| 1. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 3. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 4. |
- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 7. |
- Bulik, CM, et al.
(författare)
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The changing "weightscape" of bulimia nervosa
- 2012
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Ingår i: The American journal of psychiatry. - : American Psychiatric Association Publishing. - 1535-7228 .- 0002-953X. ; 169:10, s. 1031-1036
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Tidskriftsartikel (refereegranskat)
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| 11. |
- Lundqvist, Eva, 1985-
(författare)
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Distal radius fractures AO type C : A clinical and radiographic investigation
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The function of the hand is of substantial importance, and injuries have an impact on daily life. Distal radius fracture (DRF) is the most common fracture among adults. The annual incidence is 26 per 10,000 inhabitants, and the incidence is increasing because of an aging population. There has been a shift from conservative and other operative treatments, toward volar plate fixation to restore the anatomy and improve results. Operative treatment is often considered for displaced and unstable fractures. The optimal choice of treatment and fixation is still debated. The aim of this thesis was to study results after internal fixation of DRF AO type C.Study I (retrospective study, n=74) assessed outcomes after combined plating (CP) of DRFs AO type C, with 1-year follow-up. CP restored the anatomy and achieved a good functional outcome. The radiographic outcome did not correspond to the clinical or functional outcome.Study II (prospective study, n=97) assessed the prevalence of post-traumatic arthritis (PA) following CP of DRFs AO type C. CP yielded a good clinical outcome 7 years postoperatively and the prevalence of PA was low (29%). The presence of PA did not correlate with fracture group, radio-graphic, clinical, or functional outcome. Study III (randomized controlled trial, n=147) assessed the radiographic and clinical outcome following surgical treatment of DRFs AO type C, comparing volar plating (VP) with CP. Fixation with VP yieldedthe same radiographic and functional results as CP, but with a lower frequency of complications in the VP group.Study IV (prospective pilot study, n=10) assessed fragment migration with CTMA (CT-based micromotion analysis) after osteosynthesis with VP after DRF AO type C. The CTMA technique indicated that variable angle volar locking plate fixation can yield and maintain a stable reduction of the fracture fragments. CT volume registration could be a valuable tool in the detailed assessment of fracture fragment migration following VP fixation of DRFs.
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| 21. |
- Zerwas, SC, et al.
(författare)
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CBT4BN: A Randomized Controlled Trial of Online Chat and Face-to-Face Group Therapy for Bulimia Nervosa
- 2017
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 1423-0348 .- 0033-3190. ; 86:1, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Objective:</i></b> Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most individuals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F). <b><i>Method:</i></b> In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F. A total of 179 adult patients with BN (2.6% males) received up to 16 sessions of group CBT over 20 weeks in either CBT4BN or CBTF2F, and outcomes were compared at the end of treatment and at the 12-month follow-up. <b><i>Results:</i></b> At the end of treatment, CBT4BN was inferior to CBTF2F in producing abstinence from binge eating and purging. However, by the 12-month follow-up, CBT4BN was mostly not inferior to CBTF2F. Participants in the CBT4BN condition, but not CBTF2F, continued to reduce their binge-eating and purging frequency from the end of treatment to the 12-month follow-up. <b><i>Conclusions:</i></b> CBT delivered online in a group chat format appears to be an efficacious treatment for BN, although the trajectory of recovery may be slower than face-to-face group therapy. Online chat groups may increase accessibility of treatment and represent a cost-effective approach to service delivery. However, barriers in service delivery such as state-specific license and ethical guidelines for online therapists need to be addressed.
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| 22. |
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| 23. |
- Bjorling, Patrik, et al.
(författare)
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Ten Year Follow-up After Total Wrist Arthroplasty
- 2017
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Konferensbidrag (refereegranskat)abstract
- Hypothesis Total wrist arthroplasty (TWA) is an option in the management of wrist arthritis. The aim of the study was to evaluate the long-term results of TWA.Methods In this cohort study, we followed 56 cases that underwent TWA (Avanta, Biax, Universal 2 and Maestro) between 2005 and 2006 at a single-center. Data was collected preoperatively and 10 years postoperatively. Patient-related outcome measures, grip strength, range of motion (ROM), VAS pain scores were analyzed.Results VAS pain scores and patient-related measures were significantly improved at the 10-year follow-up. Jamar grip strength was also significantly improved. ROM remained largely unchanged, except for extension which improved significantly at the 10-year follow-up. Five of 56 TWAs were revised. Five patients died of unrelated causes and 10 were lost to follow-up.Summary Points This study shows good long-term results after TWA with a high level of patient satisfaction. The revision rate was acceptable.
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| 24. |
- Björk, Marie, et al.
