Etiquette for doctors on social media. / Lege artis i sosiale medier.

Are tolerance, understanding and humility in short supply in social media? The internet is helping to shape who we are, but as doctors we should also help to shape the online communities that we are a part of.

Doctors' treatment of family and friends. / Legers behandling av familie og venner.

All doctors inevitably receive requests both big and small from family, friends and acquaintances in relation to medical advice and treatment. This article discusses the ethical, legal and medical aspects of such involvement, and suggests what issues to consider before accepting the role of treating physician.

Failed internal fixation of femoral neck fractures.

BACKGROUND: There are two types of surgical treatment for fractures of the femoral neck; internal fixation and arthroplasty. Internal fixation is associated with a higher risk of complications such as secondary displacement, non-union and avascular necrosis. To improve treatment results of internal fixation, we have tried to identify procedure related risk-factors associated with fixation failure. MATERIAL AND METHOD: A retrospective study was conducted based on the medical records and X-ray images of 337 patients sustaining intracapsular fractures of the hip during the period 1999-2000. The patients were treated with closed reduction and internal fixation at Oslo University Hospital, Aker. The reduction of the fracture and the placement of the fixation implants were evaluated and scored (six points representing best achievable result). RESULTS: Fixation failed in 23 (18,3 %) out of 126 patients with displaced fractures awarded six points for the reduction. In contrast, fixation failed in five (50 %) out of ten patients given a score of three points or less (p = 0.017). The risk of non-union increased when patients were treated more than 48 hours after the initial injury. In this group, 5 (25 %) out of 20 patients developed non-union compared to 16 (8 %) out of 200 patients treated within 48 hours (p = 0.014). INTERPRETATION: Our findings emphasize the importance of achieving anatomical reduction of displaced femoral neck fractures, and to perform surgery within 48 hours unless an acute medical condition needs to be stabilized.