RESUMEN
The treatment of acromioclavicular injuries is controversial; few studies document the late results. We have reviewed 53 patients about five years after conservative management, in nine for subluxation and 44 for dislocation. Subjective and objective results were satisfactory in all cases except for one with painful subluxation, who was the only patient to change her occupation because of the injury. At review, joint stability was demonstrated by improvement in position and by the very small increase in the coracoclavicular gap on stress radiographs.
Asunto(s)
Articulación Acromioclavicular/lesiones , Luxaciones Articulares/terapia , Articulación Acromioclavicular/diagnóstico por imagen , Adulto , Anciano , Vendajes , Femenino , Estudios de Seguimiento , Humanos , Inmovilización , Luxaciones Articulares/complicaciones , Luxaciones Articulares/diagnóstico por imagen , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/etiología , Masculino , Persona de Mediana Edad , RadiografíaAsunto(s)
Actividades Cotidianas , Fracturas del Cuello Femoral/epidemiología , Fracturas de Cadera/epidemiología , Anciano , Anciano de 80 o más Años , Fracturas del Cuello Femoral/sangre , Hemoglobinas/metabolismo , Fracturas de Cadera/sangre , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Albúmina Sérica/metabolismoRESUMEN
Unnecessary preoperative cross-matching of blood wastes time and money and may increase morbidity and mortality by delaying a necessary operation. One hundred and ninety-three consecutive patients who underwent semi-urgent operative treatment for fractures of the neck of the femur at a large district general hospital were evaluated. Of the patients with haemoglobin values of 11 g/dl or more, only 12 per cent required transfusion for the operation. None of the patients with fractures treated by 'pinning' required a transfusion. It is our opinion that patients with normal preoperative haemoglobin levels can undergo operative treatment for fractures of the neck of femur after typing but without the necessity of cross-matching blood.
Asunto(s)
Transfusión Sanguínea , Fracturas del Cuello Femoral/cirugía , Tipificación y Pruebas Cruzadas Sanguíneas , Urgencias Médicas , Hemoglobinas/análisis , Humanos , Cuidados PreoperatoriosRESUMEN
Peak expiratory flow rate (PEFR) was measured using a Wright peak flow meter in 190 patients with fracture of the proximal part of the femur, and in 110 patients who underwent elective total hip replacement. PEFR was significantly lower in the fracture group than in the elective group when similar age ranges were compared. In the fracture group, PEFR of less than 100 was associated with a 69.6 per cent mortality rate, whereas no deaths occurred where the PEFR was greater than 300. It is suggested that the patients' PEFR is a good indicator of their prospects and it can be easily measured on admission.
Asunto(s)
Flujo Espiratorio Forzado , Fracturas de Cadera/cirugía , Prótesis de Cadera , Ápice del Flujo Espiratorio , Factores de Edad , Anciano , Femenino , Fracturas del Cuello Femoral/cirugía , Fracturas de Cadera/mortalidad , Humanos , Masculino , PronósticoRESUMEN
Two cases are described of blunt injury to the forearm in the absence of bone injury, resulting in an acute deep volar compartment syndrome. The importance of the deep flexor compartment of the forearm is noted. The diagnostic pitfalls and the use of intra-compartmental monitoring are discussed. We emphasize that all such cases must be admitted and carefully studied as a matter of routine. If operation is undertaken, both the superficial and deep volar compartments must be adequately decompressed.
Asunto(s)
Síndromes Compartimentales/etiología , Traumatismos del Antebrazo/complicaciones , Heridas no Penetrantes/complicaciones , Enfermedad Aguda , Adolescente , Adulto , Síndromes Compartimentales/cirugía , Fasciotomía , Humanos , Masculino , Factores de TiempoRESUMEN
Some conditions commonly associated with Dupuytren's disease are well-known. No attention has been paid to conditions with a significantly low incidence of Dupuytren's. A large number of patients with rheumatoid arthritis were studied, and were found to have a statistically significantly lower incidence of Dupuytren's disease, than was observed by the same clinicians in age, sex, matched controlled patients.
Asunto(s)
Artritis Reumatoide/complicaciones , Contractura de Dupuytren/epidemiología , Adulto , Anciano , Contractura de Dupuytren/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reino UnidoRESUMEN
One hundred patients with mallet finger injuries were reviewed and examined three to five years after injury. Twenty nine patients still had symptoms consisting mainly of pain and cold intolerance. The degree of residual deformity, presence of a fracture, or delay in treatment were not related to symptoms.