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Biomedical subjects

O Kiviluoto

Publications and source records attributed to O Kiviluoto.

At least 37 records · Page 2Linked to original sources
PubMed1981

Application of free autogenous fibular graft in the treatment of aggressive bone tumours of the distal end of the radius.

Long-term results of the application of free autogenous fibular graft in the treatment of aggressive bone tumours of the distal end of the radius are presented. Six patients underwent radical resection of the tumour including the articular surface of the distal radius during the period 1969 to 1978, the average follow-up time being 5 years. In one case the tumour was low grade chondrosarcoma, in three cases a giant cell tumour grade two to three and in the remaining two a hemangioma. Five to twelve cm of the distal radius was resected and the defect was replaced using the ipsilateral proximal part of the fibula as free graft. Osteosynthesis was performed end to end with a plate fixation, or side to side with screw fixation. At follow-up, the range of motion in the radiocarpal joint was normal or close to normal in each case and all patients had returned to work within 6 months of the operation. None of the patients presented a recidive of the tumour.

Adult↗
PubMed1981

Comminuted displaced fractures of the patella.

A series of 64 comminuted displaced fractures of the patella is reviewed. Morphologically the fractures can be classified into three groups reflecting the mechanism of injury and the degree of soft tissue damage. All fractures were operated on. Tension band wire was used in 21, partial patellectomy in 33 and total patellectomy in patients. The problem of the management of these fractures is often in making the choice between excision and internal fixation. In this retrospective analysis the results of anterior tension band wire fixation were acceptable even in severe comminuted fractures. Partial excision showed satisfactory results provided that at least three-fifths of the patella could be preserved. Total excision is sometimes clearly unavoidable but should be preceded by sober contemplation whenever considered as the alternative to internal fixation.

Adult↗
PubMed1980

Role of drugs in traffic accidents.

Serum samples from 201 drivers who presented at emergency departments within six hours after being injured in a road accident and 325 control drivers selected randomly at petrol stations were screened for drugs by combined thin-layer and gas chromatography. Blood alcohol concentrations were also measured, and a questionnaire on the subjects' state of health and use of drugs administered. At interview 30 patients (15%) and 44 controls (13%) said that they had taken drugs in the previous 24 hours. Four patients (2%) and six controls (2%) said that they had taken psychotropic drugs, but serum analysis detected psychotropic drugs in 10 patients (5%) and eight controls (2.5%). Diazepam was found in 16 of the 18 subjects in whom psychotropic drugs were detected. Alcohol was detected in 30 patients (15%) and three controls (1%). Drug use appeared to be somewhat lower in Finland than in other Western countries, and illness to be a more important traffic hazard than drugs in general. Interview was not a reliable method of establishing whether drivers had taken psychotropic drugs. Taking diazepam may increase the risk of being involved in a traffic accident, but alcohol was the most powerful risk factor.

Accidents, Traffic↗
PubMed1980

Unfavourable radiological signs in fractures of the calcaneum.

Although 28 radiological signs in both primary and late radiographs were analysed for 67 patients with 86 fractures of the calcaneum. The fracture type is correlated with the clinical late result in Table 1. The radiological signs which predict or correlate with a poor late result are presented in Table 2. The operative reduction is mainly directed to improve the architecture of the posterior talocalcaneal joint: in our series the improvement was observed in half of the postoperative radiographs. However, this improvement was not usually followed by a favourable late result; mainly because the operated patients had also the most severe injuries.

Adolescent↗
PubMed1980

Victims of assault attending casualty departments.

Victims of assault make up about 8% of all adult injury cases. The purpose of this study was to analyse the personal characteristics and injuries of 518 victims of assault (=case material) and 496 accidentally injured (=controls), selected at random in a large casualty department. The proportion of males was higher among the assault cases than among controls (76 vs. 61%). Assault victims were more concentrated in the age range 15 to 44 years (81 vs. 64%). Fifty per cent of the cases and 8% of the controls were intoxicated, while the rates of chronic misuse of alcohol were 37 and 18%, respectively. Forty seven per cent of the cases and 18% of the controls arrived at night. Assault cases had sustained mostly minor head injuries. However, injuries needing referral to the ENT department or Dept. of jaw surgery were also common. Casualty departments are well suited to victim studies. Additional information as to social background, criminality and psychiatric morbidity of victims is needed.

