Cervical spine fracture caused by high jump.
A case of disabling cervical spine arthrosis after a facet joint fracture sustained during a high jump is described. The condition was successfully treated by posterior fusion.
Adolescent↗
Biomedical subjects
C Olerud
Publications and source records attributed to C Olerud.
Incidence of hip fractures in the elderly. Uppsala County 1980-1987.
The age-, sex-, and fracture-type-specific annual incidence of hip fracture in patients over 55 years of age in Uppsala County were computed for the years 1980 to 1987. The number of fractures increased by less than 2 percent annually. The increase was mainly due to age changes in the population. The overall increase in specific incidence rates was approximately 1 percent; and most age, sex, and fracture-type groups demonstrated an unaltered incidence. Cervical fractures in women 55 to 64 and 75 to 84 years of age decreased in specific incidence.
Aged↗
Uppsala screw fixation versus the von Bahr technique in displaced cervical hip fractures: preliminary report.
A study of 75 patients with displaced cervical hip fractures was done utilizing two different multiple pinning techniques with threaded screws. One was the refined method of internal fixation by which the strongest bone of the femoral head was utilized to increase the stability of the fracture, and the other was the von Bahr method. As much as possible, other factors influencing healing were standardized in both groups. Forty-three of the patients were treated with the refined method and 32 with the von Bahr method. Complications occurred in 5 of 43 patients in the group treated with the new method, compared with 12 of 32 patients in the von Bahr group. Early redisplacement and nonunion were more common in the von Bahr group. Late segmental collapse was the same in both groups. In our opinion the early complications of redisplacement and nonunion are due to poor stability of the fracture. With the new, refined method, it is possible to reduce these complications.
Aged↗
Subchondral screw fixation of cervical hip fractures: joint congruence studied with combined arthrography and tomography.
This study was done to determine whether fixation with the Uppsala internal fixation technique into the subchondral bone of the femoral head in the treatment of cervical hip fractures could lead to elevation of the femoral head cartilage. Combined arthrography and frontal tomography of the hip joint in the plane of the screws was performed. The series consisted of 16 patients. In two of the patients, the tips of the screws had penetrated into the cartilage of the femoral head. In the other 14, the internal fixation was technically correct with the tips of the screws in the subchondral bone. In the two hips with the screws penetrating into the cartilage, the cartilage was slightly elevated. In the hips where the screws were in the correct position, no incongruities or deformity in the cartilage could be detected. Combined arthrography and frontal tomography can, therefore, detect elevation of the cartilage of the femoral head. By placing the screws in the immediate subchondral bone, no elevation of the cartilage of the femoral head surface should occur.
Aged↗
The stability of femoral neck fractures and its influence on healing.
We measured the stability of fixation in femoral neck fractures treated with von Bahr screws, investigated the influence of impaction and correlated peroperative stability with the clinical results. Stability was measured at operation using a metal probe fitted with strain gauges. Its tip was anchored in the subchondral bone of the femoral head and its lateral end was fixed in the lateral femoral cortex. The shearing force produced by longitudinal compression applied to the foot of the operated leg was recorded. The results in 41 consecutive patients all followed for 30 months, showed that fractures with early loosening or nonunion had all had significantly poorer stability than the fractures that had healed. Impaction improved stability in only 23 out of the 41 fractures; in the others stability had deteriorated or was unchanged.
Aged↗
Subchondral screw fixation for femoral neck fractures.
We describe a method of internal fixation for femoral neck fractures which has been newly developed to reduce the frequency of early complications. Two cannulated screws are inserted in the axis of the femoral neck to reach into the subchondral bone of the femoral head. The screws are inserted over guide pins and the tip of the screw is self-tapping and designed to provide good anchorage in the femoral head. We used this method in 44 consecutive patients in a prospective study with no exclusions, followed for a minimum of 24 months. All fractures healed within 12 months, and there were no cases of early loosening or nonunion. In four cases, late segmental collapse had developed during the mean follow-up period of 30 months.
Aged↗
Fixation of femoral neck fractures. Comparison of the Uppsala and von Bahr screws.
In a prospective randomized study, a newly developed so-called Uppsala technique for internal fixation of femoral neck fractures was compared with the von Bahr technique. The series consisted of 222 consecutive patients, 167 women and 55 men, with a mean age of 80 years. Half of the patients were randomized to each treatment group. During the first postoperative year, 18 failures occurred in the Uppsala group, compared with 39 in the von Bahr group (P less than 0.01). Of 128 patients without pain at 4 months, 9 developed failures, compared with 29 of the 37 that had pain at this time (P less than 0.001). We conclude that the new technique gives better results during the first postoperative year and that most failures occur among those with pain at 4 months. Follow-up radiography is indicated only in patients with pain at 4 months.
Aged↗
External fixation versus traditional treatment for comminuted Colles fractures.
The results of conservative treatment of comminuted Colles fractures are discouraging. Due to this several different operative techniques have been presented by different authors for treatment of these injuries. Good results have been reported by external fixation, but this has usually been the "second line of defense" and has been applied only after conservative treatment has failed. The aim of the present study was to compare primary external fixation and conservative treatment for comminuted Colles fractures of type Frykman VIII. The study was designed as a prospective, controlled study.
Adult↗
Plaster cast versus external fixation for unstable intraarticular Colles' fractures.
