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Biomedical subjects

J Puranen

Publications and source records attributed to J Puranen.

At least 73 records · Page 4Linked to original sources

Ring total hip replacement in osteoarthrosis.

A follow-up is given of the results of 40 arthroplasties with the non-cemented, vitallium-to-vitallium bearing Ring total hip prosthesis in 37 patients with osteoarthrosis. Operative indication was an intolerably painful and stiff joint. The surgery was performed by two specialists in orthopaedics. Point scors according to a modification of merle d'Aubigné's classification showed excellent or at least good results in 52.5 per cent, and fair results in 27.5 per cent of the operations. One prosthesis was removed because of deep infection. The mortality rate was zero. In 20 per cent the total score was between 0 and 7, signifying little or no improvement. Loosening was the main problem even although it was in many cases well tolerated by the patients.

Adult↗

The Moore vitallium femoral-head prosthesis in fractures of the femoral neck.

A follow-up is given of early and late results in 109 arthroplasties with the self-locking Austin T. Moore vitallium femoral head prosthesis in fractures of the femoral neck on 106 patients. Operative indication was usually fresh medical fracture of the femoral neck in an elderly woman, or its late complication. The surgery was performed in a unit for general surgery also engaged in pre- and postgraduate teaching activities. Many operations were performed by residents engaged in general surgery or orthopaedics. Point scores according to a modification of Merle D'Aubigné's classification showed excellent or at least good results in 81 per cent of the 69 mobile patients. Because of deteriorated general physical condition 11 patients were chronically bed-ridden. Five patients could not be reached. In three instances the prosthesis was removed. 21 patients died, three during the stay in hospital and 18 later for reasons not connected with the operative procedure. The mortality during 40 months of observation corresponded fairly well to that expected in the age group for the population as a whole.

Adult↗

Intertrochanteric osteotomy in the treatment of Perthes' disease.

Intertrochanteric osteotomy has been carried out in 34 children with Perthes' disease. Five weeks after the operation the patients were allowed to move about freely. The average postoperative follow-up period was 27 months. At that time the results seemed to be at least as good as those of Thomas' splint therapy. The varus-derotation osteotomy performed in the initial stage accelerated the process of reossification and seemed to prevent subluxation. According to our findings it is worthwhile correcting the subluxation even in cases with irreversible changes.

Child↗

The effect of intertrochanteric osteotomy on the venous drainage of the femoral neck in Perthes' disease.

Intraosseous femoral neck venography was performed both pre- and postoperatively on 30 patients with Perthes' disease. At the time of the operation (osteotomy) and the preoperative venographies, the disease was in the initial stage in 16 patients, in the fragmentation stage in eight patients and in the restitution stage in six patients. As shown previously the venous drainage of the femoral neck preoperatively, in the initial and fragmentation stages of the disease, was different from the venous pattern of the healthy (control) hips in every case, indicating an obstruction of the venous flow. 4-15 months after the osteotomies this venous obstruction had disappeared completely or almost completely in most cases. This normalization happened sooner than expected on the basis of our findings with conservatively-treated patients.

Child↗

Strontium-85 profile counting in fractures of the tibial shaft.

A total of 203 profile countings were performed on 68 fractures of the tibial shaft, which included 25 normally healing cases, 37 cases of delayed union, and six cases of non-union. The measurements were performed on the 1st and the 7th day after the injection of strontium. In 27 cases the fracture received 2-3 strontium injections with associated profile counting at different stages of the healing process. The cases of normally healing fractures and delayed union showed differences in the average strontium uptake. However, these differences were not distinct enough to enable classification of individual fractures into groups. In cases requiring bone grafting, the transplant was found to accelerate metabolism and increase the accretion of strontium at the site of the fracture. The investigation shows that the real value of strontium profile counting lies in its ability to give information about the osteogenetic activity of the bone, which is a necessary prerequisite for the healing of the fracture.

Bone Transplantation↗