Adolescent↗
PubMed1980

Immobilization after primary dislocation of the shoulder.

A total of 226 patients with primary shoulder dislocation were followed up for 1 year, the primary object being to observe the effect of immobilization on the incidence of redislocation. The shoulders were immobilized in a mitella for 1 week in all the 127 patients older than 50 years of age, and in 53 of the patients under 50 years of age. The shoulders of the remaining 46 patients (under 50 years) were completely immobilized with a stockinette-Gilchrist bandage for a period of 3 weeks. Thirteen per cent (30/226) suffered from one to four redislocations each during the follow-up period. Because most recurrences occurred in the patients under 30 years of age, these patients were compared with the older ones in the analysis. The frequency of redislocation was higher in the group of 53 patients under 30 years than in the older subgroup (P less than 0.001). Twenty-six of these 53 patients (under 30 years), who had been immobilized for 1 week, presented a higher frequency of redislocation than the remaining 27 patients subjected to 3 weeks' immobilization (P less than 0.05). Manual labourers experienced more numerous redislocations than office workers (P less than 0.01). The greater the initial trauma to the shoulder, the lower was the incidence of recurrence. There were only two among the 57 patients with early complications of the primary shoulder dislocation who had a redislocation (P less than 0.001). Residual stiffness was encountered more often in the patients over 30 years than in the younger ones (P less than 0.001). Following primary shoulder dislocation, 1 week's immobilization in a sling is sufficient in patients over 30 years, while in the case of most of the younger patients 3 weeks' complete immobilization of the shoulder is recommended.

Adolescent↗
PubMed1980

[Prevention of venous thromboemboli with low doses of heparin in patients with proximal femur fractures].

The value of low dosage heparin in preventing venous thromboembolism was studied in 150 patients with proximal femoral fractures. This was a prospective, randomized, clinical trial, consisting of 116 women and 34 men with a mean age of 73 years (38 to 92). 5000 units of subcutaneous heparin was given twice a day for a fortnight to the heparinized group and the control group was left without. The heparin was commenced on admission to hospital. Deep venous thromboses (D. V. T.) and pulmonary embolism (P. E.) was diagnosed on clinical grounds. Fatal P. E. was verified by necropsy. There was significantly less D. V. T. in the heparinized group than in the control group (p < 0.01) and the incidence of P. E. was smaller in the heparinized group, 0 and 4 per cent respectively. This difference is not statistically significant. There were no significant differences in the amount of blood needed. We recommend routine use of low dosage heparin started on admission to hospital in proximal femoral fractures.

Adult↗
PubMed1980

Injuries of competitive skiers in Finland: a three year survey.

The present investigation reports on the injuries of competition skiers in Finland during the period 1976 to 1978. This investigation was made possible through the present system in Finland where an obligatory competition licence is always linked with accident insurance and the authors were able to base their work on an insurance company's records. The total number of licensed competition skiers in 1978 was 7814, 7052 being cross-country skiers, 275 skijumpers and 487 downhill skiers. During the period under investigation 180 accidents leading to an injury were rcorded. Cross-country skiers had 47% of these injuries, downhill skiers 23% and skijumpers 30%. The injury risk in skijumping (47%) proved to be highly significantly (p < 0.001) greater than in the other events (3% and 18%). In the comparison of the injury risk, men (8.5%) outnumbered women (4.4%) (p < 0.001). Men under 30 had more injuries than the older age group (p < 0.001). Muscle and tendon injuries were most common in cross-country skiing. The risk of sustaining a fracture was higher in skijumping than in the downhill events (p < 0.001) and higher in downhill skiing than in cross-country (p < 0.001). On the basis of the present investigation cross-country skiing seems to be a safe activity, but downhill skiers and especially skijumpers seem to be subject to a relatively high risk of injury.

Adult↗
PubMed1979

External fixation of unstable pelvic fractures.

