| 1. |
- Alcala, Yvonne, et al.
(författare)
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Qualifying CT for wrist arthroplasty : Extending techniques for total hip arthroplasty to total wrist arthroplasty
- 2005
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Ingår i: Medical Imaging 2005. - : SPIE - The International Sooceity for Optical Engineeering. - 0819457213 ; , s. 1155-1164
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Konferensbidrag (refereegranskat)abstract
- The purpose of this study was to extend previous work to detect migration of total wrist arthroplasty non-invasively, and with greater accuracy. Two human cadaverous arms, each with a cemented total wrist implant, were used in this study. In one of the arms, I mm tantalum balls were implanted, six in the carpal bones and five in the radius. Five CT scans of each arm were acquired, changing the position of the arm each time to mimic different positions patients might take on repeated examinations. Registration of CT volume data sets was performed using an extensively validated, 3D semi-automatic volume fusion tool in which co-homologous point pairs (landmarks) are chosen on each volume to be registered. Three sets of ten cases each were obtained by placing landmarks on 1) bone only (using only arm one), 2) tantalum implants only, and 3) bone and tantalum implants (both using only arm two). The accuracy of the match was assessed visually in 2D and 3D, and numerically by calculating the distance difference between the actual position of the transformed landmarks and their ideal position (i.e., the reference landmark positions). All cases were matched visually within one width of cortical bone and numerically within one half CT voxel (0.32 mm, p = 0.05). This method matched only the bone/arm and not the prosthetic component per se, thus making it possible to detect prosthetic movement and wear. This method was clinically used for one patient with pain. Loosening of the carpal prosthetic component was accurately detected and this was confirmed at surgery.
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| 2. |
- Axelsson, Peter, 1963, et al.
(författare)
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Ulnar Head Replacement: 21 Cases; Mean Follow-Up, 7.5 Years.
- 2015
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Ingår i: The Journal of hand surgery. - : Elsevier BV. - 1531-6564 .- 0363-5023. ; 40:9, s. 1731-8
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Tidskriftsartikel (refereegranskat)abstract
- To report clinical and radiographic outcomes for the Herbert ulnar head prosthesis after a mean of 7.5 years (range, 2.0-12.5 years).
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| 3. |
- Axelsson, Peter, 1963, et al.
(författare)
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Validity and Responsiveness of Forearm Strength Measurements in the Evaluation of Distal Radioulnar Joint Implant Arthroplasty
- 2020
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Ingår i: Journal of Hand Surgery. - : Elsevier BV. - 0363-5023. ; 45:8
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess the responsiveness of forearm strength tests and to correlate the change to grip strength and a patient-reported outcome measure used for evaluation of distal radioulnar joint (DRUJ) implant arthroplasty. Methods: We performed a retrospective review of 18 patients treated with Herbert (n = 12) and Scheker (n = 6) DRUJ implants. Patients who had undergone the various measurements of arm and grip strength both before surgery and after a minimum follow-up of 1 year were included. Our primary aim was to compare the responsiveness of grip strength with our new methods for measuring forearm torque and lifting strength. The secondary aim was to correlate observed changes in strength measurements to change in a patient-reported outcome measure with use of the patient-reported wrist evaluation (PRWE). Measurements of grip strength, forearm torque, and lifting strength were performed with the Jamar dynamometer and the Kern and Baseline instruments. Preoperative values were compared with 1-year values. Results: Standardized response mean and effect size values were higher for forearm torque than for grip strength. Change in forearm torque and lifting strength had a moderate to strong correlation with change in PRWE. The correlation between grip strength and PRWE was weak. Conclusions: Forearm torque measurements were better than grip strength in detecting changes after DRUJ arthroplasty. It also had a stronger correlation to patient-reported outcome, measured with the PRWE. Clinical relevance: Forearm torque testing may add further information to the evaluation of DRUJ disorders and their treatments. These tests can provide quantifiable data on the patient's ability to perform various tasks requiring physical strength. © 2020 American Society for Surgery of the Hand
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| 4. |
- Bodelsson, Mikael, et al.