(författare)
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Self-efficacy corresponds to wrist function after combined plating of distal radius fractures
- 2020
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Ingår i: Journal of Hand Therapy. - : Elsevier. - 0894-1130 .- 1545-004X. ; 33:3, s. 314-319
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: A prospective cohort single-center study.INTRODUCTION: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability will more likely reach a good outcome.PURPOSE OF THE STUDY: The aim of this study was to examine if SE has an effect to physical functioning, pain and patient-rated wrist function three months postoperatively in patients undergoing plating due to a distal radius fracture.METHODS: Sixty-seven patients undergoing plating for a distal radius fracture rated SE at the first appointment with the physiotherapist. At the three-month follow-up, the following assessments were administered: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip strength, and range of motion.RESULTS: The group with a high SE showed significantly better range of motion for flexion (P = .046) and supination (P = .045), hand grip strength (P = .001) and PRWE scores (P = .04). The NRS pain during activity was lower, although not significantly lower (P = .09). Using Spearman's rank correlation coefficient, there was a moderate correlation between SE and pain during activity, wrist flexion, and PRWE score.DISCUSSION: SE corresponds to wrist function after combined plating of distal radius fractures.CONCLUSION: Measurement of SE could possibly be useful to identify patients in special need of support during the postoperative rehabilitation.
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| 25. |
- Björk, Marie, et al.
(författare)
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Self-efficacy corresponds to wrist function after combined plating of distal radius fractures
- 2019
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Ingår i: Abstract book IFSHT. - Freiburg : Intercongress GmbH. - 9783000635854
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Konferensbidrag (refereegranskat)abstract
- Clinical issue/s: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability willmore likely reach a good outcome. The distal radius fracture (DRF) is the most common fracture in adults constituting 18% of all fractures in an orthopedic trauma unit. To our knowledge there are no reports investigating the role of patient-reported self-efficacy in the rehabilitation of surgically treated DRFs. A tool that could identify patients in need of increased postoperative rehabilitation could potentially improve the allocation of rehabilitation resources.Clinical reasoning: The aim of this study was to examine if SE has an effect on physical functioning, pain and patient-rated wrist function three months postoperatively in patients who underwent combined plating with a volar and dorsal plate due to a distal radius fracture (DRF).innovative, analytical or new approach: Methods: This prospective study involved 67 patients. Follow-up results were available for 55 of them. The patients rated SE at the first appointment with the physiotherapist. The three months follow-up contained the outcome values: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip-strength and range of motion. Thestudy was approved by the regional ethical committee.Results: Three months after surgery the average wrist motion was 62-93 percent and hand grip-strength was 58 percent compared to the uninjured hand. Patients who rated high SE showed significantly better ROM for flexion and supination, handgrip-strength and PRWE-scores.Contribution to advancing HT practice: Discussion: Patients with a high SE are more likely to have a better wrist functionthree months postoperatively compared to patients with a low SE. Conclusion: SE can be a tool to assist the hand therapist in the allocation of rehabilitation resources.
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| 26. |
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| 27. |
- Boniolo, Manuel, et al.
(författare)
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Water Oxidation by Pentapyridyl Base Metal Complexes? : A Case Study
- 2022
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Ingår i: Inorganic Chemistry. - : American Chemical Society (ACS). - 0020-1669 .- 1520-510X. ; 61:24, s. 9104-9118
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Tidskriftsartikel (refereegranskat)abstract
- The design of molecular water oxidation catalysts (WOCs) requires a rational approach that considers the intermediate steps of the catalytic cycle, including water binding, deprotonation, storage of oxidizing equivalents, O–O bond formation, and O2 release. We investigated several of these properties for a series of base metal complexes (M = Mn, Fe, Co, Ni) bearing two variants of a pentapyridyl ligand framework, of which some were reported previously to be active WOCs. We found that only [Fe(Py5OMe)Cl]+ (Py5OMe = pyridine-2,6-diylbis[di-(pyridin-2-yl)methoxymethane]) showed an appreciable catalytic activity with a turnover number (TON) = 130 in light-driven experiments using the [Ru(bpy)3]2+/S2O82– system at pH 8.0, but that activity is demonstrated to arise from the rapid degradation in the buffered solution leading to the formation of catalytically active amorphous iron oxide/hydroxide (FeOOH), which subsequently lost the catalytic activity by forming more extensive and structured FeOOH species. The detailed analysis of the redox and water-binding properties employing electrochemistry, X-ray absorption spectroscopy (XAS), UV–vis spectroscopy, and density-functional theory (DFT) showed that all complexes were able to undergo the MIII/MII oxidation, but none was able to yield a detectable amount of a MIV state in our potential window (up to +2 V vs SHE). This inability was traced to (i) the preference for binding Cl– or acetonitrile instead of water-derived species in the apical position, which excludes redox leveling via proton coupled electron transfer, and (ii) the lack of sigma donor ligands that would stabilize oxidation states beyond MIII. On that basis, design features for next-generation molecular WOCs are suggested.
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| 28. |
- Delios, A., et al.
(författare)
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Examining the generalizability of research findings from archival data
- 2022
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 119:30
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Tidskriftsartikel (refereegranskat)abstract
- This initiative examined systematically the extent to which a large set of archival research findings generalizes across contexts. We repeated the key analyses for 29 original strategic management effects in the same context (direct reproduction) as well as in 52 novel time periods and geographies; 45% of the reproductions returned results matching the original reports together with 55% of tests in different spans of years and 40% of tests in novel geographies. Some original findings were associated with multiple new tests. Reproducibility was the best predictor of generalizability-for the findings that proved directly reproducible, 84% emerged in other available time periods and 57% emerged in other geographies. Overall, only limited empirical evidence emerged for context sensitivity. In a forecasting survey, independent scientists were able to anticipate which effects would find support in tests in new samples.
