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- Akesson, T, et al.
(författare)
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Displaced fractures of the neck of the radius in adults - An excellent long-term outcome
- 2006
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Ingår i: Journal of Bone and Joint Surgery: British Volume. - 2044-5377. ; 88B:5, s. 642-644
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Tidskriftsartikel (refereegranskat)abstract
- We have reviewed 20 women and three men aged 22 to 73 years, who had sustained a Mason type-lib fracture of the neck of the radius 14 to 25 years earlier. There were 19 patients with displacement of the fractures of 2 mm to 4 mm, of whom 13 had been subjected to early mobilisation and six had been treated in plaster for one to four weeks. Of four patients with displacement of 4 mm to 8 mm, three had undergone excision and one an open reduction of the head of radius. A total of 21 patients had no subjective complaints at follow-up, but two had slight impairment and occasional elbow pain. The mean range of movement and strength of the elbow were not impaired. The elbows had a higher prevalence of degenerative changes than the opposite side, but no greater reduction of joint space. Mason type-lib fractures have an excellent long-term outcome if operation is undertaken when the displacement of the fracture exceeds 4 mm.
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| 2. |
- Akesson, Thomas, et al.
(författare)
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Primary nonoperative treatment of moderately displaced two-part fractures of the radial head
- 2006
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Ingår i: Journal of Bone and Joint Surgery. American Volume. - 1535-1386. ; 88A:9, s. 1909-1914
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Tidskriftsartikel (refereegranskat)abstract
- Background: Moderately displaced two-fragment fractures of the radial head have been treated predominantly nonoperatively. Recently, however, open reduction and internal fixation has gradually gained interest, without clear evidence that initial nonoperative treatment leads to an unfavorable outcome. As a consequence, the purpose of the present study was to evaluate the long-term outcome after the initial nonoperative treatment of this type of fracture. Methods: Fifteen men and thirty-four women, with a mean age of forty-nine years at the time of the injury, were included in the study. All patients initially had been managed nonoperatively for a two-fragment fracture of the radial head that was displaced 2 to 5 mm and that included >= 30% of the joint surface (a Mason type-IIa fracture). Early mobilization had been used for twenty-seven patients, and cast immobilization for a mean of two weeks (range, one to four weeks) had been used for twenty-two. All patients were reevaluated with a questionnaire after a mean of nineteen years, and thirty-four also had a clinical and a radiographic evaluation. Six patients had had a delayed radial head excision because of an unsatisfactory primary outcome. Results: Forty of the forty-nine patients had no subjective complaints, eight were slightly impaired as the result of occasional elbow pain, and one had daily pain. Flexion was slightly impaired in the injured elbows as compared with the uninjured elbows (137 degrees +/- 8 degrees compared with 139 degrees +/- 7 degrees) as was extension (-3 degrees +/- 7 degrees compared with 1 degrees +/- 5 degrees) and supination (86 degrees +/- 7 degrees compared with 88 degrees +/- 4 degrees) (p < 0.05 for all comparisons). The prevalence of degenerative changes on radiographs was higher for the injured elbows than for the uninjured elbows (82% [twenty-eight of thirty-four] compared with 21% [seven of thirty-four]; p < 0.01). Conclusions: The initial nonoperative treatment of Mason type-IIa fractures of the radial head that are displaced by 2 to 5 mm is associated with a predominantly favorable outcome, especially if a delayed radial head excision is performed in the few cases in which the early outcome is unsatisfactory. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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| 3. |
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| 4. |
- Alwis, Gayani, et al.
