Acta orthopaedica Scandinavica
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During the period 1987-91, 153 cases of total Achilles tendon rupture were diagnosed in the city of Malmo (population 230,000). Almost two thirds were caused by sporting activities, notably badminton. ⋯ Patients with Achilles tendon ruptures can be classified into two subgroups with partly different etiologies: young or middle-aged athletes and older non-athletic persons. The increase in the former group is mostly explained by increased participation in recreational sports; the cause of increase in the latter group is unknown.
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We recorded prospectively all adult patients with a fracture of the proximal end of the humerus, clavicle and scapula or a primary shoulder or acromioclavicular dislocation in the city of Malmö in 1987. Altogether there were 413 injures. The hospital records from the Department of Alcohol Diseases were searched for these patients and for 2 age- and gender-matched controls for each patient. 12% of all patients with a shoulder injury were recorded as alcohol abusers. ⋯ In men between 30 and 64 years, almost half of the proximal humerus fractures and shoulder dislocations, one third of mid-clavicular fractures and two thirds of all lateral clavicle fractures were sustained by alcohol abusers. Our findings emphasize the significance of alcohol abuse in the etiology of shoulder injuries, especially in men. Most of the men with a fracture of the lateral clavicle are registered at the Department of Alcohol Diseases, making this injury a marker of alcohol abuse.
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Comparative Study
Cement augmentation of intertrochanteric fracture fixation: a cadaver comparison of 2 techniques.
We evaluated 2 techniques of cement augmentation to enhance fixation of intertrochanteric hip fractures. 4 fixation groups with 6 cadaver femurs in each group were compared: stainless steel lag screw and side plate with and without cement augmentation and a titanium alloy expandable dome plunger and side plate with and without cement augmentation. Gauges were used to establish the mechanical behavior of intact and then fractured femurs to simple uniaxial loads. Subsequent loading to failure allowed determination of maximum fixation strengths and modes of failure. ⋯ Proper cement augmentation increases load to failure and minimizes nail cut-out for both devices studied. However, the dome plunger, a device with a large fixation area in the femoral head, was equally effective and eliminated potential cement encroachment. Failure of intertrochanteric fracture fixation in osteoporotic bone may be minimized by an appropriate choice of device or cement augmentation.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Heterotopic ossification after hip arthroplasty: a randomized double-blind multicenter study tenoxicam in 147 hips.
147 patients due to have a cemented total hip arthroplasty were randomized to 4 groups. They received either tenoxicam 20 mg or 40 mg, or placebo, for 5 days or morphine on the day of operation and placebo for 4 days. ⋯ At follow-up, significantly fewer patients had heterotopic ossifications in the tenoxicam groups than in the placebo and morphine groups. There was no significant difference between the 2 tenoxicam-treated groups, and we therefore conclude that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty.
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Randomized Controlled Trial Comparative Study Clinical Trial
Treatment of acute ankle sprain. Comparison of a semi-rigid ankle brace and compression bandage in 73 patients.
We randomized 73 patients with grades II and III ankle sprain to treatment with an Air-Stirrup ankle brace or a compression bandage. All patients were instructed to attempt early motion and weight bearing when comfortable. ⋯ The group treated with the Air-Stirrup ankle brace was more mobile in the initial phase of rehabilitation and had a shorter sick leave. Ankle brace treatment resulted in socioeconomic savings.