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| 29. |
- Fischer, Per, 1981-, et al.
(författare)
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Total Wrist Arthroplasty : A 10-Year Follow-Up
- 2020
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Ingår i: Journal of Hand Surgery-American Volume. - : Elsevier. - 0363-5023 .- 1531-6564. ; 45:8, s. 780.e1-780.e10
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To assess long-term implant survival in total wrist arthroplasty (TWA), comparing 4 different implants.Methods: In a prospective cohort of 124 patients, 136 TWAs were evaluated 5 years and 10 years after surgery. The TWAs were implanted between 2005 and 2009. The primary outcome was implant survival. Survival analysis was performed with revision and radiographic loosening as the final end point. Revision was defined as exchange of whole or parts of the prosthesis. Implant loosening was assessed using radiographic examination at the 5-year and 10-year follow-up. Secondary outcome measures included wrist range of motion, hand grip strength, visual analog scale (VAS) pain scores, and patient-related outcome measures, including Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), and Canadian Occupational Performance Measure (COPM).Results: Total cumulative implant survival was 92% with revision as the primary end point. When including a nonrevised radiographic loose implant as a failure, total implant survival was 75%. Radiographic loosening differed significantly between the implants with a range in frequency from 0% to 37.5%. At the 10-year follow-up, assessing the nonrevised TWAs, range of motion was preserved compared with preoperative values. Significant improvement was recorded for hand grip strength, VAS pain scores, and patient-related outcome measures at the 10-year follow-up compared with preovperative values.Conclusions: High 10-year implant survival was found when defining the primary end point as revision of any cause. When including radiographic loosening of the implant in the survival analysis, implant survival was considerably lower. However, radiographic loosening does not seem to correlate with changes in secondary outcome measures, questioning the need for revision surgery in these cases.
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| 30. |
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| 31. |
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| 32. |
- Jakobsson, Hugo, 1990-, et al.
(författare)
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Pulp-to-palm distance after plate fixation of a distal radius fracture corresponds to functional outcome
- 2023
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Ingår i: Archives of physiotherapy. - : BioMed Central (BMC). - 2057-0082. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Several factors can influence the outcome after a distal radius fracture (DRF). The aim of this study was to assess whether postoperative pulp-to-palm (PTP) distance correlated with functional outcomes after plate fixation of DRF. MATERIALS &METHODS: This is a secondary analysis of a randomized controlled trial aimed to investigate the effects of plate fixation in patients with type-C fractures. Subjects (N = 135) were divided into 2 groups based on PTP distance (equal to or higher than 0 cm) at 4 weeks postoperatively. Outcome measures were collected prospectively at 3, 6 and 12 months and included Patient-Rated Wrist Evaluation (PRWE), Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) scores, wrist range of motion (ROM), Visual Analog Scale (VAS) pain scores, and hand grip strength.RESULTS: Overall, at 3 and 6 months patients with PTP > 0 cm had significantly worse outcomes (PRWE, QuickDASH, wrist ROM) than those with PTP =0 cm. At 12 months, QuickDASH and wrist ROM were still significantly worse. In the volar-plating subgroup, patients with PTP > 0 cm had significantly worse wrist ROM and grip strength at 3 months, but no significant differences were found in subsequent follow-ups. In the combined-plating group, patients with PTP > 0 cm had significantly worse QuickDASH, wrist ROM and grip strength at 3 months. At 6 and 12 months, wrist ROM was still significantly worse.CONCLUSIONS: Measurement of PTP distance appears to be useful to identify patients likely to have worse outcome after plating of a DRF. This could be a tool to improve the allocation of hand rehabilitation resources.
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| 33. |
- Karlsson, Emma, et al.
(författare)
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Combined volar and dorsal plating vs. volar plating of distal radius fractures : A single-center study of 105 cases
- 2020
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Ingår i: Hand surgery & rehabilitation. - : Elsevier. - 2468-1229 .- 2468-1210. ; 39:6, s. 516-521
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Tidskriftsartikel (refereegranskat)abstract
- Despite recent advances in the surgical management of distal radius fractures (DRFs), the optimal treatment remains controversial as different fixation methods often have similar clinical functional and radiographic outcomes. The objective of this study was to assess the differences in outcomes 1 year postoperatively between volar plating and combined plating for DRFs. In a retrospective cohort study, we evaluated 105 consecutive patients operated with either a volar locking plate or combined dorsal and volar plating. The primary outcome was wrist range of motion (ROM). Secondary outcome measures included hand grip strength, visual analog scale (VAS) pain scores, radiographic examination and patient-related outcome measures. Patients treated with combined plating had significantly inferior wrist flexion, extension and ulnar deviation. The radiographic Batra score 1 year postoperatively was similar for both groups. The PRWE (patient-rated wrist evaluation) score was 16 for the volar plating group and 14 for the combined plating group. The QuickDASH (Quick disabilities of the hand arm and shoulder) score was 9 for the volar plating group and 16 for the combined plating group. VAS pain scores were 0 at rest and 2 during activity for both groups. Grip strength was similar between the two groups. Hardware removal was done in 18/78 patients for the combined plating group and 1/27 for the volar plate group. Two patients operated with combined plating had tendon ruptures. Our findings indicate that both methods can yield satisfactory clinical and radiographic outcomes. However, combined plating resulted in inferior wrist ROM and substantially higher frequency of hardware removal. The potential advantages of combined plating in stabilizing a comminuted DRF must be balanced by the potential drawbacks such as inferior wrist ROM and higher frequency of hardware removal.
