[Laser therapy of ankle sprain]. / Laserbehandling af fodledsdistorsion.

The effect of low-power laser therapy on acute ankle sprains was evaluated in a double-blind randomised clinical study consisting of 40 patients from the casualty ward. All patients received treatment until their ankle joint was painless. No statistically significant differences regarding discolouring, pain, oedema, and use of analgetics were observed between patients treated with laser and placebo. The patients treated with active laser had a significantly longer sick leave.

[Injection of high viscosity liquids. Acute or delayed excision?]. / Injektion af højviskøse vaesker. Akut eller sen excision?

Two cases of self-inflicted injection of paraffin and silicone in the male chest to modify chest contour are reported. Both cases were followed by subsequent inflammation and necrosis. Clinical course, therapy and consequences are discussed. The correlations between silicone breast implants and connective tissue disease and breast cancer are discussed.

["Mouse" in Baker's cyst]. / Mus i Baker-cyste.

Calcified bodies may arise in a joint due to trauma, arthropathy resulting in joint destruction or synovial osteochondromatosis. These calcified loose bodies may pass into a popliteal cyst though posterior joint-bursal communications, or can arise in a popliteal cyst de novo on account of chondrometaplasia. A case history illustrates the differential diagnostic considerations. X-ray combined with ultrasound investigation will exclude soft tissue tumors and vascular lesions.

[Retroperitoneal complications after lumbar disk prolapse surgery]. / Retroperitoneale komplikationer ved operation for lumbal discusprolaps.

Injury to retroperitoneal vascular structures secondary to lumbar disc surgery is a rare but serious complication. In some cases early recognition and surgical intervention is of vital importance. Vascular injuries may be classified in in the following manner. 1. Laceration of one artery or a vein only. 2. Laceration of a artery and a vein leading to formation of arteriovenous fistula. 3. False aneurysm. Based on a review of the literature and three case reports, the anatomy is reviewed. The diagnosis, clinical pictures and the vascular reconstruction are discussed.

[Mediastinal infection following open heart surgery]. / Mediastinalinfektion efter åben hjertekirurgi.

A retrospective investigation was undertaken of the mediastinal infections in patients submitted to cardiac surgery. A total of 1,763 patients participated in a period of 11 years from 1978 to 1988. All of the case records were reviewed for the occurrence of infections in the mediastinum and 24 patients (1.4%) were found to have had mediastinitis. Predisposing factors to mediastinal infections are reviewed. In all of the cases, treatment consisted re-thoracotomy with removal of all necrotic and infectious material. This was followed by primary closure over a retrosternal irrigation system which supplied an antibiotic solution for six days. In addition, oral antibiotics were administered on the basis of the findings on culture. The incidence of infection was found to be increased when the left internal mammary artery (LIMA) had been employed and in cases of combined cusp and coronary surgery. In 20 patients (83%), relevant culture findings were found from the mediastinal drain on an average of 2.5 days after the primary operation. These were reencountered in the mediastinum at rethoracotomy which was performed on an average of 15 days after the primary operation. This raises the question of the possibility of earlier intervention. The commonest microorganisms were micrococci and Staphylococcus aureus which together comprized approximately 83%. The antibiotic treatment routinely employed was 1 g meticillin four times daily. Five patients died (21%) and 19 patients were discharged. On follow-up examination, the sternum was stable and the scar healed. When infection in the mediastinum is suspected after cardiac surgery, early diagnosis and active surgical treatment are important. The closed method of irrigation drainage is recommended by the authors.