[Country-wide product control of total hip prostheses].
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Hip Prosthesis↗
Biomedical subjects
A Alho
Publications and source records attributed to A Alho.
Slotted versus non-slotted locked intramedullary nailing for femoral shaft fractures.
Experimentally, two slotted nails, the Grosse-Kempf nail and the AO/ASIF universal femoral nail, were compared to the non-slotted Grosse-Kempf nail and control bone using a cadaver femoral osteotomy. The stiffnesses and strengths of the osteotomies fixed with slotted nails in 10-30 degrees torsion were 6-8% and the values of non-slotted nails 40% of control bone. The maximal moments were 14-18% and 48%, respectively. In the "clinical range" of torsion, the implant-bone construct never failed or was deformed. Clinically, 46 femoral shaft fractures were randomized to treatment with Gross-Kempf nails, 24 with slotted nails and 22 with non-slotted nails. Four complications in the slotted nail group and three in the non-slotted nail group were considered to be independent of the choice of nail and did not affect the end result. Three splinterings of the distal fragment, one resulting in a change of the osteosynthesis implant to a condylar plate, were considered to result from the high stiffness of the non-slotted nail. Osteosynthesis of femoral shaft fractures using slotted nails has not resulted in healing disturbances, which could be accounted for by the high torsional elasticity of the nail; there seems to be no indication for high-stiffness nails in femoral fractures.
Adolescent↗
Prediction of disturbed healing in femoral neck fracture. Radiographic analysis of 149 cases.
To determine factors predictive of early healing disturbances after fixation of femoral neck fracture, the radiographic and clinical data of 149 patients were subjected to a logistic regression analysis comparing them with the results 3 months postoperatively. As in previous studies, fracture reduction distinguished between fractures with or without healing disturbances. The following signs in the preoperative radiographs were predictive of unfavorable outcome: small head fragment, comminution of the calcar femorale, and varus angulation of the head. Fractures with negative predictive signs may be selected for primary arthroplasty.
Age Factors↗
Implant holding power of the femoral head. A cadaver study of fracture screws.
The holding power against axial pull-out forces of eight different screws implanted in the femoral heads of cadavers was tested. The Olmed screw had the greatest resistance to pull-out forces followed by the recently designed Ullevaal screw with long threads, and the von Bahr screw. There were substantial differences in the holding power in the four sectors of the femoral head. The holding power was strongly correlated with the logarithm of the moment of inertia of the screw threads, which is a function of the area and number of the threads (r = 0.94, P = 0.0002).
Adult↗
A case of multifocal liposarcoma?
A 53-year-old man presented with a grade 2 liposarcoma in his left thigh and grade III liposarcomas in the mediastinum and omentum. Later, a grade 2 tumor was discovered in the musculature of his right thigh. In addition to recurrences, he developed lesions that were considered metastatic. He died 3 years later of multiple lesions. The case may represent a multifocal liposarcoma, which has been previously reported in only 35 cases.
Abdominal Neoplasms↗
Acute compartment syndrome: for how long can muscle tolerate increased tissue pressure?
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Adult↗
Femoral shaft fractures in the elderly treated with Grosse-Kempf slotted locked intramedullary nail.
Thirty-one femoral shaft fractures in patients over 60 years of age were treated with the Grosse-Kempf slotted, locked intramedullary nail and followed for a median of 24 months. The patients tolerated the operation reasonably well and the mortality was not higher than the mortality connected with femoral neck fractures. Three reoperations were performed due to intra- and postoperative complications. The main reason for the less satisfactory result was shortening > 2 cm after unstable dynamical locking. This occurred in 8 of 15 dynamically nailed fractures with locking screw(s) in one end of the nail only. A 9 cm shortening among these was the reason for one of the two poor results in the series. The other poor result was a malalignment of the distal fragment in a statically locked fracture. We conclude that locked intramedullary nailing is a good way to treat femoral shaft fractures in the elderly, the high subtrochanteric, midshaft and infraisthmic fractures.
Aged↗
Comparison of functional bracing and locked intramedullary nailing in the treatment of displaced tibial shaft fractures.
Thirty-five displaced tibial shaft fractures, treated with functional bracing were compared with 43 similar fractures, treated with locked intramedullary nailing. There were 22 excellent/good results in the brace group and 38 in the nail group. There was one infection in the brace group and three in the nailed group. There were five delayed unions and two nonunions in the brace group and one delayed union in the nail group. The functional results in the nailed group were better than the braced group but locked intramedullary nailing of tibial shaft fractures require special resources and training. Locked intramedullary nailing fullfils all the functional criteria for acceptable fracture care.
