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Biomedical subjects

A Alho

Publications and source records attributed to A Alho.

At least 73 records · Page 4Linked to original sources
PubMed1991

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↗
PubMed1991

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↗
PubMed1991

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↗
PubMed1991

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↗
PubMed1991

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↗
PubMed1991

[The surgical treatment of spinal metastases in Scandinavia].

The article consists in a review of the findings in a questionnaire study, which indicate that the adoption of new surgical techniques varies from one centre to another. Several prognostic factors have been identified, that enable the differentiation of treatment from palliation to reconstruction. The new fixation methods yield improved functional outcome without a significant increase in surgical trauma. An active surgical approach is outlined which, in conjunction with overall oncological care, may improve the patient's quality of life.

Humans↗
PubMed1991

The fate of hemijoint allografts after tumor resection about the knee.

Distal femoral or proximal tibial resection was performed in 15 patients for bone tumor and replaced by defrosted allogeneic osteoarticular transplants. The patients were followed for a median of 11 years (range 2 to 18 years). The major complications were 3 fractures, one delayed union, 3 graft resorptions, and one secondary infection to salvage by total knee prosthesis. Sixteen reoperations were performed in 8 patients. The small number of bone healing problems was accounted for by the autologous bone sleeve in the graft-host junction. The knee motion improved considerably after early mobilization in hinged orthosis. The early results (1 to 7 years) were as follows: excellent--3, good--6, and fair--6. The late results (8 to 18 years) were: good--4, fair--5, and poor--1. The poor result was salvaged to fair by arthrodesis. It is concluded that osteoarticular allografting yields an alternative to salvage the limb, but still presents unsolved immunologic and preservation problems which make the prognosis unpredictable.

Bone Neoplasms↗
PubMed1991

Assessment of bone mineral content in the internal bone volume.

A method for assessing values related to bone density and mass is described. Mean attenuation and pixel area are measured in pixels selected on the basis of CT units. The method is to a large extent computerized and not dependent on manual positioning or outlining of a region of interest. Because it is not dependent on a comparatively large volume of homogeneous bone it can be used to make assessments even in very heterogeneous bones including cortical bone. The method is adaptable for measurement in all parts of the skeleton and values related to both bone density (DRV) and bone mass (MRV) are derived. The measurements in the femoral condyles were shown to have a precision of approximately 0.25 to 0.30 Z-score units (standard deviation of the measurements expressed in Z-score units). The agreement between chemically analyzed calcium density (weight of calcium per volume) and DRV was little less than 0.50 Z-scores and 0.30 Z-scores for the chemically determined calcium mass and the MRV. The agreement with mechanical bone strength was 0.78 Z-scores for DRV and 0.64 for the MRV. Altering scan parameters or measuring approaches gave systematic differences in measurements. There were, however, good linear correlations between the measurements which show that these different measuring approaches essentially gave identical measurements.

Bone Density↗
PubMed1990

Locked intramedullary nailing for displaced tibial shaft fractures.

We analysed the results of 93 tibial shaft fractures treated with the Grosse-Kempf locked nail. Twenty-six fractures were comminuted, 19 were open grade I to II, and 54 were located outside the middle third of the tibia. The deep infection rate was 3.2%. There were only two poor results. The use of this method is recommended and discussed.

Adolescent↗
PubMed1990

The Grosse-Kempf nail for distal femoral fractures. 2-year follow-up of 25 cases.

Totally, 25 patients with an infraisthmic fracture of the femur, treated with a Grosse-Kempf slotted nail, were followed up for a median of 21 (8-44) months. The median age of the 9 males and 16 females was 45 (18-90) years. No deep infections occurred. An excellent result was obtained in 14 patients, good in 5, fair in 5, and poor in 1 patient in whom intraoperative splintering led to a 9-cm shortening. We conclude that intramedullary locked nailing of fractures of the infraisthmic, extraarticular part of the femur compares favorably with alternative methods.

Adult↗
PubMed1990

Femoral cortical/cancellous bone related to age.

The femoral cancellous/cortical relationship with age has been determined in 53 dissected femoral specimens. By means of computed tomography (CT) values related to bone density and mass were assessed in the femoral head, neck, trochanter, shaft, and condyles. In the neck and trochanter separate measures were made in cortical and cancellous bone. The results were analyzed by means of correlation and regression analyses. There were significant negative linear correlations between the CT measures and age for all measures except for the isolated cancellous measures in the femoral neck and trochanter. Our results indicate that in the femoral neck and trochanter the cortical bone mass constitutes a substantial amount of the total bone mass. We conclude that, since bone strength to a large part is a function of the total bone mass, loss of cortical bone may be more important than loss of cancellous bone.

Aged↗
PubMed1990

[Experiences with interlocking nails in the femur. A retrospective analysis of 99 operated femur shaft fractures].

In 95 patients 99 femoral fractures treated with an intramedullary locking nail were followed-up for median 22 months (12-60). 62 results were classified as excellent, 19 as good and 16 results as fair. A poor result was registered in 2 patients. We had 13 operation-related complications. Four of these complications required a new operation and one ended up with a poor end-result. Operative-technical complications do not necessarily need to impair the result if the surgeon is aware of them and knows how they are to be handled.

Adolescent↗
PubMed1990

Axial and appendicular bone mineral content determined by computed tomography. Relationship to age and body size in males.

Bone density and mass related values were determined in femoral condyles and in the second lumbar vertebra in males of middle age. A poor agreement was found between measurements in the two locations. The measurements were compared with age and body size by means of correlation analysis and multiple regression analysis. There was a significant linear relationship between lumbar measures and age (beta coefficient -0.61 and -0.75) while the relationship with age for the femoral measures was less (beta -0.36 and -0.45). For all measurements there was a poor correlation with body size (weight, length and surface area). Bone mineral content measurements in the lumbar and appendicular skeleton have different clinical implications. When selecting a method for estimating the bone mineral content careful attention must be paid to what type of information is wanted and whether the method is adequate for that particular purpose.

Aging↗
PubMed1989

Allogeneic grafts for bone tumor. 21 cases of osteoarticular and segmental grafts.

We treated 21 aggressive and malignant bone tumors by wide resection and replacement with deep-frozen osteoarticular and segmental (intercalary and block) allografts. Radiologic and histologic studies showed a gradual accretion of new bone on the graft trabeculae, sometimes with total creeping substitution. Substantial resorption of grafted condylar bone occurred in 3 of 14 cases. One of them ended with arthrodesis; in the other 2 the result after augmentation autografts was fair. Radiographically, a gradual joint surface destruction was observed in all the osteoarticular grafts after 5 years, not correlating with joint function, however. Biopsies showed some cartilage regeneration. Each patient underwent, on an average, two operations. Function after osteoarticular grafts at 3-16 years was excellent in 1 case, good in 4, fair in 6, and poor in 1 case; 2 cases were too recent for evaluation. Function 3-12 years after segmental grafts was excellent in 3 cases and poor in 3 cases (1 amputation due to nonunion, 1 amputation due to recurrence, and 1 prosthetic replacement due to recurrence); 1 case was too recent for evaluation. We conclude that an allograft is an acceptable alternative in the reconstruction of large tumor defects. However, it still presents unsolved immunologic and preservation problems, which make the prognosis guarded.

Adolescent↗