Cycling injuries and alcohol.

BACKGROUND: Most of the cycling accidents that occur in Finland do not end up in the official traffic accident statistics. Thus, there is minimal information on these accidents and their consequences, particularly in cases in which alcohol was involved. The focus of the present study is on cycling accidents and injuries involving alcohol in particular. METHODS: Data on patients visiting the emergency department at North Kymi Hospital because of a cycling accident was prospectively collected for two years, from June 1, 2004 to May 31, 2006. Blood alcohol concentration (BAC) was measured on admission with a breath analyser. The severity of the cycling injuries was classified according to the Abbreviated Injury Scale (AIS). RESULTS: A total of 217 cycling accidents occurred. One third of the injured cyclists were involved with alcohol at the time of visiting the hospital. Of these, 85% were males. A blood alcohol concentration of ≥ 1.2 g/L was measured in nearly 90% of all alcohol-related cases. A positive BAC result was more common among males than females (p < 0.001), and head injuries were more common among cyclists where alcohol was involved (AI) (60%) than among sober cyclists (29%) (p < 0.001). Two thirds (64%) of the cyclists with AI were not wearing a bicycle helmet. The figure for serious injuries (MAIS ≥ 3) was similar in both groups. Intoxication with an alcohol level of more than 1.5 g/L and the age of 15 to 24 years were found to be risk factors for head injuries. The mean cost of treatment was higher among sober cyclists than among cyclists with AI (€2143 vs. €1629), whereas in respect of the cost of work absence, the situation was the opposite (€1348 vs. €1770, respectively). CONCLUSIONS: Cyclists involved with alcohol were, in most cases, heavily intoxicated and were not wearing a bicycle helmet. Head injuries were more common among these cyclists than among sober cyclists. As cycling continues to increase, it is important to monitor cycling accidents, improve the accident statistics and heighten awareness of the risks of head injuries when cycling under the influence of alcohol.

Long-term survival after falls among the elderly in institutional care.

Falls of the elderly are a major problem in institutional care. However, more comprehensive studies concerning the long-time survival of fallen institutionalised elderly are lacking. We investigated the 5-year survival of institutionalised elderly fallers and controls. Data of the patients aged over 60 years, who fell during the 1-year period (n=218) in four institutions were collected prospectively. The controls consisted of patients of the same age who did not fall within the same period (n=632). The survival of both groups was analysed by gender in the total data, and in the short-term (ST) and long-term (LT) patients separately. In addition, the survival of fallers was investigated according to the number of falls per patient. After follow-up, 164 (75%) fallers and 369 (58%) controls were dead. The female controls survived best and the survival of the male fallers was the poorest. The death rate was higher than expected among female fallers and lower than expected among female controls. The survival of the patients who fell twice during the 1-year period was clearly poorer than of those who fell once or three or more times. No difference in the survival rates was found between the injured and non-injured fallers. Falls in institutional care predict poor survival. The first and especially the second fall should be prevented.

Ruptured tibio-fibular syndesmosis: comparison study of metallic to bioabsorbable fixation.

The patients of this study come from a series of 43 consecutive ankle fracture patients with syndesmotic rupture operated on at our department. Of these patients, 18 were treated with bioabsorbable self-reinforced poly-L-lactide screw and 12 treated with metallic screw. All agreed to participate in this study. They were examined after a minimum follow-up period of 12 months. The patients were examined for measurements from ankle radiographic and computed tomography films, loaded dorsal range of movement of the ankle, and duration of sick leave. Subjective results were obtained by a constructed questionnaire. There were no significant differences between the patient groups in any of the parameters measured. We conclude that the fixation of a syndesmotic rupture can be done with a bioabsorbable self-reinforced poly-L-lactide screw.