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Biomedical subjects

C F Larsen

Publications and source records attributed to C F Larsen.

At least 37 records · Page 2Linked to original sources

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↗

[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↗

An algorithm for acute wrist trauma. A systematic approach to diagnosis.

A systematic approach to the acute traumatized wrist is of importance to achieve early diagnosis, with efficient use of advanced imaging modalities. In a 6-month period 641 patients aged 15 years or over were examined using an algorithm for acute wrist trauma in order to secure early and appropriate treatment. In 293 (46%) cases routine radiographic examination supplied sufficient information to establish a fracture diagnosis. All 33 scaphoid fractures (including five scaphoid non-unions) were demonstrated on the initial X-ray examination. In 56 patients (9%) scintigraphy proved useful for selecting cases in need of further radiographic examination. Among 31 patients with focal activity on bone scintigraphy, CT and/or tomography revealed eight distal radial fractures, one fracture of the ulnar styloid, and eight fractures of carpal bones. Fractures were revealed using tomography and/or "hot spot views" in patients with negative CT examinations suggesting that further examinations should be performed in cases with increased focal activity on bone scintigraphy and a negative CT examination.

Acute Disease↗

Epidemiology of acute wrist trauma.

Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated in 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 x-ray examination was 58 per 10,000 per year. The incidence of distal radius fractures 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 in the emergency room to 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. An x-ray had been taken for all patients reporting a fracture thus justifying the use of fractures as an incidence measure when comparing groups of patients with wrist trauma.

Acute Disease↗

[Prehospital service in Denmark].

In Denmark, emergency ambulances are dispatched by 41 centres manned either by trained firemen (in Copenhagen) or policemen (outside Copenhagen). In 1990, emergency ambulance calls totalled 284,000. Utilisation of emergency ambulance services increases with urbanisation. A doctor-manned ambulance is in operation in Copenhagen, and in some other large towns anaesthesiology and intensive care teams can be dispatched from hospital to give on-the-spot care. In less populated areas, some general practitioners give advanced life-support. Although many areas are serviced by ambulances equipped with defibrillators, the majority of patients receive only basic life-support from ambulance personnel. New initiatives resulting from a recent report by a commission appointed by central authorities, and focused on prehospital treatment, are expected to improve the service by raising the level of training given to ambulance personnel.

Aged↗

[Ambulance services in Copenhagen, Odense and Ringkøbing County. Results of the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 1. Epidemiological data].

In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of Ringkøbing (a mixed rural and urban region). The investigation included data collected by the ambulance staff before hospitalization and the diagnoses on discharge from casualty and hospital departments. The frequency of AU per 1,000 population was found to be 101 annually in Copenhagen, 44 in Odense and 19 in the County of Ringkøbing. More than 10% of the services in all three regions did not result in transport of the patient to hospital treatment. The average age of the patients was 52 years in Copenhagen compared with 44 years in the other two regions. The age-specific frequency of AU for patients aged 0-4 year-old was nine times as great in Copenhagen than in Odense and the County of Ringkøbing and, where patients aged more than 80 years were concerned, the frequency was 4-10 times as great. In all three regions, the activities of ambulance services were most numerous between 6-16 hours and lowest during the period 0-6 hours. Services to patients' homes constituted 44-46% and to traffic regions 32-40%. Services on account of illness constituted 41-45% and, on account of accidents, 27-35%. In cases of rapid emergency transport (using signals), 78% of the ambulances had reached the patient within five minutes in Copenhagen as compared with 44% in Odense and the County of Ringkøbing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Ambulance services in Copenhagen, Odense and Ringkøbing County. Results from the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 2. Treatment by ambulance staff, medical support and pattern of diagnoses].

In this investigation, the results from a spot test investigation comprising 3182 emergency ambulance services (AU) from three geographical regions with different degrees of urbanization are presented: The Danish capital (Municipality of Copenhagen), a large provincial town (Odense) and a rural district with smaller towns (the County of Ringkøbing). The conditions of the patients were assessed by the ambulance staff: 7-12% of the patients transported had visible haemorrhage, 5-8% were unconscious, 4-7% were cyanotic, 2-3% had seizures and 1-2% had pareses. The serious cases tended to be most frequent in the least urbanized regions. Registration of the therapeutic efforts by the ambulance staff prior to and during transport revealed that 15-33% of the patients did not receive any treatment. The commonest forms of treatment consisted of oxygen treatment (13-18%), treatment for shock (8-12%), Nato position (4-16%) and stopping of haemorrhage (7-12%). No differences were observed between the three geographic regions except that fewer patients in the capital received treatment. In cases of emergency ambulance services employing signals, medical support was available in 22% of the cases in Copenhagen, mainly by means of medically staffed ambulances. In the County of Ringkøbing, doctors, usually the doctor-on-call, participated in 27% of these services while medical support was only available in 2% of the cases in Odense. Registration of the diagnoses by the hospitals which received the patients revealed that the commonest group of diagnoses were injuries (36-44%) and cardiovascular disease (14-21%).(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗

Fracture of the carpal scaphoid: frequency and distribution in a well-defined population.

