Raymond E Anakwe

Publications (6)15.87 Total impact

• Article: Preventing venous thromboembolism in elective upper limb surgery.

  Raymond E Anakwe, Scott D Middleton, Nicholas Beresford-Cleary, Jane E McEachan, Sumedh C Talwalkar
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  ABSTRACT: BACKGROUND: Deep venous thrombosis (DVT) and pulmonary embolism (PE) have considerable clinical and economic consequences. The prevention of venous thrombosis and PE are increasingly seen as quality markers for surgery. Guidance is available from a number of sources to stratify risk for different patients and procedures and to define an appropriate standard of care. Despite this, best practice is unclear. METHODS: We reviewed the available guidance for orthopedic surgeons undertaking elective upper limb surgery with respect to prescribing DVT prophylaxis. Material was identified from publications produced by professional and regulatory bodies, including United States Surgeon General, United Kingdom Department of Health, the American Academy of Orthopaedic Surgeons, the Scottish Intercollegiate Guideline Network, the National Institute for Clinical Excellence, and the American College of Chest Physicians, as well as a structured MEDLINE database search. RESULTS: The picture is particularly confused in the case of elective upper limb surgery. Much of the evidence for prescribing DVT prophylaxis is related to lower limb surgery or trauma surgery. CONCLUSIONS: Failing to prescribe prophylaxis against venous thromboembolism (VTE) may be presented as a failure of care. We present a review of current guidance and the supporting evidence in order to establish evidence-based best practice and a standard of care for elective upper limb surgery.
  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 01/2013; · 1.93 Impact Factor
• Article: Hemiarthroplasty augmented with bone graft for the failed hallux metatarsophalangeal Silastic® implant.

  Raymond E Anakwe, Scott D Middleton, Colin E Thomson, John C McKinley
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  ABSTRACT: Symptomatic failure of Silastic® implants at the hallux metatarsophalangeal joint can result in the challenging problem of instability which may be painful. There is often marked bone loss making reconstruction difficult. Arthrodesis sacrifices joint movement while excision arthroplasty shortens the ray and is less acceptable to active patients. We describe a case in which reconstruction was achieved by using a porous coated metatarsophalangeal hemiarthroplasty augmented with bone graft with good early results. This previously unreported technique may offer an additional surgical option for reconstruction, maintaining joint movement without compromising future arthrodesis or excision arthroplasty as salvage measures. Long term follow up is required to confirm the success of this technique.
  Foot and Ankle Surgery 09/2011; 17(3):e43-6.
• Article: Patient-reported outcomes after simple dislocation of the elbow.

  Raymond E Anakwe, Scott D Middleton, Paul J Jenkins, Margaret M McQueen, Charles M Court-Brown
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  ABSTRACT: The current study was designed to investigate the epidemiology and long-term clinical and patient-reported outcomes following simple dislocation of the elbow in adults. We identified all adult patients treated at our trauma center for a simple dislocation of the elbow during a ten-year period. One hundred and forty patients were eligible for review, and 110 (79%) were reviewed at a mean of eighty-eight months (range, sixteen to 171 months) after the injury. This review included clinical examination, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Oxford elbow questionnaire, and a patient satisfaction questionnaire. Patients reported long-term residual deficits in the range of elbow motion. The mean DASH score was 6.7 points (95% confidence interval, 4 to 9 points). The mean Oxford elbow score was 90.3 points (95% confidence interval, 87.8 to 92.9 points). The mean satisfaction score was 85.6 points (95% confidence interval, 82.2 to 89 points). Sixty-two patients (56%) reported residual subjective stiffness of the elbow. Nine patients (8%) reported subjective instability, and sixty-eight (62%) reported residual pain. The satisfaction and DASH scores showed good correlation with absolute range of motion in the injured elbow, as did the overall Oxford elbow score and the pain and function components of that score. Multivariate analysis demonstrated that loss of elbow flexion (p = 0.001) and female sex (p = 0.002) were both independent predictors of a poorer DASH score. Reduced elbow flexion also predicted a poorer score on the function component of the Oxford elbow score (p = 0.02). A reduced flexion-extension arc of motion predicted a poorer overall Oxford elbow score (p = 0.02), a poorer score on the pain component of the Oxford elbow score (p = 0.02), and poorer overall satisfaction (p = 0.005). Female sex predicted a poorer score on the psychosocial component of the Oxford elbow score (p < 0.05). Although patients generally report a favorable long-term functional outcome after simple dislocation of the elbow, these injuries are not entirely benign. The rate of residual pain and elbow stiffness is high. Functional instability is less common and does not often limit activities.
  The Journal of Bone and Joint Surgery 07/2011; 93(13):1220-6. · 3.27 Impact Factor
• Source

  Available from: canadianmedicaljournal.ca

  Article: A glomus tumour beneath the painful unpolished nail.

  Raymond E Anakwe, Jane E McEachan
  Canadian Medical Association Journal 09/2010; 182(12):1329. · 8.22 Impact Factor
• Article: Delayed ulnar nerve palsy after open reduction and internal fixation of medial epicondylar fractures.

  Raymond E Anakwe, Adam C Watts, Jane E McEachan
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  ABSTRACT: We present two cases of patients with delayed ulnar nerve palsies after operative fixation of displaced medial epicondyle fractures. These fractures are common childhood injuries and the optimal management for the ulnar nerve is not universally agreed. The ulnar nerve is at risk of compression distal to the elbow and where surgical decompression is selected, care must be taken to ensure that this is complete.
  Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 05/2010; 19(3):239-41. · 0.66 Impact Factor
• Article: Predicting dissatisfaction after total hip arthroplasty: a study of 850 patients.

  Raymond E Anakwe, Paul J Jenkins, Matthew Moran
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  ABSTRACT: We conducted a prospective cohort study investigating the rate and predictors of dissatisfaction among patients after primary total hip arthroplasty (THA). Eight hundred fifty patients were assessed preoperatively and 1 year postoperatively using Patient Reported Outcome Measures. There was a 7% rate of dissatisfaction after THA. After univariate analysis, depression, preoperative Short Form 12 mental component score, and symptomatic arthritis of another major joint predicted dissatisfaction at 1 year, but after multivariate analysis, only symptomatic arthritis in another major joint was significant. The development of a major complication did not predict dissatisfaction. Satisfaction also correlates strongly with postoperative functional scores, relief of pain, restoration of function, and success in meeting patient expectations. Pain relief and expectation management are critical in maximizing patient satisfaction after THA.
  The Journal of arthroplasty 05/2010; 26(2):209-13. · 1.79 Impact Factor