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| 34. |
- Khan, MD. Ershad Ullah, 1979-
(författare)
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Renewables Based Polygeneration for Rural Development in Bangladesh
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite the country's rural electrification programme, kerosene is the predominant source for lighting, and unsustainable and polluting woody biomass is virtually the only option available for cooking. The rural population also struggles with unsafe drinking water in terms of widespread arsenic contamination of well water. The present work has taken an integrated approach in an attempt to mitigate problems through small-scale polygeneration, a concept linking renewable energy sources to these energy needs via novel energy conversion systems.Anaerobic digesters (AD) for biogas production are promising in the rural setting, and field surveys have identified problems in the construction, maintenance and operation of existing AD, particularly in overall performance of household digesters. Based on these results, a number of operational and technological improvements are suggested for employing digesters in polygeneration units. This study also examines one approach for small-scale, low cost arsenic removal in groundwater through air gap membrane distillation, a thermally-driven water purification technology.Integration of biogas production with power generation and water purification is an innovative concept that lies at the core of feasibility analyses conducted in this work. One of the case studies presents a new concept for integrated biogas based polygeneration and analyzes the techno-economic performance of the scheme for meeting the demand of electricity, cooking energy and safe drinking water of 30 households in a rural village of Bangladesh. The specific technologies chosen for the key energy conversion steps are as follows: plug-flow digester; internal combustion engine; and membrane distillation. One major concern is local feedstock availability for the digester, since a single feedstock is impractical to serve both cooking, lighting and water purification systems. In this circumstance solar PV could be a potential option for integrated hybrid systems.
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| 35. |
- Larsson, Sune, et al.
(författare)
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Augmentation of Tibial Plateau Fractures with Calcium Phosphate Cement : A Randomized Study Using Radiostereometry
- 2004
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Konferensbidrag (refereegranskat)abstract
- Purpose: One problem with tibial plateau fractures that involve a depressed articular fragment is the difficulty of maintaining reduction until healing. The conventional method is to fill the subchondral void with autologous bone transplant followed by restricted weightbearing for 8 to 12 weeks. Recently, biomaterials have been introduced that might overcome several problems associated with bone transplant. The purpose of this study was to evaluate an injectible calcium-phosphate cement when used as a bone graft substitute in lateral tibial plateau fractures, with special emphasis on the stability of the elevated articular fragment.Methods: Twenty-four patients with a lateral tibial plateau fracture type 41-B2 or 41-B3 (OTA classification) were included. The authors operated on all patients. Conventional metal fixation was used to fix the fracture following elevation of the articular fragment. The subchondral void was filled with injectable calcium-phosphate cement (Norian SRS, Synthes) or conventional iliac bone graft according to randomization during surgery. There were 12 patients in each group with an average age of 50 and 52 years, respectively. During surgery, tantalum markers were inserted for subsequent radio stereometry (RSA) (RSA Biomedical Innovation, Umeå, Sweden), a radiologic technique that enables measurement of movement along and around three orthogonal axes with a precision of less than 0.5 mm and 0.7°. Continuous passive motion was begun immediately after surgery. Weightbearing was restricted to 20 kg for 6 weeks in the SRS group and for 12 weeks in the control group. Radio stereometry was performed before weightbearing and at 1, 6, and 12 weeks and at 6 and 12 months. Conventional radiographs were used for assessment of reduction and healing. Clinical evaluation (Lysholm score and a visual analog scale score of 0 to 10 for pain) was conducted by a physiotherapist. For assessment of compliance with regard to weightbearing, patients were examined with F Scan (Tecscan, Inc., Boston, Massachusetts, USA) at each time point.Results: No patients were lost but two were excluded from the RSA evaluation due to technical problems. All fractures healed. There was one deep infection (SRS). At 6 weeks, average weightbearing was 22 kg in the SRS group and 19 kg among the controls (NS); at 12 weeks, 66 kg vs. 28 kg (P <0.001); and at 6 and 12 months, on average, between 66 and 72 kg with no difference between groups. Pain during activity was lower in the SRS group at 1 week (P <0.01), 6 weeks (P <0.004), 3 months (P <0.005), and at 6 months (P <0.02), with no difference at 1 year. The Lysholm knee score was better at 6 weeks (P <0.01), 12 weeks (P <0.002), and 6 months (P <0.02) in the SRS group, and there was no significant difference at 1 year. Radio stereometry revealed movement of the articular fragment in all patients. The total translation was, on average, 1.41 mm in the SRS group and 3.88 mm in the controls (P <0.001). In both groups the most significant movement occurred during the first 6 weeks, and there was no significant movement of the articular fragment from 6 to 12 months, indicating stable healing. The most typical pattern of movement was subsidence along the vertical axis or rotation in the transversal axis (forward tilt) or both, and as toe-out rotation around the vertical axis. One patient from the SRS group had a migration exceeding 3 mm, and two controls had a migration exceeding 5 mm.Conclusion/Significance: Injectable calcium-phosphate cement provided a more stable fixation of the elevated articular fragment in lateral tibial plateau fractures when compared with conventional bone graft, despite the fact that cement-augmented patients were allowed earlier weightbearing. Patients treated with cement also had less pain during the entire course of healing when compared with controls. Bone graft substitutes can offer new perspectives for treatment of fractures involving metaphyseal defects, without the side effects associated with bone grafting.
