[Acute aortic dissection].
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Biomedical subjects
Publications and source records attributed to P S Vang.
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Subphrenic omental bursa abscess is frequently overlooked and the overall mortality is 70%. Early diagnosis and drainage improve the prognosis considerably. In cases with abdominal symptoms followed by pyrexia, possibly with signs of sepsis, and pleural effusion but with no or only slight findings on objective clinical examination, subphrenic abscess should be suspected and a scanning of the abdomen should be performed.
Knee replacement using the Total Condylar Prosthesis was carried out on six large cadaveric knees. Tibiofemoral articulation was studied radiographically with the tibial component placed anteriorly as well as posteriorly on the tibial plateau. It is concluded that, in this model, when using the Total Condylar Prosthesis for big-sized knees, a tall, posteriorly placed tibial component gave the best placement of the femoral component and the most central tibio-femoral articulation, entailing optimal distribution of the load on the trabecular bone beneath the tibial component.
The trabecular bone of the proximal end of the tibia was assessed as an endoprosthesis-bearing structure. The mass and mineral content as well as the activity of subchondral trabecular bone were determined in osteoarthritis knees with varus or valgus deformity. Bone specimens were taken from the lateral condyle, the medial condyle, and centrally from the intercondylar area of seven varus and four valgus knees. The percentage volume of trabecular bone was determined by histomorphometry. On an additional nine knees, five with varus and four with valgus deformity, as well as ten knees from a normal autopsy material, photon absorptiometric determination of the mineral content of the same areas was performed. On average, the loaded condyle had twice the percentage volume of trabecular bone, and accordingly twice the mineral content, of the unloaded condyle. It was remarkable that the mineral content of the latter was of the same order as the condyles of the normal material.
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To measure the strength of the juxta-articular trabecular bone in knee replacement, an osteopenetrometer was developed. The principle of its function is tha a needle penetrates the bony tissue and during this penetration the pressure on and the displacement of the needle is registered. The instrument was tested on cadaveric specimens of the proximal tibia. Good agreement was found between the osteopenetrometer findings in 18 cases and compression tests on the same bony structure. Forty-five measurements at different sites of the tibial resection surface revealed that the force needed for the penetration varied according to a pattern known from the determination of the elasticity modulus and ultimate compressive strength of bone in the same area. Histological examination of the penetration canals in the bone disclosed only sparse upsetting of bone. Curves from corresponding bone proved to reflect, in height as well as shape, the morphology of the skeletal structure. The osteopenetrometer appears to be applicable fo objectively assessing the solidity of trabecular bone during the operation. Thereby it is possible, in each individual case, to form a basis for more varied planning of the postoperative treatment programme.
A modified Watson-Jones technique, using only half of the peroneus brevis tendon, was applied as an operative procedure for lateral ankle instability. Twenty-nine patients with 30 operated ankles were examined with an average follow-up period of 7 years and 6 months. Functional stability was achieved in all but one of the operated ankles. In 15 cases there were periodic pains and swelling on activity, while the remaining 14 ankles were without symptoms. Supination of the foot was slightly decreased in 4 cases.
A soft tissue interposition arthroplasty for carpometacarpal osteoarthritis of the thumb is described. Thirty-seven joints in 32 patients were operated on. The results with regard to pain, strength and mobility are recorded. In 34 cases the patients reported considerable improvement after the operation and the majority of the patients could resume their usual work. Only minor complications occurred.
A case of intraosseous haemangiopericytoma of the humerus is described. Exarticulation at the shoulder joint was performed and the patient has been followed for 8 years, so far without developing a local recurrence or metastases. The 16 cases of intraosseous haemangiopericytomas on record are reviewed.
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