[The treatment of mandibular fractures, complicated by inflammations in the fracture area, by means of xenogenic cartilage]. / Uber die Behandlung von Unterkieferbrüchen mit entzündlichen Komplikationen im Frakturbereich mittels xenogenem Knorpelgewebe.

The authors used a personal technique for the management of infected jaw fractures. If the fracture cleft was not wider than 1 cm, they performed a surgical revision (having made an incision through the mucoperiosteum of the oral vestibule) and replaced the excochleated gra-ulation tissue (including sequestrums) by lyophilized cartilage. The bone fragments were immoblized by bone sutures previously applied and also by additional plastic splints. The substitution of the cartilage by bone begun 6-8 weeks after the surgical intervention (as evidenced by radiographs); the process had terminated in about 6-10 months, the implanted cartilage being completely replaced by newly formed bone. The observation involved 16 cases. The method is also recommended for treatment on an out-patient basis.

How well do patients obtain short-term follow-up after discharge from the emergency department?

STUDY OBJECTIVE: We sought to determine the follow-up rate of discharged emergency department patients who were instructed to obtain reevaluation within 48 hours at our ED, a clinic, or a private physician's office and to determine the reasons why patients do not obtain short-term follow-up when instructed. METHODS: Emergency physicians prospectively enrolled a convenience sample of patients discharged from a university hospital ED who were believed to be at risk for clinical deterioration. Patients were instructed to obtain reevaluation within 48 hours at a public clinic, private physician's office, or our ED (without charge). A telephone interview was conducted after 48 hours had elapsed. RESULTS: Three hundred twenty-five patients were enrolled, 300 were included in data analysis, and 203 (67.7%) of these obtained follow-up as instructed. Those referred to the ED had a higher follow-up rate (105/127 [82.7%]) than those referred to clinics (59/99 [59.6%]) or private physicians (39/74 [52.7%]). Inability to obtain an appointment was cited by 34.3% of those who did not obtain follow-up care as instructed. CONCLUSION: Many patients discharged from the ED who were believed to be at risk for clinical deterioration did not obtain medical follow-up within 48 hours when so instructed. Free ED follow-up resulted in a better rate of short-term follow-up than that for clinics and private physicians and may be especially useful if a patient's ability to obtain follow-up is uncertain or if timely reevaluation is particularly imperative.