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Biomedical subjects

T Pohjolainen

Publications and source records attributed to T Pohjolainen.

15 recordsLinked to original sources
PubMed1994

Subjective benefits of energy storing prostheses.

The energy storing (ES) prosthesis has been used in the Prosthetic Foundation's workshop since 1987. Subjective responses from 168 amputees (141 trans-tibial and 27 trans-femoral) fitted with the ES prosthesis were analysed. Ratings were generally favourable in comparison with those for conventional prostheses. The most pronounced advantages of the new prosthesis as shown by the ratings were in walking uphill or swift walking. The younger amputees had more benefit than the older ones. High body weight decreased the benefit of the ES prosthesis. The ES prosthesis does not seem to provide any major advantage for the less active amputee whose movements are mainly indoors.

Adult↗
PubMed1993

Spondylodesis augmented by transpedicular fixation in the treatment of olisthetic and degenerative conditions of the lumbar spine.

Fifty-one patients having lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation were reviewed retrospectively two years after the fusion by an independent observer. In 44 patients, the underlying condition was lytic or degenerative spondylolisthesis. The internal device was removed one year after the fusion. The fusion rate was 94%. The subjective disability was assessed using the Oswestry disability index. The mean Oswestry score was 38% preoperatively, and 24% two years after the fusion. Preoperatively, only every fifth patient was able to work; two years postoperatively, almost 60% held jobs. Complications due to internal fixation were recorded in 57% of the cases. Most of these, such as screw breakage and screw loosening in the sacrum, were of no clinical importance. The use of internal fixation seems to enhance the fusion rate but is associated with more complications than posterolateral fusion without implants.

Adult↗
PubMed1993

Lower-limb amputations.

The current epidemiological situation with regard to lower-limb amputations in southern Finland was analysed for the year 1989. Lower-limb amputations were performed on 268 patients. The amputation rate was 22.0 per 100,000 inhabitants, and the mean age of amputees was 70 years. Peripheral vascular disease was the main reason for amputation (79%). The most common level of amputation was above-knee (49%) followed by below-knee (29%). Two thirds (64%) of the patients lived over one year, and half (53%) over two years after the amputation. In the group of patients undergoing unilateral amputation and surviving over two months, 26% of the above-knee and 63% of the below-knee amputation patients received a prosthesis. The (average) time lag between surgery and fitting the prosthesis was 97 days. Incidence and mortality were decreased after 1985. The rate of prosthesis fitting was still low but the time lag between surgery and prosthetic fitting had decreased.

Adult↗
PubMed1992

Calcitonin treatment in lumbar spinal stenosis: a randomized, placebo-controlled, double-blind, cross-over study with one-year follow-up.

A randomized, placebo-controlled, double-blind, crossover study in 40 lumbar spinal stenosis patients with a 1-year follow-up showed that calcitonin had beneficial effects on the patients' symptoms without producing any notable side effects. Calcitonin had a clear analgesic effect. The mean of walking distance increased, but the crossover trend was not as good as the analgesic effect. Side effects such as erythema and nausea were usually mild and transient. Calcitonin therapy can be used as a conservative treatment in selected cases of lumbar spinal stenosis. When rest pain was mild or the walking distance was under 200-300 m because of neurogenic claudication, the effect of calcitonin seemed to be poor.

Adult↗
PubMed1991

A clinical evaluation of stumps in lower limb amputees.

A study was carried out on 93 consecutive unilateral below-knee (BK) and 62 above-knee (AK) amputees. The dimensions of the amputation stumps were measured and the general condition and contralateral limb assessed at the time of prosthetic fitting. After one postoperative year, follow-up information for 124 (89%) of the surviving patients was obtained by personal contact. The observations were based on the standard formula for stump classification constructed by the International Society for Prosthetics and Orthotics. The 93 BK stumps had a mean length of 16.0 cm and the 62 AK stumps a mean length of 28.0 cm. The scar on the stump was adherent in 13% of BK and 2% of AK stumps. The scar was deeply wrinkled in 7% of BK stumps and 10% of AK stumps. The scar on the stump was most frequently adherent or deeply wrinkled in trauma patients (33%). The skin was undamaged in 93% of all the patients at the first visit and in 94% at the time of follow-up. The mobility of the stump in the proximal joint was limited at the time of prosthetic fitting in 15% of cases. Phantom pain was reported by 59% and stump pain by 5% of patients at this time. Although the phantom pain was mild in most cases, it was usually still present after one year, and 53% of the surviving patients suffered from phantom pain. At the first visit, 20% of patients had problems in their contralateral leg. During the first postoperative year, 6 contralateral BK amputations were performed in the BK group and one contralateral AK amputation in the AK group. Thus, along with examination of the stump, attention must be paid to the contralateral limb with a view to preserving it. The study supports the usefulness of the standard form and classification of amputation stumps.

