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Biomedical subjects

A Udén

Publications and source records attributed to A Udén.

At least 19 recordsLinked to original sources
PubMed1999

Can an external frame fixation reduce the movements in the sacroiliac joint? A radiostereometric analysis of 10 patients.

To evaluate whether a Hoffmann-Slätis frame can reduce movements in the sacroiliac joints, 10 patients (7 women) with severe posterior pelvic pain of long duration were externally stabilized. The movements were analyzed with radiostereometric analysis (RSA) in supine and standing positions, preoperatively and postoperatively with the frame applied. In 2 patients, there was no reduction in the movements with the frame, perhaps because it was not properly tightened. In the remaining 8 patients, the median reduction in rotation was 55% on the left side and 63% on the right side around the helical axes, and 74% around the x-axes on the left side and 66% on the right side. Our data suggest that external fixation using the Hoffmann-Slätis frame, substantially reduces sacroiliac joint mobility in some patients, which must be considered when using the frame as a diagnostic tool. Pre-stressing the frame by tightening the vertical bars before the compression bar is applied is recommended to reduce the risk of this shortcoming.

Adult↗
PubMed1997

Pain pattern in pregnancy and "catching" of the leg in pregnant women with posterior pelvic pain.

STUDY DESIGN: A cross-sectional study of symptoms and signs in pregnant women. OBJECTIVES: To describe the clinical appearance of back pain in pregnancy and the relation between pain distribution and symptoms in women with posterior pelvic pain, in order to shed light on etiologic factors. SUMMARY OF BACKGROUND DATA: Back pain is common in the general population. During pregnancy, it is even more common, and back pain is experienced by about 50% of pregnant women. In the pregnant woman, differentiation between common low back pain and posterior pelvic pain is believed to be essential because these symptoms should be treated in different ways. METHODS: The women were interviewed with a questionnaire. Those with back symptoms completed a pain drawing and were examined by an orthopedic surgeon. Based on the symptoms and findings, the women were divided into three groups: thoracic pain, lumbar pain, and posterior pelvic pain. RESULTS: Of 335 pregnant women, 51% had back pain at the time of examination. The pain was more widespread compared with common low back pain. Seventy-one percent of the 171 patients examined by the orthopedic surgeon had a positive posterior pelvic pain test. These women more often had pain in the gluteal and posterior thigh regions. A "catching" feeling of the leg was described when walking by 44 of 122 these women, whereas only 1 of 49 women without a posterior pelvic pain test had such symptoms. CONCLUSIONS: The higher prevalence of back pain in pregnancy may be due to several factors. In women with posterior pelvic pain, there is a specific symptom-a catching of the leg when walking. The most probable explanation for the catching is that local nociception disturbs muscular function in women with posterior pelvic pain because changes in the sacroiliac joint range of motion, which is very small, cannot cause this symptom.

Adult↗
PubMed1994

Specified diagnosis in 532 cases of back pain.

In the city of Malmö, Sweden, a project was started to improve the rehabilitation of patients with back pain. Among 532 patients with back pain who were on sick leave for an average of 98 days the year preceding the consultation, very few specific diagnoses were made in spite of a thorough clinical and radiological examination. Only five of the patients were cured by surgery. During the same period 103 patients were operated on for disc herniation or nerve root stenosis at the Orthopaedic Department at Malmö General Hospital. Thus the routines for somatic diagnosis of the medical service in Malmö are adequate and an improvement would have very little effect on the expenditures for sick leave and early retirement. As suggested in this paper social and psychological factors are of greater importance in the rehabilitation and we should focus less on the physical problems of the patient.

Adult↗
PubMed1994

The impact of intra-uterine factors on neonatal hip instability. An analysis of 1,059,479 children in Norway.

