Annales chirurgiae et gynaecologiae
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The purpose of the study was to find out the consequences of malunion of tibial shaft fracture. ⋯ Malunion of tibial shaft fracture seems to be especially harmful in distal fractures, in fractures with marked primary displacement, in fractures caused by high energy injury, and among patients less than 45 years of age.
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Randomized Controlled Trial Comparative Study Clinical Trial
Perioperative volume effect of HES 120/0.7 compared with dextran 70 and Ringer acetate.
Hydroxyethyl starch 120 (HES 120/0.7, Plasmafusin) is the smallest medium molecular weight HES preparation used as a plasma substitute for all clinical purposes. We compared the volume and colloid osmotic effect of 6% HES 120 with 6% dextran 70 and Ringer's solution during and after surgery with minimal blood loss. Patients (n = 48) having general anaesthesia were randomly divided into six groups. ⋯ With both infusions rates the COPs of dextran and HES groups were higher compared with Ringer groups. There were no differences in COP between the dextran and HES groups. It is concluded, that in this clinical setting the volume effect of 6% dextran 70 exceeds that of the HES 120/0.7, and that both colloids are superior to Ringer's solution.
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The purpose of this prospective study was to elucidate the characteristics of adult patients with acute abdomen admitted to a Finnish university hospital. A total of 639 patients entered the study. The most common cause of acute abdomen was non-specific abdominal pain (NSAP) (33.0%) followed by acute appendicitis (23.3%) and acute biliary disease (8.8%). ⋯ In conclusion, a considerably large proportion (one third) of cases with acute abdomen remained without any specific explanation. Further, age and gender seem to be important factors when the most probable cause of acute abdomen is to be considered. Operative treatment is necessary in almost half of cases, and mortality for acute abdomen is low.
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Clinical Trial Controlled Clinical Trial
The value of osteosynthesis in the treatment of bimalleolar fractures.
A total of 69 patients with displaced bimalleolar fractures were treated by open reduction and internal fixation, 35 using AO/ASIF implants and 34 using biodegradable self-reinforced polyglycolide or polylactide devices. A third group consisted on 35 patients who were treated non-operatively. The result of treatment was evaluated after a minimum follow-up time of twelve months. ⋯ A transient local fluid accumulation was seen in two patients with biodegradable implants. Four patients under non-operative treatment suffered redisplacement of the fracture. In conclusion, biodegradable internal fracture fixation devices proved to be a valuable new method for the treatment of displaced ankle fractures.
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Sixty-four displaced tibial shaft fractures were treated using intramedullary nailing, either primarily or after an attempt at conservative treatment, which consisted of closed reduction under anaesthesia and immobilisation in a long-leg plaster cast. There were 37 closed and 27 open fractures. Three patients had a fracture of both tibiae. ⋯ Although the fractures were different in these groups, it is possible that the time spent in conservative treatment before intramedullary nailing brings no additional benefits. The incidence of deep infection in open fractures after primary nailing was 1/16. The fractures, in which an acceptable position could not be maintained using conservative methods, were mainly spiral in configuration and located in the distal third or at the junction of the middle and distal thirds of the tibia.