Helvetica chirurgica acta
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Out of 224 patients with femoral neck fractures, 40 patients have been treated by ORIF with the dynamic hip screw, whereas 27 have been fixed by large cancellous bone screws and 148 femoral heads were replaced by a prosthesis. The ORIF with dynamic hip screw has been performed as an emergency intervention within 6.2 hours after accident. ⋯ We conclude that these good results are due to the short interval between accident and operation as well as to the evacuation of the intraarticular hematoma together with stable internal fixation and functional rehabilitation. Due to our good results we prefer long cancellous bone screws for the operative fixation of femoral neck fractures in younger patients, whereas in the older group the dynamic hip screw is preferred.
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Helvetica chirurgica acta · Mar 1993
[Management of femoral neck fractures at the Liestal canton hospital].
The mode of treatment for femoral neck fractures at the Kantonsspital Liestal depends on age primarily. Patients over 70 years of age are treated with a unipolar endoprosthesis. Screws are being used in cases of medial femoral neck fractures, DHS in cases of lateral fractures. ⋯ Clinically all 13 surviving patients are not compromised by the endoprosthesis after 5 years. We consider the implantation of a unipolar endoprosthesis in patients with femoral neck fractures at age over 70 years the treatment of choice. There is an acceptably low risk for protrusion as a late complication in regard to a reduced life expectancy.
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Indications for surgical therapy in uncomplicated peptic ulcer disease have decreased considerably since the introduction of H2-receptor blocking drugs and more recently omeprazole. On the other side, the number of acute complications such as perforation or hemorrhage has remained nearly constant. The recent literature seems to indicate that the pattern of patients presenting with complications has changed and that the number of acute ulcers has increased. ⋯ The mortality is 14.3% and 12.5%, respectively. The vast majority of our patients have chronic ulcers, and only 7% have acute or subacute lesions confirmed by histologic examination. Based on our experience and the literature, we propose a therapeutic algorythm for these two conditions.