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| 36. |
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| 37. |
- Lundqvist, Eva, 1985-, et al.
(författare)
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CT-Based Micromotion Analysis After Locking Plate Fixation of AO Type C Distal Radius Fractures
- 2023
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Ingår i: Indian Journal of Orthopaedics. - : Springer. - 0019-5413 .- 1998-3727. ; 57:12, s. 2031-2039
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Tidskriftsartikel (refereegranskat)abstract
- Background: Volar locking plate fixation (VLPF) is the most common method for operative fixation of distal radius fractures (DRF). The dorsal ulnar corner (DUC) can be difficult to stabilize as the fragment is small and not exposed when using the volar approach. The purpose of this study was to study fracture fragment migration after VLPF of AO type C DRF, using a volume registration technique of paired CT scans with special focus on the DUC fragment.Materials and Methods: This pilot study included ten patients with AO type C DRF, all operated with VLPF. The primary outcome was radiographic outcome. Postoperative and 1-year scans were compared and analyzed. Fragment migration was assessed with CT-based micromotion analysis (CTMA), a software technique used for volume registration of paired CT scans.Results: All plates were stable over time. Two patients showed signs of screw movement (0.2-0.35 mm and 0.35- > 1 mm respectively). Postoperative reduction was maintained, and there was no fragment migration at the 1-year follow-up except for one case with increased dorsal tilt. The DUC fragment was found in 8/10 cases, fixated in 7/8 cases, and not dislocated in any case at the 1-year follow-up.Conclusion: The CTMA results indicate that variable-angle VLPF after AO type C DRF can yield and maintain a highly stable reduction of the fracture fragments. The DUC fragment remained stable regardless of the number of screws through the fragment. CT volume registration can be a valuable tool in the detailed assessment of fracture fragment migration following volar plate fixation of DRFs.
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| 38. |
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| 39. |
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| 40. |
- Lundqvist, Eva, 1985-, et al.
(författare)
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Posttraumatic Arthritis After Combined Plating of Distal Radius Fractures AO Type C : A 7-Year Follow-up of 97 Cases
- 2022
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Ingår i: Hand (New York, N.Y.). - : Sage Publications. - 1558-9447 .- 1558-9455. ; :Sup. 1, s. 50S-59S
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Volar locking plate fixation is the most common method of operative fixation of distal radius fractures (DRFs). For more complex cases, combined plating is an option for stabilizing intra-articular fragments. The prevalence of posttraumatic arthritis (PA) after an intra-articular DRF, and its relation to patient-reported outcome measures (PROMs), remains unclear. The purpose of this study was to study the prevalence of PA and its correlation to clinical outcome measures.METHODS: We evaluated 97 consecutive patients with intra-articular DRF, operated with combined plating, 7 years postoperatively. The primary outcome measure was the prevalence of radiographic PA. Secondary outcome measures included visual analog scale (VAS) pain score, hand grip strength, wrist range of motion (ROM), Patient-Rated Wrist Evaluation (PRWE) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Radiographic examination was performed between 1 and 7 years postoperatively.RESULTS: The prevalence of PA was 29% at the 7-year follow-up. No correlation was found between PA and ROM, hand grip strength, PRWE, QuickDASH, VAS pain scores, or radiographic reduction. Median wrist ROM and grip strength were significantly inferior compared with the uninjured side. Hardware removal was performed in 51.5% of cases. There were 2 cases of tendon ruptures.CONCLUSIONS: Combined plating can yield a good clinical outcome 7 years postoperatively and a low prevalence of PA. The presence of PA did not correlate to clinical outcome measures or to the accuracy of anatomical reduction 1 year postoperatively. The frequency of tendon ruptures was acceptable, but the high frequency of hardware removal is a concern.
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| 41. |
- Lundqvist, Eva, 1985-, et al.
