RESUMEN
BACKGROUND/PURPOSE: There is a lack of knowledge on respiratory and physical function, mobility and pain following stabilising surgery for 'flail chest'. The purpose of this study was, therefore, to evaluate pain, respiratory function, range of motion and physical function/activity 3 and 6 months after stabilising surgery in patients with 'flail chest' due to trauma. METHOD: Twenty-four patients diagnosed with 'flail chest' were, 3 and 6 months after the trauma, measured with regard to remaining pain, lung volume, breathing movements, and range of motion in the rib cage and thoracic spine. Physical function and level of physical activity were also estimated. RESULTS: Approximately 50 % of the patients had remaining pain after 3 months and 35 % had remaining pain after 6 months. Vital capacity was significantly decreased after 3 and 6 months compared to predicted values: >83 % after 3 months and >86 % after 6 months. There were no significant differences between the injured versus non-injured side in breathing movements, nor between the values of the range of motion between the two test occasions. The results of physical function showed mild to moderate disability 3 months after surgery and some or mild disability at 6 months. The patients were active, performing moderate exercise 1-2 h/week or light physical activities more than 4 h/week at 3 and 6 months. CONCLUSIONS: Patients who had undergone stabilising surgery due to 'flail chest' showed decreased range of motion 3 and 6 months after surgery. Despite decreased range of motion and remaining pain, the breathing movements are synchronic.
RESUMEN
STUDY DESIGN: Retrospective study. OBJECTIVE: To examine the functional results and effect on quality of life of continent cutaneous urinary diversion in spinal cord injured patients. SETTING: Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. SUBJECTS: A total of 10 patients with spinal cord injury (SCI). METHOD: The patients were operated on with an ileal reservoir (Kock reservoir or T-pouch), Cr-EDTA clearance was determined preoperatively and at follow-up. The patients answered a questionnaire concerning reservoir function, various activities and quality of life. The patient charts were reviewed. RESULTS: One patient died of pulmonary embolism 3 years after surgery. Two patients were reoperated on for reservoir perforation. All patients were satisfied/very satisfied with their reservoirs. Half of them reported improved ability to perform various activities. Eight out of nine patients reported improved quality of life. CONCLUSION: For a selected group of patients with SCI, continent cutaneous urinary diversion provides successful outcome with improved quality of life.