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Biomedical subjects

N Westlin

Publications and source records attributed to N Westlin.

At least 19 recordsLinked to original sources
PubMed2002

Herniographic findings in athletes with unclear groin pain.

BACKGROUND: Groin pain in athletes is a common symptom and may, among many other entities, be caused by skeletal changes in the symphysis and the pubic bone or hernia. MATERIAL AND METHODS: Herniographies in 51 athletes -- mainly soccer players -- with unclear groin pain were reviewed. The prevalence of various hernias and skeletal changes at the symphysis and os pubis was registered. A questionnaire was also sent to the patients 3-20 years after the herniography. RESULTS: A hernia was found in 13 patients. Four patients had an indirect inguinal hernia. Eight patients had a direct inguinal hernia and 1 had an obturator hernia. The prevalence of direct inguinal hernia was higher than expected in young men. This may be explained by strain at physical exercise. Bone changes at the pubic symphysis were found in 32 patients, 21 of whom had advanced changes. CONCLUSION: A hernia can be found with herniography in one-fourth of athletes with long-standing unclear groin pain. Therefore herniography should be included in the diagnostic procedure. Lesions of the symphysis may be the result of strain of tendons, ligaments and fascias. This may predispose for an inguinal hernia as well.

Adolescent↗
PubMed1997

Immediate external compression in the management of an acute muscle injury.

In a prospective, non-randomized study 40 athletes with contusion or distension injuries to the thigh or the calf muscle were followed with tests of range of motion (ROM) of knee or ankle joint, test of serum creatine kinase (CK) and ultrasonography of the injury until completely recovered. An experimental group of 19 injuries where subjects received treatment with application of a maximum compression bandage within 5 min (mean = 2 min) of the injury was compared to a control group of 21 injuries where subjects were treated with rest and elevation only, and in some cases non-maximum compression after 10-30 min. No significant differences were noted with respect to time to complete subjective recovery, ultrasonic size of the injury or time to normal findings on ultrasound between treatment and control groups. Strain injuries, although showing a tendency to be smaller in size, took a longer time to complete recovery than contusion injuries (mean +/- SD = 26 +/- 22 days and 19 +/- 9 days, respectively, P = 0.02). Diagnostic CK values and reductions in ROM were not correlated to the severity of the trauma, while ROM showed weak correlation to the sonographically measured size of the hematoma (r = 0.42: P < 0.01). Injuries displaying a circumscript anechoic, low-echogenic or mixed lesion at the diagnostic ultrasound investigation normalized more slowly (P = 0.001) and took longer to complete recovery (P = 0.001) than injuries with diffuse hyperechogenic lesions. We conclude that in this study the application of a maximum compression bandage within 5 min of a muscle trauma did not significantly reduce the size of the hematoma nor significantly shorten the time to complete subjective recovery compared with no immediate treatment. The diagnostic ultrasound investigation was valuable in predicting the severity of the trauma.

Adolescent↗
PubMed1996

Sports-related groin pain: evaluation with MR imaging.

Our purpose was to assess the role of MRI in evaluating the musculoskeletal system in athletes with chronic pain laterally in the groin of unknown etiology. Magnetic resonance imaging (MRI) of the pubic ring was performed in 11 young athletes (soccer players) with long-standing groin pain. MR findings were compared with plain films and isotope examination (bone scan Tc 99M). Abnormal MRI findings included a broadened and irregular symphysis with a characteristic pattern of low signal intensity on T1W and high signal intensity on T2W images localized in the superior pubic ramus at a distance from the symphysis. Positive findings were also observed on plain films and on nuclear medicine studies. However, the imaging findings in the superior public ramus of the symphysis was located considerably more laterally on MRI. MRI is a valuable method for evaluating discrete and ambiguous pelvic pain in athletes, particularly for identifying concomitant changes in the superior ramus, which may give rise to long-standing pain localized laterally in the groin.

Adolescent↗
PubMed1996

Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases.

