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Biomedical subjects

V Finsen

Publications and source records attributed to V Finsen.

At least 37 records · Page 2Linked to original sources
PubMed1994

Poor results after resection for Haglund's heel. Analysis of 35 heels in 23 patients after 3 years.

We reviewed 23 patients 3 (1-6) years after resection of the calcaneus for 35 Haglund's heels. 19 heels had been treated with a small resection and 16 with a large resection. The effect on the heel pain was independent of the size of the resection, but stiffness and ankle pain were more frequently associated with large than small resections. At follow-up persistent heel pain was found in 12 heels and additional various late complaints in 22. The overall clinical outcome was good in 20 heels, satisfactory in 10 and poor in 5 heels.

Achilles Tendon↗
PubMed1993

[Aspiration of ganglia in the wrist].

Because of recently published good results we wished to evaluate the therapeutic effect among our own patients of simple aspiration of ganglia near the wrist. We entered 24 consecutive patients referred for operation of wrist ganglia into the study and administered a regimen of up to three aspirations at intervals of four to six weeks. There were five deviants from the protocol. Among the remaining 19 patients the ganglion had disappeared in 13 by the end of the aspiration regimen. However, one year after the first aspiration there had been seven recurrences. Only eight of the original 24 patients underwent surgery. The remainder felt that this was no longer necessary. In our material simple aspiration had little therapeutic effect, but markedly reduced the number of patients operated on for ganglia of the wrist.

Adolescent↗
PubMed1993

Muscle function after plated and nailed femoral shaft fractures.

We studied retrospectively 14 patients who had been nailed and 12 patients who had been plated for femoral shaft fractures respectively 37 and 67 months previously. Isokinetic thigh muscle function measurements showed quadriceps strength to be fully restored in nailed patients, while there was a moderate persisting median deficit among plated patients. There was a similar moderate deficit in flexion strength for both groups. Strength restoration did not correlate with age at fracture or fracture level in the femur. It did, however, correlate strongly with the interval between fracture and study for flexion strength among nailed patients. It may be that this parameter also is eventually normalized in nailed patients.

Adolescent↗
PubMed1992

Preoperative traction in patients with hip fractures.

A series of 80 patients with cervical, trochanteric or subtrochanteric hip fractures were randomized to either treatment without traction, skin traction, or skeletal traction during the 1883 h between admission and operation. The institution of skin or skeletal traction was not particularly painful for the patient, but we found no indication that either was of discernible benefit. The number of analgesic medications needed was no higher in patients without traction. We conclude that traction should not be administered routinely to patients awaiting operation for hip fracture.

Aged↗
PubMed1992

Bone mineral and hormone status in paraplegics.

Nineteen men who had suffered permanent paraplegia a median of 4 years previously were studied. Eight also had varying degrees of neurological deficit of the upper extremities. Bone mineral, biochemical and hormonal values were compared to those in an age-matched control group in order to detect evidence of systemic osteopenia. There were very considerable individual variations in bone mineral density (BMD) deficits among patients compared to controls, probably partly due to methodological problems. Significant BMD deficits were found in the metaphysis (45%) and diaphysis (26%) of the tibia, while the deficit of the distal forearm was barely significant for the group as a whole. There was a negative correlation between time since injury and degree of BMD deficit in the lower extremity. Those with neurological affection of the upper extremities had a greater BMD deficit of their arms than those with neurologically intact arms. It was concluded that osteopenia in paraplegics is largely confined to the paralysed extremities, and thus not systemic. Serum alanine aminotransferase, phosphate, follicle stimulating hormone, and free androgen index (testosterone/sex hormone binding globulin) were mainly within normal limits, but significantly higher in paraplegics than in controls. Osteopenia in these patients is thus not due to gonadal dysfunction.

Adolescent↗
PubMed1990

Removal of osteosynthesis material from healed hip fractures. Indications and prognosis.

Many patients complain of pain after their hip fractures have healed. We tried to determine if it is possible, on the basis of radiographic findings and pain localization, to select the patients who will improve if the osteosynthesis material is removed. In 39 instances (34 patients) hardware was removed because of pain. These patients were interviewed and their radiographs reviewed. In 23 instances the pain was lateral, in 4 in the groin and in 12 in both locations. Complete or very considerable alleviation of pain was seen in respectively 16, 2, and 7 of the patients in these groups after osteosynthesis material removal, in 22 within three months. Seventeen patients had pathological radiographic findings before removal. No consistent association was detected between these findings and pain localization. Four out of nine with segmental collapse of the head of the femur were improved by removal. A number of these had had only lateral pain. Of the ten patients where the hardware protruded laterally into the soft tissues, eight improved. Three of these had only groin pains. Pain localization is a poor indicator of the value of osteosynthesis material removal. Perhaps more patients should be offered removal. This may also apply to those with some segmental collapse of the femoral head.