(författare)
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Cooling enhances alpha 2-adrenoceptor-mediated vasoconstriction in human hand veins
- 1990
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772. ; 138:3, s. 283-291
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Tidskriftsartikel (refereegranskat)abstract
- The contribution of different receptor subtypes in the contractile response during cooling in human hand vessels is of considerable interest in the understanding of cold-induced peripheral vasospasm as it appears in Raynaud's phenomenon. Subcutaneous vein segments from 50 patients undergoing hand operations not related to vascular disorders were examined in vitro. The temperature in the organ bath was initially 37 degrees C and was either continuously lowered to 10 degrees C or kept constant at 37 degrees C, 29 degrees C or 20 degrees C. The characteristics of the alpha-adrenoceptor-mediated motor response were elucidated with the use of the alpha 1-antagonist, prazosin, and the alpha 2-antagonist, yohimbine. A great variability between individuals in the proportions of alpha 1- and alpha 2-adrenoceptors was found. In the majority of the vessels continuous cooling to 25 degrees C augmented a noradrenaline-induced contraction. This augmentation was unaltered in the presence of prazosin but abolished by yohimbine, suggesting that it was mediated via the alpha 2-adrenoceptor. In the remaining vessels with a predominating alpha 1-adrenoceptor-mediated response a cold-induced relaxation was registered. This could be the result of a reduced alpha 1-adrenoceptor-mediated contraction at this low temperature. These varying reactions to cooling were unaffected by the beta-antagonist, propranolol, and by endothelial denudation. The results obtained in corresponding experiments with the alpha 1-agonist methoxamine and alpha 2-agonist, oxymetazoline, were conflicting, probably due to the poor selectivity of these agonists in human tissues.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 5. |
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| 6. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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A new force measurement device for evaluating finger extension function in the healthy and rheumatoid arthritis hand
- 2008
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Ingår i: Technology and Health Care. - Amsterdam : IOS Press. - 0928-7329 .- 1878-7401. ; 16:4, s. 283-292
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Tidskriftsartikel (refereegranskat)abstract
- Although often neglected, finger extension force is of great importance for developing grip strength. This paper describes the design and evaluation of a new finger extension force measurement device (EX-it) based on the biomechanics of the hand. Measurement accuracy and test-retest reliability were analysed. The device allows measurements on single fingers as well as all the fingers (excluding the thumb) of both healthy and deformed hands. The coefficient of variation in the device was 1.8% of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. This study also provides reference values for finger extension force in healthy subjects and patients with rheumatoid arthritis (RA). Significant differences were found in extension strength between healthy subject and RA patients (men, p < 0.05 and women, p < 0.001). EX-it provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and can be used to evaluate the outcome of therapeutic interventions after hand trauma or disease
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| 7. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - Basingstoke : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 41:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.METHODS:Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme. RESULTS: The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound. CONCLUSION:A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.
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| 8. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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Ultrasound evaluation in combination with finger extension force measurements of the forearm musculus extensor digitorum communis in healthy subjects
- 2008
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Ingår i: BMC Medical Imaging. - London : BioMed Central. - 1471-2342. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background:The aim of this study was to evaluate the usefulness of an ultrasound-based method of examining extensor muscle architecture, especially the parameters important for force development. This paper presents the combination of two non-invasive methods for studying the extensor muscle architecture using ultrasound simultaneously with finger extension force measurements.Methods:M. extensor digitorum communis (EDC) was examined in 40 healthy subjects, 20 women and 20 men, aged 35-73 years. Ultrasound measurements were made in a relaxed position of the hand as well as in full contraction. Muscle cross-sectional area (CSA), pennation angle and contraction patterns were measured with ultrasound, and muscle volume and fascicle length were also estimated. Finger extension force was measured using a newly developed finger force measurement device.Results:The following muscle parameters were determined: CSA, circumference, thickness, pennation angles and changes in shape of the muscle CSA. The mean EDC volume in men was 28.3 cm3 and in women 16.6 cm3. The mean CSA was 2.54 cm2 for men and 1.84 cm2 for women. The mean pennation angle for men was 6.5° and for women 5.5°. The mean muscle thickness for men was 1.2 cm and for women 0.76 cm. The mean fascicle length for men was 7.3 cm and for women 5.0 cm. Significant differences were found between men and women regarding EDC volume (p < 0.001), CSA (p < 0.001), pennation angle (p < 0.05), muscle thickness (p < 0.001), fascicle length (p < 0.001) and finger force (p < 0.001). Changes in the shape of muscle architecture during contraction were more pronounced in men than women (p < 0.01). The mean finger extension force for men was 96.7 N and for women 39.6 N. Muscle parameters related to the extension force differed between men and women. For men the muscle volume and muscle CSA were related to extension force, while for women muscle thickness was related to the extension force.Conclusion:Ultrasound is a useful tool for studying muscle architectures in EDC. Muscle parameters of importance for force development were identified. Knowledge concerning the correlation between muscle dynamics and force is of importance for the development of new hand training programmes and rehabilitation after surgery.© 2008 Brorsson et al; licensee BioMed Central Ltd.
