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T Paavilainen

Publications and source records attributed to T Paavilainen.

At least 19 recordsLinked to original sources
PubMed1992

Social adaptation of young adults with congenital heart disease.

The social status of 71 young adults (30 females, 41 males, aged 22.9 +/- 1.9 yr) with congenital heart disease was compared with that of 211 (106 females, 105 males, mean age 23.2 +/- 1.4 yr) randomly selected controls. The clinical examinations included clinical study with ultrasonic visualization, electrocardiography, X-ray and measurement of exercise capacity. In the study group 87% had completed school at the secondary level and another 21% at high school level, while the corresponding figures in the control group were 98% and 51%. About half of both groups continued to vocational training and a fifth to a higher level. Those without any vocational education made up 32% of the study group (95% confidence interval 21-43%) and 11% of the controls (95% confidence interval 7-15%). State benefits were the main source of income for 13% of the study group as compared to 2% among the controls. The employment status of the actual labour force showed no significant difference between the groups. Among patients with congenital heart disease there were significantly more of those who had developed a dependent life style, living with their parents without a marital or quasi-marital relationship. A cyanotic type of severe heart defect is one of the factors predisposing to poor success at school and a dependent lifestyle. Congenital heart disease, even when treated, is a significant factor which influences adult life. The results call for more practical support to assist psychosocial maturation, especially in patients with residual defects.

Adult↗
PubMed1992

Cementless hip arthroplasty in diastrophic dysplasia.

Diastrophic dysplasia results in severe disproportionate growth failure, generalized joint dysplasia, and early osteoarthrosis of the hips. A total hip arthroplasty is often necessary in patients afflicted with diastrophic dysplasia by time they reach early middle age. During 1983-1988, total hip arthroplasties were performed on six women and four men (15 hips) with diastrophic dysplasia at the Orthopaedic Hospital of the Invalid Foundation. The mean age of the patients at the time of operation was 37 years and the mean height was 133 cm. A Lord endoprosthesis was used in nine hips and a Biomet endoprosthesis in six. Cementless fixation was used in all cases. Autogenous bone grafting to the acetabulum was performed in six hips. Simultaneous corrective osteotomy of the proximal femur and transposition of the greater trochanter was performed in three cases. Soft tissue release and tenotomies were performed in 10 hips. The average follow-up period was 5 years. Overall clinical results were good, with marked relief of pain and improvement of hip joint mobility. Aseptic loosening of the acetabular component was noted in two hips. As for complications, two femoral nerve paresis and two perioperative fractures of the proximal femur occurred, which all healed.

Adult↗
PubMed1991

Methodology for restoring functional leg length in revision total hip arthroplasty.

Functional leg length was measured in 30 patients before and after revision total hip arthroplasty. The authors emphasize the importance of preoperative planning, and determination of adjustment of the leg length should be aimed at a balanced attitude of the entire pelvis and lower back. In order to correct the length inequality, the leg was lengthened in the revision in 25 cases, left unchanged in 2 cases, and shortened in 3 cases. The mean functional leg-length inequality was 13 mm before operation and 4 mm after operation. The mean radiographic inequality between the upper surfaces of the iliac crest was 13 mm before operation and 9 mm after operation. The side operated was more often functionally shorter than the other side before operation, and longer than the other side after operation. The authors emphasize the importance of functional leg length in revision hip arthroplasty. The functional length discrepancy can be corrected in revision, but there appears to be a risk of overlengthening.

Aged↗
PubMed1991

Leg length inequality in total hip replacement.

Clinical and radiographic leg length inequality and pelvic tilt were measured in the erect posture in 36 patients before and after total hip replacement. Good correlation was observed between clinical and radiographic evaluations of pelvic tilt, assessed as height difference between iliac crests. Intraoperative alteration of leg length correlated well with changes in pelvic tilt but not with changes in true radiographic leg length inequality. It is suggested that adjustment of leg length during total hip arthroplasty should aim at correction of preoperative pelvic tilt observed during clinical and radiographic examination. True leg length, assessed as the height of the vertex of the femoral or prosthetic head is misleading. It does not reveal functional leg length, which is determined not only by the true leg length but also by the position of the hip joint on the pelvic wall.

Adult↗
PubMed1990

Vascularized pedicled bone graft into the femoral head--treatment of aseptic necrosis of the femoral head.

Revitalization of the femoral head in cases of aseptic necrosis was attempted in 13 hips of 11 patients 15-33 years of age. The necrotic bone was replaced by a vascularized pedicular iliac bone graft and free cancellous transplants. The results after an average follow-up of 53 months are satisfying in some cases. The surgical technique used is simple and applicable when a vascularized bone graft is needed in the hip region.

Adolescent↗
PubMed1990

Cementless total replacement for severely dysplastic or dislocated hips.

We report the short-term results of 100 cementless total hip replacements in 52 severely dysplastic and 48 totally dislocated hips, with some new technical solutions to the problems involved. In cases with a very narrow iliac bone, the acetabular screw ring is seated below the true cotyloid area. In hips with tight flexor and abductor muscles or with deformities of the proximal femur, various osteotomies were performed. Special attention was paid to careful pre-operative planning and precise operative technique. In spite of a high complication rate the results were generally good and even patients who required reoperation were satisfied with the final result.

Adult↗
PubMed1990

Aggressive granulomatous lesions in cementless total hip arthroplasty.

