Acta orthopaedica Scandinavica
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A total of 488 fractures of the ankle are described and classified into types and stages according to Lauge Hansen (1942). The classification was partly based on operative findings. The type division was: supination-eversion fractures 57.4 per cent, supination fractures 20.1 per cent, pronation and pronation-eversion fractures 20.1 per cent and pronation-dorsiflexion fractures 0.4 per cent. ⋯ It was found that the stage 2 injury in pronation and pronation-eversion fractures is not fully explained by Lauge Hansen. The classification of Lauge Hansen gives a very exact description of ankle fractures. This is very important for the operative treatment and also indispensable for the evaluation of the results of various methods of treatment.
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Follow-up data for at least 4 years was collected for 675 patients treated for hip fractures in the period 1961--1970. Compared with a series from the same hospital for the years 1948--1957 the number of patients had more than doubled and a higher hospital mortality was encountered, but the 4-year survival rate was unchanged. The mortality after hip fracture was found to be related to the age and sex of the patient and to the nature and number of associated diseases. The mortality rate was found to be high in the first 2 months following the fracture, but patients surviving the second month showed no excess mortality during the following 4 years, having the same life expectancy as the general population.
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The value of isotope scanning in patients with suspected fracture of the scaphoid bone of the wrist was examined. For this purpose comparable examinations were made of 50 patients using both radiography and isotope scanning. With a normal scan, the suspicion of fracture or other bone diseases can be excluded. Increased focal activity corresponding to the region of the scaphoid bone indicates the possibility of a fracture, even if a fracture cannot be seen in the initial X-rays.
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In this study the cost-benefit ratio of posterior fusion of the lumbosacral spine was assessed. The calculations were based on 118 operated patients, followed up for an average of 4.8 years. Costs were calculated using the average costs of treatment at central hospitals, visits to the outpatient department and travelling. ⋯ It is emphasized that cost-benefit analyses of surgical procedures are important from the standpoint of principles of treatment and priority of operations. This study deals with economic aspects only. The medical aspects of the present material have been presented in two previous papers.
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A 32-year-old man with a fracture of the scapular notch associated with a lesion of the suprascapular nerve is reported. A nerve decompression operation was performed 20 months after the injury with relief of pain. ⋯ The value of X-ray examination with projections visualizing the notch and diagnostic local anaesthetic block of the nerve passing through the notch are emphasized. Primary wide resection of the scapular notch is a preferable procedure preventing recurrence of nerve compression symptoms.