(författare)
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Pyrolytic Carbon Hemiarthroplasty for Proximal Interphalangeal Joint Arthritis, Long-Term Follow-Up
- 2024
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Ingår i: Journal of Hand Surgery-American Volume. - : Elsevier. - 0363-5023 .- 1531-6564. ; 49:2, s. 99-107
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to assess the long-term clinical, subjective, and radiographic results of pyrocarbon hemiarthroplasty for proximal interphalangeal joint (PIPJ) arthritis at a single institution.METHODS: Patients treated with a pyrolytic carbon hemiarthroplasty between 2005 and 2015 were contacted for a clinical follow-up visit. Patients were assessed before surgery, one year after surgery, and again after a mean of 11 years (range: 6-16 years). Objective outcomes were assessed with grip strength, pinch strength, and range of motion (ROM). Subjective outcomes were assessed by the Disabilities of the Arm, Shoulder, and Hand score, Canadian Occupational Performance Measure (performance and satisfaction), and Visual Analog Scale pain scores at rest and during activity. Radiographic assessments were completed according to Sweets and Stern as modified by Wagner et al.RESULTS: A total of 68 fingers in 52 patients underwent PIPJ hemiarthroplasty. Thirty-six arthroplasties in 29 patients were available for the long-term follow-up, five patients had died, and the remaining cases were contacted by phone. Three cases were lost to follow-up. Preoperative diagnoses included 41 fingers with osteoarthritis or posttraumatic arthritis, and 27 fingers with inflammatory arthritis. Eight cases had undergone revision at the time of follow-up, and the 10-year implant survival was 72%. The revisions were performed after a mean of two years after surgery. Three patients had undergone soft-tissue procedures. Visual Analog Scale pain scores, Disabilities of the Arm, Shoulder, and Hand scores, and Canadian Occupational Performance Measure scores improved significantly compared with that before surgery. Grip strength and pinch grip remained unchanged. However, PIPJ ROM deteriorated significantly one year after surgery, when compared with that before surgery.CONCLUSIONS: Pyrocarbon hemiarthroplasty of the PIPJ has an acceptable long-term implant survival, and the significant improvement in pain scores and patient-reported outcomes is maintained over time. Pyrocarbon hemiarthroplasty could be a viable option in the management of PIPJ arthritis. Patients should be advised that PIPJ ROM deteriorates over time.TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
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| 42. |
- Lundqvist, Eva, 1985-, et al.
(författare)
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Volar Locking Plate Compared With Combined Plating of AO Type C Distal Radius Fractures : A Randomized Controlled Study of 150 Cases
- 2022
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Ingår i: Journal of Hand Surgery-American Volume. - : Elsevier. - 0363-5023 .- 1531-6564. ; 47:9, s. 813-822
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The optimal way to stabilize intra-articular distal radius fractures is unclear despite recent advances in surgical management. Volar plating is the most common treatment but may not be sufficient for more complex intra-articular AO type C fractures. The purpose of this randomized controlled study was to evaluate the radiographic and clinical outcomes following surgical treatment of AO type C distal radius fractures, comparing volar with combined plating.METHODS: In this study, 150 patients were randomized to volar locking plate (n = 75) or combined plating (n = 75) following a distal radius fracture AO type C. The 1-year follow-up included radiographic outcome (Batra score), visual analog scale pain score, hand grip strength, wrist range of motion, Patient-Rated Wrist Evaluation score, and Quick Disabilities of the Arm, Shoulder, and Hand score.RESULTS: Overall, 147 patients (median age 61 years) completed the 1-year follow-up (73 patients with volar plate and 74 with combined plating). No difference was found in radiographic outcome between the treatment groups. The volar plate group had significantly better Patient-Rated Wrist Evaluation scores, Quick Disabilities of the Arm, Shoulder, and Hand scores, hand grip strength, visual analog scale scores during activity, and flexion, extension, ulnar and radial deviation than the combined plate group. Hardware removal was performed in 10% in the volar plate group and in 31% in the combined plate group. There was no postoperative infection in the volar plate group but 3 cases in the combined plate group.CONCLUSIONS: In patients with complex AO type C intra-articular fractures, volar and combined plating yielded the same radiographic result. The differences in Patient-Rated Wrist Evaluation and Quick Disabilities of the Arm, Shoulder, and Hand scores between the groups did not reach the thresholds for minimal clinically important differences, suggesting similar clinical outcome. The combined plating group had a considerably higher frequency of hardware removal and postoperative infections.TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.
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| 43. |
- Mehta, Raghav, et al.
(författare)
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QU-BraTS : MICCAI BraTS 2020 Challenge on QuantifyingUncertainty in Brain Tumor Segmentation - Analysis of Ranking Scores and Benchmarking Results
- 2022
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Ingår i: Journal of Machine Learning for Biomedical Imaging. - 2766-905X. ; , s. 1-54
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Tidskriftsartikel (refereegranskat)abstract
- Deep learning (DL) models have provided the state-of-the-art performance in a wide variety of medical imaging benchmarking challenges, including the Brain Tumor Segmentation (BraTS) challenges. However, the task of focal pathology multi-compartment segmentation (e.g., tumor and lesion sub-regions) is particularly challenging, and potential errors hinder the translation of DL models into clinical workflows. Quantifying the reliability of DL model predictions in the form of uncertainties, could enable clinical review of the most uncertain regions, thereby building trust and paving the way towards clinical translation. Recently, a number of uncertainty estimation methods have been introduced for DL medical image segmentation tasks. Developing scores to evaluate and compare the performance of uncertainty measures will assist the end-user in making more informed decisions. In this study, we explore and evaluate a score developed during the BraTS 2019-2020 task on uncertainty quantification (QU-BraTS), and designed to assess and rank uncertainty estimates for brain tumor multi-compartment segmentation. This score (1) rewards uncertainty estimates that produce high confidence in correct assertions, and those that assign low confidence levels at incorrect assertions, and (2) penalizes uncertainty measures that lead to a higher percentages of under-confident correct assertions. We further benchmark the segmentation uncertainties generated by 14 independent participating teams of QU-BraTS 2020, all of which also participated in the main BraTS segmentation task. Overall, our findings confirm the importance and complementary value that uncertainty estimates provide to segmentation algorithms, and hence highlight the need for uncertainty quantification in medical image analyses. Our evaluation code is made publicly available at https://github.com/RagMeh11/QU-BraTS
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| 44. |
- Niklasson, Johan, et al.
