RESUMO
In a retrospective review and follow-up study of 43 patients who had had high-energy pelvic fractures 5 or more years earlier, the occurrence of late pain and the functional outcome were adversely related to residual deformity of the pelvic ring. Among patients who had no residual deformity (displacement less than 1 cm), 88% had no serious pain and 82% had normal function. Of patients who had residual deformity (displacement more than 1 cm posteriorly), only 30% had no serious pain (p less than 0.01) and only 30% had normal function (p less than 0.01). Definitive reduction and stabilization is therefore recommended early after the injury whenever possible.
Assuntos
Atividades Cotidianas , Protocolos Clínicos/normas , Fraturas não Consolidadas/terapia , Dor/etiologia , Ossos Pélvicos/lesões , Adolescente , Adulto , Doença Crônica , Feminino , Seguimentos , Fixação de Fratura/métodos , Fixação de Fratura/normas , Fraturas não Consolidadas/complicações , Fraturas não Consolidadas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Dor/epidemiologia , Dor/fisiopatologia , Estudos RetrospectivosRESUMO
A retrospective study of 61 fractures (60 patients) involving the supracondylar and intercondylar areas of the femur was made. All patients were younger than 60 years and sustained their injuries in motor vehicle accidents. Follow-up was from 1 to 9 years (mean 30 months). Clinical results of operative and nonoperative treatment were compared with respect to knee motion, pain and function. Extra-articular (type A) fractures had superior clinical ratings if treated operatively (45% excellent and 30% unsatisfactory). Intra-articular (type B) fractures had a substantial number of unsatisfactory ratings (45%) and results of operative and nonoperative treatment were comparable. Fractures of one condyle only did best with open reduction and internal fixation. Rates of nonunion were low (7%); malunion in varus led to poorer overall function. The most important factor for acceptable function was early knee mobilization. Early motion of the knee and quadriceps rehabilitation are facilitated by operative management or use of the cast brace.
Assuntos
Fraturas do Fêmur/terapia , Fixação de Fratura/métodos , Adolescente , Adulto , Feminino , Fraturas do Fêmur/classificação , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
In-patient data show high rates for mental illness in the Republic of Ireland, particularly for schizophrenia. 'One-day prevalence' figures from the Three County psychiatric case register have been compared with similar data from the Camberwell register. The results confirm much higher contact rates in Ireland.
