Stability and migration across femoral varus derotation osteotomies in children with neuromuscular disorders.

Background and purpose - Studies have indicated that one-third of children with cerebral palsy (CP) develop dislocation of the hip that needs surgical intervention. When hip dislocation occurs during childhood surgical treatment consists of tenotomies, femoral varus derotation osteotomy (VDRO), and acetabuloplasty. Relapse is observed in one-fifth of cases during adolescence.

The Danish Cerebral Palsy Follow-up Program.

Aim Of Database: The Danish Cerebral Palsy Follow-up Program is a combined follow-up program and national clinical quality database that aims to monitor and improve the quality of health care for children with cerebral palsy (CP).

Study Population: The database includes children with CP aged 0-15 years and children with symptoms of CP aged 0-5 years.

Main Variables: In the follow-up program, the children are offered examinations throughout their childhood by orthopedic surgeons, physiotherapists, occupational therapists, and pediatricians.

[Ultrasound in the diagnosis and treatment of developmental dysplasia of the hip. Evaluation of a selective screening procedure].

Introduction: With the intention of reducing the treatment frequency of Developmental Dysplasia of the Hip (DDH), two hospitals in Copenhagen implemented a screening and treatment procedure based on selective referral to ultrasonography of the hip (US). This paper describes and evaluates the procedure.

Materials And Methods: The procedure defines procedures for referral, diagnosis, treatment and follow-up of DDH.

[Tuberculous osteomyelitis in children--a problem of immigrants?].

The incidence of tuberculosis in Denmark has increased in recent years, owing to immigrants from, primarily, Somalia. Bone and joint TB are mainly seen in young immigrants and a case of tuberculous ostitis of the tarsal bones and surrounding soft tissue is described.

Decreasing incidence of major amputations in people with diabetes.

Aims/hypothesis: To assess the results of the strategy used in avoiding major amputations in patients with diabetes mellitus.

Methods: A retrospective study for the years 1981 to 1995 in a central district hospital in Copenhagen with a catchment area population of about 178,000.

Results: There were 463 major leg amputations and the incidence decreased from 27.

Patient compliance and effect of orthopaedic shoes.

Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed orthopaedic shoes at the authors' department during a 3 year period received a questionnaire concerning relief of symptoms and daily use of the shoes.

Hypertrophic scars and keloids: a recurrent problem revisited.

Excess scarring caused by pathologically overabundant collagen deposition is a problem known by all surgeons. Such complications to wound healing known as hypertrophic scars and keloids might turn out aesthetically unacceptable to the patient and some scars might even cause anatomic dysfunction. Reviewing the literature in planning a strategy of treatment the surgeon encounters an overwhelming amount of hypotheses on the topic.

[Reduced frequency of amputation in diabetic patients].

The number of major amputations performed for vascular disease in Bispebjerbx Hospital, Copenhagen, has decreased from 122 to 29 per year during the period 1981 to 1994. In diabetic patients the frequency decreased from 25.5/100,000 to 5.

No effect of low power laser in lateral epicondylitis.

Thirty-six patients with lateral epicondylitis of the elbow (19 women, 17 men, median age 48 yrs) were treated either with active laser or placebo, 18 patients in each group. The active laser was a GA-AL-AS 30 mW/830 nm low power laser (LPL). The study design was double blind and randomized.

Long-term results after surgical reduction cheiloplasty in patients with Melkersson-Rosenthal syndrome and cheilitis granulomatosa.

Cheilitis granulomatosa in patients with Melkersson-Rosenthal syndrome has proven difficult to treat, and various forms of symptomatic treatment of orofacial swellings have been used with varying success. To evaluate long-term results after surgical reduction cheiloplasty in patients suffering from persistent lip swellings, a follow-up study was performed on 13 patients after 16 years (median). The operations were performed after unsuccessful conservative treatment and regardless of disease activity.

[Development of carcinoma in chronic pressure sores in patients with spinal cord injuries].

Three cases are presented of squamous cell carcinoma arising from chronic pressure sores in spinal cord injury (SCI) patients. These pressure-sore carcinomas are characterised by a fulminant clinical course with a very high metastatic rate. Prevention of pressure sores and surgical management of chronic ulcers are the best means of preventing malignant changes.

Hypoxaemia after osteosynthesis of hip fractures.

Hypoxaemia may cause postoperative confusion after operations for hip fractures in elderly patients. Twenty-two consecutive patients, with a median age of 73 years, had fractures fixed with a sliding hip screw within 48 hours of admission. The incidence of hypoxaemia was investigated postoperatively using a pulse oximeter.

Aplasia of the anterior cruciate ligament with a compensating posterior cruciate ligament.

Aplasia of the anterior cruciate ligament is a rare condition and is usually associated with other abnormalities of the lower extremities. We report aplasia of the anterior cruciate ligament with a compensating posterior cruciate ligament in a 15-year-old boy.

Low level laser treatment of chondromalacia patellae.

A randomized, double blind study of low level laser treatment of chondromalacia of the patella in 40 patients has been undertaken. Chondromalacia was established by arthroscopy and was related to subjective symptoms. Eight treatments were given during five weeks by a physiotherapist with the use of a GAAS pulsed laser, real or sham.

Changes in C-reactive protein and erythrocyte sedimentation rate after hip fractures.

Serial measurements of C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were performed during the week after operation in 140 patients with hip fractures. There was no selection, and patients with minor or major complications before or after operation were included. In uncomplicated cases, the ESR was variably raised during the first week, whereas the CRP showed a distinct pattern with a rapid increase on the second day; it then decreased by the 7th day.

Outcome in 282 lower extremity amputations. Knee salvage and survival.

Lower-extremity amputation for arterial insufficiency was performed in 282 cases ineligible for vascular surgery. In 203 cases (Group I), amputation was elective without previous vascular surgery. In 14 cases (Group II), amputation followed recent vascular reconstruction, and in 12 cases (Group III) amputation was performed after failed thromboembolectomy.

Injury producing factors in sport parachuting.

On the basis of a study of the literature and a description of the parachute jump, the injury producing factors of civil parachuting is described. The majority of injury happens during landing; the assuming of a correct "prepare to land attitude" and the execution of a good parachute landing fall may prevent a great part of the injuries to the spine and the lower extremities. The factors mentioned are often correlated to ignorance, inexperience or to willful neglect of current regulations.

Movements causing ankle fractures in parachuting.

The parachutist injured in a dramatic accident often describes the injury in an incomplete and biased way and evaluation of materials based solely upon subjective information of this kind can be misleading and of no value for recommendations. As the relation between the mechanical factors of the injury and the lesion in ankle fractures is well documented, an investigation of clinical, radiological and operative findings in 46 parachutists with ankle fractures was conducted. Classification was possible in 44 of 46 fractures.

Parachuting injuries: a study of 110,000 sports jumps.

A study was undertaken to examine the type, location, incidence and mechanism of injury sustained by amateur parachutists in Denmark during a five-year-period. A total of 110,000 parachute jumps resulted in six (0.005%) fatalities and 155 (0.