Standardised audit of hip fractures in Europe

The objectives of this study were to evaluate the outcomes of our patients admitted with hip fractures, and to benchmark these results with other hospitals, initially in Europe and subsequently in Australia. The Standardised Audit of Hip Fractures in Europe (SAHFE) questionnaires was used as the data gathering instrument. The participants were all patients admitted to Redcliffe Hospital with a fractured neck of femur prior to surgery. This paper reports the results of the first 70 consecutive patients admitted to Redcliffe Hospital with a fractured neck of femur from November 1st 2000. The main outcome measures were mobility, independence, residence prior to fracture; type of fracture and surgical repair; and time to surgery, survival rates and discharge destination. Results: 43 patients were admitted from home, but only 13 returned home directly from the orthopaedic ward. It is hoped that most of the 26 transferred to the rehabilitation ward will ultimately return home. 7 patients died, these were aged 82 to 102, and all had premorbid disease. Delays in surgery were apparent for 13 patients, mainly due to administrative problems. Conclusions: We support the recommendation in the Fifteenth Scottish Intercollegiate Guidelines Network Publication on the management of hip fractures, that all units treating this condition should enter an audit to evaluate their management. (author abstract)

America's nuclear deterrence in the age of terrorism

The September 11, 2001 terrorist attacks in the US and the leakage of the Nuclear Posture Report (NPR) spur a complete review of the nuclear doctrine under Pres George W. Bush's administration. Kampmark discusses the contrariness of NPR in relation to America's deterrence of nuclear weapons and the possible proliferation of tactical offensive weapons as compared to strategic nuclear weapons.

Repair of three pathologic fractures in a dog with multiple myeloma

Three pathological fractures occurred secondary to osteolytic lesions of multiple myeloma. Two long bone fractures were each stabilised using interlocking nail fixation augmented with polymethyl meth acral ate bone cement. One vertebral fracture was stabilised using Steinmann pins and PMMA. Successful stabilisation, rapid return to function and improvement in quality of life occurred in all fractures. The patient survived approximately eight months on concurrent chemotherapy.