Acta orthopaedica Scandinavica
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Two series of patients with a hip fracture, sustained at home, were assessed regarding utilization of rehabilitation resources before and after adoption of an active policy favoring rehabilitation at home. Out of 86 consecutive patients in 1985 (Series I), 22 were discharged directly to their home versus 44 out of 84 in 1986 (Series II). ⋯ Twenty of the 77 surviving patients in Series I were permanently institutionalized compared with 14 of 77 in Series II. We conclude that an active attitude towards home rehabilitation after a hip fracture benefits patients and the community alike.
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Totally, 146 Colles' fractures that were displaced after the primary reduction were treated by closed rereduction and plaster immobilization. A permanently acceptable position was achieved in 11 of 27 cases, where dorsal angulation was the only malalignment. ⋯ The chances of achieving a permanently acceptable position by rereduction are rather small in Colles' fracture with axial compression alone or combined with deviation of the dorsal angle. High age and the presence of dorsal comminution are further factors likely to worsen the prognosis.
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Radiographic and functional results of external fixation of 32 Colles' fractures were compared with the results of plaster fixation of 189 Colles' fractures. Despite the fact that the fractures treated with the external device were more unstable and comminuted, the final results were equal in both groups, and the radiographic outcome of external fixation was superior. Pin loosening decreased with predrilling rather than self-tapping. We recommend external fixation for unstable fractures of the distal forearm.
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We recorded all the distal forearm fractures in inhabitants under 20 years of age in Frederiksborg County, Denmark, throughout 1985. The population at risk was 97,791 persons, and fractures occurred in 269 boys and 205 girls. The peak incidence in girls occurred at ages 10-12 (105 per 10,000) and in boys at ages 12-14 (100 per 10,000). Fractures occurred more often in the autumn than in the spring.
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Fifteen patients with large segmental necrosis of the tibia with deep infection, following open fractures, were treated according to the Burri-Papineau protocol. After radical debridement, the segmental bone defects averaged 8.4 (5-15) cm. ⋯ One patient underwent amputation. Functional results in the other 14, after a follow-up averaging 4 years, were good in 9 cases, fair in 3, and poor in 2.