RESUMO
This review comprises all 641 patients subjected to inpatient treatment in 1976, 1980 and 1984 at the Basel district hospital after accidents involving bicycles or motorcycles. A study of the case histories--supplemented by phone conversations--yielded the following results: Accidents involving bicycles or motor-driven bicycles were seen in all age groups, but motorcycle accidents occurred exclusively among the younger generation. Whereas motorcycle accidents mostly happened during joyrides, accidents with bicycles or mobikes mainly occurred on the way to work. The incidence rate was highest during summertime and in the rush hours at noon or in the evening. Motorcycle accidents resulted in more severe injuries, longer hospitalisation, longer periods of disability and higher costs than bicycle or mobike accidents the latter being mainly characterised by mostly slight head injuries and the former by injuries of the legs and arms.
Assuntos
Ciclismo/lesões , Motocicletas/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Controle de Custos , Estudos Transversais , Avaliação da Deficiência , Feminino , Hospitalização/economia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Suíça/epidemiologia , Ferimentos e Lesões/economia , Ferimentos e Lesões/prevenção & controleRESUMO
Sphincter-saving operations are now generally accepted for the treatment of mid-rectal cancers. Different techniques have been described: low colorectal anastomosis with staplers, pull-through procedures and coloanal anastomosis. The functional results following these procedures are impaired by loss of the reservoir function of the rectum. To avoid frequency and urgency a J-shaped colonic reservoir is constructed and anastomosed to the anal canal. We are presenting our first four cases using this technique. All patients are personally reviewed 19-29 months after the operation. In correspondence with the literature all our patients had a good functional result with good continence and only one bowel movement per day. We conclude the creation of a neorectum makes the functional result of a coloanal anastomosis more predicable.
Assuntos
Canal Anal/cirurgia , Anastomose Cirúrgica/métodos , Colo/cirurgia , Incontinência Fecal/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Retais/cirurgia , Seguimentos , Humanos , Técnicas de SuturaRESUMO
Two hundred consecutive patients admitted with 214 open fractures were reevaluated 6--10 years following injury. All patients were seen in follow-up by the authors. The average hospital stay was 36 days. Many of the patients sustained multiple injuries in automobile accidents. Concomitant head, chest or abdominal trauma occurred in 41% of the patients; 38% sustained multiple fractures. The average patient achieved full weight-bearing at 28 weeks. Late complications were infrequent. All postoperative bone infections (7%) were eradicated with appropriate treatment an average of 27 months postinjury; all of the infected fractures united, and no major limitations of motion resulted. Roentgenograms taken an average of 8 years postinjury revealed only 9 patients with major joint incongruities or arthritic changes. All of the fractures were united except for one with an asymptomatic fibrous union of the patella. Anatomic restitution was possible in most patients. Only one patient had an axial malalignment which necessitated correction by osteotomy and 6 patients had shortening of 1 cm or less. The functional results were excellent with only minor limitations of motion having been found in 25 patients. Disability payments were made to 39 patients and all patients (except for the one who retired due to age) had returned to their prior jobs.