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- W2038961889 abstract "A 78-year-old right hand dominant lady, a passenger in a car, was involved in a low impact head-on collision. She was taken to the local hospital and treated according to the ATLS guidelines. She had sustained a fracture of the left distal radius (Fig. 1, Fig. 2). In addition, she had fractured her sternum and sustained soft tissue injury to her ankle, which were treated conservatively. The distal radial fracture was manipulated in the Accident and Emergency Department under a haematoma block using sterile precautions. A combination of lignocaine and bupivicaine was used for the block. A week later, she was seen in the fracture clinic and the plaster completed. She had no clinical signs suggestive of an infection at the wrist. The patient was reviewed 5 weeks later and the plaster removed. Clinically the wrist was stiff and hence she was referred physiotherapy for mobilization. The patient’s wrist pain continued to increase and her wrist movements decreased despite physiotherapy. The physiotherapist therefore referred her back to the orthopaedic department. She was reviewed in clinic 4 weeks later. Clinically, there was evidence of radial shortening and a dinner fork deformity. Radiological examination showed evidence of significant radial shortening and degenerative changes affecting the radio carpal joint and a radiolucent area around the region of the distal radius (Fig. 3, Fig. 4). Haematological parameters showed a raised erythrocyte sedimentation rate (31 mm/h) and her C-reactive protein was 10 μl. As activity-related pain was her main problem, taking into account her general health, a wrist arthrodesis was carried out as a single stage procedure. At operation there was evidence of rheumatoid like thick granulation tissue around the distal radius and extensor tendons. There was destruction of the radio carpal and mid carpal joints. Specimens were sent for both microbiological (including mycobacterium) and histological examination. The wrist was fused using a Mannerfelt procedure with antibiotic cover. Fig. 2Lateral X-ray of left wrist showing fracture of distal radius with dorsal angulation. View Large Image Figure Viewer Download Hi-res image Fig. 3Anterioposterior X-ray of the left wrist at 10 weeks showing destruction of left wrist with lytic areas in the distal radius, ulna and the proximal carpal bones. View Large Image Figure Viewer Download Hi-res image Fig. 4Lateral X-ray of the left wrist showing the complete destruction of the wrist joint and radial shortening. View Large Image Figure Viewer Download Hi-res image" @default.
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- W2038961889 date "2003-01-01" @default.
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- W2038961889 title "Osteomyelitis following a haematoma block" @default.
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- W2038961889 doi "https://doi.org/10.1016/s0020-1383(02)00087-6" @default.
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