| 1. |
- Adolfsson, L., et al.
(författare)
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Acutrak screw fixation versus cast immobilisation for undisplaced scaphoid waist fractures
- 2001
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 26 B:3, s. 192-195
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Tidskriftsartikel (refereegranskat)abstract
- Fifty-three patients with less than 14 day-old, undisplaced fractures of the waist of the scaphoid were randomized to two groups. Twenty-eight patients were treated by immobilisation in a below elbow plaster cast for 10 weeks while 25 were treated by percutaneous insertion of an Acutrak standard screw. There were no statistically significant differences between the two treatment groups with regard to either the rate of union or the time to union. Patients who underwent surgery had a significantly better range of motion at 16 weeks but there were no significant differences for grip strength. Acute percutaneous internal fixation of undisplaced scaphoid waist fractures using the Acutrak screw allows early mobilisation without adverse effects on fracture healing.
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| 2. |
- Adolfsson, Lars, 1955-, et al.
(författare)
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Arthroscopic findings in wrists with severe post-traumatic pain despite normal standard radiographs
- 2004
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 29 B:3, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- This study assessed the role of diagnostic arthroscopy following a wrist injury in patients with normal standard radiographs, an unclear clinical diagnosis and persistent severe pain at 4 to 12 weeks. Forty-three patients were included after conservative management had failed to improve their wrist pain so that a stability test could be performed satisfactorily and underwent arthroscopy within 12 weeks. Arthroscopy revealed recent pathology in 41 wrists, of which 17 had significant ligament lesions that might have benefited from acute repair. We conclude that patients with marked persistent post-traumatic symptoms despite conservative management are likely to have sustained ligament injuries despite normal radiographs. We therefore recommend that under these circumstances an arthroscopy is carried out within 4 weeks if the patient and surgeon wish to acutely repair significant ligament injuries.
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| 3. |
- Berglund, Maria, 1975-, et al.
(författare)
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Assessment of mRNA levels for matrix molecules and TGF-B1 in rabbit flexor and peroneus tendons reveals regional differences in steady-state expression
- 2004
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 29:2, s. 165-169
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Tidskriftsartikel (refereegranskat)abstract
- This study analysed the differences on a molecular level between two segments of the deep flexor tendon, and compared the intrasynovial flexor tendon with the tendon sheath and the extrasynovial peroneus tendon in a rabbit model. The TRIspin method of RNA extraction was combined with the reverse transcription polymerase chain reaction to assess mRNA levels in the tissue segments. Significant differences were detected for all genes studied. mRNA levels for aggrecan, biglycan and collagen III were significantly higher in the fibrocartilaginous proximal segment of the flexor tendon. Collagen I was higher in the flexor tendon than the sheath and the peroneus tendon, and TGF-beta1 was significantly lower in the peroneus tendon. This study demonstrates differences at the mRNA level between different segments of tendon, indicating that the tendon tissue may be adapted to its environment.
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| 4. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury
- 2003
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Ingår i: Journal of Hand Surgery - British and European Volume. - 0266-7681 .- 1532-2211. ; 28B:4, s. 332-338
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to estimate the incidence of trauma-related distress and mood disorders in the early stages after acute traumatic hand injuries and identify characteristics associated with these reactions. Data were obtained from 112 patients by means of mailed questionnaires and medical records. Nearly half of the patients had increased levels of intrusive and avoidance symptoms, indicating trauma-related distress. One-third showed signs of a mood disorder. Mood disorders were associated with the need for help with activities of daily living, pain and avoidance symptoms. The study showed that emotional problems in the early stages after injury are related to the consequences of both the injury and the traumatic experience. Negative reactions to the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observation of the reactions to the sight of the hand could help to identify patients in need of psychological support.
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| 5. |
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| 6. |
- Kopylov, Philippe, et al.
(författare)
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Norian SRS versus functional treatment in redisplaced distal radial fractures : A randomized study in 20 patients
- 2002
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 27 B:6, s. 538-541
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Tidskriftsartikel (refereegranskat)abstract
- We compared the use of Norian SRS, an injectable calcium phosphate bone cement, with functional treatment of redisplaced distal radial fractures in a prospective randomized study of 20 patients. The redisplaced fractures were either rereduced and stabilized by Norian SRS, or the displaced position was accepted and was not rereduced. All wrists were immobilized in a short-arm dorsal splint for 1 week, followed by a removable splint for another 3 weeks. The chosen primary effect variable was grip strength at 7 weeks, and this did not differ between the two treatment groups. The clinical results at 6 months in both groups were similar. We conclude that aggressive treatment of redisplaced fractures of the distal radius may be unnecessary in most women aged 50 years or more.
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| 7. |
- Lutz, Barbara S., et al.
(författare)
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Nerve transfer to the median nerve using parts of the ulnar and radial nerves in the rabbit : effects on motor recovery of the median nerve and donor nerve morbidity
- 2000
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 25:4, s. 329-335
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Tidskriftsartikel (refereegranskat)abstract
- In this study, motor re-innervation of the median nerve by transfer of one-third, one-half, and two-thirds of either the agonistic ulnar nerve or the antagonistic radial nerve was investigated in both extremities of 20 rabbits.Recipient median nerve: Muscle contraction force of the flexor digitorum sublimus muscle after a one-third and a one-half of the ulnar nerve transfer achieved an average of 75 and 97% muscle power respectively as compared to conventional end-to-end neurorrhaphy. Muscle contraction force after one-third or one-half of the radial nerve transfer was significantly lower (36%).Donor nerves: Extensor carpi radialis muscle or flexor carpi ulnaris muscle contraction force 6 months postoperatively demonstrated a significant decrease after a one-half ulnar nerve and a two-thirds ulnar or radial nerve transfer, but not after a one-third transfer of either radial or ulnar nerves.Histologically, the number of axons in the re-innervated median nerve and both donor nerves distal to the coaptation site seemed to follow variable patterns.It was concluded that in the rabbit use of one-third of the agonistic ulnar nerve for re-innervation of the median nerve results in useful motor recovery with negligible donor site morbidity. Clinically, this technique may offer an alternative option for proximal nerve injuries or for free functioning muscle transplantations.
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| 8. |
- Wilbrand, Stephan, et al.
(författare)
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Cancer incidence in patients treated surgically for Dupuytren's contracture
- 2000
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Ingår i: Journal of Hand Surgery - British and European Volume. - : SAGE Publications. - 0266-7681 .- 1532-2211. ; 25:3, s. 283-287
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to study risk factors for Dupuytren's contracture (DC) by assessing cancer morbidity in a group of Swedish patients treated surgically for Dupuytren's contracture. The risk of cancer was determined in 15,212 patients operated on for Dupuytren's contracture, identified in the nationwide Swedish Inpatient Register during the period 1965 to 1994 by means of record linkage to the Swedish Cancer Register. Standardized incidence ratios (SIRs) were computed using age-, sex- and period-specific incidence rates derived from the entire Swedish population. The overall relative risk of cancer was increased by 24%. There were significantly increased risks for malignancies related to smoking such as buccal, oesophageal, gastric, lung and pancreatic cancers. Significantly increased risks were present for both prostate and rectal cancer in men and an increase risk for breast cancer in women was noted 1 year or more after surgery for Dupuytren's contracture. The present study confirms smoking and alcohol abuse as probable risk factors for DC. There are characteristics in patients with DC that alter the risks for other malignancies compared with the general population.
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