Annales chirurgiae et gynaecologiae
-
Comparative Study
Prevention of fat embolism syndrome in patients with femoral fractures--immediate or delayed operative fixation?
From January 1976 until August 1980, femoral fractures in our department were initially stabilized with tibial traction and fixed operatively after 4-7 days. From August 1980 the fractures were treated with immediate operative fixation. ⋯ Eleven patients (10.4%) developed fat embolism syndrome in the group treated with delayed fixation, compared with two patients (1.8%) in the immediate osteosynthesis group (p less than 0.02). We concluded that early operative fixation of femoral fractures seems beneficial for the prevention of fat embolism syndrome.
-
In 1980 there were 1296 emergency hospitalizations for burn injuries in Finland, averaging 27 per 10(5) inhabitants. The incidence varied from 20 to 58 per 10(5) by central hospital district, 70% of the patients were men. The incidence was higher among men than women at all ages. ⋯ The average duration of the emergency hospital stay was 14.3 days. Causes of regional variation and high incidence among old men require further research. The establishment of burn units in high risk areas should be considered.
-
All records of 652 patients treated for blunt chest trauma at Ullevål Hospital, Surgical Department 3, during the period 1973-1981 were analyzed for factors predictive of prognosis. Mortality for the whole group was 7.7%. Age, blood pressure on admission, the number of fractured ribs, the need for blood transfusions and the need for artificial ventilation were the most important predictors of prognosis. ⋯ The incidence of bronchial infection, septicaemia and hypercoagulability was significantly higher for patients on ventilators than for patients breathing spontaneously. Mortality increased when septicaemia or bronchial infection was present (30.8 and 21.9%, respectively). The injury severity score (ISS) for the 50 patients who died in the hospital was similar to that of some other reports.
-
The number and type of reoperations after fractures of the proximal femur was studied in Jokilaakso Regional Hospital, Finland, from 1970 to 1981. Reoperations after fractures of the femoral neck occurred in 32% (24/74), in trochanteric fractures in 13% (6/48). In fractures of the femoral neck 38% (9/24) of the reoperations were performed during the first postoperative year, in trochanteric fractures half of the cases. The average time of hospital stay for reoperation was 19 days.