[Instructions on the Internet or Intranet within a department].
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Computer Communication Networks↗
Biomedical subjects
C F Larsen
Publications and source records attributed to C F Larsen.
[Occupational accidents in road traffic].
An emergency room material covering 13 years (1980-92) was analyzed to see whether occupational accidents in road traffic had been following special patterns revealing possibilities for prevention. Of 41,332 traffic accident victims, every year 2.3-4.2% had sustained their injuries during working hours. Males were overrepresented, the male to female sex ratio was 2.9 for occupational accidents, 1.6 for non-occupational accidents. The age group 15-19 years accounted for a relatively large share of both occupational and non-occupational accidents. There were no differences according to body distribution of injuries, severity or need for treatment between occupational and non-occupational accidents. In occupational accidents more automobiles but fewer bicycles and motorbikes were involved. No type of accident showed increasing tendency throughout the period. It is concluded, that occupational road traffic accidents do not seem to follow special patterns, and the proportion is not increasing. Although the younger age groups were overrepresented, the limited material does not give grounds for elevating the age limit for occupational car driving, as for extent of exposure in the single age groups is not known.
Accidents, Traffic↗
Nonunion rates of limited carpal arthrodesis: a meta-analysis of the literature.
Numerous types of limited intercarpal arthrodeses have been reported in dozens of articles in the English-language medical literature. The nonunion rate varies considerably within and between the different types of arthrodeses. This may be due in part to the small number of cases in most studies. The data on the number of good results and nonunion rates for 27 different types of limited carpal arthrodeses reported in the English-language medical literature from 1946 to 1993 were collected, and for each study, the 95% confidence intervals (95% CI) were calculated. The studies were then combined for specific types of arthrodeses and the overall nonunion rates and confidence intervals were calculated to more accurately determine the actual nonunion rate expected for limited intercarpal arthrodeses. Nonunion rates (95% CI) for the most popular types of limited arthrodeses were as follows: of 385 scaphotrapezium-trapezoid arthrodeses reported, there was a 14% nonunion rate (95% CI, 11%-18%); of 104 lunotriquetral arthrodeses, the nonunion rate was 27% (95% CI, 19%-36%); and of 17 scapholunate arthrodeses, the nonunion rate was 47% (95% CI, 26%-69%).
Arthrodesis↗
Scaphopisocapitate alignment: criterion to establish a neutral lateral view of the wrist.
PURPOSE: To determine whether a "true" neutral lateral view of the wrist is necessary for accurate capitolunate angle measurement, to compare two standards of diagnostic adequacy for neutral lateral wrist views (distal radioulnar overlap [RUO] and scaphopisocapitate [SPC] relationship), and to confirm positional reproducibility and measurement precision of the SPC criterion. MATERIALS AND METHODS: Capitolunate angles were measured on neutral lateral and supine pisotriquetral views of 10 normal wrists. Two hundred neutral lateral wrist views were classified by each standard (RUO and SPC) as excellent, acceptable, or unacceptable. In two subgroups, capitolunate angles were measured on the lateral views to determine SPC practicality and sensitivity. RESULTS: Compared with neutral lateral positioning, supinated off-lateral views showed an apparent increase in lunate dorsiflexion of up to 30 degrees. Diagnostically unacceptable, excellent, and acceptable pronosupination was present on 118, 22, and 60 of 200 views by using the RUO criterion and on 40, 79, and 81 of 200 views by using the SPC criterion, respectively. The capitolunate angle did not show a significant difference between each of the two subgroups (P > .05). CONCLUSION: A true neutral lateral view of the wrist is necessary for accurate measurement of the capitolunate angle on the basis of a comparison with off-lateral views. SPC relationship provides a diagnostically reproducible standard for a neutral lateral wrist view and should reduce the need for repeat lateral radiographs.
Adult↗
Postoperative infection in a double-occupancy operating room. A prospective study of two thousand four hundred and fifty-eight procedures on the extremities.
