Isolated capitate fracture diagnosed by computed tomography. Case report.

Isolated fractures of the capitate, though rare, are probably often missed entirely. As in scaphoid fractures, repeated radiographs, tomography, or bone scanning are necessary for the diagnosis. Reviewing the literature, we found that most capitate fractures reported were transverse or combined with other carpal injuries, including the scapho-capitate fracture syndrome. Our patient presented an isolated oblique intraarticular fracture of the capitate. An old fracture of the styloid process of the ulna was seen at the primary examination. This special type of capitate fracture has not been previously described. The fracture was missed on standard radiographs, but discovered by computed tomography (CT). The different types of fractures of the capitate and their treatment are discussed.

[Preoperative dacryocystography in patients with epiphora]. / Praeoperativ dakryocystografi hos patienter med tåreflåd.

In this retrospective study 56 dacryocystographies (DCG) were performed preoperatively in 50 patients with epiphora, due to obstruction in the lacrimal drainage system. We found DCG to be an easy and sufficient examination of patients with uncomplicated epiphora without suspicion of tumour. Tumours in the lacrimal drainage system are rare, and CT-scan or MR-imaging as a routine examination is not indicated. DCG provides a fair prediction regarding success rate of the dacryocystorhinostomy operation (DCR). We found the DCR to be successful in 91.7% when the obstruction was located distally, but only in 45.5% when the obstruction was in the canaliculi. Further investigations are necessary to clarify whether higher success rates after surgery can be obtained in patients with canalicular obstruction by using the DCG-findings more specifically when planning operation type.

[Magnetic resonance imaging of the knee joint after trauma with intra-articular accentuation]. / Magnetisk resonansundersøgelse af knaeleddet efter traume med intraartikulaer ansamling.

Two male adolescents with direct trauma to the knee and haemarthrosis were followed up with MR imaging (MAI). No fractures were detected on plain films and both patients had extensive bone marrow lesions in MRI. The lesions were located within the metaphysis and the lateral tibial and femoral condyle respectively. In one patient MRI demonstrated additional soft tissue lesions of the femoral muscles. One patient had almost no clinical symptoms, while the other patient suffered from severe pain, inability to walk, and delayed recovery. The present report emphasizes the potential of MRI for the detection of occult injuries of bone and soft tissue, and calls for prospective studies of their clinical significance.

[Normal hysterosalpingography in tubal pregnancies]. / Normale Hysterosalpingographie bei Eileiterschwangerschaften.

We report on the case of a patient who had a laparotomy for an 8-week-old tubal ectopic pregnancy 11 days after a normal HSG. A recent normal HSG cannot exclude an extrauterine, tubal pregnancy in fertile patients.

[Withdrawal of high estrogen containing oral contraceptives and the demand for medical service]. / Hljlstrogene p-pillers tilbagetraekning og eftersplrgsel på laegelig service

PIP: The results of a survey are presented conerning the effectiveness of mass media publicity with the public. After oral contraceptives containing high levels of estrogen were prohibited in Denmark, a telephone survey of 23 doctors was taken to determine the fluctuation in demand for medical information from patients, and the reason for the fluctuation. The reasons were divided into 3 groups: 1) resulting from mass media publicity, 2) resulting from the unavailability of a particular contraceptive, and 3) other. 3 surveys were conducted of the frequency of demand for information on the high estrogen contraceptives, 1 for each of the 2 weeks after the prohibition and withdrawal of the contraceptives took place, and 1 1 month after the prohibition. 2-3% of the inquiries received by the doctors concerned the prohibited contraceptives, and half of these could be attributed directly to the mass media publicity. The number of requests in categories 1 and 2 dropped sharply in the 2nd and 3rd surveys, indicating that the effect of the mass meida publicity and the withdrawal of the contraceptive from the market had only a very immediate effect. It is also shown that the telephone can be used successfully to ascertain the effects of a short-term social phenomenon on the public.^ieng