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- Thorngren, Karl-Göran, et al.
(author)
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Epidemiology of femoral neck fractures
- 2002
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In: Injury. - 1879-0267. ; 33:Suppl 3, s. 1-7
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Journal article (peer-reviewed)abstract
- Fractures of the femoral neck, that is, "cervical hip fractures" constitute 53% of all fractures of the proximal femur (hip fractures) according to the Swedish National Hip Fracture Register linked to SAHFE (Standardised Audit of Hip Fractures in Europe). The most reproducible classification system divides cervical hip fractures into undisplaced (33%) and displaced (67%). Hip fractures are common and costly. Due to the expected increase in the number of elderly in the world during the coming decades the number of hip fractures will increase dramatically, particularly in developing countries. In Sweden three quarters of the patients are women, the mean age is now 81 years and half of the patients are living alone. Hip fractures are rare below 50 years of age. In recent years there has been an incidence increase in the oldest patients, i.e. those over 80 years of age. For these elderly, the incidence in Lund, Sweden, increased from 13.2/1000 in 1966 to 25.5/1000 in 1986. The high number of patients with hip fractures and the cost of treatment increases the need for prevention as well as optimization of operative treatment and rehabilitation. National guidelines are being developed in Europe. Linked with national audits like SAHFE they can improve the quality of care by audit and feedback.
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| 3. |
- Thorngren, Karl-Göran, et al.
(author)
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Influence of age, sex, fracture type and pre-fracture living on rehabilitation pattern after hip fracture in the elderly
- 2005
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In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 27:18-19, s. 1091-1097
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate the influence of background factors on the rehabilitation pattern after a hip fracture in the elderly.Method: Prospective registration based on the Swedish national register for hip fracture patients called RIKSHÖFT/SAHFE (Standardised Audit of Hip Fractures in Europe). The place of living was registered both before fracture and during the following four months period (120 days). Graphs were calculated and drawn based on day-to‐day changes. Also influences of age, sex, fracture type and type of operation were analyzed.Results: The patient's pre-fracture functional capacity as evidence by the place they were able to manage to live before the fracture was the most discriminating factor for the rehabilitation; more than sex, fracture type or type of operation. Age was also a highly discriminating factor with a pronounced influence on the rehabilitation pattern.Conclusions: These background parameters are very important factors when planning the rehabilitation of hip fracture patients. A strategy with individualized planning of the rehabilitation procedure will be highly necessary in the future, in view of the increasing amount of elderly with hip fractures prognosticated during the coming decades. The knowledge about influencing factors here presented will be useful when planning and performing the rehabilitation for this resource-consuming group of patients.
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| 5. |
- Ahrengart, L, et al.
(author)
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A randomized study of the compression hip screw and gamma nail in 426 fractures
- 2002
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In: Clinical Orthopaedics and Related Research. - 0009-921X. ; :401, s. 209-222
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Journal article (peer-reviewed)abstract
- A prospective, randomized study comparing the compression hip screw with the Gamma nail in the treatment of 426 intertrochanteric fractures is reported. The median patient age was 80 years, and 71 % were women The compression hip screw operation took less time except in Evans Type 5 fractures. Blood loss generally was less in the compression hip screw group except in patients with Type 5 fractures. The most frequent surgical problem for patients in the Gamma group was problems with distal locking. Cephalic position of the femoral head screw and cut-out were seen more often in the Gamma nail group. The Gamma nail more frequently preserved the fracture position obtained perioperatively. Whether there was distal locking of the Gamma nail in unstable fractures did not seem to affect the healing rate. Additional fissures or fractures in the proximal femur occurred during five Gamma nail operations and two compression hip screw operations. Postoperative walking ability did not differ between the groups. At 6 months 88% of the fractures were healed. In less comminuted fractures, the compression hip screw method is the preferred method of treatment whereas the Gamma nail is an alternative treatment for more comminuted Evans Type 5 fractures.
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| 8. |
- Amer-Wåhlin, Isis, et al.
(author)
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Brain-specific NSE and S-100 proteins in umbilical blood after normal delivery
- 2001
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In: Clinica Chimica Acta. - 0009-8981. ; 304:1-2, s. 57-63
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Journal article (peer-reviewed)abstract
- BACKGROUND: To determine normal blood levels of brain-specific proteins S-100 and neuron specific enolase (NSE) in healthy newborns and their mothers following uncomplicated birth. METHODS: Umbilical artery and vein blood and maternal venous blood was collected at 112 consecutive uncomplicated deliveries. Venous blood samples were taken from 18 of the neonates 3 days after birth. S-100 and NSE were analyzed quantitatively by double antibody immunoluminometric assay (Sangtec Medical AB, Sweden). RESULTS: Compared with adults, healthy neonates had higher levels of both S-100 and NSE. For S-100, median levels (range) were 1.10 microg/l (0.38-5.50 microg/l and 0.98 microg/l (0.43-2.70 microg/l) in umbilical artery and vein, respectively. For NSE, median levels (range) in umbilical artery blood and vein were 27 microg/l (10-140 microg/l) and 10.75 microg/l (8.80->/=200 microg/l) respectively. The maternal venous blood levels of both S-100 and NSE were significantly lower than in their infants. At 3 days of life, neonatal venous levels of the proteins were still high: S-100, 0.48-9.70 microg/l; NSE, 17->/=200 microg/l. In contrast to adults, haemolysis affected the S-100 levels in umbilical blood significantly. CONCLUSION: Concentrations of both S-100 and NSE in blood are greater in newborns after normal birth than in healthy adults. The higher levels in umbilical artery blood than in umbilical vein blood are consistent with a fetal origin of these proteins. High levels in venous blood at 3 days of life suggest that the high levels at birth are not related to the birth process but reflect a high activity of these proteins during fetal development.
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