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Biomedical subjects

B van Linge

Publications and source records attributed to B van Linge.

At least 19 recordsLinked to original sources
PubMed1998

Spontaneous remodeling of the spinal canal after conservative management of thoracolumbar burst fractures.

STUDY DESIGN: Forty-two conservatively treated patients with a burst fracture of the thoracic, thoracolumbar, or lumbar spine with more than 25% stenosis of the spinal canal were reviewed more than 1 year after injury to investigate spontaneous remodeling of the spinal canal. OBJECTIVES: To investigate the natural development of the changes in the spinal canal after thoracolumbar burst fractures. SUMMARY OF THE BACKGROUND DATA: Surgical removal of bony fragments from the spinal canal may restore the shape of the spinal canal after burst fractures. However, it was reported that restoration of the spinal canal does not affect the extent of neurologic recovery. METHODS: Using computerized tomography, the authors compared the least sagittal diameter of the spinal canal at the time of injury with the least sagittal diameter at the follow-up examination. RESULTS: Remodeling and reconstitution of the spinal canal takes place within the first 12 months after injury. The mean percentage of the sagittal diameter of the spinal canal was 50% of the normal diameter (50% stenosis) at the time of the fracture and 75% of the normal diameter (25% stenosis) at the follow-up examination. The correlation was positive between the increase in the sagittal diameter of the spinal canal and the initial percentage stenosis. There was a negative correlation between the increase in the sagittal diameter of the spinal canal and age at time of injury. Remodeling of the spinal canal was not influenced by the presence of a neurologic deficit. CONCLUSION: Conservative management of thoracolumbar burst fractures is followed by a marked degree of spontaneous redevelopment of the deformed spinal canal. Therefore, this study provides a new argument in favor of the conservative management of thoracolumbar burst fractures.

Adolescent↗
PubMed1995

Stress radiography of the talocrural and subtalar joints.

The object of this investigation was to determine a possible subtalar component in a group of 33 patients with chronic ankle instability. A group of 10 subjects without ankle/foot symptoms acted as controls. A standardized radiographic assessment of talar and simultaneous subtalar tilt was made. A hinge device to stress the joints and a specific subtalar stress view (Brodén view) were used under fluoroscopic control. Radiographs were made with the feet: (1) in neutral position, (2) after inversion with moderate force until the point of fair restraint (step 1), and (3) after inverting with more force as far as the conditions would allow (step 2). An increase of talar tilt between step 1 and step 2 was only found in feet that were symptomatic. This suggests that this increase is only possible when lateral ligaments are damaged. Further research is necessary to determine whether this finding can serve as a parameter to discriminate between physiological and abnormal talar tilt. A wide range of subtalar motion was found in both symptomatic and asymptomatic feet. With the present method, practically all subtalar joints showed some loss of congruity and medial shift of the calcaneus in relation to the talus. This could not be correlated with ankle instability at the talocrural joint. The consequence of the use of different subtalar stress methods has so far received little attention and is discussed.

Adolescent↗
PubMed1995

Peroneus longus and tibialis anterior muscle activity in the stance phase. A quantified electromyographic study of 10 controls and 25 patients with chronic ankle instability.

The electromyographic activity of the peroneus longus and anterior tibial muscles of 25 patients with chronic ankle instability (18 patients with bilateral symptoms and 7 patients with unilateral complaints) and 10 controls was registered during the stance phase under different walking conditions. With balance secured by external support, there was a variable amount of peroneal activity, most of which was found in the third quarter of stance. A high increase in peroneus longus activity starting after foot-flat was found when subjects had to maintain balance in a natural way. No difference in peroneal activity was found in relation to instability complaints. It is thought that the peroneus longus serves to maintain balance, that this function decreases with increase of speed and that one cannot rely on this muscle to prevent an inversion injury during normal walking. The anterior tibial muscle was predominantly active in the first quarter after heel contact. An increase in activity in the second quarter as an effect of loss of secured balance suggests that this muscle plays some part in balance control, but this is not its main function. A significant increase in tibialis anterior activity was found in patients with bilateral instability. No significant difference was found between the symptomatic and asymptomatic leg of patients with unilateral instability under the same walking conditions. These findings suggest changes in central control.

Adult↗
PubMed1994

The surgical anatomy of the superior gluteal nerve and anatomical radiologic bases of the direct lateral approach to the hip.

In view of the increasing popularity of the direct lateral approach to the hip joint for hemi- or total hip arthroplasty, the location of the superior gluteal nerve (SGN) was studied. This nerve is in danger when using a transgluteal incision. In 20 embalmed specimens the relation of the SGN to the tip of the greater trochanter (TT) was studied as well as the relation to the iliac crest. For this purpose macroscopy, microscopy and CT were used. In 13 hips a so-called most inferior branch was found at an average of 1 cm distal to the inferior branch, the main trunk of the nerve. There was substantial variation in the course of both the inferior and the most inferior branch of the SGN. In order to prevent nerve damage, proximal extension of the transgluteal incision should be limited to 3 cm cranial to TT. Furthermore the incision has to be confined to the distal one third of the distance TT-iliac crest. In tall people extra care should be taken.

Aged↗
PubMed1993

Rupture of the pectoralis major muscle in body-builders.

