[Conservative treatment of the knee with stable hemarthrosis]. / Konservativ behandling af det stabile haemarthronknae.

Follow-up examination of 27 patients nine years after conservative treatment for traumatic haemarthromatous knees with stable ligaments revealed that the injuries which should have been anticipated very frequently, according to other authors, were only found in one patient, viz lesion of the anterior cruciate ligament. Two patients had undergone operative treatment for menicsal lesions which may have been related to the primary injury. The delayed treatment had not resulted in arthrosis or other permanent sequelae. Expectant treatment with arthroscopy appears to be justified in cases of traumatic haemarthroma of the knee in patients in whom the ligaments have been demonstrated to be stable at repeated clinical examinations.

[Discontinuing postoperative wound dressings]. / Seponering af postoperativ sårforbinding.

The influence of postoperative dressings on wound healing was investigated. Clean and potentially contaminated operation wounds were subdivided at random into a group with dressings until the sutures were removed or a group with dressings during the first 24 hours after operation only. No significant differences in the incidences of wound infections were observed in the two groups. The majority of the patients treated with dressings for a brief period only did not desire prolonged periods with dressings after possible future operations.

[Tarsometatarsal fracture dislocations]. / Tarsometatarsal fraktur-luksation.

The late results of 16 tarsometatarsal fracture-dislocations are presented. The median period of observation was 9.5 years. Closed or operative reduction of the dislocations was performed and, in 11 cases, internal fixation with Kirschner wires was employed. Re-dislocation occurred only in the cases where the joint was not stabilized with Kirschner wire. The results were good in nine out of 12 cases with normal positions in the tarsometatarsal joints. None of the patients with persistent dislocation in the joint had good results. Exact closed reduction or operative reduction with internal fixation with Kirschner wire are recommended in the treatment of tarsometatarsal fracture-dislocations.

[Evaluation of clinical tests in meniscal injuries]. / Evaluering af kliniske menisktest.

The values of clinical tests in general use were calculated in a group of patients who were not selected in advance as suffering from meniscal damage. Arthroscopic examination was employed to control the diagnosis. Employing Smillie's, Bragard's and McMurrays's tests, it was possible to exclude meniscal lesions with 75-95% probability and these could be demonstrated with 25-60% probability. Böhler's test was not correlated significantly with meniscal lesions and the true positive nosographic frequency of Apley's and Jones' tests were so low that their value was limited.

[Subtalar luxation]. / Subtalaer luksation.

Fourteen cases of subtalar dislocation were reviewed after an average period of observation of 13 years (5-27 years). Ten dislocations were medial and four were lateral. Two dislocations were open and, in seven of the cases, dislocation fractures were present. No cases of avascular necrosis of the talus were found. Three patients developed severe arthrosis and arthrodesis was performed in two of these. In cases of subtalar dislocation without fractures or dislocation fractures which did not involve the joints surrounding the talus, the prognoses were good. In cases of open dislocations or dislocations with intra-articular fractures, the prognoses were less favorable.

[Second-look surgery in ischemic volvulus of the small intestine]. / Kontroloperation ved iskaemisk tyndtarmsvolvulus.

A case of volvulus of the small intestine in a child is reported. At the primary exploration, a segment of the small intestine measuring 240 cm was found to be clinically devitalized. Repeated exploration three days later revealed 90 cm of gangrenous intestine with distinct delimitation from the vital intestine. A second look operation may thus limit intestinal resection in cases of extensive ischaemia of the intestine and indefinite delimitation of the devitalized intestine.

Need for surgical wound dressing.

The need for dressings on clean and clean contaminated surgical wounds was investigated. A total of 1202 patients with 1202 clean or clean contaminated surgical wounds were randomized into two groups: 633 wounds were covered by dressings up until the time of suture removal, and 569 wounds were treated without dressings after the first postoperative day. In the group characterized by long dressing time, the rate of postoperative wound infections was 4.9 per cent. The rate was 4.7 per cent in the group represented by short dressing time. Using short dressing time not only reduces the number of nursing hours but also limits the need for costly dressing material. In addition, both wound observation and patients' personal hygiene are made easier.

Solitary metastatic endometrial carcinoma of the spleen.

Carcinomatous metastatic involvement of the spleen usually indicates widespread malignant disease. Solitary metastatic lesions in this organ are exceedingly rare and the literature reveals fewer than 15 cases. We have observed a poorly differentiated adenocarcinoma of the body of the uterus (adenoacanthoma) with an unusual route of metastasis in a 59-year-old patient. Only one case with the same pattern of spread from an endometrial carcinoma has been reported earlier.