Mogens Thomsen

Zygomatic fractures. II. A follow-up study of 137 patients.

Out of a total of 137 patients with zygomatic fractures, 87 with post-reductively stable fractures were treated solely with Gillies procedure. Twenty-eight patients with unstable fractures were treated with transosseous wiring. In 22 patients, in whom the fracture was considered undisplaced, no fracture treatment was given. At the follow-up only 2 of the patients treated by Gillies procedure presented malunited fractures, and these only minor ones,this reductive method thus being satisfactory in 64% of all cases. Malunion was seen in one-third of the patients treated with transosseous wiring, this treatment thus appearing frequently insufficient. Consequently, accomplishment with Kirschner-pin fixation is proposed. Finally, a schedule for treatment of zygomatic fractures is given.

The total number of burn injuries in a Scandinavian population.

The treatment of burn injuries must be on two fronts. Within surgical treatment great advances have been made, and the next improvements must doubtless be made in the form of better prophylaxis.There is an ample literature on this subject, but most analyses are based upon the study of in-patients, while little is known about the total frequency of burn injuries in a general population.In the municipality of Copenhagen the treatment of burns has been centralized for 50 years, and the municipality comprises a well-defined geographical area with a population of 700,000 who must be considered representative of the whole of Denmark.For social and insurance reasons even the slightest injuries are treated by doctors, and there is a possibility of recording all persons who have sought medical aid for burn injuries.Burn injuries entail 8 deaths per annum, while 230 persons require admissions, 650 patients are treated in the out-patient department for burns and 1400 in other casualty wards, while the general practi...

Zygomatic Fractures: I. A Simplified Classification for Practical Use

A review of classifications of zygomatic fractures demonstrates an increasing complexity in the choice of proper treatment. To facilitate the choice of treatment a proposal is made of a simplified classification with prediction of post-reductive fracture stability. The authors material, comprising 137 patients, has been accordingly divided and the proposed classification justified by the peroperative findings and by the follow-up results.

Tendon Transfers for Defective Long Extensors of the Wrist and Fingers

Operative methods for activating wrist extension, thumb abduction, and finger extension in the event of defects in these functions are birefly reviewed.In the Orthopaedic Hospital, Copenhagen, 26 patients, 16 with radial paralysis and 10 with sequelae of softtissue injuries to the dorsum of the hand or to the forearm, were operated upon during the period 1954-1965.Finger extension was activated in 11 cases by flexor digitorum sublimis by the method of Boyes and in 15 cases by flexor carpi ulnaris. The wrist was activated in 13 cases by pronator teres. The abductor pollicis longus was activated by flexor carpi radialis or by palmaris longus. The results were assessed by the criteria of Zachary and compared with his results as well as those of Moberg & Nachemson which were somewhat better than ours, especially in the group having sequelae of soft-tissue injuries. The difference is presumably due to the operative technique, and in the future we intend to resect the dorsal carpal ligament as well as the end o...

The Burns Unit in Copenhagen: I. Principles of Treatment

In the municipality of Copenhagen the treatment of burns has been centralized for more than 100 years, first in a dermatological department, later in a department of general surgery, and from 1961 in a separate Burns Unit. This Unit accommodates 16 patients. Its layout and staffing are described. The principle of treatment is exposure, before as well as after grafting, if done. The therapeutic procedure is described in detail, and the principles of general treatment, antibiotic and antishock therapy are reviewed. Up to 1964 major burns were treated by repeated excisions and grafting procedures. After 1964, total excision is performed on the 14th day postburn. During the same operation, all defects are covered with autografts, if necessary also with homografts. Energetic physiotherapy is employed, and the haemoglobin level is maintained by repeated transfusions.

Different Clinical Types of Lipomatosis: Case Report

Following a brief review of the literature, three characteristic case histories are reported in order to demonstrate the different appearances of lipomatosis. According to the survey, grouping into three main types is suggested: 1) Diffuse lipomatosis without any sharp demarcation from the surrounding soft tissue, and a tendency to recurrence; 2) Diffuse, symmetrical lipomatosis mainly located to the neck region, and 3) Multiple lipomatosis with well-defined, encapsulated, small lipomas which never recur following removal.

The Burns Unit in Copenhagen: Bacteriology

After briefly reviewing the literature on bacteriology in burns, the author reports the distribution of the wound cultures during the period 1961-1968 in the Burns Unit, Copenhagen. The bacteria are related to the clinical infection findings, the patients’ ages, and the depth as well as extent of the burns. Staphylococcus aureus was endemic and demonstrable in 80% of the patients exhibiting clinical infection, regardless of age and area of burn. On the other hand, gram-negative bacteria and fungi were most common in elderly patients as well as in deep and extensive burns. Gram-negative bacteria were more common in patients transferred from other hospitals and in patients treated by dressing. Thanks to extensive penicillin prophylaxis, haemolytic streptococci were uncommon and not observed at all in extensive burns. Patients with tracheostomy showed the same bacterial flora in their burns as in the trachea. Most of the infections were mixed, but gram-negative bacteria occurred at a later stage of the cours...

The Burns Unit in Copenhagen: II. Material and Results, 1962–1966

A 5–year material comprising 1326 in-patients from the Burns Unit, Kommunehospitalet. Copenhagen, is presented. This Unit admits all patients with burns from the municipality of Copenhagen (1136) as well as severe burn cases from other parts of Denmark (190). In addition, the Unit includes an out-patient clinic. The total annual number of patients has been fairly constant, while the proportion of patients from other parts of Denmark has increased considerably through the 5 years. The composition of the material in respect to sex, age, cause of burn, and place of accident is compared with the authors previous paper on the “Total number of burn injuries in a Scandinavian population”. The marked differences between a material composed exclusively of in-patients and a material comprising also out-patients are discussed. Tables V and VI list the material by age, sex, extent of burn, and mortality in the various groups. Only 209 patients (one-sixth) had burns exceeding 10% of the body surface (Fig. 3). The dep...

The Burns Unit in Copenhagen: IV. Gastrointestinal Bleeding Complicating Burns

As the Burns Unit in Copenhagen is functioning in close collaboration with a department of gastroenterologic surgery, we have always taken a great interest in gastrointestinal bleeding in patients with burns. The comprehensive literature on the subject is reviewed, and the two pathological types of gastrointestinal ulcerations occurring in relation to burns are discussed. Duodenal ulceration was first described by Curling and is known by his name. Multiple erosions of the gastric mucosa, currently more common, were described by Dupuytren, so that it seems reasonable to call them Dupuytrens ulcers. The reported incidence varies within wide limits, depending upon the composition of the patient series. Within the municipality of Copenhagen all burn injuries are treated in the Burns Unit. Accordingly, the exact incidence of gastrointestinal bleeding due to burns was calculated as three cases annually in one million of the population. All peptic ulcerations observed in the Burns Unit. Copenhagen, have been si...

Cost of burns in Denmark

In continuation of a study on the number of burns in a Scandinavian population (Thomsen & S