| 1. |
- Hägglund, Gunnar, et al.
(författare)
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Prevention of dislocation of the hip in children with cerebral palsy. The first ten years of a population-based prevention programme.
- 2005
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Ingår i: Journal of Bone and Joint Surgery: British Volume. - 2044-5377. ; 87:1, s. 95-101
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Tidskriftsartikel (refereegranskat)abstract
- In 1994, a register for cerebral palsy and a health-care programme were started in southern Sweden with the aim of preventing dislocation of the hip in children with cerebral palsy. It involved all children with cerebral palsy born in 1992 or later. None of the 206 affected children born between 1992 and 1997 has developed a dislocation following the introduction of the prevention programme. Another 48 children moved into the area and none developed any further dislocation. Of the 251 children with cerebral palsy, aged between five and 11 years, living in the area on January 1, 2003, only two had a dislocated hip. One boy had moved into the area at age of nine with a dislocation and a girl whose parents chose not to participate in the programme developed bilateral dislocation. One boy, whose condition was considered to be too poor for preventative surgery, developed a painful dislocation of the hip at the age of five years and died three years later. Eight of 103 children in a control group, consisting of all children with cerebral palsy living in the area between 1994 and 2002, and born between 1990 and 1991, developed a dislocation of the hip before the age of six years. The decreased incidence of dislocation after the introduction of the prevention programme was significant (p < 0.001). Dislocation of the hip in cerebral palsy remains a serious problem, and prevention is important. Our screening programme and early intervention when lateral displacement of the femoral head was detected appear to be successful.
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| 2. |
- Valdimarsson, Örnolfur, et al.
(författare)
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Reduced training is associated with increased loss of BMD.
- 2005
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Ingår i: Journal of Bone and Mineral Research. - 1523-4681. ; 20:6, s. 906-912
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Tidskriftsartikel (refereegranskat)abstract
- This 8-year controlled, follow-up study in 66 Swedish soccer women evaluated the effect of training and reduced training on BMD. The players who retired during the follow-up lost BMD in the femoral neck, whereas the controls did not. Introduction: Physical activity during adolescence increases BMD, but whether the benefits are retained with reduced activity is controversial. Materials and Methods: At baseline, DXA evaluated BMD in 48 active female soccer players with a mean age of 18.2 ± 4.4 (SD) years, in 18 former female soccer players with a mean age of 43.2 ± 6.2 years and retired for a mean of 9.4 ± 5.3 years, and in 64 age- and sex-matched controls. The soccer women were remeasured after a mean of 8.0 ± 0.3 years, when 35 of the players active at baseline had been retired for a mean of 5.3 ± 1.6 years. Results and Conclusions: The players still active at follow-up had a higher BMD at baseline than the matched controls in the femoral neck (FN; 1.13 ± 0.19 versus 1.00 ± 0.13 g/cm2; p = 0.02). The yearly gain in BMD during follow-up was higher in the active players than in the controls in the leg (0.015 ± 0.006 versus 0.007 ± 0.012 g/cm2, p = 0.04). The soccer players who retired during follow-up had a higher BMD at baseline than the matched controls in the FN (1.13 ± 0.13 versus 1.04 ± 0.13 g/cm2; p = 0.005). The players that retired during follow-up lost BMD, whereas the controls gained BMD during the study period in the FN (−0.007 ± 0.01 versus 0.003 ± 0.02 g/cm2 yearly; p = 0.01). The soccer players already retired at baseline had higher BMD at study start than the matched controls in the leg (1.26 ± 0.09 versus 1.18 ± 0.10 g/cm2; p = 0.01). The former players who were retired at study start lost BMD, whereas the controls gained BMD during the study period in the trochanter (−0.006 ± 0.01 versus 0.004 ± 0.014 g/cm2 yearly; p = 0.01). This study shows that, in girls, intense exercise after puberty is associated with higher accrual of BMD, and decreased physical activity in both the short-term and long-term perspective is associated with higher BMD loss than in controls.
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| 3. |
- Dahlin, Lars, et al.
(författare)
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Compression of the lower trunk of the brachial plexus by a cervical rib in two adolescent girls : case reports and surgical treatment.
- 2009
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Ingår i: Journal of Brachial Plexus and Peripheral Nerve Injury. - : BioMed Central. - 1749-7221. ; 4, s. 14-
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Tidskriftsartikel (refereegranskat)abstract
- Presence of a cervical rib in children is extremely rare, particularly when symptoms of compression of the lower trunk of the brachial plexus occur. We present two cases with such a condition, where two young girls, 11 and 16 years of age were treated by resection of the cervical rib after a supraclavicular exploration of the lower trunk of the brachial plexus. The procedure led to successful results, objectively verified with tests in a work simulator, at one year follow-up.
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| 4. |
- Dahlin, Lars, et al.
(författare)
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Incidence of early posterior shoulder dislocation in brachial plexus birth palsy.
- 2007
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Ingår i: Journal of Brachial Plexus and Peripheral Nerve Injury. - : Georg Thieme Verlag KG. - 1749-7221. ; 2:Dec 16, s. 24-24
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Posterior dislocation of the shoulder in brachial plexus birth palsy during the first year of life is rare but the incidence increases with age. The aim was to calculate the incidence of these lesions in children below one year of age. METHODS: The incidence of brachial plexus birth lesion and occurrence of posterior shoulder dislocation was calculated based on a prospective follow up of all brachial plexus patients at an age below one in Malmö municipality, Sweden, 2000-2005. RESULTS: The incidence of brachial plexus birth palsy was 3.8/1000 living infants and year with a corresponding incidence of posterior shoulder dislocation (history, clinical examination and x-ray) during the first year of 0.28/1000 living infants and year, i.e. 7.3% of all brachial plexus birth palsies. CONCLUSION: All children with a brachial plexus birth lesion (incidence 3.8 per thousand) should be screened, above the assessment of neurological recovery, during the first year of life for posterior dislocation of the shoulder (incidence 0.28 per thousand) since such a condition may occur in 7% of children with a brachial plexus birth lesion.
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| 5. |
- Dahlin, Lars, et al.
(författare)
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Injuries to the nerves associated with fractured forearms in children
- 2007
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 41:4, s. 207-210
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Tidskriftsartikel (refereegranskat)abstract
- Partial and complete injured median and ulnar nerves caused by fractures of the radius and ulna, respectively, in which the symptoms of nervous injury were induced at the time of fracture are reported. In cases with complete loss of nervous function early exploration should be considered at the time of reposition or plating of the fractured bones, or both, and in patients in whom nervous dysfunction occurs after the operation.
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| 6. |
- Hägglund, Gunnar, et al.
(författare)
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Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity
- 2005
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Ingår i: Journal of Pediatric Orthopedics. Part B. - 1473-5865. ; 14:4, s. 269-273
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Tidskriftsartikel (refereegranskat)abstract
- During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CID register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P=0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated.
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