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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 255 - 256
1 Mar 2004
Venesmaa P Arokoski J Airaksinen O Eskelinen J Suomalainen O Kröger H
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Aim of the study: We compared Aircast versus standard plastic cast immobilisation methods after ankle fractures surgery. Materials and methods: 32 patients who had had a low energy uni- or bimalleolar fracture were included into this prospective study in Kuopio University Hospital. They were randomised to use either standard cast or Aircast for 6 weeks after surgery. 18 patients (10 women and 8 men) average age 41 (20 – 63) years used Aircast and 14 patients (8 women and 6 men) average age 48 (19–69) years used standard cast. All fractures were treated operatively using standard A-O techniques. Patients were followed for 6 months; clinical and radiographic evaluation was carried out at nine and 26 weeks after surgery by senior doctors. The function of ankle joint after injury was evaluated as proposed by Kaikkonen et al. (Am J Sports Med 4:462–69, 1994). Results: All fractures healed without complications. There were no statistical difference between the study groups when evaluating the ability to walk or run, climbing down stairs, rising on heels or on toes with injured leg, single limb stance with injured leg, laxity of the ankle joint or range of foot dorsifl exion during the follow-up. The subjective assessment of the injured ankle was significantly better in the Aircast group nine weeks after the injury. In the Aircast group 13 patients had mild and 5 moderate symptoms but in the standard cast group 4 patients had mild, 9 moderate and 1 severe symptoms (p = 0.013). Rising on heels with injured leg was also remarkably different between the groups after nine weeks follow-up despite (p = 0.052). Conclusion: Aircast immobilisation seems to be safe method to immobilise ankle fractures after surgery. It seems to improve patient satisfaction and may not disturb function of ankle joint as much as the standard cast immobilisation.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 238 - 238
1 Mar 2004
Haara M Kröger H Arokoski J Manninen P Heliövaara M
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Aims: Prevalence and risk factors of osteoarthritis in the carpometacarpal joint of the thumb have been amply explored in previous studies. However, no study has focused on CMC OA as a predictor of disability and mortality. We investigated CMC OA for its associations with risk factors, disability and with life expectancy in a extensive health survey. Methods: In 1978–80, a representative population sample of 8,000 Finns aged 30 or over were invited to participate in a comprehensive health examination; 90% complied. Hand radiographs were taken from 3,595 subjects and the clinical status was completed for 3,434 subjects. By the end of 1994, 897 subjects with hand radiographs had died. Results: The age adjusted prevalence rate of CMC OA of Kellgren’s grade 2 to 4 was 7% for men and 15% for women. Adjusted for alleged risk determinants, body mass index was directly proportional to the prevalence of CMC OA in both sexes, OR =1.29 (95% confidence interval 1.15–1.43) per each increase of 5 kg/m2 in body mass index. Smoking seemed to carry a protection against CMC OA in men but not in women. No significant association was found between history of workload and CMC OA. Restricted mobility, tenderness and swelling were frequently found in the presence of radiological CMC OA, but no significant increase occurred in the prevalence of disability. In men CMC OA of Kellgren’s grade 3 to 4 significantly predicted total mortality (adjusted relative risk 1.32, 95% confidence interval 1.03–1.69). Conclusion: In line with previous studies, body mass index strongly determines the prevalence of CMC OA. CMC OA is highly prevalent, but its impact on disability in the general population is scanty.