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Lower limb intracast pressures generated by different types of immobilisation casts

World Journal of Orthopedics 2017年第2期8卷 170-177页

作者： Salma Chaudhury Alexandra Hazlerigg anuhya vusirikala Joseph Nguyen Stuart Matthews Trauma Unit John Radcliffe HospitalUniversity of Oxford Trauma and Orthopaedics Department Royal Berkshire Hospital Hospital for Special Surgery

AIM To determine if complete, split casts and backslabs [plaster of Paris(POP) and fiberglass] generate different intracast pressures and pain. METHODS Increased swelling within casts was modeled by a closed water system attached to an expandable bag placed directly under different types of casts applied to a healthy lower limb. Complete fiberglass and POP casts, split casts and backslabs were applied. Twenty-five milliliter aliquots of saline were injected into the system and the generated intracast pressures were measured using a sphygmomanometer. The subject was blinded to the pressure scores to avoid bias. All casts were applied to the same right limb on the same subject to avoid the effects of variations in anatomy or physiology on intracast pressures. Pain levels were evaluated using the Visual Analogue Score after each sequential saline injection. Each type of cast was reapplied four times and the measurements were repeated on four separate occasions. Sample sizes were determined by a pre-study 90% power calculation to detect a 20% difference in intracast pressures between cast groups. RESULTS A significant difference between the various types of casts was noted when the saline volume was greater than 100 mL(P = 0.009). The greatest intracast pressure was generated by complete fiberglass casts, which were significantly higher than complete POP casts or backslabs(P = 0.018 and P = 0.008 respectively) at intracast saline volumes of 100 mL and higher. Backslabs produced a significantly lower intracast pressure compared to complete POP only once the saline volume within casts exceeded 225 mL(P = 0.009). Intracast pressures were significantly lower in split casts(P = 0.003). Split POP and fiberglass casts produced the lowest intracast pressures, even compared to backslabs(P = 0.009). Complete fiberglass casts generated the highest pain levels at manometer pressures of 75 mm Hg and greater(P = 0.001). Split fiberglass casts had significantly reduced pain levels(P =

关键词： Fracture Pressure Lower limb Plaster of Paris Cast Fiberglass Backslab Compartment syndrome

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Hello,can you hear me?Orthopaedic clinic telephone consultations in the COVID-19 era-a patient and clinician perspective

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World Journal of Orthopedics 2021年第1期12卷 24-34页

作者： anuhya vusirikala David Ensor Ajay K Asokan Alvin JX Lee Ravi Ray Dimitrios Tsekes John Edwin Department of Trauma and Orthopaedics Basildon University HospitalBasildon SS165NLEssexUnited Kingdom Medical Oncology UCL Cancer InstituteLondon WC1E 6BTUnited Kingdom

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare *** a result of this,hospital footfall required to be reduced due to increased risk of transmission of *** ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general *** To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic *** This is a single centre,prospective study conducted in a busy National Health Service district general *** May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction *** questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long *** and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey *** 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation *** found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the *** majority found it less laborious in time and administration in comparison to face to face *** and clinicians expressed their desire for video consultations as a method of further improving their experience with remote *** Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reduci

关键词： COVID-19 Telephone consultation Orthopaedic clinic Patient satisfaction Patient perspective Clinician perspective

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