The Hoffmann external fixator was used to stabilize unstable pelvic fractures in 56 patients with multiple injuries. It was applied under general anaesthesia and the dislocated pelvis reduced and secured with a single tie bar. In 16 cases residual dislocation of less than 1.5 cm was noted after the reduction and the reduced position was maintained in 48 out of 51 cases, a minor redislocation occurred in the remaining 3 patients. Few complications could be attributed to the method, infection was noted in one patient, the iliac crest was fractured in one case and an exostosis of the iliac crest occurred in one youth. Forty-three patients were symptom free with regard to the pelvis at the time of review whereas 5 patients had residual pain and 3 diffuse symptoms. The technique of application is simple but requires two surgeons at the time of reduction and fixation of the pelvis.

Adolescent↗
PubMed1979

Operative control of massive haemorrhage in comminuted pelvic fractures.

In 42 patients, massive haemorrhage following comminuted pelvic fractures was treated by operation through a mid-line, Pfannenstiel, anterior iliac crest-femoral or posterolateral approach, or using these in combination. The superior and inferior gluteal, pudendal and obturator arteries were the usual source of bleeding. Bleeding from the pelvic bone tissue was of minor importance. Temporary compression of the abdominal aorta was sometimes required to help control bleeding before ligation of injured vessels could be accomplished. An average of nine units of blood was given to each patient before operation and 30 units during or after the procedure. Of the 12 deaths, only three were attributable to bleeding from the pelvic fractures, indicating the value of operation in the treatment of massive haemorrhage from such injuries.

Adolescent↗
PubMed1979

Fractures of the calcaneum.

Sixty-seven patients with 86 fractures of the calcaneum were re-examined 2 to 6 years after their injury. These fractures of the calcaneum were of two types: thalamic, involving the posterior subtalar joint (85%); and nonthalamic, confined to the extra-articular area (15%). Treatment had been by functional therapy, plaster fixation, pin reduction, or open reduction. At followup, only 28 of the 86 heels were entirely painless. Pain was most common posterolaterally along the peroneal tendons; reduction of the tuber (Böhler) angle correlated significantly (p less than 0.001) with an abutment of the peroneal tendons. Motion in the subtalar joint was restricted in two thirds of the series, and in the talocrural joint in one third; a reduction of the tuber angle correlated significantly (p less than 0.001) with reduced mobility of these joints. The duration of sick leave was significantly (p less than 0.05) shorter after functional treatment of displaced thalamic fractures than after treatment with pin reduction and immobilization in plaster. Results were the same with both modes of treatment. The results of treatment of nonthalamic fractures were rewarding, whereas a common consequence of thalamic fractures was considerable impairment of ankle function. The significant correlation between a depressed tuber angle and unsatisfactory functional results suggests that closer attention should be paid to the accurate alignment of the posterior subtalar joint in the treatment of thalamic fractures of the calcaneum.

Adolescent↗
PubMed1978

Fractures of the olecranon. Analysis of 37 consecutive cases.

This study is based on 37 consecutive cases of fracture of the olecranon, treated during the period 1973-1975. The average follow-up time was 2 years. The treatment was operative in all but two of the cases. Superficial post-operative infection occurred in three cases and in three cases the internal fixation failed due to porotic bone. The transverse fractures healed more satisfactorily than the comminuted ones. A short post-operative immobilization of 3 weeks or less gave the best results (P less than 0.05). In the comparison of methods cerclage combined with two Kirschner wires gave better results than cerclage alone.

Adolescent↗
PubMed1978

Early complications of primary shoulder dislocations.

A prospective study of the complications of primary shoulder dislocation was carried out for the 3-year period 1973-1976. The clinical examination was made initially in the Casualty Department and the patient was re-examined in the Department of Physical Medicine. In the evaluation special attention was given to the condition of the rotator cuff, the blood vessels and the motor and sensory function of the affected extremity. Sixty-three out of 238 patients (26 per cent) presented with the following complications: 29 lesions of the brachial plexus, 21 of the axillary nerve and 28 ruptures of the rotator cuff tendon. Complications occurred more frequently in the age group over 50 years (P less than 0.001) and in manual labourers compared with office workers (P less than 0.05). If the humerus remained unreduced for more than 12 hours, the frequency of complications increased (P less than 0.01).

Adolescent↗