The incidence, location, and type of scaphoid fractures found in a well-defined population is described. Fractures of the carpal scaphoid (n = 442) were identified during an eight-year period, of which 19 (5%) were nonunions. At the initial radiographic examination the fractures were visible on PA views in 70% of the cases (true lateral 10%, scaphoid view neutral 77%, scaphoid view ulnar deviated 73%, and scaphoid view with the X-ray tube tilted 30 degrees distally 71%). Among inhabitants living in the Odense Municipality (population at risk 170648 in 1983 to 174948 in 1989) 222 males and 51 females (age range 9-87 year) sustaining scaphoid fractures during a seven-year were period used for computation of incidences. During the survey, there was an average annual incidence of scaphoid fracture of 8 per 100000 females, and 38 per 100000 males. All patients (except a 9-year-old male) were aged 10 years or over. In the age-group 10-14 years there was an average annual incidence of 3 per 100000 females, and 39 per 100000 males. Average annual incidence per 100000 inhabitants of carpal scaphoid fractures according to the location was proximal 6, middle 15, and distal (fractures of the tuberosity included) 2. Average annual incidence per 100000 inhabitants of carpal scaphoid fractures according to type was transverse 7, horizontal oblique 9, vertical oblique 1, avulsion/fracture of the tuberosity 5, and not stated 1.

Adolescent↗

Epidemiology of scaphoid fractures in Odense, Denmark.

During a 7-year period, 273 scaphoid fractures were diagnosed in the approximately 175,000 residents of the municipality of Odense. The average annual incidence of scaphoid fracture was 8 per 100,000 women and 38 per 100,000 men, predominantly in young persons. The cause of injury was a fall in 69 percent and a blow in 28 percent.

Adolescent↗

Lack of correlation between ulnar variance and carpal bone angles on lateral radiographs in normal wrists.

It has been proposed that negative ulnar variance is a predisposing factor to development of posttraumatic carpal ligamentous instability. However, this implies that no correlation exists between ulnar variance and carpal bone angles in the normal wrist. Carpal bone angles on lateral wrist radiographs and ulnar variance were measured in a series of 75 normal wrists. The mean ulnar variance was -0.03 mm (SD 1.56, range -5 to 5). The correlation coefficients were 0.06, -0.11, and -0.05 between the ulnar variance, and radiolunate, radioscaphoid, and scapholunate angles, respectively. A correlation between the carpal angles on lateral wrist radiographs, and ulnar variance in normal wrists could not be demonstrated, suggesting that the presence of negative ulnar variance may serve as an impartial clue to the presence of ligamentous instability.

Adult↗

Measurements of carpal bone angles on lateral wrist radiographs.

Measurements of carpal bone angles on lateral wrist radiographs can be of assistance in the diagnostic evaluation of wrist malalignment. A series of 75 normal wrists was examined by use of a standardized radiographic technique. The normal carpal bone angles were determined using the bone axes with the least observer variability (mean and range): radiolunate, -1.02 (-10 to 12), radioscaphoid, 51.80 (35 to 65), and scapholunate, 50.77 (36 to 66). Normal mean values and ranges for intercarpal bone angles may be of assistance in the diagnostic evaluation of ligamentous injury to the wrist.

Adult↗

Observer variability in measurements of carpal bone angles on lateral wrist radiographs.

Determinations of carpal bone angles are used in the clinical evaluation of carpal malalignment. Eleven frequently referred radiological measures in lateral projection of the wrists in 23 wrists were assessed using different definitions of axes. Interobserver- and intraobserver variations were calculated. The standard deviation of the interobserver variation ranged from 2.60 degrees to 18.15 degrees, and the intraobserver variation from 1.89 degrees to 4.66 degrees depending on the angles measured. The use of three angles for the least observer variability in assessment of carpal alignment is recommended. These angles were defined from the following carpal bone axes: radius, the line through the center of the medullary canal at 2 cm and 5 cm proximal to the radiocarpal joint; lunate, the line perpendicular to the tangent of the two distal poles; scaphoid, the tangent of the palmar proximal and distal margins, and capitate, the tangent of the dorsal margin of the diaphysis of the third metacarpal bone (substitute axis).

Adult↗