(författare)
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Pulp-to-palm distance is associated with functional outcome 3 months after combined plating for distal radius fracture
- 2019
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Ingår i: Abstract book IFSHT. - Freiburg : Intercongress GmbH. - 9783000635854
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Konferensbidrag (refereegranskat)abstract
- Clinical issue/s: Objective: The Distal Radius Fracture (DRF) is the most common fracture in adults. After surgical management, extensive rehabilitation programs are common in order to restore function. Some patients are not able to fully move their fingers during the first month after a DRF-surgery (Pulp-to-palm distance=PTP).Clinical reasoning: The purpose of this study was to investigate if increased PTP 4 weeks after DRF surgery is associated with an inferior functional outcome 3 months postoperatively after DRF-surgery.innovative, analytical or new approach: Materials and Methods: This prospective study involved 53 DRF-patients with intra-articular type C fractures according to the AO-classification. All patients were treated with combined volar and dorsal plating. The patients were assessed at 4 weeks and 3 months postoperatively according to PTP-distance, wrist range of motion, grip strength, VAS pain scores and self-assessed hand function. Rehabilitation was the same for all patients with focus on self-training instructions, regardless of individual finger and wrist status.Results: 20 patients had a PTP > 0 cm 4 weeks after surgery. Three months after surgery, all patients had regained full fingermotion. The group with PTP > 0 cm showed significantly inferior range of motion regarding dorsal- and volar flexion, radial- and ulnar deviation as well as grip strength and quick-DASH 3 months after surgery. Inferior outcomes for pro- and supination and PRWE-scores was seen but were not significant. Pain at rest and during activity showed no significant differences between the groups.Contribution to advancing HT practice: Conclusions: Impaired finger motion 4 weeks postoperatively is a significant predictor of functional outcome 3 months postoperatively in surgically treated DRFs. Measuring the PTP-distance can assist the physiotherapist in the allocation of rehabilitation resources.
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| 45. |
- Rahman Jabin, MD Shafiqur, et al.
(författare)
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Effectiveness and Experiences of Quality Improvement Interventions in Older Adult Care : Protocol for a Mixed Methods Systematic Review
- 2024
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background:Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their own care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older adult care settings and further improve health and social care systems associated with older adults.Objective:This review aims to compile and synthesize the best available evidence regarding the effectiveness of policy and practice QI interventions in older adult care. The secondary aim is to understand the care of older individuals and QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families.Methods:The mixed methods review will follow the standard methodology used by Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycINFO, ASSIA, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of patients undergoing older adult care and any health and care professionals involved in the care delivery for older adults; a broad range of QI interventions, including assistive technologies, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older adult care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, that is, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will be followed.Results:A result-based convergent synthesis design will be used in which both quantitative and qualitative studies will be analyzed separately, and the results of both syntheses will be then integrated during a final (convergent) synthesis. The integration will compare the findings of quantitative and qualitative evidence using tables in light of the results of both syntheses.Conclusions:This comprehensive review is expected to reflect on the insights into some QI interventions and their impact, outline some common challenges of quality for older adult care, and benefit both the practical usefulness of care service activities and the society at large.
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| 46. |
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| 47. |
- Reiser, Daniel, 1972-, et al.
(författare)
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Clinical, Radiographic, and Patient-Perceived Outcome After Radial Hemi-Wrist Arthroplasty With a New Implant : 20 Cases With 5-Year Follow-up
- 2024
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Ingår i: Hand (New York, N.Y.). - : Sage Publications. - 1558-9447 .- 1558-9455. ; 19:5, s. 742-750
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Distal component loosening is a common mode of failure in total wrist arthroplasty (TWA). A radial hemi-wrist arthroplasty (RHWA) has the potential to avoid problems related to the distal component in TWA. The aim of this study is to investigate clinical outcomes following surgical treatment with a new RHWA design.METHODS: In this pilot study of 20 consecutive RHWAs, patients were assessed preoperatively and postoperatively for range of motion, grip strength, Visual Analog Scale (VAS) pain scores, and functional scoring using Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH), and Canadian Occupational Performance Measure. Radiographs were analyzed at 12 months and 5 years (mean, 5.1 years) postoperatively.RESULTS: A total of 46 secondary surgeries were undertaken in 16 wrists, including 7 revisions. Another 6 patients are waiting for revision to radiocarpal arthrodesis. In non-revised patients, the DASH and PRWE scores improved, and wrist range of motion remained largely unchanged except for wrist flexion, which decreased. The VAS pain score during activity was reduced, and hand grip strength remained largely unchanged.CONCLUSIONS: The new implant resulted in improved functional scoring and improved VAS pain scores in non-revised patients, but many cases needed secondary surgery due to persistent pain. The high revision rate is a major concern, and further use of the implant in its current form cannot be recommended.
