Search

Pia Kjær Kristensen,1,2 Niels Dieter Röck,3 Helle Collatz Christensen,4 Alma Becic Pedersen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark; 3Department of Orthopaedic Surgery, Odense University Hospital, Odense, Denmark; 4Danish Clinical Quality Program (RKKP) National Clinical Registries, Frederiksberg Hospital, Frederiksberg, DenmarkCorrespondence: Pia Kjær KristensenDepartment of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus DK-8200, DenmarkTel +45 87168063Fax +45 87167215Email pkkr@clin.au.dkAim of the Registry: The aim of the Danish Multidisciplinary Hip Fracture Registry (DMHFR) is to collect data on processes of treatment, nursing care and rehabilitation as well as outcomes for patients with hip fracture in Denmark, and thereby monitor and improve the quality.Study Population: Hip fracture patients at age 65 or older that have undergone surgery with arthroplasty or internal fixation since 2004.Main Variables: DMHFR collects quality indicators and descriptive variables. Quality indicators include eight process performance measures within treatment, nursing care and rehabilitation, reflecting recommendations from the national clinical guideline for hip fracture patients, and three outcome measures including survival within 30-days, unplanned acute readmission within 30 days and reoperation within 2 years. Descriptive variables include a number of patient- and surgery-related characteristics. All data are collected prospectively.Results: By the end of 2018, the DMHFR included 86,438 hip fracture patients. Since 2006, all hospital departments in Denmark, treating patients with hip fracture, have reported improvement in quality of care and improvement in survival, and reoperation over time as well as high completeness of variables registration.Conclusion: The DMHFR is a well-established nationwide clinical registry, which plays a key role for monitoring and improving hip fracture care in Denmark. The registry can further be linked to a range of other nationwide registries in order to answer a number of relevant clinical research questions.Keywords: hip fracture, quality indicators, registry, mortality, reoperation, readmission

In a randomized prospective study we compared 2 femoral plugs as regards probable migration of the restrictor, cement leakage and possible early aseptic loosening. In group I, the femoral canal was plugged with a resorbable Shuttle Stop (HC Implants, BV. Leiden, The Netherlands). In group II, a nonresorbable restrictor of polyethylene was used (De Puy, UK). Both groups were identical as regards age, gender and primary disease. All patients were followed for at least 2 years after surgery. Postoperatively, we found more failures with displacement of the femoral plug and cement leakage in group I than in group II. At the 2-year follow-up, we found no differences in stem loosening or grade of radiolucent lines in the cement-bone interface. We can not recommend the Shuttle Stop for femoral canal sealing in total hip replacememt.

We investigated the number and seriousness of moon-car accidents in our region (a moon-car is a toy-vehicle, see Fig. 1). The study was retrospective combined with a telephone-interview. Forty-seven patients were seen in the emergency room after a moon-car accident in the period 1/1 1990-31/12 95. There were 12 fractures, including five fractures of the tibial shaft and one supracondylar humeral fracture which was operated. There were 17 wounds, 14 of which were sutured. Seventeen patients had distorsions/contusions, three cases of head contusions (observed for concussion) and two with teeth damages. We found that the number of moon-car accidents is increasing (13 patients the last year), and that the accidents are not only minor. New rules in day care centres should be able to especially limit the number of more serious accidents.

The aim of this study was to investigate the number and types of accidents which occur in connection with roller-skates, and also to find out in which anatomical area the most injuries occurred. During the period 01.02.1995 to 31.08.1996, 389 patients sustained injuries in connection with roller-skates. Fifty-nine percent of all accidents happened on a public road. Out of 389 injuries, 174 sustained a fracture: 68% were forearm or distal radius/ulna fractures; 89% were upper extremity fractures. Thirty-three patients were admitted: four for observation due to concussion; 15 for reduction of fractures and application of plaster; and ten for osteosynthesis. Roller-skating accidents are extremely common. Possible prophylaxis includes protective equipment and restricted rinks for roller-skate enthusiast.

Previous studies from outdoor music festivals have recommended medical service facilities at first-aid stations. The Cutty Sark Tallships Race was a large outdoor event that took place over four days in Esbjerg harbour with about 500,000 participants and spectators. A total of 68 patients were treated, 28 in the first-aid station at the harbour and 40 at the nearby located hospital. The disease and injuries presented were not severe. The orthopaedic casualties dominated (82%), wounds, contusions and fractures being the most common ones. Only seven casualties were related to alcohol abuse. No casualties were related to drug abuse. The economic expense was estimated to DKK 14,676. Thus, at outdoor mass gatherings of a nature like the Cutty Sark Tallships Race, located near a hospital, first-aid stations are not necessary.

Gases may be formed in containers for inflammable fluids and these may burn explosively if lit. Even apparently empty containers may contain sufficient quantities of gas to result in violent explosions precipitated by procedures which produce heat or sparks in the neighbourhood of the container. Seventeen persons were found to be injured in accidents of this type in a Danish investigation. Two of the accidental injuries proved fatal. The serious risk involved in handling and treating containers which contain or have contained inflammable fluids is, therefore, emphasized.