Many patients consulting medical emergency services make the initial contact because of psychiatric emergency situations. However, emergency physicians and their assistants are usually not sufficiently experienced in psychiatry. Therefore, psychiatric emergencies are sometimes only reluctantly accepted or inadequately treated by these services. Our present contribution aims at improving this situation. It gives a review of the main diagnostic groups concerned, their symptomatology and psychopathology, and offers some advice with regard to empathic verbal interventions and counselling in those emergency situations.
In 163 patients--125 (76.7%) female, 38 (23.3%) male--172 cementfree isoelastic acetabular cups were implanted. The average patient age was 72.6 years (range: 16 to 96 years). Sixty-seven (41.1%) patients with 72 (41.9%) cups could be followed-up for an average of 6.0 years (range: 2.0 to 12.2 years) after the procedure. Using the Harris-hip-score we found 49 (68.1%) "very good" to "fair" results. In 23 (31.9%) hips scoring had to be classified as "bad". The rate of cup-loosenings in the collective was low at 3.5% (6/172), probably due to the reduced physical activity of our comparatively older patients. Because after the 8th year symptomatic loosening must be routinely expected, the procedure is not indicated for younger patients. In older patients with femoral neck fractures the cementfree isoelastic acetabular cup has proven itself effective in our experience.
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