Acta orthopaedica Scandinavica
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We have evaluated the use of laboratory parameters to predict the risk of adult respiratory distress syndrome (ARDS) at an early stage after major trauma. Patients with lung contusion were excluded. Five of 29 patients fulfilled our criteria of ARDS, i.e. ⋯ The most sensitive indicator of ARDS seemed to be the platelet count, although it was also related to blood loss and amount of blood transfused. Hence the platelet count should be considered in relation to blood replacement in the patient with major trauma. Tentative laboratory values are suggested to indicate risk levels of developing ARDS.
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A seven-year-old boy fell against a blackthorn bush and found that thorns had penetrated the skin over the left knee. Aseptic synovitis developed with repeated febrile episodes. With the suspicion of septic arthritis, the patient was treated with antibiotics on repeated occasions, two negative joint aspirations and a knee joint exploration were performed. Three months after the injury the correct diagnosis was made at a second arthrotomy when an intra-articular thorn was removed and synovectomy carried out, after which healing was uneventful.
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Twenty-two patients suffering from progressive kyphosis due to ankylosing spondylitis underwent one or more lumbar osteotomies during 1957-1983. The primary thoracic kyphosis was 80 degrees (45 degrees-155 degrees). The mean correction obtained by one level osteotomy was 44 degrees (30 degrees-60 degrees). ⋯ The use of internal fixation reduced the loss of correction from 9 degrees to 1 degree, also allowing ambulatory after-care and a shorter period of immobilization in plaster or jackets. We had no fatal and relatively few non-fatal complications; three cases of retrograde ejaculation were observed however. All the patients reported subjective respiratory improvement.
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A hernia developed in the region of the inferior lumbar triangle of Petit 1.5 years after a full thickness bone graft had been taken from the part of the iliac crest that forms the base of the triangle.
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Ninety-eight fractures of the femoral neck treated with a sliding screw-plate system were followed from 6 to 65 months. Two cases developing deep infection and four cases of primary technical failure were reoperated. ⋯ Serious complications were thus encountered in 31/98 of the fractures, and 27 of these were reoperated. On the basis of comparison with reports on other methods for internal fixation, the sliding screw-plate method is recommended for fixation of femoral neck fractures.