The purposes of this study were to determine the rate of infection associated with elective outpatient operations on an extremity, performed in a double-occupancy operating room (one operating room designed to accommodate two separate operating teams), and to determine which factors influenced this rate. We evaluated the records of 2458 consecutive patients who had had such a procedure, performed by one of nine surgeons during a two and one-half-year period, and in whom the operative wound had been classified as clean (without a drain) or clean-contaminated (with a drain). The information regarding the factors associated with the operation and the operating-room environment was recorded for each patient at the time of the operation. Each wound was inspected periodically in the attending surgeon's office for at least thirty days postoperatively. Using definitions established by the Centers for Disease Control, the attending surgeon determined the presence of infection primarily by judging whether there was purulent drainage or whether erythema or swelling at the operative site was beyond that expected from the procedure. Of the 2458 patients, thirty-seven (1.5 per cent; 95 per cent confidence interval, 1.1 to 2.1 per cent) had infection of the operative wound. Only eight patients (0.3 per cent) had deep infection, with seven of the infections necessitating a reoperation. Infection developed in thirty of the 2311 clean wounds, a rate of 1.3 per cent (95 per cent confidence interval, 0.9 to 1.8 per cent), and in seven of the 147 clean-contaminated wounds, a rate of 4.8 per cent (95 per cent confidence interval, 2.3 to 9.5 per cent) (p = 0.001). No cross-contamination occurred between patients who had infection. The rate of infection was not related to the number of patients who were operated on in the same room at the same time. Logistic regression analysis, used to account for confounding factors, demonstrated a significant association between the classification of the wound (use of a drain) and a higher rate of infection (p = 0.006) as well as between the instillation of a topical steroid solution and a lower rate of infection (p = 0.04). It also demonstrated a significant difference, with respect to the rate of infection, among individual surgeons (p = 0.02).
Adolescent↗
[Traumatology. Scoring systems and their use].
Centralized trauma care is developing in Denmark, and is producing an increasing interest in the scoring systems used in traumatology. A large number of scoring systems have been developed within the trauma field. After reviewing the literature, we recommend the Revised Trauma Score at strategic intervals during admission, and scoring of the Abbreviated Injury Scale (AIS) according to the 1990 revision at discharge or by autopsy. This will allow calculation of the Injury Severity Scale (ISS) and The Trauma Score--Injury Severity Score (TRISS) making scientific studies in accordance with international standards possible.
Abbreviated Injury Scale↗
[Fractures of the scaphoid].
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Fracture Fixation↗
Scapholunate distance in children.
PURPOSE: To measure the scapholunate distance in normal wrists in a child population. MATERIAL AND METHODS: In 79 children with unilateral wrist trauma boths wrists were radiographed in p.a. and lateral views. RESULTS: The median scapholunate distance ranged from 9 mm in the 7-year-old to 3 mm in the 15-year-old children. Baseline values are presented.
Adolescent↗
[Frequency of self-reported alcohol influence in injured bicycle riders].
The aim of the study was to determine the frequency of self reported alcohol influence in injured bicyclists. The study was based upon a combination of data from a questionnaire and recordings from the emergency room. Eighteen percent of cyclists 15 years of age or older treated at the emergency room reported themselves influenced by alcohol at the time of accident. The highest injury rate in patients riding under influence was found in the age group 20-29 years, and the proportion of injured cyclists riding under influence was four times higher in males than in females. The lesions sustained by alcohol influenced bicyclists were not more severe than those of the not influenced injured bicyclists.
Accidents, Traffic↗
Analysis of carpal instability: I. Description of the scheme.
There is a lack of a generally agreed analysis of carpal instability that can assist in the diagnosis, give guidelines for treatment, and ensure unity when reporting results of treatment. Based on the literature and using six categories describing chronicity, constancy, etiology, location, direction, and pattern of the instability, we present a proposal for a standardized analysis. Using this analysis, an instability should be presented with information in all six categories. The analysis may be expanded and developed according to future needs.
Acute Disease↗
Analysis of carpal instability: II. Clinical applications.
An analytic scheme for carpal instability patterns has been described to help standardize reporting of these conditions. Six categories to be recognized in each case are chronicity, constancy, etiology, location, direction, and pattern. Examples are presented to illustrate the use of this scheme.
Acute Disease↗
Diagnosis of scaphoid fractures. A prospective multicenter study of 1,052 patients with 160 fractures.
In a prospective multicenter study of 1,052 patients with clinical signs of a scaphoid fracture, mammographic films and fine intensifying screens were used at the radiographic examination. 5 standardized projections including 3 special projections focused on the scaphoid were taken. 150 fractures were diagnosed at the first examination but in 10 cases the fracture was first diagnosed at a second radiographic examination after 10-14 days. The second examination still seems mandatory despite the use of high quality radiographs with optimal spatial resolution and contrast, and the value of supplementary special projections.
