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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_16 | Pages 10 - 10
1 Oct 2017
Rothschild-Pearson B Gerard-Wilson M Cnudde P Lewis K
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Smoking is negatively implicated in healing and may increase the risk of surgical complications in orthopaedic patients. Carbon monoxide (CO) breath testing provides a rapid way of measuring recent smoking activity, but so far, to our knowledge, this has not been studied in elective orthopaedic patients. We studied whether CO-testing can be performed preoperatively in elective orthopaedic patients and whether testing accurately correlates with self-reported smoking status?

CO breath testing was performed on and a brief smoking history was obtained from 154 elective orthopaedic patients on the day of surgery. All patients admitted over 6 weeks for elective orthopaedic intervention were enrolled.

16.2% patients admitted to smoking. The mean CO levels were 15.2 ppm for self-reported smokers and 3.1 ppm for self-reporting non-smokers. One self-reporting non-smoker admitted to smoking after testing. 5 non-smoking patients had a CO breath of >=7, 1 had a CO level of >= 10 ppm. Using a cutoff of 7 ppm gave a sensitivity of 65.4% and a specificity of 96.1%, whilst a cutoff of 10 ppm gave a sensitivity of 57.6% and specificity of 99.2%.

Whilst most patients are honest about smoking, CO testing can identify non-disclosing smokers undergoing elective orthopaedic procedures. Due to the high specificity, speed and cost-effectiveness, CO breath testing could be performed routinely to identify patients at risk from smoking-related complications in pre-assessment clinics. Smoking cessation services may reduce the risk of harm. CO testing on admission may demonstrate the efficacy of smoking cessation services.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_10 | Pages 5 - 5
1 Oct 2015
Babu A Joshi Y Lewis K Singh R
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Aim

To determine effectiveness of Collagenase Clostridium Histolyticum (CCH) in deformity correction and hand function for patients with Dupuytren's disease.

Materials & Methods

Patients with MCPJ contractures with no previous surgery to the same finger were included. Treatment consisted of one Xiapex injection to a prominent pretendinous band as an outpatient procedure. Follow up was arranged at 48 hours, 3 weeks and final follow up > 6 months.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_IV | Pages 105 - 105
1 Mar 2012
Guha A Das S Debnath U Shah R Lewis K
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Introduction

Displaced distal radius fractures in children have been treated in above elbow plaster casts since the last century. Cast index has been calculated previously, which is a measure of the sagittal cast width divided by the coronal cast width measurement at the fracture site. This indicates how well the cast was moulded to the contours of the forearm. We retrospectively analysed the cast index in post manipulation radiographs to evaluate its relevance in redisplacement or reangulation of distal forearm fractures.

Study Design

Consecutive radiographic analysis.