Combined orthogeriatric care in the management of hip fractures: a prospective study.

Aims: To evaluate the efficacy of combined care between orthopaedic surgeons and geriatricians in the management of patients with fractured necks of femur.

Patients And Methods: A prospective study of the admissions to a district general hospital with hip fractures was carried out over a 5-year period. In the years 1992-1994, medical problems in this patient group were managed by a consultation-only service.

Patellar tendon rupture in identical twins.

We report on identical traumatic injuries in a pair of monozygotic (identical) twins treated at the same unit, one year apart. Both had sustained a complete tear of the patellar tendon and were treated surgically.

Pentose-shunt oxidation in the periosteal cells in healing fractures.

The activity of pentose-shunt dehydrogenases is very low in periosteal cells of normal rat metatarsals, but increases one day post-fracture and rises linearly over the next two days. By four days post-fracture, the distribution of this activity along the bone shows two centres of high activity: the first in the region of proliferation to form callus and the second at the site where new bone is first seen, one day later. The high rate of generation of NADPH would be expected to reduce glutathione; reduced glutathione has been shown to inhibit alkaline phosphatase activity in these cells.