Adolescent↗
PubMed1991

Predictive factors of functional ability after lower-limb amputation.

Functional ability and accommodation situation were studied by personal interview and examination of 125 surviving lower-limb amputees after one postoperative year. Among ten independent variables studied by multiple linear regression analysis, an unfavourable association was found between increasing age and the following aspects of physical function: walking distance (P less than 0.001), walking time (P less than 0.001), amount of outdoor walking outdoors (P less than 0.001), increased need for aids to ambulation (P less than 0.01), use of a prosthesis (P less than 0.05). Using a partial correlation coefficient analysis of functional ability and accommodation situation, with adjustment for age, the time lag between surgery and prosthetic fitting, and the occurrence of cerebrovascular disease displayed a similar unfavourable association with prosthetic usage. In the group of BK (below-knee) amputees the length of the stump had a significant favourable relationship with walking distance (P less than 0.01). In the male group of vascular BK amputees, smoking had an unfavourable association with walking distance (P less than 0.01), ability to walk outdoors (P less than 0.01) and walking time (P less than 0.05). None of the variables showed any significant relationship with the postoperative accommodation situation.

Adolescent↗
PubMed1990

Severe frostbite of the upper extremities--a psychosocial problem mostly associated with alcohol abuse.

In the catchment area of Helsinki University Central Hospital (in total 16 surgical hospitals) amputation was performed on 9 patients with frostbite in the upper extremities during 1984-1985. The population during the study period in this area was 1.165,000 inhabitants, corresponding to 24% of the whole population in Finland. All 9 patients were male and the mean age was 49 years (range 31-75). All amputations performed were of the fingers, the third, fourth and fifth fingers most frequently affected. Alcohol was a marked etiologic or contributing factor in most of the frostbites. Two patients were chronic schizophrenics showing no signs of alcohol abuse, but the remaining 7 were either acutely or chronically alcohol intoxicated: 5 patients were chronic alcoholics, one was an alcohol abuser without a definite diagnosis of alcoholism, and one patient with no previous history of alcohol abuse was alcohol intoxicated. Based on the present study it is clear that, in addition to the cold winters in Finland, other factors contribute to severe frostbite. These include many psychosocial factors such as alcoholism or mental disease, unbalanced marital status, occupation handicap and lack of regular residence.

Adult↗
PubMed1990

Prosthetic use and functional and social outcome following major lower limb amputation.

A total of 175 consecutive below and above-knee amputees sent to the prosthetic workshop in Helsinki for prosthetic fitting from 32 hospitals were reviewed to determine their functional ambulation and social adaptation. The average age of the patients was 62.2 years at the time of the prosthetic fitting. The mortality was 11% (19) during the first postoperative year. One-year postoperative information was obtained for 141 of the surviving patients (90%) by personal contact. At the time of the review, 68% of the amputees (96 patients) who had been fitted with a prosthesis made extensive and regular use of it. Half of all the above-knee amputees and 79% of the below-knee amputees used their prosthesis throughout the day or over seven hours a day. A total of 72% of the above-knee amputees (33/46) and 85% of the below-knee amputees (67/79) had useful ambulation, at least indoors. Of the 141 patients contacted, 124 (88%) lived in their own homes. The remaining 16 patients (11%) lived in apartment houses for the aged or old people's homes. A total of 48 amputees (34%) needed a regular home help.

Adolescent↗
PubMed1989

Calcitonin treatment in lumbar spinal stenosis: clinical observations.

