Lisfranc injuries can be difficult injuries to identify and treat, while also being the subject of significant debate on proper surgical management. A narrative literature review was performed using Pubmed and Google ...Lisfranc injuries can be difficult injuries to identify and treat, while also being the subject of significant debate on proper surgical management. A narrative literature review was performed using Pubmed and Google Scholar databases to identify recent studies evaluating open reduction internal fixation vs primary arthrodesis for Lisfranc injuries to further elucidate optimal surgical management. Additional focus was placed removal of hardware after ORIF to identify the need for routine hardware removal as an additional surgery may guide surgeon decision-making. This review showed inconclusive data on the superiority of ORIF vs arthrodesis, as multiple conflicting results exist, though established that functional results are similar between these options. Though both are generally accepted treatment options, there are no well-designed randomized controlled trials directly comparing the two. Retention of hardware after ORIF has been shown to be tolerated, though there is a significant risk of the need for unplanned removal due to pain and hardware breakage.展开更多
We present a case of a near-term infant who developed respiratory distress, shortly after birth. Chest X-ray showed a right sided tension pneumothorax (PTX) with a large air containing structure at the base of the rig...We present a case of a near-term infant who developed respiratory distress, shortly after birth. Chest X-ray showed a right sided tension pneumothorax (PTX) with a large air containing structure at the base of the right hemithorax. The pneumothorax was partially evacuated with needle aspiration at which time the patient became asymptomatic, despite a small residual pneumothorax. CT scan of the chest confirmed a multilocular air-filled structure within the right lower lobe, most likely consistent with a congenital pulmonary airway malformation (CPAM). Subsequently, there was spontaneous resolution of the PTX and CPAM prior to surgical intervention. This case illustrates post-natal spontaneous resolution of a CPAM, thus obviating the need for surgical removal.展开更多
Introduction: The impact of the COVID-19 has resulted in a decrease in presentations in emergency departments (ED). This has been influenced by societal restrictions, lockdowns and access to services. This study aims ...Introduction: The impact of the COVID-19 has resulted in a decrease in presentations in emergency departments (ED). This has been influenced by societal restrictions, lockdowns and access to services. This study aims to observe the patterns in ED presentations for Bankstown-Lidcombe Hospital over the course of the initial COVID-19 pandemic wave. Methods: A retrospective review of all presentations to Bankstown-Lidcombe Hospital ED was conducted comparing monthly patient encounters from February-August for 2017-2020. Results: The total number of ED presentations was 42,225. There was a statistically significant reduction during 2020 of 9.8% between the study periods (1546 vs 1395, p = 0.014). The period of greatest reduction was seen in March-May, the strictest lockdown period for New South Wales. The admitting disciplines that showed a reduction in this time were colorectal (76.62%, p = 0.046), emergency (25.53%, p = 0.025), endocrine (31.82%, p = 0.026), orthopaedics (33.63%, p = 0.004), and vascular (35.71%, p = 0.017). The disciplines that showed an increase in presentations over the entire studied time were gynaecology (26.54%, p = 0.008), and psychiatry (17.46%, p = 0.011). Conclusion: There were significant reductions in total number of ED presentations. Notably, there were significant reductions across multiple admitting disciplines, as well as in a decrease in presentations for those in younger age groups.展开更多
文摘Lisfranc injuries can be difficult injuries to identify and treat, while also being the subject of significant debate on proper surgical management. A narrative literature review was performed using Pubmed and Google Scholar databases to identify recent studies evaluating open reduction internal fixation vs primary arthrodesis for Lisfranc injuries to further elucidate optimal surgical management. Additional focus was placed removal of hardware after ORIF to identify the need for routine hardware removal as an additional surgery may guide surgeon decision-making. This review showed inconclusive data on the superiority of ORIF vs arthrodesis, as multiple conflicting results exist, though established that functional results are similar between these options. Though both are generally accepted treatment options, there are no well-designed randomized controlled trials directly comparing the two. Retention of hardware after ORIF has been shown to be tolerated, though there is a significant risk of the need for unplanned removal due to pain and hardware breakage.
文摘We present a case of a near-term infant who developed respiratory distress, shortly after birth. Chest X-ray showed a right sided tension pneumothorax (PTX) with a large air containing structure at the base of the right hemithorax. The pneumothorax was partially evacuated with needle aspiration at which time the patient became asymptomatic, despite a small residual pneumothorax. CT scan of the chest confirmed a multilocular air-filled structure within the right lower lobe, most likely consistent with a congenital pulmonary airway malformation (CPAM). Subsequently, there was spontaneous resolution of the PTX and CPAM prior to surgical intervention. This case illustrates post-natal spontaneous resolution of a CPAM, thus obviating the need for surgical removal.
文摘Introduction: The impact of the COVID-19 has resulted in a decrease in presentations in emergency departments (ED). This has been influenced by societal restrictions, lockdowns and access to services. This study aims to observe the patterns in ED presentations for Bankstown-Lidcombe Hospital over the course of the initial COVID-19 pandemic wave. Methods: A retrospective review of all presentations to Bankstown-Lidcombe Hospital ED was conducted comparing monthly patient encounters from February-August for 2017-2020. Results: The total number of ED presentations was 42,225. There was a statistically significant reduction during 2020 of 9.8% between the study periods (1546 vs 1395, p = 0.014). The period of greatest reduction was seen in March-May, the strictest lockdown period for New South Wales. The admitting disciplines that showed a reduction in this time were colorectal (76.62%, p = 0.046), emergency (25.53%, p = 0.025), endocrine (31.82%, p = 0.026), orthopaedics (33.63%, p = 0.004), and vascular (35.71%, p = 0.017). The disciplines that showed an increase in presentations over the entire studied time were gynaecology (26.54%, p = 0.008), and psychiatry (17.46%, p = 0.011). Conclusion: There were significant reductions in total number of ED presentations. Notably, there were significant reductions across multiple admitting disciplines, as well as in a decrease in presentations for those in younger age groups.