Rupture of the pectoralis major muscle is rarely encountered. However, among body-builders this lesion, commonly called the "pec-tear", is well known. The bench-press exercise is a common cause. In the following report the typical history, symptomatology, and treatment are discussed.

Adult↗
PubMed1993

Effect of intravenous fluid administration on recovery after running a marathon.

After the Rotterdam Marathon on 21 April 1991 (ambient temperature 5.8 degrees C, relative humidity 74%, wind velocity 5 m s-1) data from 66 athletes were analysed for information concerning total recovery and recovery from pain, stiffness, loss of appetite, sleep disturbance and fatigue. The pulse rate, body weight and temperature were measured. The athletes were divided at random into two groups. Thirty-four athletes received an intravenous infusion of 2.5 l of a 2.5% glucose/0.45% NaCl solution. Thirty-two athletes received a placebo infusion of 100 ml 0.9% NaCl. Recovery took 9.2 days in the placebo group and 10.2 days in the infusion group. All athletes had pain and/or stiffness after the marathon. The immediate replacement of 2.5 l of fluid had no significant influence on the rate of total recovery, the number of days with pain or stiffness, the appetite, sleep or fatigue. On the first day after the marathon the pulse rate was increased. The rectal temperature was not affected. The athletes were also divided into fast and slow runners without regard to fluid replacement. Fast runners (those running the race in less than 2 h 55 min) needed more time to recover than slower runners and pain and/or stiffness lasted longer in the fast group. Athletes who equalled or improved their best previous results also needed more time to recover than athletes who did not, although there were no significant differences in pain and stiffness. Athletes did not benefit from immediate fluid replacement after running the 1991 Rotterdam Marathon.

Adult↗
PubMed1993

Central grafting for persistent nonunion of the tibia. A lateral approach to the tibia, creating a central compartment.

We report the operative technique and results of a new method of central grafting for persistent nonunion of the tibial shaft. The operation is performed through a lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula above, below and at the level of the nonunion. In 48 tibiae, most with long-standing nonunion and some with infection or bone defects, sound healing was obtained in 45 after one operation. Only one failure needed amputation.

Adolescent↗
PubMed1992

CT scan prediction of neurological deficit in thoracolumbar burst fractures.

In 139 patients with burst fractures of the thoracic, thoracolumbar or lumbar spine, the least sagittal diameter of the spinal canal at the level of injury was measured by computerised tomography. By multiple logistic regression we investigated the joint correlation of the level of the burst fracture and the percentage of spinal canal stenosis with the probability of an associated neurological deficit. There was a very significant correlation between neurological deficit and the percentage of spinal canal stenosis; the higher the level of injury the greater was the probability. The severity of neurological deficit could not be predicted.

Humans↗
PubMed1991

Failure of tibial bone grafting for femoral head necrosis.

We treated 20 hips with femoral head necrosis in 16 patients using the Phemister tibial bone grafting procedure. After a mean follow-up of 3 years, the Harris hip score had improved in 15 out of 18 hips, however without radiographic improvement. In 2 hips, an arthrodesis and an arthroplasty were performed. We concluded that the aim of our treatment was not achieved.

Adult↗
PubMed1990

Oxidative phosphorylation in human muscle in patients with ocular myopathy and after general anaesthesia.

The fuel preference of human muscle mitochondria has been given. Substrates which are oxidized with low velocity cannot be used to detect defects in oxidative phosphorylation. After general anaesthesia, the oxygen uptake with the different substrates is much lower than after local analgesia. The latter was therefore used in the subsequent study. In 15 out of 18 patients with ocular myopathy, defects in oxidative phosphorylation could be detected in isolated muscle mitochondria prepared from freshly biopsied tissue. Measurement of the activity of segments of the respiratory chain in homogenate from frozen muscle showed no, or minor defects. In two of these patients showing exercise intolerance, decreased oxidation of NAD(+)-linked substrates and apparently normal mitochondrial DNA, further study revealed deficiency of pyruvate dehydrogenase in a girl with ptosis and a high Km of complex I for NADH in a man. Both patients responded to vitamin therapy.

Adolescent↗
PubMed1990

Reconstruction of the tibia by dual grafting. 3 cases of tumor resection.

Large defects of the tibia can be bridged with autologous cancellous grafts between the remaining fibula and a contralateral tibial cortical graft. The long-term results of this technique in 3 cases after resection of a malignant tumor were either excellent or fair. It is concluded that this technique is an effective limb-saving surgical procedure.

Adult↗
PubMed1986

Ultrasonographic detection of the patellar plica in the knee.

In 39 knees of 38 patients, an ultrasonographic investigation of the patellofemoral space was performed to detect a plica synovialis. By arthroscopic control, we found a sensitivity for the ultrasonographic method of 92% and a specificity of 73%. The method, materials, and results are discussed in this paper.

Arthroscopy↗
PubMed1985

Incidence of osteonecrosis after renal transplantation.

The incidence of osteonecrosis was 24% in 248 patients who had received 262 kidney transplants 1971-1982. However, based only on patients at risk, i.e. alive with functioning transplants, the incidence at 1, 3 and 6 years was found to be 13, 27 and 36%; after six years no new cases were found. The relative increase in body-weight at 180 days was predictive as regards risk for osteonecrosis, while the cumulative dose of steroids was not. This suggests that individual sensitivity to steroids rather than the absolute cumulative dose is involved in the development of osteonecrosis.

Body Weight↗