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| 48. |
- Reiser, Daniel, et al.
(författare)
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Dry Arthroscopy of the Wrist With a Single-use, 1.9 mm Chip-on-tip System in Wide-awake Local Anesthesia No Tourniquet
- 2022
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Ingår i: Techniques in Hand & Upper Extremity Surgery. - : Lippincott Williams & Wilkins. - 1089-3393 .- 1531-6572. ; 26:4, s. 246-249
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Tidskriftsartikel (refereegranskat)abstract
- We retrospectively reviewed our 34 first wrist dry arthroscopy cases using a single-use, 1.9 mm chip-on-tip system in wide-awake local anesthesia no tourniquet (WALANT). Thirteen patients were acute injuries; all acute patients underwent a magnetic resonance imaging (MRI) before arthroscopy. In total, 20 of 34 patients had a preoperative MRI. We use this method as a diagnostic tool in patients with wrist pain with suspected ligament tears and for the planning of treatment. We see 2 main advantages in the use of the needle chip-on-tip system: the simplicity of the procedure, and the minimal invasive character of the procedure due to the needle size that makes it possible to perform the procedure in WALANT. We find that the needle chip-on-tip arthroscopy system is a safe and cost-efficient alternative to wrist MRI with superior diagnostic ability. The procedure is minimally invasive and well suited for WALANT.
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| 49. |
- Reiser, Daniel, 1972-, et al.
(författare)
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Intraneural Ulnar Nerve Ganglion : A Surgical Case Report of a 10-cm-Long Recurring Ganglion Cyst in the Forearm
- 2024
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Ingår i: Case Reports in Orthopedic Research. - : S. Karger. - 2296-9373. ; 6:1, s. 39-44
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Intraneural ganglions are benign and rare mucinous cysts that originate within peripheral nerves and typically can lead to symptoms and signs of peripheral neuropathy. The most common location is the peroneal nerve, and the second most common location is the ulnar nerve.Case Presentation: We present a case of a 53-year-old man who presented with increasing numbness in the ulnar aspect of the left hand and decreasing hand strength. MRI showed an intraneural ganglion, and as the patient had clinically progressive symptoms, a decision was made for surgical excision. The patient was symptom-free after the procedure and had no neurological deficits. Eighteen months later, the patient contacted us again as his symptoms had returned. A new MRI showed ganglion recurrence. Due to progressive clinical symptoms, another attempt was made to remove the ganglion surgically. Paraffin immunostains excluded other diagnoses like synovial cyst, posttraumatic neuronal cyst, Tarlov cyst, mesothelial cyst, and cystic lymphangioma. At follow-up 3 months postoperatively, the patient was symptom-free and had normal neurological findings.Conclusion: Intraneural ganglion should be considered as a differential diagnosis of a cystic mass close to a nerve. For surgery, we favor less radical methods, such as simple decompression.
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| 50. |
- Reiser, Daniel, 1972-, et al.
(författare)
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NanoScope wrist arthroscopy under wide-awake local anesthesia with no tourniquet : A prospective series of 30 consecutive patients
- 2024
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Ingår i: Journal of hand and microsurgery. - : Springer. - 0974-3227 .- 0974-6897. ; 16:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Wrist arthroscopy is an evolving procedure. The purpose of this study was to report the outcome of diagnostic arthroscopy of the wrist using a new tool, the NanoScope, under wide-awake local anesthesia with no tourniquet (WALANT).PATIENTS AND METHODS: This was a prospective study of 30 consecutive patients with suspected ligament tear after wrist trauma and remaining symptoms after initial conservative management. All patients had an MRI prior to the NanoScope procedure.RESULTS: The patients comprised 17 men and 13 women, with a mean age of 31 years. One patient declined the NanoScope procedure following their MRI. In the remaining 29 patients, NanoScope wrist arthroscopy revealed 19 cases of triangular fibrocartilaginous complex (TFCC) tears and 11 tears of the scapholunate (SL) or lunotriquetral (LT) ligaments. The correlation between preoperative MRI and the findings from NanoScope arthroscopy was poor. Six patients had additional surgery after the NanoScope arthroscopy, comprising three TFCC sutures, one SL and one LT ligament reconstruction respectively, and one wrist arthrodesis. No complications related to the NanoScope arthroscopies were noted.CONCLUSION: NanoScope arthroscopy of the wrist is safe, is well-suited for surgery in WALANT, and has superior diagnostic capacity compared to MRI. Further studies are warranted to determine the role of the NanoScope in the management of wrist ligament pathologies.LEVEL OF EVIDENCE: This is a level 4 study.
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