Randomized, double-blind, clinically controlled trial of intranasal calcitonin treatment in patients with hip fracture.

The objective of this study was to evaluate the short-term outcome of intranasal calcitonin treatment of elderly hip fracture patients on pain, bone loss, functional recovery, and length of hospital stay. In addition, we wanted to compare the effect of calcitonin with placebo on fusion of hip fractures treated with internal fixation using a screw or a nail. In a randomized, double-blind, clinically controlled trial, 260 independently living patients (aged 65 years or older) with acute hip fracture were randomly assigned to intranasal calcitonin 200 IU daily for 3 months or matching placebo nasal spray.

Intensive geriatric rehabilitation of hip fracture patients: a randomized, controlled trial.

We determined the effect of geriatric rehabilitation of hip fracture patients on mortality, length of hospital stay, and functional recovery. In a randomized, controlled intervention study, 243 community dwelling hip fracture patients over 64 years of age were randomly assigned to 2 rehabilitation groups. The intervention group (n = 120) was referred to a geriatric ward for team rehabilitation, and the controls (n = 123) to local hospital wards for standard care.

Threefold increased risk of hip fractures with rheumatoid arthritis in Central Finland.

Objectives: To evaluate the impact of rheumatoid arthritis (RA) on the incidence of hip fractures.

Methods: All patients with acute hip fractures admitted to Jyväskylä Central Hospital in 1991-93 (n=517) were selected from the hospital discharge register. Medical records of these patients were studied retrospectively for RA fulfilling the American Rheumatism Association criteria.

Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia.

Objective: To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture.

Design: Preplanned subanalysis of randomised intervention study. Settting: Jyväskylä Central Hospital, Finland.

Population based epidemiologic and morphologic study of femoral shaft fractures.

The epidemiologic and morphologic features of all femoral shaft fractures in skeletally mature patients treated during a 10-year period in a semi-urban county were analyzed. Among an average adult population of 202,592 residents, 192 people sustained 201 traumatic femoral shaft fractures during the study period. The incidence was 9.

Significant changes in the surgical methods and length of hospital stay of hip fracture patients occurring over 10 years in Central Finland.

Background And Aims: The objective of this study is to determine the changes occurring in the treatment chain and mortality of hip fracture patients in Central Finland over a ten-year period. In order to cope with an aging population and increasing cutbacks in the health care system, health-center hospitals run by general practitioners have taken a more active role in the rehabilitation of elderly patients.

Material And Methods: Patients with acute hip fracture admitted to Jyväskylä Central Hospital in 1982-1983 (n = 317) and in 1992-1993 (n = 351) were collected from the hospital discharge register and the medical records of these patients were studied retrospectively.

Asymmetry of paraspinal EMG-time characteristics in idiopathic scoliosis.

The purpose of this study was to investigate the activation pattern of the paraspinal muscles in scoliotic and normal subjects. Force-time and electromyography (EMG)-time curves of paraspinal muscles were recorded during maximal isometric trunk extensions in 15 girls with adolescent idiopathic scoliosis (AIS) and in 14 healthy girls with structurally normal spines. The isometric force-time curves as well as the maximal integrated electromyography (IEMG) activities that were recorded from both sides of the thoracic and lumbar spine did not show any significant differences between the two subject groups.

The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 years in Central Finland.

The objective of this study was to find out if the age-standardized incidence of hip fractures has changed in 10 years in Central Finland. Patients with acute hip fracture admitted to Jyväskylä Central Hospital in 1982-1983 (n = 317) and in 1992-1993 (n = 351) were selected from the hospital discharge register and from contemporaneous records of the Department of Anesthesiology and the ward of traumatology. Earlier studies in Finland have indicated that there has been an increase in incidence rates.

Specific features associated with femoral shaft fractures caused by low-energy trauma.

Objective: To scrutinize the fracture patterns of femoral shaft fractures caused by low-energy injury mechanism and to delineate the problems associated with the treatment of these fractures.

Materials And Methods: Of a total of 192 consecutive skeletally mature patients with 201 acute fresh femoral shaft fractures admitted during a 10-year period (1985-1994), 50 patients had a fracture caused by low-energy trauma. The fractures were classified in terms of their configuration, site, degree of comminution, and soft-tissue injury.

Calcaneal bone mineral density predicts fracture occurrence: a five-year follow-up study in elderly people.

A 5-year follow-up study investigated calcaneal bone mineral density (BMD) and changes in BMD in relation to fracture occurrence. The subjects comprised two cohorts born in 1914 and 1910 living in the city of Jyväskylä in central Finland. One hundred and three men (82%) and 188 women (73%), aged 75, and 57 men (74%) and 136 women (65%), aged 80, of the eligible population participated in the baseline bone measurements.

Four-year survival after hip fractures--an analysis in two Finnish health care regions.

We studied the survival of 390 patients with fresh hip fractures sustained in 1989 by a population of about 441 thousand in two health care regions in Finland during four years. The most significant explanatory factors of mortality were place of injury, place after primary treatment and age. The excess mortality of men compared with the reference population at one year was 21% and in women 16%.

Low molecular weight heparin (enoxaparin) compared with unfractionated heparin in prophylaxis of deep venous thrombosis and pulmonary embolism in patients undergoing hip replacement.