(författare)
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A one-year exercise intervention program in pre-pubertal girls does not influence hip structure
- 2008
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: We have previously reported that a one-year school-based exercise intervention program influences the accrual of bone mineral in pre-pubertal girls. This report aims to evaluate if also hip structure is affected, as geometry independent of bone mineral influences fracture risk. Methods: Fifty-three girls aged 7-9 years were included in a curriculum-based exercise intervention program comprising 40 minutes of general physical activity per school day (200 minutes/week). Fifty healthy age-matched girls who participated in the general Swedish physical education curriculum (60 minutes/week) served as controls. The hip was scanned by dual X-ray absorptiometry (DXA) and the hip structural analysis (HSA) software was applied to evaluate bone mineral content (BMC), areal bone mineral density (aBMD), periosteal and endosteal diameter, cortical thickness, cross-sectional moment of inertia (CSMI), section modulus (Z) and cross-sectional area (CSA) of the femoral neck (FN). Annual changes were compared. Group comparisons were done by independent student's t-test between means and analyses of covariance (ANCOVA). Pearson's correlation test was used to evaluate associations between activity level and annual changes in FN. All children remained at Tanner stage 1 throughout the study. Results: No between-group differences were found during the 12 months study period for changes in the FN variables. The total duration of exercise during the year was not correlated with the changes in the FN traits. Conclusion: Evaluated by the DXA technique and the HSA software, a general one-year school-based exercise program for 7-9-year-old pre-pubertal girls seems not to influence the structure of the hip.
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| 5. |
- Alwis, Gayani, et al.
(författare)
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A school-curriculum-based exercise intervention program for two years in pre-pubertal girls does not influence hip structure.
- 2008
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Ingår i: Dynamic Medicine. - : Springer Science and Business Media LLC. - 1476-5918. ; 7, s. 8-8
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: It is known that physical activity during growth has a positive influence on bone mineral accrual, and is thus possibly one strategy to prevent osteoporosis. However, as bone geometry, independent of areal bone mineral density (aBMD), influences fracture risk, this study aimed to evaluate whether hip structure in pre-pubertal girls is also affected by a two-year exercise intervention program. METHODS: Forty-two girls aged 7-9 years in a school-curriculum-based exercise intervention program comprising 40 minutes of general physical activity per school day (200 minutes per week) were compared with 43 age-matched girls who participated in the general Swedish physical education curriculum comprising a mean of 60 minutes per week. The hip was scanned by dual energy X-ray absorptiometry (DXA) and the hip structural analysis (HSA) software was applied to evaluate bone mineral content (BMC, g), areal bone mineral density (aBMD, g/cm2), periosteal diameter, cross-sectional area (CSA, cm2), section modulus (Z, cm3) and cross-sectional moment of inertia (CSMI, cm4) of the femoral neck (FN). Annual changes were compared. Subjective duration of physical activity was estimated by questionnaire and objective level of everyday physical activity at follow-up by means of accelerometers worn for four consecutive days. All children remained at Tanner stage 1 throughout the study. Group comparisons were made by independent student's t-test between means and analyses of covariance (ANCOVA). RESULTS: At baseline, the two groups did not differ with regard to age, anthropometrics or bone parameters. No between-group differences were observed for annual changes in the FN variables measured. CONCLUSION: A two-year school-based moderately intense general exercise program for 7-9-year-old pre-pubertal girls does not influence structural changes in the FN.
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| 9. |
- Anderson, Thomas, et al.
(författare)
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Tibiotalocalcaneal fusion using retrograde intramedullary nails as a salvage procedure for failed total ankle prostheses. Sixteen cases primarily operated on due to rheumaoid arthritis
- 2005
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Ingår i: Foot & Ankle Surgery. - : Elsevier BV. - 1268-7731. ; 11:3, s. 143-147
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Tidskriftsartikel (refereegranskat)abstract
- Between 1996 and 2002, 16 patients with rheumatoid arthritis and failed total ankle prosthesis underwent tibiotalocalcaneal fusion using retrograde intramedullary nails. The functional outcome was evaluated using the AOFAS scoring system and the patients were also asked about their satisfaction. Radiographs were obtained for all 16 cases minimum 1 year after surgery. Thirteen of the 16 ankles were considered radiographically healed, 11 at the first attempt and two after repeat arthrodesis. The median AOFAS pain and total scores were 40 and 58, respectively. Two deep infections resulted in a fused ankle after antibiotic treatment. In patients with rheumatoid arthritis and a failed total ankle prosthesis, tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail resulted in primary healing in two-thirds of the cases. Only two patients with a fused ankle were dissatisfied with the final result. The procedure is recommended in selected cases as an alternative to external fixation.
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