OBJECTIVE: To compare information gained by ultrasonography and magnetic resonance imaging (MRI) in chronic achilles tendinopathy with regard to the nature and severity of the lesion. DESIGN: Imaging of both achilles tendons with ultrasonography and MRI was performed prior to unilateral surgery. Operative findings and histological biopsies together served as a reference. PATIENTS: Twenty-seven patients (22 men, 5 women; mean age 44 years; 21 athletes) suffering from chronic achilles tendinopathy participated in the study. Eighteen patients had unilateral and 9 had bilateral symptoms. RESULTS AND CONCLUSIONS: Surgical findings included 4 partial ruptures, 21 degenerative lesions and 2 macroscopically normal cases. Microscopy revealed tendinosis (degeneration) in all tendon biopsies, including cases with a partial rupture, but only slight changes in the paratendinous tissues (paratenon). Ultrasonography was positive in 21 of 26 and MRI in 26 of 27 cases. Severe intratendinous abnormalities and a sagittal tendon diameter > 10 mm suggested a partial rupture. In tendons with a false negative result histopathological changes were mild and a tendency towards a better clinical outcome was noted in the sonographic cases. Assessment of the paratenon was unreliable with both methods. Ultrasonography and MRI give similar information and may have their greatest potential as prognostic instruments.

Achilles Tendon↗
PubMed1996

Anterior cruciate ligament reconstruction with the patellar tendon--augmentation or not? A 2-year follow-up of 82 patients.

The aim of this bi-centre study was to assess the possible effects of the addition of the Kennedy ligament augmentation device (LAD) in the reconstruction of the anterior cruciate ligament (ACL). The method of reconstruction used was a modification of the Brückner and Broström procedures, using the medial third of the patellar tendon tunnelled through the proximal tibia into the lateral femoral condyle and fastened with pull-out sutures. Eighty-two patients with chronic ACL insufficiency and severe symptoms of instability in spite of physiotherapy were randomly selected for reconstruction with or without a LAD. The LAD-augmented knees had the synthetic augmentation stitched to and embedded into the autogenous tissue and the composite graft was pulled through a femoral tunnel and stapled proximally. The patients were followed up regularly and the 2-year results are presented here. The outcome in both groups was good. The augmented-knee group had a larger extension deficit 1 month post-operatively compared to the non-augmented knee group but a smaller extension deficit at the 2-year follow-up. There was no difference in the median of the Lysholm knee function score but there were more patients in the non-augmented group with a lower Lysholm knee function score at the 2-year follow-up.

Adolescent↗
PubMed1996

Increasing incidence of Achilles tendon rupture.

During the period 1987-91, 153 cases of total Achilles tendon rupture were diagnosed in the city of Malmo (population 230,000). Almost two thirds were caused by sporting activities, notably badminton. Ruptures caused by nonsports injuries were found in older subjects. Compared to the age-specific incidence in 1950-73, a marked increase in both sports and nonsports injuries was found and patients in the latter group were older than in the former period. Patients with Achilles tendon ruptures can be classified into two subgroups with partly different etiologies: young or middle-aged athletes and older non-athletic persons. The increase in the former group is mostly explained by increased participation in recreational sports; the cause of increase in the latter group is unknown.

Achilles Tendon↗
PubMed1995

Fifth metatarsal fractures. Biomechanics, classification, and treatment.

Fractures of the fifth metatarsal are treated conceptually based on anatomic location and character of the fracture site. Intra-articular disruptions require reconstruction, if possible. Malalignment of acute fractures requires either closed reduction or open reduction if the malalignment represents a load-bearing dysfunction to the forefoot. Segmental defects require bone grafting and stabilization with plate and screws. Jones fracture is most effectively managed with medullary lag screw delivery in the active or athletic patient. Casting can be considered for high-risk patients. Late bone grafting for sclerotic nonunion is necessary with inlaid grafts harvested from the calcaneus or tibia. Tuberosity fractures require open reduction only when articular involvement is a problem or when distraction is apparent. Otherwise, they can be expected to heal rapidly without long-term problems.

