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PubMed1983

[Ender nailing of subcapital fractures of the femur neck (Garden I)].

In the period between 1968 and 1982 we observed 441 subcapital fractures of the femoral neck, 55 times a tight impaction in valgus position. Including the year 1976 a conservative treatment was employed (group I); from 1977 onwards operations with the Ender-nailing technique were performed (group II). The patients' average age was 81 to 84 years. In 7 out of 32 cases the conservative functional treatment led to disimpacted fractures between the 5th and 54th day after the accident. Neither a slightly gaping fracture line nor an up to ten-degree antecurvatoral position are a radiologic-morphological criterion for a prognostic assessment. For that reason we performed the Ender-nailing operation in 23 cases from 1977 on. Under immediate postoperative and complete load it was only once we obtained a partial dislocation of fracture which had a compact osseous healing up in varus deformity. A cranial displacement of the nails caused by the operation was observed three times. All patients regained their ability to walk. Until the end of the first year of the accident there was no case of death, nor could we perceive any total necrosis of the femoral head. One pseudarthrosis was found after conservative treatment. The average clinical treatment was 42 respectively 21 days. We transferred 19 out of 32 respectively 7 out of 23 patients to a convalescent hospital. The impacted subcapital fracture of the femoral neck should nowadays be treated operatively. The Ender-nailing technique represents a simple, gentle, and a low-risk procedure for surgical stabilization.

Aged↗
PubMed1980

[Patterns of complaint in a reconvalescent home for mothers and in a psychosomatic hospital (author's transl)].

The frequency of psychosomatic disorders and psychosocial burden in women referred to a spa/reconvalescent home for mothers gave rise to a comparison of their patterns of complaint with those of female patients in a psychosomatic hospital. Those complaints that were described in the complaints scales as markedly impairing their health were found to be largely identical in both groups. Assignment of the women to the one or the other type of institution (by means of a discriminant analysis) was determined less by their complaints scores than by socio-economic variables (age, marital status, number of children, occupational activities), which is explained by differences in group composition.

Adult↗
PubMedDate not supplied

A diagnostic cluster system for skilled nursing facilities.

BACKGROUND AND OBJECTIVES: Diagnostic cluster systems have been developed to assist in analyzing diagnoses in outpatient and inpatient settings but not in convalescent hospital settings. We developed a diagnostic cluster system for skilled nursing facilities (SNFs) designed to include or capture a greater proportion of such diagnoses than a previously established inpatient diagnostic cluster system. METHODS: We tested the ability of the new SNF diagnostic cluster system to code diagnoses on records from SNFs in different geographic areas. Then we compared the proportion of admitting diagnoses captured by the new SNF diagnostic cluster system and by a previously established inpatient system. RESULTS: The new diagnostic cluster system captured between 92% and 96% of admitting diagnoses at the study SNFs. There was no statistically significant difference among the facilities in the proportion of diagnoses captured by the new system. By comparison, the previously established inpatient system captured only 59%-65% of these admitting diagnoses. The new system captured significantly more diagnoses than the previously established inpatient system. CONCLUSIONS: The new SNF diagnostic cluster system can be used to capture and code diagnostic data from SNFs.

Cluster Analysis↗