Injury
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Patients undergoing treatment for fractures of the upper end of the femur in a district general hospital over a 2-year period were analysed to identify preoperative illness, operative factors or postoperative complications associated with increased mortality. Both the mean age and mortality rate were higher than in many other reported series. The elderly diabetic was identified as a particularly high-risk patient. Dislocation following hemiarthroplasty was associated with advanced age and carried a formidable mortality.
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Two hundred and thirty-seven fractures of the ankle treated with non-rigid internal fixation were reviewed with regard to classification, congruency of joint surface, range of motion and the patients' subjective symptoms. The fractures were divided into either severe fractures consisting of two or more skeletal injuries or simple fractures consisting of only one skeletal injury. ⋯ Disability was significantly more frequent after severe fractures and with incongruent joints. This study shows that the operative technique using non-rigid internal fixation is not sufficient for treating severe fractures, as exact anatomical reconstruction of the joint was not obtained.