Fractures, Bone↗
PubMed1994

Blood flow in the human Achilles tendon assessed by laser Doppler flowmetry.

This study evaluated microvascular perfusion in the human Achilles tendon by laser Doppler flowmetry (LDF) at rest, during vascular occlusion, and during passive stretch and isometric contraction of the triceps surae. In 40 healthy volunteers, an intratendinous needle probe was introduced 5 mm above the distal insertion, at the midportion, and at the musculotendinous junction of both legs. Values were obtained at rest and during temporary vascular occlusion. Twenty-eight of the subjects also were assessed during physical provocation by passive stretch and isometric contraction of the triceps surae. Blood flow was significantly lower near the calcaneal insertion but otherwise was distributed evenly in the tendon. The output signal showed a pulsatile variation synchronous with heart activity, and temporary vascular occlusion always caused a pronounced reduction in LDF values. Passive stretch and isometric contraction induced a progressive decline in LDF values as tension increased. Hyperemia often appeared after contraction. Tendon blood flow was higher in women and decreased with increasing age.

Achilles Tendon↗
PubMed1994

Blood flow in chronic Achilles tendinopathy.

Thirty five patients, most of them athletes, with chronic Achilles tendinopathy were enrolled in a study of tendon blood flow using laser Doppler flowmetry at rest and during physical provocation by passive stretch and contraction of the triceps. The patients were compared with a group of 40 healthy volunteers assessed according to a similar protocol in a previous study. In both groups values were significantly lower at the distal insertion, but otherwise the values were evenly distributed throughout the tendon. Blood flow in the symptomatic tendons was significantly elevated as compared with the controls. Both groups demonstrated a similar vascular response to physical loading, a progressive decline in blood flow as tension increased. Contrary to popular belief chronic Achilles tendinopathy is associated with an increased blood flow of uncertain origin. A local deficiency in tendon blood supply does not initiate the lesion nor does it explain why the condition persists.

Achilles Tendon↗
PubMed1992

No effect of piroxicam on achilles tendinopathy. A randomized study of 70 patients.

70 consecutive adult, nonrheumatic patients with a painful achilles tendinopathy were randomized to treatment with either a nonsteroid antiinflammatory drug (piroxicam) or placebo. Both groups received adjunct treatment with a period of rest combined with stretching and strengthening exercises. 52/70 cases were engaged in various sports, notably running. All subjects were evaluated on days 3, 7, 14, and 28 with respect to pain, tenderness, swelling, ankle joint movement and muscle strength. Results were judged from residual symptoms and an overall assessment of the efficacy. No differences were seen between the groups at any time during the study. The overall result was identical with a rate of success slightly better than 50 percent which corresponds to the placebo response reported in other studies.

Achilles Tendon↗
PubMed1987

Operative versus non-operative treatment of recent injuries to the ligaments of the knee. A prospective randomized study.

Two hundred consecutively seen patients who had an injury to either the anterior cruciate ligament or the medial collateral ligament, or both, were randomly allocated to treatment by either conservative or a surgical regimen. Injuries to the medial collateral ligament could not be demonstrated to benefit from surgical treatment in any respect--with or without surgery the results were excellent. With injuries to the anterior cruciate ligament, recovery was more rapid without surgery but otherwise the results differed between the groups in only one respect: the pivot-shift test was more often positive after conservative treatment. The results were good in both treatment groups even though most of the patients who had an injury of the anterior cruciate ligament were somewhat less pleased with the outcome after a period of time.

Adolescent↗
PubMed1987

The effect of external pressure on intramuscular blood flow at rest and after running.

