A prospective randomised trial of absorbable versus non-absorbable sutures for wound closure after fasciectomy for Dupuytren's contracture.

After fasciectomy for Dupuytren's contracture the wound has traditionally been closed with non-absorbable sutures. A prospective randomised study of 59 patients was undertaken to compare wound closure after fasciectomy with irradiated polyglactin 910 absorbable sutures and non-absorbable sutures. The outcomes studied were: time spent attending to the wound at the first postoperative visit; the patient's pain score at that visit; and any complications.

The factors affecting outcome after non-vascular bone grafting and internal fixation for nonunion of the scaphoid.

This study identified variables which influence the outcome of surgical management on 126 ununited scaphoid fractures managed by internal fixation and non-vascular bone grafting. The site of fracture was defined by a new method: the ratio of the length of the proximal fragment to the sum of the lengths of both fragments, calculated using specific views in the plain radiographs. Bone healing occurred in 71% (89) of cases.

Implementation of RCGP guidelines for acute low back pain: a cluster randomised controlled trial.

Background: The Royal College of General Practitioners (RCGP) has produced guidelines for the management of acute low back pain in primary care.

Aim: To investigate the impact on patient management of an educational strategy to promote these guidelines among general practitioners (GPs).

Design Of Study: Group randomised controlled trial, using the health centre as the unit of randomisation.

Distribution of nerve fibers in the standard incision for carpal tunnel decompression.

Twenty-two paired biopsy specimens of skin and subcutaneous tissue from the proximal and distal halves of the conventional curvilinear incision or carpal tunnel decompression were histologically examined. The specimens were immunohistochemically stained with S100 antibody to highlight the nerve fibers. The mean count of free nerve endings in the proximal biopsy site was 4.

A rare complication of pectoralis major rupture.

Pectoralis major rupture is an uncommon injury. Only 85 cases have been reported in the literature. Rupture may be partial or complete.

The results of surgical management of displaced tibial plateau fractures in the elderly.

We retrospectively reviewed 32 elderly patients (mean age 71.7 years, range 66-83 years) with displaced tibial plateau fractures after a mean of 3.7 years (range 1-7 years) after operative treatment.

Fractures of the distal radius and ulna.

Associated fractures of the distal ulnar metaphysis were present in 19 of 320 distal radial fractures requiring either closed manipulation or surgical treatment over a 2-year period. Four morphological patterns of ulnar fracture were encountered, the commonest being the type 1 simple extra-articular fracture of the distal end of ulna with minimal comminution (eight out of 19). 15 patients were treated conservatively and two each were treated by internal and external fixation.

Fibrous stabilization of the rheumatoid wrist.

19 patients (mean age 59.8 years) underwent fibrous stabilization of the wrist for rheumatoid arthritis. 17 patients were reviewed after a mean follow up of 24.

Intertrochanteric fractures of the femur and osteoarthritis of the ipsilateral hip.

We retrospectively reviewed the radiographs of 255 patients with intertrochanteric fractures over a 2 year period. The incidence of osteoarthritis of the hip joint in these patients was 12.16%, which is less than that reported in the general population, and which confirms the protective effect of osteoarthritis against intertrochanteric fractures.

Complications of the Attenborough knee replacement.

Of a consecutive series of 144 Attenborough knee replacements, 107 were re-examined between two and six years after operation and revealed a high incidence of complications. Wound problems were common and led to deep infection in four knees. When a patellar implant was used fracture of the patella followed in 17.