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Biomedical subjects

K Herrlin

Publications and source records attributed to K Herrlin.

At least 37 records · Page 2Linked to original sources
PubMed1991

Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma.

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients--47 of whom had high-grade malignant tumors--had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.

Adult↗
PubMed1991

Spinal canal remodeling after thoracolumbar fractures with intraspinal bone fragments. 17 cases followed 1-4 years.

The long-term fate of nonreduced intraspinal bone fragments in 17 thoracolumbar fractures--three not operated on and 14 stabilized with Harrington's rods or a Hartshill rectangle--was studied with CT. The reduction of the spinal canal area was measured in conjunction with the trauma in the nonoperated on cases and immediately after surgery in the other cases. The mean reduction was 29 (10-70) percent. The reduction had decreased to 14 (0-30) percent at the follow-up examination 31 (12-44) months later. The restitution of the spinal canal did not differ in the nonoperated and operated on patients. Our findings indicate that stable thoracolumbar fractures with intraspinal bone fragments, but without neurologic symptoms, can be treated nonoperatively, irrespective of the size of the fragment, without risk of subsequent symptomatic neural compression.

Adult↗
PubMed1990

External fixation of femoral fractures: experience with 15 cases.

We report our experience with external fixation in 15 femoral fractures in 14 patients. Follow-up times ranged from 4 to 56 months. Thirteen patients had multiple injuries. All but two fractures healed. In one patient with a supracondylar fracture, a knee arthrodesis had to be performed. One septic osteomyelitis of the femur led to amputation. The range of active knee joint motion was greater than or equal to 90 degree in 13 knees. Only six knees, however, regained a flexion of greater than or equal to 120 degrees. Pin tract infection occurred in one case and resolved uneventfully after revision and systemic antibiotics. External fixation should not be routinely used for fixation of femoral fractures, but may be considered in multiply injured and critically ill patients or in case of extensive soft tissue injury.

Adolescent↗
PubMed1990

Secondary total hip replacement after fractures of the femoral neck.

We studied the rate of revision in 84 consecutive total hip replacements performed for failed osteosynthesis of femoral neck fractures and compared it with that for primary arthroplasty for osteoarthritis. The age and sex adjusted risk of prosthetic failure was 2.5 times higher after failure of fixation, but all the excess risk was in patients over 70 years of age. There were radiographic signs of loosening of the femoral component at five to 12 years after secondary arthroplasty in six of 33 survivors. In general, the results of secondary replacement were no worse than those obtained after primary arthroplasty for femoral neck fracture. We consider that internal fixation should be the primary procedure: total hip replacement is a safe secondary procedure when osteosynthesis fails.

Age Factors↗
PubMed1990

Gadolinium-DTPA enhancement of soft tissue tumors in magnetic resonance imaging.

In a clinical study of 13 patients, gadolinium-DTPA (Gd-DTPA) was used for enhancement of soft tissue tumors at magnetic resonance imaging. Gd-enhanced T1 sequences were found to give additional information concerning tumor vascularity in 11 cases, tumor necrosis in 2 cases and tumor delineation in one case, compared with conventional T1 and T2 weighted spin echo sequences. If Gd-enhanced sequences were to be used as the only source of information, accurate assessment of tissue composition of the tumor would not have been possible. Furthermore, valuable information regarding tumor delineation towards surrounding fat may be lost.

Adult↗
PubMed1989

Trochanteric fractures--a clinical and radiologic evaluation of McLaughlin, Ender, and Richard's osteosynthesis.

Four hundred and thirty femoral trochanteric fractures operated with nail-plate (McLaughlin), Ender, or sliding screw-plate (Richard) osteosynthesis were followed up radiographically and clinically. For each method of osteosynthesis the initial nail position was correlated to the occurrence of late mechanical complications. Unstable fractures were associated with a higher incidence of one or more clinical complications such as repeated surgery, post-operative death, or increased pain. For Ender osteosynthesis correlations were found between several mechanical and clinical complications, while for Richard's osteosynthesis mechanical complications were significantly correlated to repeated surgery only. McLaughlin and Ender osteosyntheses had a higher incidence of reoperations than Richard's osteosynthesis, whereas the mobility and ADL function were the same at 4 months.