Prophylactic efficacy and safety of a low molecular weight heparin (LMWH) and those of conventional unfractionated heparin (UH) were investigated in a randomized study. Totally, 167 consecutive patients undergoing total hip replacement were allocated to two groups. Patients in the LMWH-group (n = 83) received a fixed dose of enoxaparin 40 mg once daily, starting 12 hours preoperatively and continuing for 10 days.

Survival of the Lubinus hip prosthesis. An eight- to 12-year follow-up evaluation of 444 cases.

The Kaplan-Meier survival method was used to analyze 444 Lubinus arthroplasties in 398 patients who were observed between eight and 12 years. The indication for arthroplasty was osteoarthrosis in 316 hips, rheumatoid arthritis in 84 hips, and various other conditions for the other 44 hips. Survival was determined for the entire prosthesis, as well as separately for the femoral stem, the acetabulum cup, and their four subgroups.

Adductor magnus tenodesis for patellar dislocation. Technique and preliminary results.

Fourteen patients with acute or chronic patellar instability had treatment with a new reconstructive procedure. It consists of isokinetic augmentation of the medial patellofemoral ligament (PFL) by making a tenodesis of the distal adductor magnus tendon to the medial border of patella. The patients were reviewed at a mean of 6.

Are smokers a risk group for delayed healing of tibial shaft fractures?

A total of 135 patients with a fresh tibial shaft fracture and with no other significant injuries underwent primary conservative treatment. Data on their smoking habits were obtained from hospital records and by questionnaire. Although the smokers had better prospects for healing of the fracture at the outset than non-smokers (lower mean age and less fractures caused by high-energy injuries), the smokers were found to have a significantly longer mean time to clinical union and a higher incidence of delayed union.

Hip fractures in two health care regions in Finland in 1989: an analysis of treatment.

We studied prospectively the demographic data, fracture types and modes of treatment in 390 patients with acute traumatic hip fractures in two health care regions in Finland, the Middle Finland region and the Kymenlaakso region in 1989. In Middle Finland population (251,203 inhabitants) 199 patients with a hip fracture were admitted to two acute care hospitals, while 191 patients were admitted in Kymenlaakso (population 189,726) to four acute hospitals. There were no significant differences in the sex- and age-specific incidences between the two regions.

Platelet activation during acute phase after multiple trauma.

The acute phase after multiple trauma is associated with both thrombotic phenomena and a bleeding diathesis. To evaluate the activation of platelets, beta-thromboglobulin (BTG) in plasma and serum and thromboxane B2 (TxB2) in serum were measured in 14 patients with multiple trauma. BTG in plasma was significantly increased on days 1, 2 and 10 to 14 after the trauma.

Hip fractures in urban population in Finland.

We studied prospectively the occurrence of hip fractures among the over 49-year-old urban populations (n = 88,206) in the cities Tampere, Jyväskylä and Kotka in 1989 and compared the results with a parallel Scandinavian multicentre study. During 1989, there were 266 inhabitants who were treated for a hip fracture, 213 of them were women. Women had in 132 cases a femoral neck fracture and in 81 cases a trochanteric fracture, and the corresponding numbers for men were 22 and 31.

Blunt injury patients benefiting from intensive care.

The files of 2,002 trauma patients admitted to our intensive care unit between 1966 and 1984 were analyzed. 74% of the patients were admitted because of the trauma after primary care and 26% later. The main reasons for later admissions were respiratory distress in 11% and postoperative follow-up in 8% of the cases.

A prospective study of the treatment of severe tears of the lateral ligament of the ankle.

A prospective randomized clinical study was undertaken to compare bandaging, plaster cast immobilisation and operative treatment for recent tears of the lateral ligament of the ankle. The follow-up period was two years. Subjectively, only the fear of giving-way showed a clear difference in favour of operative repair.

A high incidence of spinal curvature. A study of 100 young female students.

A hundred adult female students were clinically examined for scoliosis and other spinal abnormalities. Ninety-nine per cent of them participated voluntarily in X-ray examination of the spine. Of the X-rays only 34 per cent were classified into group without spinal curvature.

Stress hormones, lipids, and factors of hemostasis in trauma patients with and without fat embolism syndrome: a comparative study at least one year after severe trauma.

The pathophysiologic mechanism of fat embolism syndrome (FES) has been thought to depend on mechanical blockage of capillaries by fat emboli or on the toxic effect of free fatty acids on the capillary endothelium. Aggregation of platelets, microembolism, disseminated intravascular coagulation, and vasoactive amines are considered to be involved. The question of why some patients develop fat embolism while other patients with similar injuries do not remains to be solved.

Acromioclavicular complete dislocation. Analysis of the operative results in 48 patients.

Complete acromioclavicular separation in 48 patients was treated by operation, using Kirschner wire for fixation in 20 cases and the A--O cortical screw in 17. Late resection of the distal end of the clavicle was performed in 11 cases. Follow-up examination was performed on average two years after the operation.

Basal osteotomy of the first metatarsal bone in hallux valgus: experiences with the use of AO plate.

In young patients with hallux valgus, osteotomy with excision of the exostosis is frequently indicated. The basal, laterally based wedge osteotomy, is relatively seldom used. However this operation may produce a considerable reduction of the metatarsus primus varus.