USA(Miami): Dr. Augusto SARMIENTO: FUNCTIONAL FRACTURE BRACING (FFB)

Dr.Sarmiento: FFB is a system of nonsurgical care for certain long- bone fractures based on the proposition that immobilization of joints above and below a fracture is not essential for healing, and that the resulting physiologically induced motion at the fracture site is conducive to the formation of a stronger callus. Body Cast Editor: How has functional fracture bracing evolved from its inception? Dr. Sarmiento: Experiences with the PTB prosthesis for the below-the-knee amputee developed in the early 1960s, which successfully eliminated the traditional thigh corset, prompted me to suspect that a below-the-knee cast molded like the prosthesis could be successfully used in the treatment of tibial diaphyseal fractures, where the proximal fragment would be the equivalent of the stump and shortening would be prevented. The initial results were encouraging, but soon I realized that neither the indented patellar tendon nor the molded tibial condyles were major weight-bearing contributors. The soft tissues surrounding the fractured bones were the structures that prevented shortening above the one present at the initial injury. A degree of shortening that does not increase with the introduction of graduated weight-bearing ambulation. Therefore, the name PTB commonly used to describe the cast is wrong. Further experiences with the short-leg functional cast led to the construction of a brace that gave freedom of motion of the ankle joint, as well. Following subsequent clinical and laboratory investigations, the concept was extended to other bones, such as the humerus, forearm, isolated fractures of the ulna, the femoral shaft, tibial nonunions, and Colles' fractures. The results were mixed, so much that the use of the system was discontinued for fractures of both bones of the forearm, open tibial fractures and the femur. Advances in the surgical treatment of these fractures fully justified their dismissal. Similarly, the intramedullary nailing of fractures has made this approach a successful one in the management of many tibial fractures, particularly in those with unacceptable initial shortening or uncorrectable angulation.

UK: NURSING MEDICATION ERRORS in NHS HOSPITALS

From UK DAILY MAIL Saturday, Jun 29 2013 12PM 16°C 3PM 20°C 5-Day Forecast One in three diabetes patients 'are given the wrong medication while in hospital' A third of patients in England and Wales experienced a 'medication error' during a five week audit The audit found that 61 patients had developed life threatening ketoacidosis during a hospital stay Charity Diabetes UK says it is 'appalling' that anybody should develop the preventable condition By Daily Mail Reporter PUBLISHED: 00:49 GMT, 27 June 2013 | UPDATED: 07:52 GMT, 27 June 2013 Worrying: A third of patients in hospitals in England and Wales experienced a 'medication error' during the five-day National Diabetes Inpatient Audit (file picture) Worrying: A third of patients in hospitals in England and Wales experienced a 'medication error' during the five-day National Diabetes Inpatient Audit (file picture) One in every three diabetic patients are given the wrong medication while in hospital, a new report suggests. A third of patients in hospitals in England and Wales experienced a 'medication error' during the five-day National Diabetes Inpatient Audit. The audit, conducted last September, also found that 61 patients developed a life-threatening but preventable complication due to poor care. Charity Diabetes UK said it is 'appalling' that any patients should develop diabetic ketoacidosis during a hospital stay. The audit, which examined data from 13,400 patients, also found that a fifth of patients suffered from hypoglycaemia while in hospital. Bridget Turner, director of policy and care improvement at Diabetes UK, said: 'It is appalling that some people with diabetes are being so poorly looked after in hospitals that they are being put at risk of dying of an entirely preventable life-threatening condition. 'Even a single case of diabetic ketoacidosis developing in hospital is unacceptable because it suggests that insulin has been withheld from that person for some time. 'The fact that this is regularly happening raises serious questions about the ability of hospitals to provide even the most basic level of diabetes care. 'In every aspect of hospital diabetes care that this report shines a light on, the picture that emerges is profoundly disturbing. Read more: http://www.dailymail.co.uk/health/article-2349313/One-diabetes-patients-given-wrong-medication-hospital.html#ixzz2XbmK7OG7 Follow us: @MailOnline on Twitter | DailyMail on Facebook