Aged↗
PubMed1989

Mortality after pelvic fractures in the elderly.

Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary emboli in this group of patients(9). We retrospectively studied the outcome among 62 patients over the age of 60 years with minor pelvic fractures who were treated during a 4-year period. Pulmonary embolus was verified in only one patient, who survived. There was no clinical indication that thromboembolic complications were the cause of death among the 5% who died during the first month after admission. Prophylactic anticoagulation seems to be unwarranted among elderly patients with minor pelvic fractures.

Aged↗
PubMed1989

Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle.

Fifty-six patients who had a displaced fracture of the ankle necessitating surgical fixation were randomly assigned to one of three postoperative treatment regimens: no plaster cast or weight-bearing, and active exercises of the ankle; a non-weight-bearing plaster cast; or a plaster walking cast for the first six postoperative weeks. At follow-up with a duration of as much as two years, there were no consistent differences in the clinical results between the three groups. The time lost from work and the proportion of excellent and good clinical results were also uninfluenced by the postoperative regimen. No adverse effects could be detected as a result of the patient's having walked before the syndesmosis screw had been removed. It was concluded that none of the three postoperative regimens has any advantage over the others in a patient who has a stable osteosynthesis of a fracture of the ankle.

Adult↗
PubMed1989

Osteopenia after ankle fractures. The influence of early weight bearing and muscle activity.

Fifty-seven patients surgically treated for ankle fractures were followed for two years with bone mineral content (BMC) estimations at various levels of both lower extremities. Maximum BMC reduction was seen four months after operation. Bone mineral was partly regenerated during the remainder of the first year. There was hardly any regeneration during the second year. The persisting bone mineral deficit was between 3.5% and 9% depending on the region measured. BMC changes were minor in the contralateral limb and mainly consisted of a slight gain. During the first six postoperative weeks, patients (1) performed active movements of the ankle and subtalar joints but did not bear weight; (2) wore a plaster of paris cast without bearing weight; or (3) bore full weight in a plaster cast. The bone mineral loss was similar in the three treatment groups.

Adult↗
PubMed1989

Fracture interaction in the extremities, The possible relevance of posttraumatic osteopenia.

Regional osteopenia may persist after certain types of fractures. To investigate the practical importance of this observation, the authors studied 2744 past fractures in 1659 patients with present fractures. Radial fractures rarely occurred ipsilateral to previous radial fractures, whereas fractures of the hand were more often ipsilateral to previous hand fractures. Hip fractures rarely recurred in the same hips. Patients with previous cervical hip fractures, unlike those with previous trochanteric fractures, had a predominance of subsequent fractures distal to the hip ipsilaterally. Those with previous femoral shaft fractures were more likely to have subsequent fractures ipsilaterally. Both femoral shaft and patellar fractures were more often seen on the side of previous lower extremity fractures. Patients with previous tibial fractures had more subsequent fractures of the femur and tibia ipsilaterally, and their present tibial fractures were more frequently ipsilateral when these fracture types had occurred in the past. Some of these shifts from the equal distribution of fractures between the two sides may be due to posttraumatic osteopenia.

Bone Diseases, Metabolic↗
PubMed1988

Accuracy of visually estimated bone mineralization in routine radiographs of the lower extremity.

In order to determine the accuracy of reports of demineralization based on observations of routine radiographs of the peripheral skeleton, pairs of radiographs with known difference in bone mineral density (BMD) were shown to a panel of medically qualified observers. No significant difference in the rate of correct identification of osteopenia of metaphyseal and diaphyseal bone was observed. Experienced observers were more accurate than their juniors. The probability of correct identification was greater than 0.5 at all levels of BMD difference, and in general increased with increasing BMD differences, reaching a probability of 0.7 at a BMD difference of 30%. The probability increased considerably when the assessment relied on the majority vote of three or more observers. It is concluded that it is inadvisable for a single observer to judge BMD when studying routine X-ray studies of the peripheral skeleton.

Adolescent↗
PubMed1988

Osteopenia after osteotomy of the tibia.