The prognosis of patients with lumbar spinal stenosis is usually considered poor, and they often need decompression surgery. This study investigates the clinical efficacy and safety of intramuscular calcitonin therapy in 15 lumbar spinal stenosis patients with a neurogenic claudication syndrome. The study is based on several tests used to measure the patient's physical performance capacity. Calcitonin had some beneficial effects on the patients without appreciable side-effects. Because of possible placebo effect, a double-blind cross-over study has been started.

Adult↗
PubMed1989

Primary survival and prosthetic fitting of lower limb amputees.

During the period 1984-1985 amputation of the lower limb at a level potentially requiring a prosthesis was performed on 577 patients in 16 operative units. The mean age was 75.7 years for females and 68.1 for males. The most common site of the amputation was above the knee (49.9%). The majority of amputations (93.8%) were performed for vascular diseases and diabetes. Survival figures showed that 25.5% of amputees died within 2 months of amputation, 60.7% were alive after one year and 43.2% after two years. Out of a total of 577 patients, 26.9% were fitted with a prosthesis. Out of below-knee and above-knee amputees surviving over 2 months, 61.5% and 27.2% respectively were fitted with a prosthesis. There were markedly fewer prosthetic fittings in the over-60 age group. Diabetic patients of both sexes were fitted with a prosthesis more often than arterio-sclerotic patients. Among tumour patients 82.4% received a prosthesis. In the study area more emphasis must be put on the concept of preserving the knee joint and preoperative assessment of vascular patients for selection of amputation level. Every effort must be made to avoid delay in the postoperative mobilization and rehabilitation. Prosthetic fitting of amputees could be improved by better liaison between surgical unit and specialized rehabilitation unit and by closer team approach of amputee care.

Aged↗
PubMed1988

Lower limb amputations in southern Finland 1984-1985.

To assess the current epidemiological situation concerning lower limb amputations in southern Finland the data on all amputations made in the catchment area of the Helsinki University Central Hospital were analysed for the period 1984-85. During the two-year period, 880 amputations of lower limbs were performed on 705 patients. The amputation rate was 32.5 per 100,000 inhabitants in 1984 and 28.1 in 1985. Patients requiring amputation were arteriosclerotics in 43.1 per cent. and diabetics in 40.7 per cent. Diabetics underwent amputation 3 years younger on average than the arteriosclerotics. The most common site of unilateral amputations was above-knee (42.0 per cent) followed by below-knee (27.7 per cent) and toe amputations (22.2 per cent). The level of amputation tended to become more proximal with increasing age of the patients. The overall mortality figure during three postoperative months was 27.0 per cent. Amputation incidence increased sharply with increasing age. On the base of predictions, the overall age structure of the Finnish population will shift upward causing an increase in the proportion of elderly age groups. A 50% increase in amputation rate is expected in Finland within the next 20-30 years.

Adult↗
PubMed1988

Upper limb amputations in southern Finland 1984-85.

There is a specific requirement for amputee statistics to facilitate the planning of prosthetic rehabilitation of amputee patients. The aim of this study was to analyse the epidemiological situation concerning upper limb amputations in southern Finland. The data on all limb amputations made in the catchment area of the Helsinki University Central Hospital were collected for the period 1984-85. During the two-year period upper limb amputations had been performed on 52 patients. A total of six major amputations had been performed on 52 patients. A total of six major amputations had been performed at a level potentially requiring a prosthesis, and 46 patients had undergone amputation distal to the carpal joint. The overall upper limb amputation rate was 2.2 and rate of major amputations 0.3 per 100,000 inhabitants per year. The ratio of men to women was 7.7 for all amputations and 10.5 for finger amputations. Of the 52 amputees, 62 per cent were in the 20-59 age group. The mean age of all amputees was 42.7 years. The typical upper limb amputee was a man of active working age. Trauma, mainly occupational accident, was the most common cause, accounting for 61 per cent of all upper limb amputations. The annual incidence of major amputations in the whole of Finland is as low as 20-30 cases. It would seem reasonable to concentrate prosthetic fitting of upper limb amputations at two or three prosthetic factories and rehabilitation centres.

Adult↗