[Visits to hospital emergency departments after restricted-admission changes at the Rigshospitalet]. / Skadestuehenvendelser i H:S efter aendringen af skadestuestrukturen på Rigshospitalet.

INTRODUCTION: The aim of this study was to describe changes in the use of accident and emergency departments in the Copenhagen Hospital Co-operation after restricted admittance to the accident and emergency department at a large Danish university hospital, Rigshospitalet (admittance only for patients transported by ambulance or presenting with a referral from a doctor). MATERIAL AND METHODS: A retrospective study compared the number of patients treated in two periods, 1.7.1998 to 30.6.1999 and 1.7.1999 to 30.6.2000. Additional patient data were collected for the periods 1.7.1998 to 31.12.1998 and 1.7.1999 to 31.12.1999. RESULTS: A 4% decrease was seen in the total number of patients treated at the accident and emergency departments. The decrease in the number of patients treated at the accident and emergency department at Rigshospitalet was 69%, whereas the accident and emergency department at Bispebjerg Hospital experienced a 53% rise. DISCUSSION: The study showed good compliance in the local population after the restricted admittance to an accident and emergency department at a large university hospital. An expected total fall in the number of patients treated at the accident and emergency departments in the Copenhagen Hospital Co-operation could not be documented.

Treatment of hyperextension injuries to the PIP joint.

A prospective randomized trial of type 1 hyperextension injuries to the PIP joint treated conservatively by an elastic double-finger bandage or an aluminium splint for 2 weeks showed no differences in the clinical outcome after 6 months.

The social and economic consequences of finger amputations.

120 patients with amputation of at least 1 of the 4 ulnar fingers were admitted to hospital. In none was replantation considered to be possible because of serious damage to the soft tissues and bone. 12 (3-18) years after the accident 80 percent of the patients assessed their condition as good or fair, even those with proximal amputation or loss of 2 or 3 fingers. Our observations do not support replantation when only one of the second-to-fifth fingers have been amputated.

Absorption of pivampicillin as related to dose, and tolerability of a 700 mg tablet.

To evaluate the absorption and tolerability of a new formulation of pivampicillin administered as a 700 mg tablet, 14 healthy volunteers received single doses of 350, 500 and 700 mg p.o. Maximum serum concentrations (Cmax) of 5.73, 7.05 and 8.61 mg/l were obtained. The corresponding values for the area under the concentration/time curve (AUC) were 12.32, 18.99 and 25.30 mg/lxh. Concomitant intake of food increased the Cmax of the 700 mg tablet to 9.5 mg/l, while the AUC remained unchanged. Co-administration of the 700 mg pivampicillin dose with an antacid reduced the Cmax to 7.45 mg/l and the AUC to 17.92 mg/l x h. The tolerance of the 700 mg tablet was evaluated in a double-blind placebo-controlled study involving 57 patients. Six percent of the patients in each treatment group reported minor adverse reactions.

Crossed pins vs parallel pins in the treatment of femoral neck fractures.

Twenty femoral neck fractures treated with three crossed modified Knowles pins (Gouffon pins) were compared to 20 fractures treated with three parallel pins. All patients had survived for more than 2 years after operation. The groups were comparable concerning Garden stage, reduction, and age. No significant difference concerning the failure rate was found.

Multiple symmetric lipomatosis.

Multiple symmetric lipomatosis (MSL) is a rare disorder only mentioned in about 200 cases in the medical literature. It manifests as massive lipomatous deposits in specific areas of the body. The cause is unknown, although there frequently is a history of alcoholism. Surgical lipectomy has so far been the choice of treatment. We present a review of the disease and report one case successfully treated with liposuction.

Displaced femoral neck fractures treated with the Gouffon pin.

One hundred fractures of the neck of the femur, Garden stage III or IV, were treated with Gouffon pins during a three year period. Seventy-nine were followed from 24 to 52 months. Union occurred in 59 fractures. Eighteen fractures did not unite and 2 became redisplaced within the first week. Avascular necrosis was noted on radiographs in 14 of the 59 united fractures. A higher pin migration rate was found in Garden stage IV fractures, and in the failures.

[Hand injuries caused by hydraulic wood-splitting machines]. / Håndskader ved brug af hydrauliske braendekløvere.

Five cases of hand lesions caused by hydraulic wood-splitting machines are described. Prophylactic measures are discussed.

The social and economic consequences of failure to replant amputated thumbs.

Thirty-two patients with amputated thumbs were admitted to hospital. In none was replantation considered to be feasible because of the serious damage to the soft tissues and the bone damage. The social and economic consequences are discussed.

[Perforation of the rectosigmoid colon following autoerotic manipulation]. / Perforation af colon rectosigmoideum efter autoerotisk transanal manipulation.

A case of perforation of the rectosigmoid colon following autoerotic transanal manipulation with a billiard cue is presented. The indications for operation and aids for removal of foreign bodies in the rectum are discussed.

Alternative conservative treatment of mallet-finger injuries by elastic double-finger bandage.

A prospective trial of mallet-finger injuries treated conservatively by elastic double-finger bandage showed no disadvantages compared to other kinds of conservative treatment. The method is agreeable for the patient, being hygienic and causing no kind of skin irritation.