowed. The clinical details of 609 patients treated over a 9-month period were fed into the computer and various statistical analyses performed. The results of the audit are presented. The extent to which our aims have been achieved is discussed together with the specific problems encountered with computer hardware, software and organisation of the system.

Computers↗
PubMed1984

Orthopaedic audit: one year's experience in a district general hospital.

In 1982 a prospective Audit of complications and mortality and a quarterly retrospective analysis of work done were undertaken on the orthopaedic unit of Southmead Hospital, Bristol. Since no account has been presented of Orthopaedic Audit it was felt that a discussion of the method, results and whether the aims had been achieved and at what cost would be of interest to other surgeons, and to orthopaedic surgeons in particular. Two orthopaedic surgeons treated 1811 inpatients during the year; 73.7% of the patients undergoing surgery at Southmead Hospital were emergencies. Mortality, excluding fractures of the neck of femur, was 0.22% and total mortality 1.8%; 16.7% of patients had a recorded complication of which the largest group was technical failure (2.7%) followed by wound infection (2.4%).

England↗
PubMed1981

Expectations and outcome of total hip replacement.

The preoperative function, expectations of pain relief and expectations of improvement in activities of daily living were compared with the results nine months after total hip replacement in 145 patients with osteoarthrosis or rheumatoid arthritis. patients improved functionally and their expectations generally were met. They were most satisfied with improvements in pain relief and mobility but 28% still expressed disappointment because specific expectations were not fulfilled. The expectations of doctors were higher than those of occupational therapists.

Activities of Daily Living↗
PubMed1979

Sleeve fractures of the patella in children: a report of three cases.

The clinical characteristics of sleeve fractures of the patella are described and the methods of treatment are reviewed. Attention is drawn to the fact that the diagnosis may be missed because the distal bony fragment may be so small as not to be detectable by radiography. This is important because a large fragment of articular cartilage also separates. The best result was obtained from reconstitution of the extensor apparatus by internal fixation of the patellar fracture with repair of the quadriceps expansion.

Cartilage, Articular↗
PubMed1978

Patellectomy for osteoarthritis. A study of eighty-one patients followed from two to twenty-two years.

Eighty-one patients treated by patellectomy for osteoarthritis have been reviewed. Eighty-seven knees were examined with a mean follow-up period of six and a half years. Clinical and radiological assessment was carried out and the results have been analysed. A good result was achieved in 53 per cent, a fair result in 26 per cent and a poor result in 21 per cent. The overall result did not deteriorate significantly with time and the radiological appearance of the tibiofemoral joint deteriorated minimally. Pain before operation, radiological changes at the patellofemoral and tibiofemoral joints and the duration of immobilisation after operation were analysed against the end-result. The only factor before operation that indicated a good prognosis was a minimal radiological change at the tibiofemoral joint. Immobilisation for at least three weeks after operation appeared to be beneficial.

Adult↗
PubMed1977

Seat belts: a study of their use by the victims of road traffic accidents.

This paper reports a study of 266 patients who were admitted to an Accident Service after being involved in road traffic accidents during the four-month period from February to May in 1976. There were 216 front-seat occupants, of whom 21 per cent were wearing seat belts: 156 patients were treated as outpatients and 105 patients were admitted to the wards. Five patients were dead on arrival, none of whom had been wearing a seat belt. There was a significant reduction in the likelihood of being admitted as an impatient (P less than 0.05) if a seat belt was used. There was an 11 per cent increase in the use of seat belts compared with a similar study carried out in 1971 and random roadside surveys also showed a 10 per cent increase. The implications of these findings are discussed.

Accidents, Traffic↗
PubMed1976

The locked patella. An unusual complication of haemophilia.

Mechanical derangements of the knee are an uncommon complication of chronic haemophiliac arthropathy. Two patients with locking of the patella were treated by manipulation. The mechanism of the injury was forced flexion of the knee joint beyond the limit of its restricted range. The injury is a serious one and may take six months to recover.

Adult↗