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| 9. |
- Lindqvist, Aron, 1964-
(författare)
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Hand Injury from Powered Wood Splitters
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study on hand injury from powered wood splitters was to describe injury epidemiology and anatomy, to rate injury severity, to evaluate the outcome after injury and to describe factors of possible importance for the occurrence of injury.By searching a computerized patient registry, 131 patients injured by wood splitters from 1995 to 2001 were identified. Information was obtained from hospital records and radiographs, a written questionnaire and a structured telephone interview. Injury severity was rated according to the Hand Injury Severity Scoring System (HISS system) and the Injury Severity Score (ISS). Outcome was evaluated with the Disabilities of the Arm, Shoulder and Hand outcome questionnaire (DASH) and, in 26 of the most severely injured patients, with the Sollerman test.Forty-six percent of the injuries occurred during April or May. Wedge splitters caused 82 % of all injuries and most often injured the index finger, while screw splitters caused 18 % of all injuries and most often injured the metacarpus. Screw splitters caused palmar perforation and thumb avulsion. Sixty-three percent of all patients had an amputation or devascularising injury. The reliability of HISS rating was good. The mean Hand Injury Severity Score (HISS) was 63 which is equivalent to a severe hand injury. The mean ISS was 3.7. Nineteen percent of patients had minor, 31 % had moderate, 23 % had severe and 27 % had major injury according to the HISS system. Children had more severe injuries than adults. There was no significant difference regarding HISS or DASH scores between wedge and screw splitter injuries. The mean DASH score was 15, indicating moderate residual sequelae, but patients without sequelae and patients with grave sequelae were found in all HISS severity grades. There was a weak but significant correlation between the HISS and DASH scores. The mean Sollerman score in the injured hand was 66, indicating significantly impaired hand function. Twenty-nine percent of splitters were home-made. Very few machines had the safety measures required by European Standards. Children were present during splitting in at least 15 % of cases. Not being alone at the machine was one cause of wedge splitter injury. Glove use was one cause of screw splitter injury.Hand injury from powered wood splitters is a significant problem. Many of the injuries are severe, and cause long term sequels and impairment of hand function. Prevention is essential and should focus on unsafe machines and dangerous patterns of use.
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| 10. |
- Möller, Karin, 1962, et al.
(författare)
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Avanta versus Swanson silicone implants in the MCP joint--a prospective, randomized comparison of 30 patients followed for 2 years
- 2005
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Ingår i: J Hand Surg [Br]. - : SAGE Publications. - 0266-7681. ; 30:1, s. 8-13
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Tidskriftsartikel (refereegranskat)abstract
- The results of Swanson and Avanta metacarpophalangeal joint arthroplasties in rheumatoid patients were compared in a prospective, randomized study of 30 patients (120 implants). At 2-year follow-up, grip strength was measured, hand function was assessed with the Sollerman test and the subjective outcome was determined with visual analogue scores. With both implants ulnar deviation and flexion deformities decreased, and there was no difference between the groups. The increase in range of motion was 7 degrees greater with Avanta implants than with Swanson implants. Grip strength and hand function were unaltered but the visual analogue scales showed decreased pain levels and subjective improvements in hand function, grip strength and cosmesis. Twenty-four of 30 patients were satisfied. Fracture of the silicone spacer occurred with 12 Avanta (20%) and eight Swanson implants (13%), with a higher fracture frequency in men.
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