Recurrent macroscopic haematuria due to bladder blood vessels after exercise induced haematuria.

The case is reported of exercise induced asymptomatic macroscopic haematuria, which became recurrent haematuria no longer induced by exercise. The cause, diagnosis, and management are discussed. An overview of the potential causes of sport related haematuria is presented.

Fracture-dislocation of the tarsal navicular in a soccer player.

We describe an unusual injury of the mid-tarsal region in a soccer goalkeeper. The injury occurred in a training game as a result of an abduction-plantar-flexion. Radiographs showed a fracture-dislocation of the tarsal navicular. The patient was treated by closed reduction with percutaneous fixation using two Kirschner wires. The end-result was satisfactory but the patient felt pain in the mid-foot during and after sports activities and was unable to continue playing as a goalkeeper.

Single-dose antibiotic prophylaxis in osteosynthesis for hip fractures. A clinical multicentre study in Finland.

BACKGROUND AND AIMS: The use of antibiotic prophylaxis in open reduction and osteosynthesis of closed hip fractures is still controversial. The aim of this study was to demonstrate the effect of antibiotic prophylaxis in osteosynthesis of these fractures. MATERIAL AND METHODS: A total of 224 patients operated on between November 1994 and February 1998 in six hospitals by internal fixation for a fresh hip fracture were prospectively and randomly allocated to either a ceftriaxone antibiotic prophylaxis or no prophylaxis group and followed for one year. RESULTS: Within 6 weeks after the operation, 2.6% wound infections were recorded in the antibiotic group and 4.7% in the control group. Two (1.9%) of the five infections in the control group were deep infections (both sensitive to ceftriaxone). There were no statistically significant differences between the infection rates in both groups. However, when analyzing all complications recorded within 6 weeks, significantly more complications were found in the control group (p < 0.01). In the multivariate analysis the most important factor predicting postoperative complications was the lack of antibiotic prophylaxis. CONCLUSION: In this study the antibiotic prophylaxis group had significantly less postoperative complications than the control group within 6 weeks after the operation.

Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland.

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.

Falls among institutionalized elderly--a prospective study in four institutions in Finland.

We analyzed prospectively the incidence, the intrinsic and extrinsic factors and the consequences of falls during a 7-month period in 4 institutions in Finland in 1993. A total of 370 falls among 160 patients were recorded. Of the fallers 56% fell once and 44% more than once (range 2-24). The mean fall rate in men was higher than that in women (p < 0.01). Fallen men were younger but less ambulatory than women. Of the falls 95% occurred without eyewitness and 27% during the night shift; 30% (114/370) resulted in an injury and 7% (11/160) of the fallers suffered a fracture.

Incidence of pelvic fractures in Finland in 1988.

In 1988, 1212 patients with an acute pelvic fracture were registered in Finnish hospitals for primary treatment. The overall incidence in women was 29/10(5) and in men 20/10(5). The female to male ratio was 2.9 in patients who were over 49 years of age, while in younger age groups the ratio was 0.5. Half of the cases were pubic fractures. In half of the cases the mechanism of injury was a fall and in one quarter a traffic accident. Slightly more than half of the cases were stable and half of the cases were of moderate severity. The average length of hospital stay varied from 17 days in men to 21 days in women.

No differences in the incidences of old people's hip fractures between urban and rural populations--a comparative study in two Finnish health care regions in 1989.

In a prospective study, incidences of hip fractures among the aged in urban and rural populations were compared in two health care regions in Finland in 1989. Both the administrative and the more informative functional classification of the municipalities were used. During 1989, a total of 366 patients, aged 55 years and above, who had a permanent place of domicile in either one of the two health care regions, were treated for a fresh hip fracture. In both regions women sustained 80% of the fractures. No significant differences were found in the incidences of hip fractures between the urban and rural populations. However, a significant difference was found in the mean incidence between the towns of the two health care regions (t = 4.228, d.f. = 6, p < 0.01).

Four-year survival after hip fractures--an analysis in two Finnish health care regions.

We studied the survival of 390 patients with fresh hip fractures sustained in 1989 by a population of about 441 thousand in two health care regions in Finland during four years. The most significant explanatory factors of mortality were place of injury, place after primary treatment and age. The excess mortality of men compared with the reference population at one year was 21% and in women 16%. After this, the excess mortality rates increased slowly in both sexes and were 37% for men and 24% for women at four years. In those who had sustained the fracture in a traffic accident the mortality at four years was slightly lower than that in the reference population, and in those who had sustained the fracture in other accident outdoors there was a 10% excess mortality. Patients who had sustained the injury at home had at four years a 25% and those who had sustained the injury in institutions a 46% excess mortality. The excess mortality at four years was lowest in those who were discharged home (14%) and highest in those who were discharged to other institutions (27%).

Increasing incidence of hip fractures in Finland.

The incidence of hip fracture in Finland was studied for the year 1988. During 1988, 6139 patients were treated for a fresh hip fracture. Three out of four hip fracture patients were women, and the occurrence of cervical fractures was 2.8 times and that of trochanteric fractures 2.5 times more common in women than in men. The incidence rates of hip fractures per 100,000 were 174 in women, 70 in men and 123 in the whole population. The mean hospitalization time for fresh hip fractures was 33 days for cervical fractures and 38 days for trochanteric fractures. The costs of primary hospitalizations due to fresh hip fractures in 1988 were estimated at US $66 million.

Hip fractures in two health care regions in Finland in 1989: an analysis of treatment.

We studied prospectively the demographic data, fracture types and modes of treatment in 390 patients with acute traumatic hip fractures in two health care regions in Finland, the Middle Finland region and the Kymenlaakso region in 1989. In Middle Finland population (251,203 inhabitants) 199 patients with a hip fracture were admitted to two acute care hospitals, while 191 patients were admitted in Kymenlaakso (population 189,726) to four acute hospitals. There were no significant differences in the sex- and age-specific incidences between the two regions. In Middle Finland, 70% of the fractures were of the femoral neck, 28% were trochanteric and 2% subtrochanteric. The corresponding figures in Kymenlaakso were 57%, 38% and 5% (P < 0.05). In Middle Finland, 73% of the femoral neck fractures were treated primarily with a hemiendoprosthesis, 2% with primary total hip replacement and 25% by osteosynthesis. The corresponding figures in Kymenlaakso were 81%, 7% and 12% (P < 0.001). The mean duration of hospital stay was 14 days in Middle Finland and 21 days in Kymenlaakso (P < 0.01).

Hip fractures in urban population in Finland.

We studied prospectively the occurrence of hip fractures among the over 49-year-old urban populations (n = 88,206) in the cities Tampere, Jyväskylä and Kotka in 1989 and compared the results with a parallel Scandinavian multicentre study. During 1989, there were 266 inhabitants who were treated for a hip fracture, 213 of them were women. Women had in 132 cases a femoral neck fracture and in 81 cases a trochanteric fracture, and the corresponding numbers for men were 22 and 31. Among women, the total hip fracture incidence in Jyväskylä (n = 22) was the lowest when compared with the ones in Tampere (n = 47) and Kotka (n = 36). These incidences were on average lower than in the other Scandinavian cities studied in parallel. The all over ratio of femoral neck/trochanteric fractures was 1.1 in Tampere, 3.0 in Jyväskylä and 2.2 in Kotka and in Tampere, women had 9.3 times more femoral neck fractures than men. Our study showed that in Finland in three major cities the hip fracture incidence was lower than what has been similarly registered in corresponding urban populations in other Scandinavian countries. We also point out that the relative part of trochanteric fractures appears to be increasing.