There were significantly fewer venous thromboembolic complications in patients undergoing elective hip replacement when prophylaxis with enoxaparin was given for a total of one month, rather than only during the hospitalization.

Conventional single-radiograph technique and cineradiography were used for examination of the pharyngo-esophageal junction area during contrast medium swallowing in 500 patients with dysphagia and in 150 volunteers with no swallowing complaints. Seventeen pharyngoesophageal diverticula were found, emerging in the lateral or latero-anterior direction just below the cricopharyngeal muscle indentation. Of these, 13 had wide openings and seven had narrow openings; these forms differed in shape and in retention of contrast material during the swallowing cycle. The delineation and discrimination of the type and behavior of the diverticula were more accurately done on the cineradiographs than on the single radiographs. Five freshly obtained specimens of the pharynx and esophagus were also dissected; a weak triangular area was found located caudally to the cricopharyngeal muscle (transverse portion) in the lateral and anterior aspect of the pharyngo-esophageal junction area.

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PurposeTo describe changes in joint motion, sensibility, and scar pliability and to investigate the patients' expectations, self-reported recovery, and satisfaction with hand function, disability, and quality of life after surgery and hand therapy for Dupuytren disease. MethodsThis prospective cohort study collected measurements before surgery and 3, 6, and 12 months after surgery and hand therapy. Ninety patients with total active extension deficits of 60 degrees or more from Dupuytren contracture were included. Outcomes measures were range of motion, sensibility, scar pliability, self-reported outcomes on expectations, recovery, and satisfaction with hand function, Disabilities of the Arm, Shoulder, and Hand scores, safety and social issues of hand function, physical activity habits, and quality of life with the Euroqol. ResultsThe extension deficit decreased, and there was a transient decrease in active finger flexion during the first year after surgery. Sensibility remained unaffected. Generally, patients with surgery on multiple fingers had worse scar pliability. The majority of the patients had their expectations met, and at 6 months 32% considered hand function as fully recovered, and 73%were satisfied with their hand function. Fear of hurting the hand and worry about not trusting the hand function were of greatest concern among safety and social issues. The Disability of the Arm, Shoulder and Hand score and the Euroqol improved over time. 2 ConclusionAfter surgery and hand therapy, disability decreased independent of single or multiple operated fingers. The total active finger extension improved enough for the patients to reach a functional range of motion despite an impairment of active finger flexion still present 12 months after treatment.

In order to define the diagnostic outcome of cineradiographic examination of the swallowing act (pharyngeal stage) in patients with dysphagia, 250 such patients were consecutively examined at filmspeeds of 50 and 100 frames per second. Synchronous and symmetrical swallowing was observed in 20% of the patients while 80% exhibited functional abnormalities i.e., epiglottic dysfunction (33%), misdirected swallowing and aspiration (41%), cricopharyngeal dysfunction (22%), paresis of the pharyngeal constrictor musculature (10%), webs (15%) and Zenker diverticula (2%). These results clearly indicate that cineradiography can frequently disclose functional abnormalities in the act of swallowing among patients with dysphagia and explain the symptoms of these patients. Cineradiography is clearly superior to conventional single-film technique in revealing functional abnormalities in the act of swallowing.