Local blood flow in the thigh was measured with 133Xe clearance technique in eight male distance runners after compression with a foam rubber compress and a standard elastic bandage. Two degrees of compression were tested, and an initial experiment with rested subjects was followed by a similar experiment immediately after running. Maximum compression exerted a cutaneous pressure of 85 (+/- 8) mm Hg and caused an immediate cessation of intra-muscular blood flow in the compressed area. Moderate compression gave a cutaneous pressure of 40 (+/- 5) mm Hg and resulted in a reduction of blood flow by approximately 50%. During compression, there were no significant differences in the blood flow of rested subjects compared to subjects immediately after running. In acute soft tissue injuries, a maximum compression bandage should effectively reduce or eliminate the formation of an intra-muscular hematoma, and an additive effect on blood flow of ice should not be expected.

Adolescent↗
PubMed1986

Stability tests in knee ligament injuries.

For 182 knee joints with ligamentous injuries confirmed at surgery the records contained a complete and documented stability examination. In anterior cruciate ligament injuries the Lachman test and the anterior drawer sign were of similar value with regard to the frequency of false negatives - they missed half of the injuries - but their accuracy improved when they were repeated under anesthesia. The pivot shift was useful only under anesthesia. The medial collateral ligament injuries were usually detected because of valgus instability, also without anesthesia. The stability tests done with the patient under anesthesia are sufficiently reliable for making decisions about knee ligament surgery.

Adolescent↗
PubMed1986

Traumatic hemarthrosis in stable knees.

A thorough arthroscopic examination was performed in 90 consecutive patients with sprained knee injuries with hemarthrosis, but without signs of instability or fracture. The source of bleeding was found in all but five joints. Thirty-nine injuries were tears of the cruciate ligament, only three of which were complete tears. Fourteen injuries were (osteo)chondral fractures and six were meniscal lesions. The remainder bled from the synovium or meniscal attachments. The arthroscopic examination resulted in an altered course of treatment in few, if any, of these patients.

Adolescent↗
PubMed1985

The effect of local cold application on intramuscular blood flow at rest and after running.

Local blood flow was measured with 133Xe clearance technique in eight male distance runners, where one leg was cooled for 20 min by applying two "instant cold packs" on the quadriceps muscle. An initial cooling period after resting was followed by a second cooling period 10 min after running. Skin temperature was maximally reduced after 4.5 min of cooling, both at rest and after running, by 15 degrees C and 14.9 degrees C, respectively. During the first 5 min of cooling no reduction of blood flow was seen. After 10 min of cooling blood flow was significantly reduced in the cooled compared to the control leg by 49% (P less than 0.05) after resting and 34% (P less than 0.05) after running. A maximum reduction of blood flow by 66 and 69% (P less than 0.01), respectively, was seen 10 min after the cooling period. In the event of an acute injury, this delayed reaction of cryotherapy on intramuscular blood flow should be carefully considered.

Adolescent↗
PubMed1983

Ibuprofen and compression bandage in the treatment of ankle sprains.

One hundred patients with sprained ankles were randomly allocated to treatment with Ibuprofen 800 mg X 3 daily and placebo and to treatment with two qualities of compression bandaging. Neither Ibuprofen nor high quality bandaging had a significant effect on the swelling, pain or tenderness.

Adult↗
PubMed1982

Muscle glycogen and diet in elite soccer players.

The top players in an elite soccer team volunteered as subjects in a study to determine intramuscular glycogen concentrations after a regular season match, and whether optimal glycogen levels could be re-attained prior to the team's next match. Fifteen players were biopsied in the M. vastus lateralis following a regular season game (Day I). Of these, eight were biopsied 24 h later in the evening of a free day during which no training session was held (Day II), and again 24 h later after a very light training session (Day III). Muscle glycogen concentrations for the eight players averaged (+/- SD) 45.9 +/- 7.9, 68.9 +/- 2.7, and 72.8 +/- 8.3 mmol glucose units x kg-1 wet muscle weight on Day I, Day II, and Day III respectively. Dietary records were analysed during a week of peak, season competition and training. The average daily total energy consumption and total quantity of carbohydrates consumed were less than what is normally consumed by athletes in similar sports. The inability of the players to maintain even normal, resting levels of muscle glycogen is probably related to their dietary practices.

Adult↗