Biomedical subjects
Publications and source records attributed to O Sneppen.
A case of osteosarcoma affecting the third metatarsal bone is submitted. Below-knee amputation was performed, but the patient developed pulmonary metastases and died 1 year after the operation. The six cases of osteosarcoma in the metarsal bones published so far are reviewed. The prognosis for cases with this localization does not appear to differ from that for osteosarcoma in general.
The follow-up of 50 knees treated with the modular Marmor prosthesis and 50 with the Guepar hinge joint included tangential radiography of the femoro-patellar joint. After Marmor arthroplasty lateral patellar dislocation was found in seven knees, in six causing pain. After Guepar arthroplasty lateral patellar dislocation was found in 32 knees, but pain was present in only three. There was only a questionable correlation between pre-existing valgus deformity and postoperative lateral patellar dislocation, and an external rotation deformity of the lower leg was found in only five cases after Guepar arthroplasty. Thus, neither phenomenon could explain the high incidence of lateral patellar dislocation in the Guepar series. These dislocations must be assumed to be due to the unphysiological strain on the extensor apparatus inherent in this type of prosthesis.
Fifty-four tumors or tumor-like conditions in bone were studied by numerically assessed 99m-technetium polyphosphate scintigraphy. The uptake was expressed as a ratio of the uptake in the tumor region to the uptake in a corresponding region in the contralateral part of the body. In the malignant tumors there was marked variation in the uptake within each individual tumor group, a variation that rendered a differential diagnosis impossible. In general, the uptake was fairly high in malignant tumors and lower in benign ones. A ratio below 1.5 suggested the likelihood that the lesion was benign. The ratios also varied considerably with the site of the tumor and the patients' ages. Relatively low ratios were found for tumors of the trunk and for juxta-articular tumors in children, whereas higher and more varied ratios were observed in tumors of the peripheral skeleton in adults. It is concluded that numerically assessed scintigraphy is not a useful supplement to other methods used for diagnosing bone tumors.
Explore the source record for details and available documents.
One hundred and twenty-three patients with fracture of the neck of the talus were followed up over an average of 22 months. Ffity-four fractures were undisplaced, 53 associated with subtaler dislocation, and 16 associated with dislocation of the talus in both ankle joint and subtalar joint. Of the total 123 patients, 21% (26/123) developed avascular necrosis, 31% (38/123) developed talo-crural and 47% (58/123) subtalar osteoarthrosis. Fifteen per cent (18/123) of the fractures united with considerable deformity, and four per cent (5/123) exhibited non-union of the neck. Out of 63 patients with isolated fracture of the neck of the talus, 65% (41/63) reported moderate or severe complaints, and 52% (33/63) complained of functional disability often resulting in a change to lighter work. Even among the 54 undisplaced cases there were unexpected numbers of late sequelae, such as osteoarthrosis, subjective complaints and disablement.
Fifty-one patients with fracture of the body of the talus were seen at follow-up examination an average of 23 months after treatment. Osteonecrosis had developed in 8 out of 17 patients with displaced shearing or crush fractures of the trochlea. Malunion as well as subluxation predisposed to osteoarthrosis in the subtalar and talocrural joints. Thus, osteoarthrosis was present in 9 out of 21 patients without malunion, in 8 out of 16 patients with malunion, and in 11 out of 14 with malunion as well as subluxation. Judging from the nature of the complaints, the difficulties in rehabilitation, and the disability assessment, the prognosis was fairly grave, also after the small, usually non-displaced fractures of the posterior and lateral tubercles. Out of 20 patients with fractures of this type only 6 obtained almost complete relief from their symptoms, only 8 could go back to their previous work on a full-time basis, and 11 were assessed to be 10 per cent or more disabled. Fractures in the posterior and lateral tubercles must therefore be interpreted as links in more extensive injuries involving the subtalar joint and possibly the talocrural joint with associated injuries to articular cartilage, joint capsules, and ligaments.
During the period from 1945 to 1972, 30 cases of subtalar dislocation were reported to the Directorate of Industrial Injuries Insurance in Denmark. The lesions were classified according to type of dislocation showing that the medial inward type predominated by far. According to the findings of the present investigation, the long-term prognosis seems to be more serious than has hitherto been assumed. X-ray and clinical examination disclosed that arthrosis of the subtalar joints was demonstrable in 19 patients. Six of these patients had pantalar arthrosis, the causative factor in two cases being avascular necrosis of the talus. Clinical examination showed that walking was associated with some degree of pain in 21 patients and 15 patients had a more or less pronounced limp.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.