We describe six patients with aggressive granulomatous lesions around cementless total hip prostheses. Two patients previously had a cemented prosthesis in the same hip. The Lord prosthesis was used in five patients, the PCA in one. Both prostheses were made of chrome-cobalt alloy. Pain on weight-bearing occurred on average 3.2 years after the cementless arthroplasty, and at that time radiography revealed aggressive granulomatosis around the proximal femoral stem and the acetabular component in five of the patients; one had a large solitary granuloma in the proximal femur. Revision was performed on average 4.8 years after the cementless arthroplasty. At that time all granulomas had grown large in size; while waiting for revision operation, two femoral stem components fractured. All the granulomas showed a uniform histopathology, which included histiocytosis; the cause for these lesions was thought to be plastic debris from the acetabular socket.

Acetabulum↗
PubMed1990

Caries incidence in children with acyanotic congenital heart diseases before and after the heart operation.

An acyanotic cardiac disease (ASD) was diagnosed in a 9-year-old girl with a very high caries incidence and premature tooth eruption. After the heart operation her caries incidence declined considerably. An epidemiological survey was then conducted to find out if these observations could be generalized. dmf-t, dmfs, DMF-T and DMFS values for each year were counted retrospectively for a group of acyanotic heart diseased children operated on at the age of 5-7 years (mean 6) and another group operated on at the age of 10-13 years (mean 12), from the documents relating to annual examinations conducted by the public health dental services. The results were compared to those of healthy children matched for age and sex living in the same area. Heart disease resulted in DMF-T values above the control level in the group operated on at age 6 years, whereas the values were lower than the controls in the group operated on at age 12 years, the difference being significant after the operation in the latter case. It is concluded that acyanotic congenital heart disease may lead to a higher caries prevalence and sometimes rampant caries. When the caries prevalence of the population is high, however, (DMF-T higher than 4.5 at 12 years), the effect of heart disease remains hidden.

Child↗
PubMed1988

Construction of acetabular bone stock. A staged cementless arthroplasty of the hip.

Vascularized pedicular bone graft was used for the purpose of achieving a sufficient bone stock for cementless total hip arthroplasty in patients with major acetabular bone defects. A useful bed for the acetabular prosthesis was obtained in all three cases. The ordinary prosthetic arthroplasty was performed in the second phase. The vitality of the grafted bone was then controlled. The results after a follow-up time of 23, 32 and 40 months respectively are good.

Acetabulum↗
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↗
PubMed1978

Lymphatic abnormalities in Noonan's syndrome.

Five boys who had Noonan's syndrome and lymphatic abnormalities are reported. The youngest boy had clinical lymphoedema and the other four showed dermal backflow after interdigital injection of Patent Blue indicating impairment of flow along the superficial lymphatics. One boy had severe bilateral chylothorax. The lymphographic findings in four of these boys are reported. Patients with the Noonan syndrome frequently have oedema of the hands and feet at birth, which decreases during the first years of life [10]. It has been demonstrated by lymphography that similar peripheral oedema in patients with the Turner's syndrome is due to lymphatic hypoplasia [1, 3]. We report certain lymphatic abnormalities diagnosed by lymphography in four out of five patients with Noonan's syndrome.

Adolescent↗
PubMed1977

Primary operative fixation of long bone fractures in patients with multiple injuries.

Early mobilization is essential for patients with multiple long bone fractures associated with other injuries in order to avoid complications. Therefore, in 1969 we adopted a policy of rigid internal fixation of long bone fractures in such cases. To assess the results of this active treatment a number of consecutive patients were followed. The following conditions were necessary for the case to be included in this series: multiple injuries; treatment at the intensive care unit; and at least two long-bone fractures treated with internal fixation. During the period from 1969 to 1974 47 patients met all requirements. With primary operative fixation of long bone fractures of patients with multiple injuries it was possible to mobilize on crutches 29 patients out of 47 within 2 1/2 months of the accident, and 32 were allowed to leave the hospital within 3 months. With the exception of the death of an 80-year-old woman, no severe complications attributed to the operative treatment of these fractures occurred and 32 out of 47 patients returned to work within 16 months. The results in these 47 cases show that in patients with multiple injuries associated with several long bone fractures, primary internal fixation is preferable to the more conventional conservative methods.

Absenteeism↗
PubMed1977

Subcapital fractures of the femur treated with two thin Smith-Petersen nails.

The results of treatment of 71 patients with subcapital fractures of the femur, fixed with two thin Smith-Petersen nails, are presented, after a follow-up time of between 2 and 4 years. Excellent results of treatment were achieved in 39 out of 60 cases and good results in 11 cases. Six cases of ischemic necrosis of the femoral head were recorded, and there were four cases with pseudarthrosis of the femoral neck, one developed because of postoperative infection and three were attributed to an imperfect operative technique. The method is recommended for subcaptial femoral neck fractures amenable to closed reduction and internal fixation. Pseudarthrosis may be prevented by good reduction of the fracture and a careful nailing technique.

Adolescent↗
PubMed1977

Short term prognosis in sciatica. A prospective study of factors influencing the results with special reference to myelography.

334 Types of follow-up data were collected in 158 patients with sciatica. The following information was obtained: (a) in L4-L5 herniations, Achilles tendon reflex disturbance was not explained by S1 root compression, as visualized at this level on myelography, (b) a water-soluble myelogram was also reliable for extreme lateral herniations and only those herniations dislocated into the intervertebral root canal remained undiagnosed, (c) a positive neurological or myelographic diagnosis of herniation did not mean a better short-term prognosis. Operative removal of a large herniated mass gave the best chance of good recovery. The main indication for myelography is a guide to the surgeon for the correct operative level.

Adolescent↗