Annales chirurgiae et gynaecologiae
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A total of 135 patients with a fresh tibial shaft fracture and with no other significant injuries underwent primary conservative treatment. Data on their smoking habits were obtained from hospital records and by questionnaire. Although the smokers had better prospects for healing of the fracture at the outset than non-smokers (lower mean age and less fractures caused by high-energy injuries), the smokers were found to have a significantly longer mean time to clinical union and a higher incidence of delayed union. ⋯ A logit model indicated that comminution of the fracture, smoking and female sex were associated with delayed union and non-union. If a patient has a markedly raised probability of delayed union of tibial shaft fracture because of many risk factors as reported in the previous literature or in this study, operative treatment should be considered as the primary alternative instead of conservative treatment. Stopping smoking during healing of tibial shaft fracture could also promote the union of the fracture.
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Over a 5-year period 1985-1989, a total of 1,268 persons, 5.1 cases per 100,000 person-years, required hospital treatment for injuries caused by firearms in Finland. During the same period 1,295 persons died on the scene of the shooting or during transport to hospital. Among the 1,268 patients admitted alive, the principal modes of the shooting incident were accidental shooting in 57%, suicidal attempt in 20% and assault in 13%. ⋯ Of the 1,268 patients 141 died in hospital. The hospital mortality was 104/255 in suicidal shootings, 26/158 in assaults but only 9/725 in accidents. This study showed that firearm injuries cannot be considered a negligible medical problem in Finland.
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The current epidemiological situation with regard to lower-limb amputations in southern Finland was analysed for the year 1989. Lower-limb amputations were performed on 268 patients. The amputation rate was 22.0 per 100,000 inhabitants, and the mean age of amputees was 70 years. ⋯ The (average) time lag between surgery and fitting the prosthesis was 97 days. Incidence and mortality were decreased after 1985. The rate of prosthesis fitting was still low but the time lag between surgery and prosthetic fitting had decreased.