[Five-year follow up of patients with femoral neck fractures]. / Combnyaktáji törés miatt kezelt betegek sorsának ötéves követése.

The authors report on follow-up of 754 patients (among them 713 patients aged over 50 years) with hip fracture, treated in the National Institute of Traumatology, in 1990. Excess mortality in a year amounted 23% of cases. One third (254) of the injured survived after 5 years, current health condition of 199 out of them has been evaluated in a questionnaire type survey. Analysis of results according to age, sex and fracture type was made. Definite correlation has been observed with the age, the increase being parallel to it, while age-specific mortality is higher in men. Again, mortality was higher in trochanteric fractures. On analyzing the patients' condition from the aspect of using walking aids, walking ability and complaints, particularly the high rate of painfulness differed from the literature data, though inadequate rehabilitation, already stated before, is reflected in other indicators, too. In addition to the improvement of early rehabilitation, based on their own results the authors emphasize, that further care of patients with complaints is also of great importance.

Non-operative or operative treatment for undisplaced femoral neck fractures: a comparative study of 122 non-operative and 125 operatively treated cases.

We present a series of 247 undisplaced femoral neck fractures, of which 122 were primarily treated non-operatively, and 125 with primary operative stabilization. The background parameters did not differ significantly in the two groups. The length of hospitalization was 1 week shorter in the operatively treated group. They started to walk bearing full weight at an average of 11 days earlier. Two-thirds of the operatively treated but only one-quarter of the non-operatively treated patients were able to walk alone when they left hospital. General complications were recorded in 19 of the non-operatively and in four of the operatively treated patients during their hospitalization. Early displacement (within 6 weeks) was noted in 20 per cent of the non-operatively treated patients who required late operation. However, there was no early displacement in the operatively treated group. We therefore recommend primary operative stabilization of undisplaced femoral neck fractures.

[Accidents of the elderly]. / Idóskori balesetek.

The topic of accidents in elderly population has been studied on 2055 injured older than 65 years. The severity of injuries indicates the importance of accidents in this age-group. The proportion of fractures in the elderly population is twice of the average-in females over 75 years of age they take the half of the total number of injuries. While the incidence rate of males in the whole material with all of the age groups is twice of that of females, in elderly population it turns into equal. The rate of home-accidents grows with ageing. The elderly people specially the males suffer a high number of road traffic accidents as pedestrians or riding their bicycles. The severity of injuries and the broken health status in elderly people is a major problem both for the health care and the whole society.

[Injuries during adolescence]. / Sérülések a serdülökorban.

The incidence of injuries reaches the highest level in the adolescent age-group, as proved also in our survey of accidents in a period of one year in County Vas, Hungary. The incidence is extremely high in boys: 241 per 1000 heads of this age-group while no increase can be observed in girls due to an earlier puberty. The risk-rate of boys appears high at every type of injuries even at those that were caused intended or in an intoxicated state. As to the rest of indices the age-group of adolescents shows a transition between the childhood and the adult age, meanwhile the injuries of the adolescents stay nearer to those of the young adults.

[Significance of home accidents]. / Az otthoni balesetek jelentösége.

Authors analyse the incidence, demographic relations and data of hospitalization of the home accidents. The significance of the home accidents is emphasized. It is stated that the home accident is the most frequent type of accidents and its ratio is increasing. The incidence was found 45 on 1000 inhabitants, the home accidents give nearly the half of all accidents and more than 1/3 of the hospitalized injured. Attention is called to the possibilities of unutilized possibilities of the prevention of home accidents.

[One-year follow-up experience in the rehabilitation of patients with femoral neck fractures]. / A combnyaktáji töröttek rehabilitációjának egyéves tapasztalata.

Authors have followed 754 patients with hip fracture and have found that about 60 per cent of them are alive after one year; their functional state further improved between 4 months and 1 year, it cannot be however considered as satisfactory even after one year. Analysing the operations performed in femoral neck and trochanteric fractures it should be stated that the operative indications are generally adequate and the conditions of further improvement are defined. More significant improvement of the lasting results can be expected from a well organized rehabilitation.

[Epidemiology of hand injuries based on surveys in Vas County]. / A kézsérülések epidemiológiája a Vas megyei felmérés alpján.

Authors have found in a 1 year survey in the county Vas 7580 hand injuries. The major proportion of young men and adolescents in the material was conspicuous. The types of accidents were investigated together with the place of the accident and types of the injury. The material shows that in contrary to the accidents of the work in the recent past the number of the accidents at home has increased--and so their prophylaxis became the main point.

[Epidemiology of hand injuries in Vas County based on a survey]. / A késérülések epidemiológiája a Vas megyei felmérés alapján.