Previous studies have shown a persisting bone mineral loss of 25% at the distal femoral and proximal tibial metaphysis after fractures of the tibia. This is likely to increase the risk of later fracture. In the present study, the evolution of regional osteopenia after valgus osteotomy of the proximal tibia was investigated. In 20 patients, the bone mineral content (BMC) on both sides was determined by single-energy photon absorptiometry in the distal metaphysis; distal, mid, and proximal diaphysis of the tibia; and the distal metaphysis and diaphysis of the femur preoperatively and 6, 16, 34, 52, and 104 weeks postoperatively. A moderate fall in BMC was found at all measured levels of the extremity. In the tibia, the greatest fall in BMC (10%) was seen in the diaphysis near the osteotomy, but a considerable regeneration of bone mineral occurred later. A persisting loss was found in the distal tibial (8%) and femoral (11%) diaphysis. At these levels a fall in BMC on the contralateral side led to similar values on the two sides after 2 years.

Adult↗
PubMed1988

Osteopenia after plated and nailed femoral shaft fractures.

Twenty-six patients who had been operated for isolated femoral shaft fractures were studied. Fourteen had been treated with intramedullary nailing and 12 with AO plates. Only nailed patients were allowed early weight-bearing. Bone mineral density and muscle strength in knee extension and flexion were determined. There was a considerable loss of bone mineral in the distal femoral metaphysis and a moderate loss in the tibia. The mean loss was almost identical in the two groups. Muscle power in extension was better preserved in the nailed than in the plated patients. There was a significant correlation between loss of bone mineral and loss of muscle power.

Adolescent↗
PubMed1988

Osteoporosis and back pain among the elderly.

Questionnaire responses from 120 men and 337 women over the age of 50 years were studied to determine the prevalence of back pain among the elderly. In order to gain a rough indication of the back pain among elderly women which might be due to osteoporosis, the prevalence was compared in the two sexes. The prevalence of back pain without radiation to the legs and concomitant morbidity was found to be similar among men and women up to the 70-79-year age-group. After this age the prevalence was higher in women. Those with exceptional loss of body height or kyphosis had a high prevalence of back pain, while those who had sustained previous hip or radius fractures did not. There was increasing prevalence of back pain among women with increasing number of previous fractures. The study gives little indication of serious morbidity of osteoporosis in the form of back pain before very old age.

Age Factors↗
PubMed1988

Improvements in general health among the elderly: a factor in the rising incidence of hip fractures?

Both hip fracture incidence and life expectancy are known to have increased during the last decades. Seventeen studies of hip fracture incidence from Great Britain and Scandinavia were collected from the literature. It was found that there was a good correlation for both men and women between the incidence of cervical but not trochanteric fractures in the 75-79 year age group and the mean life expectancy at 70 years of age at the time in the country concerned. The increased incidence is probably accounted for partly by the increased lifespan of the infirm. It is, however, suggested that increases in life expectancy among a majority of the elderly also entail better general health at any particular age, and that this may lead to a higher level of physical mobility which raises the risk of falls and fractures.

Aged↗
PubMed1988

Transcutaneous electrical nerve stimulation after major amputation.

We studied the effect of transcutaneous electrical nerve stimulation (TENS) on stump healing and postoperative and late phantom pain after major amputations of the lower limb. A total of 51 patients were randomised to one of three postoperative treatment regimens: sham TENS and chlorpromazine medication, sham TENS only, and active low frequency TENS. There were fewer re-amputations and more rapid stump healing among below-knee amputees who had received active TENS. Sham TENS had a considerable placebo effect on pain. There were, however, no significant differences in the analgesic requirements or reported prevalence of phantom pain between the groups during the first four weeks. The prevalence of phantom pain after active TENS was significantly lower after four months but not after more than one year.

Adult↗
PubMed1987

Changes in bone-mass after tibial shaft fracture.

We studied 20 patients who had suffered tibial shaft fractures 30 months previously. The bone-mineral content in diaphyseal and metaphyseal bone of the femur and tibia was determined by photon absorptiometry. There was a moderate, but significant, deficit of bone-mineral in metaphyseal bone at the knee and distal tibia. This loss was, however, far smaller than that previously reported. Persisting bone-mineral changes in diaphyseal bone were insignificant except in the fracture area where there was a 28 per cent increase. This may indicate that bone may, under some circumstances, locally increase in strength after remodelling of the fracture.

Adolescent↗