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Biomedical subjects

F D Burke

Publications and source records attributed to F D Burke.

At least 19 recordsLinked to original sources
PubMed1992

Excision of the pisiform in piso-triquetral osteoarthritis.

12 patients with pain in the piso-triquetral region are described. 11 had radiological evidence of osteoarthritis of the piso-triquetral joint, which was confirmed in the nine cases treated by excision of the pisiform. Seven of these had complete relief of symptoms. The clinical findings are constant and relief of pain by conservative treatment is usually only temporary. Ulnar nerve symptoms were present in four patients and these were also relieved by surgery. Excision of the pisiform is a useful operation for this condition, which often remains undiagnosed due to incomplete clinical and radiological evaluation. Full return to normal function is the rule if the problem is not associated with other wrist pathology.

Adolescent↗
PubMed1992

Hand surgery requirements in an average sized district general hospital.

To estimate the overt need for hand surgery in an average sized district general hospital and to assess the resources required to meet this need, data were collected prospectively on all new trauma and elective patients presenting from 1 June to 30 November 1989 to the Derby Hand Unit, Derbyshire Royal Infirmary, Derby. In all, 1740 new patients with hand disorders (1082 trauma and 658 elective) were seen. All were followed up for 6 months or until discharge. Based on the Derby Hand Unit practice, the overt need for hand surgery in an average sized district general hospital was estimated and the resources required to satisfy this need were defined. Such a hospital serving a population of 250,000 should expect about 23 new trauma patients and 17 new elective patients each week. To service this demand requires between three and six outpatient clinics, between three and eight inpatient beds and three operating sessions each week. The net annual cost of such a service in 1989-1990 would be 318,753 pounds.

Adolescent↗
PubMed1991

High-pressure injection injuries.

A retrospective review of the 11 patients attending the Hand Unit at the Derbyshire Royal Infirmary over the last 5 years with high-pressure injection injuries is presented. The machines and materials that cause these injuries are outlined and the methods of treatment and rehabilitation are described in detail. The study demonstrates the morbidity of high-pressure injection injuries, particularly those inflicted by paint spray guns, and highlights a frequent delay between injury and decompression of the injured part. We wish to emphasize the importance of early diagnosis, referral, exploration and rehabilitation to ensure an optimal outcome, and to point out that failure to refer early is becoming an increasing focus of negligence claims.

Accidents, Occupational↗
PubMed1991

Providing care for hand disorders: trauma and elective. The Derby Hand Unit experience (1989-1990)

Data was collected prospectively on all patients from one health district attending the Hand Unit at Derbyshire Royal Infirmary to determine the needs for hand surgery and the resources utilised to meet them. 475 patients per 100,000 population presented with hand injuries and 289 patients per 100,000 with elective hand disorders each year. For every 100,000 population, the trauma cases required 139 inpatient days and 1723 outpatient visits. Elective cases required 221 inpatient days and 1039 outpatient visits.

Adult↗
PubMed1991

The use of totally de-proteinized heterologous bone graft in non-union of the scaphoid.

In an attempt to avoid the complications associated with taking autologous bone graft for use in the treatment of non-union of the scaphoid, a clinical trial of the use of totally de-proteinized heterologous bone graft has been carried out. Ten patients with established non-union of the scaphoid were treated with internal fixation and grafting using one such commercially available material, Pyrost. The clinical and radiological results in eight patients about one year later are reported. The operative use of this material proved difficult because of its poor mechanical properties and it is not recommended as a substitute for the patient's own bone.

Adult↗
PubMed1990

Carpal tunnel syndrome in association with vibration white finger.

In a prospective study, eight patients with 15 hands affected by both vibration white finger and carpal tunnel syndrome were treated by surgical decompression of the carpal tunnel. On review six months later, the symptoms of carpal tunnel syndrome were improved in all cases and the symptoms of white finger were improved in half of the cases. Nerve conduction studies and palmar skin histology are discussed.

Adult↗
PubMed1989

External fixation or plaster for severely displaced comminuted Colles' fractures? A prospective study of anatomical and functional results.

