Controversies in choledochal malformation.

Choledochal malformations (some of which are choledochal cysts) may be characterised as an abnormal dilatation of the biliary tract, in the absence of acute obstruction. Most do appear to be of congenital origin, probably related to distal bile duct stenosis, and almost 15% can now be detected antenatally.Excision and biliary reconstruction using a Roux loop as an open operation is still the standard to compare against, although laparoscopic reconstruction is increasingly reported.

Extra help required by litigants after simple fractures--a questionnaire based study.

A questionnaire based interview of 100 patients under fracture clinic review was undertaken to assess the help required with the activities of daily living (ADL) in the first 2 weeks following fractures of the hand, wrist, neck of humerus, foot or ankle. The amount of help patients required was correlated with whether or not the patients were claiming compensation for their injuries. Twenty-five percent were litigating and this was shown to influence the amount of help a patient reported having received with dressing, shopping, cooking, housework, personal hygiene and travelling (p<0.