Adolescent↗
[Fractures of the distal radius. Guidelines for treatment].
Fractures in the distal part of the radius are a common injury in the elderly and in an increasing number of young patients as well. In order to obtain optimal function it is essential, in older and younger patients alike, to secure anatomic length of the radius and anatomic congruency of the joint. Fractures with a tendency to secondary dislocation after primary good reduction should be recognized. Rereduction and fixation with percutaneous K-wires secure the position of the fracture. In some patients primary pinning or primary treatment with an external fixator should be considered, depending on the type of fracture. Guidelines are outlined for the treatment of this very frequent fracture.
Colles' Fracture↗
[Bone transplantation. Where are we in 1991?].
Bone transplants are used in acute injuries, non-unions, defects after tumour, and total joint surgery. Autogenous cancellous bone from the iliac crest is still the most frequently used material. Allogeneic cadaver bone is an acceptable alternative for treating major defects after tumour resection, especially as osteoarticular graft about the knee. Allografts in total hip revisions have not been successful. Demineralized allogeneic bone matrix, bone morphogenetic protein and various bone mineral substitutes are experimental. There are distinct indications for pedicled and vascularized autografts which should be available whenever their use is warranted.
Biocompatible Materials↗
Locked intramedullary nailing of femoral shaft fractures.
One hundred twenty-three femoral shaft fractures were treated with Grosse-Kempf slotted, locked nails and followed for a median 20 (range, 12-60) months. There were eight intraoperative and 11 postoperative complications, among them two superficial and two deep infections. Most of the intraoperative complications and some postoperatively lost reductions could have been prevented by a better operative technique and judgment of stability. Seventy-eight results were graded as excellent, 24 as good, 19 as fair, and two as poor (one 9-cm shortening and one 40 degrees external malrotation). All fractures united without further procedures during the first year.
Adolescent↗
Subtrochanteric femoral fractures treated with locked intramedullary nails. Experience from 31 cases.
We treated 31 proximal femoral shaft fractures, where the trochanteric area was intact, with Grosse-Kempf locked intramedullary nails. There were 19 men and 12 women with a median age of 24 (14-79) years. Sixteen fractures were comminuted and 11 were a component of severe multiple injury. No infections or other serious complications occurred. All the fractures healed within 40 weeks, with 16 results graded as excellent, 7 as good, 7 as fair, and 1 as poor. Six fair results were due to difficulties in aligning the short proximal fragment. One patient with a fair and 1 with a poor result had excessive shortening of the femur. We conclude that locked intramedullary nailing is a good alternative in these fractures and that the static variant is preferable whenever the stability is uncertain.
Adolescent↗
Radiographic prediction of early failure in femoral neck fracture.
We studied the primary radiographs of 56 patients treated with osteosynthesis for a displaced femoral neck fracture. The radiographic findings were subjected to a multiple regression analysis together with the results 3 months postoperatively. A primary fracture displacement of more than 20 mm on the AP film and a defect of the calcar due to fracture comminution were associated with a failed osteosynthesis.
Aged↗
Bone mass distribution in the lower leg. A quantitative computed tomographic study of 36 individuals.
We measured bone density and volume at different levels of the normal lower leg by computed tomography. The fibular mass at each transverse level was 18-20 percent of the total bone mass. Tibial masses at all the levels correlated with distal femoral and proximal tibial masses. Summing the fibular and tibial masses augmented the correlations. The mass values varied substantially at different levels of the lower leg, being highest in the midshaft. We hypothesize that the lower extremity is a biomechanical continuum where the distribution of the bone mass corresponds to the functional demands, indicating that the fibula is not "dispensable."
Adult↗
A case of mastocytosis involving bone.
A case of mastocytosis of the bone associated with urticaria pigmentosa was first suspected of being a generalized metastatic malignancy, for the radiographic manifestations were not connected by us with the patient's skin disease. The histologic diagnosis of systemic mastocytosis was also missed primarily, because mast cells are not visualized in the conventional hematoxylin and eosin staining of the histologic sections. Special stainings revealed mastocytosis. Irregular remodeling of the bone was also seen, which was consistent with the radiographically irregular bone structure.
Adult↗
Orthopedic research and education in Scandinavia.
Based upon an enquiry conducted in 1988 and 1989, data on the resources for orthopedic research in Scandinavia are presented, supplemented with a survey of the number of scientific papers published from Scandinavia in major orthopedic journals. The postgraduate training programs for orthopedic surgeons in the Scandinavian countries are outlined.
Education, Medical, Graduate↗