Authors have found in a 1 year survey in the county Vas 7580 hand injuries. The major proportion of young men and adolescents in the material was conspicuous. The types of accidents were investigated together with the place of the accident and types of the injury. The material shows that in contrary to the work accidents in the recent past the number of the accidents at home has increased--and so their prophylaxis became the main point.

[Childhood accidents]. / Gyermekbalesetek.

A survey of accidents in a period of one year in County Vas, Hungary was performed. The injury of children in the age-group of 0-14 was found in case 5841 i.e. in 22.5% of the total number of the injured. The incidence was 101/1000 head of puerile population. The rate of accidents appeared to be low in early childhood while it showed a significant increase in the school age. The home accidents accounted for the most of the accidents especially in the early childhood. Over the age of 7 the school and sport/playground accidents exceeded. The roads were involved as a high risk factor for each of the age groups. The high (21.5%) rate of fractures indicates severity of the injuries although the number of the most severe injuries remained low. The accident conditions of County Vas are at an advantage compared with international data meanwhile the high rate of accidents in the school age group calls for prevention and educational work.

[Bicycle accidents]. / Kerékpáros balesetek.

Authors analyse the 1684 bicycle accidents, observed in the county Vas in one year, compared with the international data. It is underlined that no sufficient attention is given to the bicycle accidents, reaching 6 per cents of all traumas, and the increase of which can be still expected, and to the prophylaxis of these accidents. Especially endangered were found the little children transported on bicycles, those aged 11-14 years and the drunken drivers. Prophylactic measures are suggested.

[The role of Gardner's classification in the detection of dislocation in femoral neck fractures]. / A Garden-beosztás jelentösége a combnyaktörés dislocatiójának meghatározásában.

As the literary data are contradictory, authors examined in 489 operated femoral neck fractures the significance of Garden's classification. Based on their material it was found that this classification gives help in the judgement of the single fractures and in the choice of the adequate treatment. For a more exact assessment however they think the consideration of the lateral Roentgenograms also necessary.

[Problems of rehabilitation after femoral neck fractures in Hungary and possible solutions]. / A combnyaktáji törés utáni rehabilitáció hazai problémái és a fejlesztés lehetöségei.

Authors examined the results of the 4 months rehabilitation of 753 cases of hip fractures treated in one year in their Institute. It was stated that a significant part of the patients had to be discharged too early. It is contributed to the inadequacy of the rehabilitation possibilities of the patients that 3/4 of those living after 4 months have complaints, only half of them can leave their flat, only 1/5 walks without a stick and 1/3 with one stick. On the basis of Swedish experiences they see the possibility of improving their results in a closer cooperation with the primary health care.

[Osteosynthesis of femoral neck fractures by double-cannulated screws (preliminary report)]. / A combnyaktörés osteosynthesise két cannulalt (furatos) csavarral. (Elözetes jelentés).

Authors report on a new osteosynthesis based on the double nailing of femoral neck fracture and screwing, and developed from the "Uppsala" double screwing. The preliminaries of the double cannulated screwing method, its advantages, the experiences gained in 30 cases operated in one year and the early results are described.

[Femoral neck fracture--selection of treatment method]. / A combnyaktáji törés--a kezelés megválasztása.

Authors followed for 4 months the life of 753 patients with femoral fractures of the hip and state, that with an extension of the operative indication the hospital mortality was decreased to the half during 15 years in spite of the further rise of the age. It is contributed first of all to the inadequacy of the rehabilitation that the later mortality is high and it is the double of that in the hospital: not more than 3 of 4 injured reaches the 4 months control.

[Incidence of fractures of the proximal femur and the distal end of the forearm (results of a Vas County survey compared to international data)]. / A combcsont proximális és az alkar distalis vége töréseinek incidenciája (a Vas megyei felmérés eredményei nemzetközi összehasonlításban).

Authors analysing the one year material of injured in one county, state the age and sex specific incidence in the two types of fractures. Compared with other European data they found difference in male/female distribution: the values concerning women are substantially lower in the county Vas, those of men are on the other side equal. To clear the difference and the tendency further examinations are thought to be necessary, especially regarding the increasing importance of femoral fractures of the hip region in public health and national economy.

[Nondisplaced (impacted) femoral neck fracture--conservative or surgical treatment?]. / Die nichtdislozierte (eingekeilte) Schenkelhalsfraktur--konservative oder operative Behandlung?

The treatment of undisplaced femoral neck fractures, having been disputed for the past 50 years, is analysed on the basis of 111 observations during the period of 1981 to 1983. Osteosynthesis proved to be advantageous. Fixation with a three-flanged nail did not increase mortality rate, had no negative effect on late complications, while it could prevent dislocation and permitted full loading at an early stage.