The art and science of editing.
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Biomedical subjects
Publications and source records attributed to R L Batten.
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One hundred and three displaced malleolar fractures of the ankle joint were treated by one orthopaedic firm between 1968 and 1974. Originally, 150 patients were reviewed, but 47 patients were excluded from the series for the following reasons: associated fractures of the lower tibia (10), associated fractures of the talus (3), inadequate follow-up (15) and patients lost to follow-up (19). Only patients who were followed up for at least one year were included in the series. The purpose of this study is to present the results obtained by treating displaced malleolar fractures using AO instrumentation.
A prospective study was carried out on 142 fresh fractures of the tibial shaft treated by internal fixation according to the AO principles, 99 fractures being closed and 43 open. A total of 140 cases was reviewed at 1 year and 125 cases at 2 years following injury, at which times a functional assessment score was awarded by the surgeon and the patient himself, and a precise measurement of ankle range was made. The time taken for the fracture to unite and the incidence of non-union was greater if the fracture was comminuted (whether open or closed) than if there was no comminution. For patients with closed fractures the minor infection rate (erythema and increased local temperature) was 4.1 per cent and the major infection rate (pus present) was 4.1 per cent, no infection being severe enough to warrant removal of the plate. In open fractures, the overall infection rate was 14 per cent, 7 per cent having major infection and only 1 case requiring removal of the plate. The functional results and complications are discussed.
This paper describes our experience over a period of 10 years (1966-76) with fractures showing non-union and delayed union. All were treated by the AO technique. The source of our patients, the management of their fractures and the results are described. From this experience we have drawn conclusions on which future policy will be based.
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