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Earlier reports of results after proximal humerus fractures have often been short- or medium-term studies. The aim of this investigation was to follow an unselected group of patients prospectively and assess the long-term results in relation to fracture type and health, and to evaluate the possibility of predicting the long-term results after 1 year.258 consecutive urban patients who sustained a proximal humerus fracture in 1987 were followed prospectively and examined after 1 and 13 years. 158 patients had died by the year 2000 and 47 of the surviving patients were available for clinical and radiographic evaluation. The Constant-Murley score (CM-score) was used in the clinical assessment. In the final follow-up group, all patients except 1 were treated nonoperatively.21 patients had asymptomatic, pain-free shoulders. In 26 patients with shoulder symptoms, 11 had severe pain and 10 had moderate pain, and only 2 of these 21 patients had normal shoulder function. The remaining 5 patients in the symptomatic group had no shoulder pain but had reduced shoulder function. Shoulders with a displaced fracture and also injured shoulders of patients with a chronic disease were significantly worse at the long-term follow-up. The 1-year examination had been able to predict the long-term results with 71% sensitivity for protracted pain and 88% sensitivity for persistent shoulder dysfunction.Our results suggest that there is a substantial mortality in patients with a proximal humerus fracture, as we have previously reported, and that surviving patients frequently have persistent symptoms that can be predicted as early as after 1 year.

Background: Several studies have shown a higher mortality rate in patients with osteoporosis-related fractures of the hip and vertebrae. Method: In 1999, we did a long-term follow-up case-control mortality study of 253 patients, mean age 72 years, who had sustained a fracture of the surgical neck of the humerus in 1987. Results: We found a higher mortality in fracture patients giving at end point a cumulative survival difference of 16%. The median survival time was 8.9 years in patients and 12 years in controls (pÊ= 0.005). The mortality rate was higher in men during the first 3 years after fracture and fewer than half of the male patients survived this period. The median survival time was 6.5 years in male patients and 12 years in their male controls (pÊ= 0.02). The mortality was only slightly higher in women (pÊ= 0.06). Interpretation: Cardiovascular disease and malignancy were the commonest causes of death in both groups. We could not explain the higher mortality rate in patients with a fracture of the surgical neck of the humerus.

We evaluated the incidence and clinical significance of postfracture shortening of the clavicle in 85 patients. There were 71 mid-clavicular fractures and 14 of the lateral end of the clavicle. 46 fractures were primarily undisplaced and 39 displaced. All fractures were nonoperatively treated with sling immobilization. All patients were reexamined 5 years after the fracture. 35 clavicles had healed with at least 5 mm shortening. Clavicles with originally displaced fractures were shorter and radiologically more frequently malunited. Mobility, strength and the functional Constant score were similar in the injured and normal shoulders. Our findings suggest that permanent shortening of the clavicle is common after fracture, but has no clinical significance.

We recorded prospectively all adult patients with a fracture of the proximal end of the humerus, clavicle and scapula or a primary shoulder or acromioclavicular dislocation in the city of Malmö in 1987. Altogether there were 413 injures. The hospital records from the Department of Alcohol Diseases were searched for these patients and for 2 age- and gender-matched controls for each patient. 12% of all patients with a shoulder injury were recorded as alcohol abusers. This number was significantly greater than that of the controls. The difference was more obvious in men than in women. In men between 30 and 64 years, almost half of the proximal humerus fractures and shoulder dislocations, one third of mid-clavicular fractures and two thirds of all lateral clavicle fractures were sustained by alcohol abusers. Our findings emphasize the significance of alcohol abuse in the etiology of shoulder injuries, especially in men. Most of the men with a fracture of the lateral clavicle are registered at the Department of Alcohol Diseases, making this injury a marker of alcohol abuse.

We present an experimental and theoretical study of the carrier capture time into a semiconductor quantum well. The carrier capture time was obtained by measuring both the rise of the quantum well (QW) population using time-resolved luminescence measurements and the decay of the barrier population using pump-probe correlation experiments. In the first technique, we compare the QW rise-times after direct (below the barrier band gap) and indirect (above the barrier band gap) excitation in order to eliminate the effects of relaxation and exciton formation in the quantum well. We report the first experimental observation of oscillations in the carrier capture time between 3 and 20 ps as a function of quantum well thickness, obtained from both techniques. The observed capture times are, for the first time, in agreement with theoretical predictions from an ambipolar capture model.

In five patients under the age of 15 with hemophilia and inhibitors, due to frequent joint bleedings, 13 joints were treated with synoviorthesis (intra-articular injection of radioactive gold). The patients received high doses of factor VIII/IX for 2-4 days or were treated simultaneously with tolerance induction according to the Malmö protocol. Of the 13 joints treated, a bleeding-free interval of more than 6 months was obtained in nine of which six remained free from bleedings for more than a year. Ease of performance, the limited requirements of pre- and postoperative care, and a definite decrease in the joint bleeding frequency render synoviorthesis well suited for use in hemophiliacs with inhibitors who are otherwise difficult to treat.

(1990). In vivo bone-mineral measurement: How and why—a review. Acta Orthopaedica Scandinavica: Vol. 61, No. 3, pp. 275-281.