We report a prospective, randomised, controlled trial of 50 severely displaced comminuted Colles' fractures treated by either external fixation or manipulation and plaster. Each patient was assessed radiographically throughout treatment, and functionally by an independent observer at three and six months. The functional result correlated with the anatomical result, which was significantly better in patients treated by external fixation. This resulted in significantly improved function especially in young patients, and also a lower complication rate. We recommend the use of external fixation for young patients with comminuted displaced Colles' fractures unless manipulation and plaster show excellent reduction.

Casts, Surgical↗
PubMed1989

Triceps to biceps transfer for established brachial plexus palsy.

We have reviewed seven patients who had triceps transfer after an old brachial plexus injury. All patients had a useful functional improvement with a good range of powerful elbow flexion; five patients could manage to bring their hand to their mouth. The basis of patient selection and the relative advantages of triceps transfer are discussed.

Adult↗
PubMed1988

Vibration white finger.

Nineteen consecutive patients claiming compensation for vibration white finger were reviewed. The cold provocation test was found to be of no value in confirming a diagnosis of vibration white finger. Small cysts were apparent on the radiographs in 61% of patients' wrists but none had developed significant degenerative changes of the wrist or digits. In this group of claimants, 63% had carpal tunnel syndrome on nerve conduction studies.

Adult↗
PubMed1987

Fractures of the phalanges: results of internal fixation using 1.5mm and 2mm A. O. screws.

Thirty-six patients were treated for 38 phalangeal fractures using 1.5 mm and 2 mm A. O. screws. Plates were not used in the fingers. Oblique fractures of the condyles, shafts or bases of the proximal or middle phalanges were treated by internal fixation because of instability, displacement or rotation. 40% of fractures had associated skin wounds, were comminuted or had damage to the extensor mechanism. The mean duration of post-operative immobilization was 9 days and the mean time off work was 6 weeks. Total active movement in the involved ray was 220 degrees or greater in 24 cases, 180 degrees to 215 degrees in eight cases, and less than 180 degrees in two patients at follow up. The patients were reviewed between three and 54 months after treatment and the mean duration of follow up was 24 months. The most frequent complication was 10 degrees to 30 degrees of flexion deformity of the proximal interphalangeal joint after internal fixation of condylar fractures. Results were satisfactory in 90% of cases.

Adult↗
PubMed1987

Fractures of the metacarpals: treatment by A. O. screw and plate fixation.

Twenty-two patients with 26 fractured metacarpals were treated by internal fixation using A. O. mini-fragment screws and plates. This form of internal fixation was reserved for metacarpal fractures which were multiple, unstable, displaced or rotated. Nine patients had open fractures, two had divided extensor tendons and four had multiple fractures. Fractures consistently united without infection or deformity. The mean duration of postoperative immobilization was seven days and mean time off work was six weeks. All but one patient did manual work. No patients had persistent symptoms which caused difficulty with work or sport. Fourteen patients regained full movement. Four had total active movement of 220 degrees or more in the involved ray and 6 patients had total active movement of between 180 and 220 degrees. Restricted movement was present in patients with open fractures and divided extensor tendons or intra-articular fractures of the metacarpal head. Uniformly satisfactory results were found after mini-screw and plate fixation of metacarpal fractures.

Adult↗
PubMed1987

A review of attitudes to splintage in Dupuytren's contracture.

A questionnaire on the use of splintage before and after operations for Dupuytren's contracture has been completed by 45 hand surgeons and ten hand therapists. None considered that preoperative splintage was beneficial, but nearly all used some form of splintage after operation. The types of splint and programmes for using them varied widely, and these are discussed.

Attitude of Health Personnel↗
PubMed1987

Mycobacterium kansasii osteomyelitis of the scaphoid.

A 31-year-old man was found to have a diffuse infection of the wrist and osteomyelitis of the scaphoid caused by Mycobacterium kansasii. The 3-year delay in establishing the diagnosis is characteristic of hand infections caused by atypical mycobacteria. We treated the patient surgically and with antituberculous chemotherapy. This is the only case of M. kansasii osteomyelitis of the scaphoid recorded in the medical literature.

Abscess↗