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Biomedical subjects

Dominic M Nielsen

Publications and source records attributed to Dominic M Nielsen.

5 recordsLinked to original sources

Arthroscopic visualization of the posterior horn of the medial meniscus.

We present a method of visualizing the posterior horn of the medial meniscus through the anterolateral portal that has not been previously described in the literature. It allows easy visualization and instrumentation of the posterior horn, an area that commonly has pathology that can be difficult to identify and treat. The technique involves allowing the knee to flex to 60 degrees to 90 degrees over the side of the bed and applying a varus force to the tibia, opening up the posteromedial part of the joint. It does not require any valgus force and therefore minimizes the risk of injury to the medial collateral ligament.

Arthroscopy↗

Keeping plaster casts dry: what works?

Plaster casts are commonly used in the management of fractures. The mechanical properties of plasters are adversely affected by water. There are a number of commercial products available to allow patients to continue to shower and swim by protecting the plaster. The aim of this study was to compare these products with a plastic bag and elastic band. Each protector was tested in a shower, immersed in a swimming pool and worn while swimming. The volume of water intrusion was measured. There was no significant difference between a plastic bag and the commercially available products. We do not recommend the use of commercially available plaster protectors for showering or swimming: a plastic bag and elastic band is a cheaper and more convenient device.

Activities of Daily Living↗

Where to split plaster casts.

Plaster casts are often split to accommodate swelling following injury. This is not influenced by the axis of the split. The aim of this study was to compare the mechanical properties of plasters split along different axes. Full plasters were applied to mannequin forearms, and then split along dorsal, volar, radial or ulnar sides. Following this the plasters were loaded in a dorsal direction. We found that of all the axes tested, the dorsal split was the best for maintaining fracture reduction (p = 0.001).

Casts, Surgical↗

Satisfaction levels in orthopaedic out-patients.

INTRODUCTION: It is important that patients are satisfied with an out-patient consultation. This ensures compliance with treatment and attendance for follow-up. The aim of this study was to identify factors regarding out-patient consultation associated with patient satisfaction. METHODS: A two-part questionnaire identifying expectations of, and subsequent satisfaction with, a new out-patient consultation was completed by 106 out-patients. RESULTS: There was no correlation between not seeing the clinician anticipated and reduced satisfaction (P = 0.17). Using more information sources was associated with less satisfaction (P = 0.02). Patients were less satisfied if their expectations of either treatment or outcome were changed. CONCLUSIONS: Meeting patients' expectations is an essential part of effective communication. The use of specialist physiotherapists and general practitioners with a special interest is an effective way of seeing more new patients.

Communication↗

Short-listing for orthopaedic specialist registrar posts--what is important?

INTRODUCTION: Competition for specialist registrar (SpR) posts in orthopaedics is high. The aim of the current study was to provide evidence-based advice for applicants applying for SpR posts in orthopaedics. METHODS: The short-listing forms of 273 applicants for orthopaedic SpR posts in South Thames (West) were reviewed. The experience of short-listed candidates was compared with those that were not. RESULTS: We have shown a high chance of being short-listed between 5 and 6 years after qualification with a sharp fall off either side of this. It is clear that a wide range of appropriate experience is more important than high volume and low quality experience in orthopaedics alone. CONCLUSION: Candidates who plan ahead and gain a broad experience have a better chance of progressing in an orthopaedic career. Good, early career advice is essential to achieve this.

Career Mobility↗