Bone Plates↗
PubMed1988

Silastic replacement of the trapezium for arthrosis--a twelve year follow-up study.

Thirty-three patients with 39 Swanson silastic trapezium implants have been studied. Three years after operation no dislocation or evidence of implant wear was found, but re-examination at an average of 12 years after operation revealed dislocations and implant wear in about half of the cases. Cyst formation in surrounding carpal bones was found in twenty cases. The result in terms of pain relief and thumb function was good and comparable to the three-year follow-up. A significant correlation was found between weakness of the pinch grip and dislocation of the implant. No correlation was found between pain and dislocation of the implants, nor between pain and presence of intraosseous cysts.

Aged↗
PubMed1985

Traumatic hip joint tamponade. Two cases with femoral head ischaemia.

Two elderly patients had pain after hip trauma with no radiographic evidence of fracture. Computed tomography demonstrated capsular haematoma. Scintimetry revealed femoral head ischaemia. Intracapsular hip joint pressure in extension was 240 and 176 mm Hg, respectively, in neutral position and 280 and 360 mm Hg in internal rotation. The hip joints were aspirated for 8 ml and 5 ml of blood, respectively, leading to pain relief and regained radiotracer uptake in the femoral head. It is concluded that traumatic hip joint tamponade may cause femoral head ischaemia which may be reversed by aspiration.

Accidents, Home↗
PubMed1984

Ileopectineal bursitis following total hip replacement.

Two cases of ileopectineal bursitis following total hip replacement are presented. Inflammation, infection and trauma are discussed as pathogenic factors. The results of fine needle biopsy, radiologic examination including CT and ultrasonography, as well as bacteriological cultures are described. The therapy was surgical in both cases.

Adult↗
PubMed1984

Complications after trochanteric fractures. A comparison between Ender and nail-plate osteosynthesis.

Three hundred and forty-one trochanteric femoral fractures operated with intramedullary nailing (Ender) or nail-plate osteosynthesis (McLaughlin) were followed up for 4 months and reoperations were recorded at 18 months. Both methods had an unacceptably high frequency of complications, radiographically in one third and reoperations in one tenth of the total material. The greatest number of operative technical problems was encountered in the Ender group. The 4-month radiographic follow-up showed more complications in unstable than in stable fractures for both methods. In stable fractures, the Ender group had more radiographic complications. There was a slightly better walking capacity at 4 months and fewer reoperations at 18 months in the McLaughlin group.

Bone Nails↗
PubMed1983

Renal artery aneurysms. Natural history and prognosis.

Eighty-three patients out of 8,525 undergoing renal angiography during the years 1970-1979 were found to have renal artery aneurysm, which in six patients were bilateral and in 11 multiple. This corresponds to an incidence of almost 1% in this group of patients. Sixty-nine patients were treated conservatively and followed for a mean of 4.3 years. At that time nine patients had died. The cause of death was in no case related to the aneurysm. None of the 60 living patients had symptoms which could be related to the aneurysm. Reports of 36,656 autopsies, including most of the sudden deaths occurring in southern Sweden during a ten-year period, were analyzed. Nineteen cases of ruptured arterial aneurysms in the branches of abdominal aorta were found, but in no case were the renal arteries involved. It is concluded that the risk for rupture of a renal artery aneurysm is extremely small. The indications to operate renal artery aneurysms are discussed.

Adolescent↗
PubMed1983

Radiologic and clinical evaluation of Harrington instrumentation in the injured dorsolumbar spine.

Conventional radiography and CT examination of the dorsolumbar spine were performed in 9 cases of vertebral fractures before and after Harrington instrumentation. The findings were correlated with neurologic symptoms and signs and the role of a commonly observed retropulsed vertebral body fragment in the development of compression symptoms of the spinal cord or cauda equina is discussed.

Adolescent↗
PubMed1983

Incidence and stability of trochanteric femoral fractures.

Sex, age and stability were recorded in 376 cases of trochanteric femoral fractures. In 168 cases the age and sex specific incidence was determined. When comparing our results with those in previous studies from the same region there was no increase that could not be related to age. This is in contrast to other reports from Scandinavia where investigators have found an increase in fracture incidence that could not be explained by the increasing number of old people. We, as others, have found a high proportion of unstable fractures. The unstable fractures did not occur more frequently in the oldest age groups.

Adult↗