Adolescent↗
[Scaphoid fractures. Fracture types and localization].
The incidence, localization, and type of scaphoid fractures found in a well-defined population is described. Fractures of the carpal scaphoid (n = 442) of which 19 (5%) were nonunions were identified during an eight-year period. Among inhabitants living in the Odense Municipality (population at risk 170,648 in 1983 to 174,948 in 1989) 222 males and 51 females who sustained scaphoid fractures during a seven-year period were used for computation of incidence. During the survey, there was an average annual incidence of scaphoid fracture of eight per 100,000 females, and 38 per 100,000 males. The average annual incidence per 100,000 inhabitants of carpal scaphoid fractures according to the location was proximal two, middle 15, and distal six. Average annual incidence per 100,000 inhabitants of carpal scaphoid fractures according to type was transverse seven, horizontal oblique nine, vertical oblique one, avulsion/fracture of the tuberosity five, and not stated one.
Adolescent↗
[Structure of emergency units in Denmark 1985-1992].
The aim of the study was to investigate the changes in trauma treatment structure in Denmark during the period 1985-1992. The design was a repeated cross-sectional analysis performed as a questionnaire in 1985, 1989 and 1992 given to the heads of the medical staff of all accident and emergency departments in Denmark. The analysis showed that the number of accident and emergency departments was reduced from 81 in 1985 to 69 in 1992. The median number of annual patient contacts increased from 5911 (150-50,000) to 8757 (150-47,000) over the period. The median number of inhabitants in the uptake-areas of the accident and emergency departments increased from 50,000 (4500-230,000) to 67,000 (4500-230,000). Only at 12 accident and emergency departments (with 1,183,000 inhabitants) was prehospital treatment given by medical doctors to trauma patients. Only one accident and emergency department used trauma scores routinely, and 29 (42%) used the Glasgow Coma Scale as a routine. It is concluded that there has only been a minor centralisation in trauma treatment structure in Denmark over the period 1985-1992, and there are still many accident and emergency departments with relatively few annual patient contacts. Prehospital treatment by medical doctors is still not routine in most areas of Denmark.
Denmark↗
[Epidemiology of acute wrist injuries].
Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria of care and thus deriving estimates of needs for care according to currently desirable standards. In a one-year study all patients 15 years or older with acute wrist trauma and treated at the emergency room were examined according to an algorithm until a diagnosis was established. The overall incidence of wrist trauma was 69 per 10,000 inhabitants per year. Incidence of wrist trauma requiring radiographic examination was 58 per 10,000 per year. The incidence of fractures of the distal radius was 27 per 10,000 per year (males, 16 per 10,000, females, 37 per 10,000 per year). In order to evaluate the completeness (defined as the proportion of patients with wrist injuries seen at the emergency room out of all patients with wrist injuries in the catchment area) of the hospital based data an analysis was performed using data from a population based study. A completeness rate of 0.56 (95% confidence interval 0.31-0.78) was found. A radiographic examination had been performed in all patients reporting a fracture, justifying the use of fractures as an incidence measure when comparing groups of patients with a wrist trauma.
Acute Disease↗
[Bicycle accidents 1980-1992. Do the official traffic accident statistics show the true picture?].
In Denmark, official statistics concerning road traffic accidents are based upon police recordings. In this study, these official data are compared to data from the emergency room at Odense University Hospital from the period 1980 to 1992. The purpose is to examine whether the official statistics show a reliable picture of the development in accident numbers compared to data from the emergency room. The results confirm that it is necessary to use data from the emergency room to describe the true development in numbers of bicycle accidents.
Accidents, Traffic↗
Poisoning with household chemicals in children.
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Accidents, Home↗
[Prehospital treatment at large outdoor music festivals. Economic aspects].
An emergency facility was provided at the Midtfyn Rock Music Festival in 1990 (comprising 7,000 musicians and ancillaries and an overall public attendance of 60,000). A total of 329 patients were treated at the facility during the four and a half days that the festival lasted. The numbers of diseases and injuries were recorded, and the economic aspects are discussed in the article. In 74 per cent of cases, treatment was completed at the emergency facility, and the patients could be discharged. In terms of staff costs and the saving in patient transport costs alone, the economic gain to the community was estimated to be about 25,000 DKR. Thus, the provision of an emergency facility was cost-effective, and is recommended at such mass outdoor gatherings as cultural and sports events.
Cost-Benefit Analysis↗