http://hdl.handle.net/10147/129740 Thu, 20 Jun 2013 02:46:27 GMT 2013-06-20T02:46:27Z http://hdl.handle.net/10147/273233 Title: The upper hand on compartment syndrome. Authors: Dolan, Roisin T; Al Khudairy, Ammar; Mc Kenna, Paul; Butler, Joseph S; O'Beirne, Joseph; Quinlan, John F Abstract: Metacarpal fractures are common injuries, accounting for approximately 30% to 40% of all hand fractures and with a lifetime incidence of 2.5%. Traditionally regarded as an innocuous injury, metacarpal fractures tend to be associated with successful outcomes after closed reduction and immobilization. Hand compartment syndrome (HCS) is a rare clinical entity with potential devastating consequences in terms of loss of function and quality-of-life outcomes. We discuss the case of a 44-year-old woman presenting with multiple closed metacarpal fractures as a result of low-energy trauma, complicated by acute HCS. We review the presentation, clinical assessment, and optimal surgical management of acute HCS with reference to international literature. Thu, 01 Nov 2012 00:00:00 GMT http://hdl.handle.net/10147/273233 2012-11-01T00:00:00Z http://hdl.handle.net/10147/264472 Title: Arts and health-an intercultural marriage Authors: Grehan, Mary Mon, 22 Oct 2012 00:00:00 GMT http://hdl.handle.net/10147/264472 2012-10-22T00:00:00Z http://hdl.handle.net/10147/246251 Title: HIV-associated neurocognitive disorder: rate of referral for neurorehabilitation and psychiatric co-morbidity. Authors: Herlihy, D; Samarawickrama, A; Gibson, S; Taylor, C; O'Flynn, D Abstract: Despite advances in antiretroviral therapy, HIV-infected patients continue to present with HIV-associated neurocognitive disorder (HAND) which may be associated with significant psychiatric co-morbidity. We audited our patients with HAND referred for psychiatric assessment against the National Service Framework guidelines that they should receive neurorehabilitation. We found that despite these patients posing a risk to themselves and others due to poor insight and medication adherence, high rates of psychiatric co-morbidity and severely challenging behaviour, few were referred for neurorehabilitation. We recommend that clear referral pathways for psychiatric intervention and neurorehabilitation are established in HIV treatment centres. Sun, 01 Apr 2012 00:00:00 GMT http://hdl.handle.net/10147/246251 2012-04-01T00:00:00Z http://hdl.handle.net/10147/245433 Title: An inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures. Authors: Donnelly, M; Green, C; Kelly, I P Abstract: The need for emergent management of displaced paediatric supracondylar humeral fractures is being questioned in the literature. Open reduction rates of up to 46% have been reported in the non-emergent management of these injuries. At our institution these fractures are managed as operative emergencies by senior personnel. To examine the ongoing need for this policy we reviewed our results. All patients managed over a five year period with Gartland type IIB or III paeditric supracondylar humeral fractures were identified and a comprehensive chart and radiographic review undertaken. The mean time from injury to fracture reduction and stabilization was 6.6 h. Consultants performed or supervised 90% of cases. Open reduction was necessary in 5% of cases. Complications included a perioperative nerve injury rate of 6% and a superficial pin site infection rate of 3%. This study suggests that, despite the challenge to trauma on-call rostering, the emergency management of these injuries is advantageous to patients in units of our size. Based on the data presented here we continue our practice of emergent management. We suggest that units of a similar size to our own would show a benefit from an analogous policy albeit an inconvenient truth. Fri, 01 Jun 2012 00:00:00 GMT http://hdl.handle.net/10147/245433 2012-06-01T00:00:00Z