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At least 55 records · Page 3Linked to original sources
PubMed2004

[Radio-ulnar and radio-scaphoid-lunate arthrodesis in chronic polyarthritis. Clinical and radiologic follow-up of 32 cases].

INTRODUCTION: In 75% of all cases of rheumatoid arthritis the wrist is affected and in 12% is the region of initial manifestation of this chronic inflammatory joint disease. To prevent destruction of the wrist through carpal dislocation, radiolunate and radioscapholunate arthrodeses have increased in importance. METHODS: During a 6.5-year period, 28 radiolunate and 4 radioscapholunate arthrodeses were performed in 30 patients. The indication for operation was progressive carpal translation and increasing subluxation of the wrist in which existent radiological damage had not reached more than grade III according to the classification of Larsen and co-workers. RESULTS: The results obtained during the follow-up study (median: 17.3 months) showed in most treated patients after partial arthrodesis of the wrist no or fewer complaints concerning swelling and pain and an acceptable remaining range of motion of the wrist in everyday life. In patients with preoperatively existing ulnar deviation less than 15 degrees progressive carpal collapse and dislocation could be mostly prevented. CONCLUSION: All told radiolunate and radioscapholunate arthrodeses successfully stabilized the wrist in patients suffering from rheumatoid arthritis.

Adult↗
PubMed2000

Neoadjuvant and adjuvant radio- and radio-chemotherapy of rectal carcinomas.

The objectives in treating rectal cancer are to achieve locoregional tumor control and to prolong overall survival. With surgery alone the reported local failure rates in recent decades have been unacceptably high, and this is associated with substantial morbidity and mortality. Perioperative radiotherapy with or without concomitant chemotherapy has been used extensively to reduce the high frequency of local recurrence. Adjuvant radiotherapy reduces the local recurrence rate dramatically if the dose is high enough and is administered preoperatively. Although a higher dose has been used in most postoperative radiotherapy trials, the reduction has not proven particularly pronounced. If the reduction were as great as that with preoperative radiotherapy, it would also have a positive effect on survival, which as yet has not been achieved with postoperative radiotherapy. However, postoperative irradiation combined with chemotherapy yields a survival benefit of the same magnitude as preoperative irradiation. Modern radiation techniques allow preoperative radiotherapy to be delivered without interfering substantially in the postoperative healing process; it does not increase mortality or morbidity and entails a low rate of late toxicity if the radiation technique is optimal. A major question today is whether radiotherapy is necessary if surgery is optimal. Control trials report an average local recurrence rate of 29% with standard surgery. With optimal surgery the figure reported from institutional series is about 10%. Other questions to be answered include whether to use superfractionation or standard fractionation in radiotherapy, and how chemotherapy should be given, concomitantly to radiotherapy or in the classical method of postoperative intravenous treatment.

Humans↗
PubMed1994

Incidence of cartilaginous and ligamentous lesions of the radio-carpal and distal radio-ulnar joint in an elderly population.

51 wrists of 30 embalmed cadavers have been used to perform an anatomical and radiological study relating cartilaginous and ligamentous lesions of the wrist with sex, age, ulnar variance (UV) and the state of the triangular fibrocartilage complex (TFCC) in an elderly population (mean 76.6 years). Two-thirds of all wrists (66%) showed cartilaginous lesions, mainly on the lunate (22, or 44%). The TFCC was perforated in 23 wrists (46%), and most were central degenerative perforations. Correlations were found between ulnar variance and TFCC thickness (P < 0.05) and ulnar variance and TFCC perforations (P < 0.05). A significant relation was observed between age and proximal row intercarpal ligamentous ruptures (P < 0.05) and between age and ulnar variance (P < 0.05). No statistical correlation was seen between ulnar variance and cartilaginous lesions on the lunate (P < 0.05) in this slightly ulnar negative population (mean-0.37 mm).

Age Factors↗