This study compares 75 consecutive patients with Frykman Type VIII fractures of the distal forearm treated by primary external fixation with 32 patients who sustained similar injuries and were treated by closed reduction and cast immobilization. The latter group of patients served as an historical control. The two groups were similar with respect to injury and demographic characteristics. All fractures treated with external fixation remained well reduced and aligned, whereas 88% of those treated with casts had unsatisfactory alignment despite the fact that 30% had a second reduction. The external fixator group also had superior results with respect to functional outcome, range of motion, and grip strength.
Adult↗
[A new method for osteosynthesis prevents early complications in cervical hip fractures].
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Aged↗
The congruence of the distal radioulnar joint. A magnetic resonance imaging study.
The functional anatomy of the distal radioulnar joint was studied in 10 healthy volunteers. The joint surface of both the ulnar head and the sigmoid notch of the radius form arcs of circles with small areas of contact because the diameters of the circles are different. The distal radioulnar joint is congruent throughout its range of motion, but the area of contact shifts from dorsal in the sigmoid notch in pronation to volar in supination. The insertion of the distal radioulnar ligaments on the ulnar head explains the congruence of the joint.
Adult↗
Prominent radial tubercle causing limited pronation: brief report.
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Adult↗
[External fixation of comminuted Colles' fractures gives better results than conservative treatment].
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Adult↗
Comminuted Colles' fractures treated with external fixation.
In a prospective series of 75 patients the results of early external fixation of comminuted intraarticular Colles' fractures were studied. Comparison was made to a control group of 32 patients treated with plaster cast fixation. The groups were equal with regard to age, sex and fracture type. The treatment consisted of reduction in general anaesthesia or arm block followed by the application of a small external fixation device. The fixation lasted for five weeks after which the patients were allowed free exercises. For evaluation at the one year follow up the following variables were used: Radiographic appearance. Healing in of the styloid process of the ulna. Subjective evaluation according to the Lidström score. Objective evaluation including range of motion and grip strength. In all follow up variables the treatment group was significantly better than the control group. The prognosis of conservatively treated comminuted intraarticular Colles' fractures is poor. The results of after external fixation are, however, very encouraging and the method can be recommended.
Adult↗
Reduction of Colles' fractures without anaesthesia using a new dynamic bone alignment system.
Two techniques for reduction of Colles' fractures were compared in a prospective, randomized study. With use of a newly designed dynamic bone alignment device, reduction manoeuvres were performed on 62 patients with Colles' fractures (group A) without any form of anaesthesia. In a control group of 54 patients (group B) Colles' fractures were reduced manually in the traditional way using local infiltration anaesthesia. In each group the pain experienced by the patients was recorded. Severe pain during the reduction was reported by 8 per cent of the patients in group A and by 35 per cent of those in group B. No complications occurred during or after dynamic reduction without anaesthesia. This method of treatment seems to be a very gentle one for the patients, with the advantage of causing less pain than treatment under local anaesthesia.
Adult↗
Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia.
To investigate whether or not injection of local anesthetic into the fracture hematoma on reduction of a Colles' fracture increases the risk of neurological complications, a prospective randomized trial was conducted. The outcome in 62 patients whose Colles' fractures were reduced in a new bone-alignment device without anesthesia was compared with that in 54 patients with Colles' fractures that were reduced manually after injection of local anesthetic. At follow-up, any symptoms and signs of nerve damage were recorded. Four cases of such damage were noted in the group treated without local anesthesia, as opposed to 14 in the group in which a local anesthetic was used. The difference is significant (p less than 0.01). The authors have previously shown that injection of local anesthetic into the hematoma of Colles' fractures increases the carpal tunnel pressure. Neurological complications after the use of local anesthesia in reducing Colles' fractures is considered to be secondary to the scarring and fibrosis caused by this increase in pressure.
Adult↗
Torsion-transmitting properties of the hind foot.
The torsion-transmitting capacity of the hind foot was studied experimentally in ten cadaver specimens. An average of 0.44 degrees of outward rotation of the tibia occurred for every degree of supination of the foot. The relationship was linear. There was less transmission of torsion during dorsal extension than during plantar flexion of the ankle. The joint complex of the hind foot somewhat resembles a universal joint except that the distal fork of the universal joint changes its configuration through its range of motion. This distal fork, consisting of the calcaneus, the cuboid, and the navicular, together with the central piece, the talus, constitutes a three-arm link system, which explains the configurational change. The process of balance when standing on one leg and when walking on uneven surfaces, when the torsion-transmitting effect plays a central role, can be controlled as rotations in the hip joint. This torsion-transmitting model helps to elucidate the trauma mechanisms of various ankle fractures. It also may explain why anterior knee pain due to malalignment can be relieved with supinating foot supports.
Ankle Joint↗
Carpal tunnel pressure in the acute phase after Colles' fracture.
In order to analyze the pressure on the carpal tunnel in the acute phase after Colles' fractures 13 patients were studied. The initial pressure and the variation after injection of a local anesthetic into the fracture hematoma, as well as the effects of increased volar flexion of the wrist, were measured using a wick catheter technique. Comparisons were made with a control group of ten healthy volunteers. The pressure was significantly higher in the fracture group than in the control group, and it increased significantly after injection of a local anesthetic into the fracture hematoma. A correlation was found between high increases after local anesthetic injection and high initial pressure. The pressure increased linearly with volar flexion of the wrist. There was a correlation between high increases due to volar flexion of the wrist and high initial pressure. The trauma itself causes increased carpal tunnel pressure due to edema and bleeding. Injection of a local anesthetic solution increases the fluid content of the carpal tunnel and raises the pressure. Volar flexion of the wrist decreases the space in the carpal tunnel, which also increases the pressure.
Adult↗