The records of the Medical Birth Registry of Norway from 1970 through 1988 contain information on maternal health, course of delivery and health of 1,059,479 newborns. The overall prevalence at birth of neonatal hip instability (NHI) was 0.9 percent: 0.6 percent in boys and 1.4 percent in girls. In breech presentation, the rate was 4.4 percent. In vaginally delivered children, the rate was only marginally higher compared to those delivered by cesarean section. In children with a birthweight less than 2,500 g, the rate was 0.3 percent. In vertex presentation, the duration of pregnancy had no influence in boys whilst, in breech presentation, the prevalence increased up to the 39th week of gestation. In girls, the NHI rate increased with the duration of gestation, particularly in breech presentation. In first-born children, these patterns were even more obvious. The data are consistent with a hypothesis that intra-uterine mechanical factors, in combination with hormonal factors, are of importance rather than the actual trauma of vaginal delivery.

Birth Order↗
PubMed1992

The von Rosen splint compared with the Frejka pillow. A study of 408 neonatally unstable hips.

101 children in Tromsö, Norway, treated with the Frejka pillow for 4.5 months because of neonatal hip instability (NHI) were compared with 307 children in Malmö, Sweden, treated with the von Rosen splint for 3 months. The pelvic radiographs, taken when the treatment was terminated, were assessed by the acetabular index (AI) and the cases of failure were evaluated. The AI showed no difference between the two groups. The Frejka group had 4 patients who received further treatment because of remaining acetabular dysplasia and/or subluxation while the von Rosen group had none. The difference in risk of failure might partly be explained by different criteria for failure.

Female↗
PubMed1992

The natural course of lumbar spinal stenosis.

The course of 32 untreated patients with spinal stenosis was studied. The mean patient age was 60 years, and the mean period of observation was 49 months. About 75% of the patients had spinal claudication. In the follow-up survey, the same number of patients had claudication, but the symptoms were milder. In estimation by visual analog scale, symptoms in 70% of the cases were unchanged, 15% showed improvement, and 15% worsened. No proof of severe deterioration was found after four years, and expectant observation may be an alternative to surgical treatment.

Adult↗
PubMed1991

The effect of decompression on the natural course of spinal stenosis. A comparison of surgically treated and untreated patients.

The clinical course of 19 untreated patients with spinal stenosis (mean age, 60 years) was compared with that of 44 patients treated surgically (mean age, 65 years). The time of follow-up was 31 and 53 months, respectively. About 80% of the patients had neurogenic intermittent claudication. In the follow-up, one third of the treated and one half of the untreated patients still had neurogenic claudication. By visual analogue-scale estimation, 60% of those treated surgically and 33% of the untreated patients felt better. Fifty-eight percent of the untreated patients were unchanged. Neurophysiologic changes showed progression in almost all cases; it was more pronounced in the treated patients. No proof of severe deterioration was found in the untreated patients, and observation for 2-3 years seems to be a good alternative to surgery.

Aged↗
PubMed1991

Why is congenital dislocation of the hip still missed? Analysis of 96,891 infants screened in Malmö 1956-1987.

During 1956 through 1987, 96,891 children have been screened for neonatal hip instability according to the tests of Ortolani and Barlow. In 1956 through 1972 only 4/58, 759 (0.07 permille) were missed, whereas during 1980 through 1987, 12/19, 398 (0.6 permille) were missed. This increase is not caused by any formal alteration of the screening programme. The screening has prevented a late diagnosis in all children born in breech presentation and in all boys except one. General factors such as female sex and joint laxity imply an increased risk for being missed in the screening, whereas mechanical factors such as breech presentation and the primogeniture effect likely facilitate an early diagnosis in the screening. The time between birth and the first examination is also of some importance.

Birth Weight↗
PubMed1989

Why do people seek medical advice for back pain: a comparison of consulters and nonconsulters.

Respondents with back pain who had answered affirmatively to the question about back pain in a population study were divided into two groups depending on whether they had consulted or had not consulted a physician due to their back pain. There were 17 nonconsulters and 37 consulters. The subjects participated in a stringent physical examination and in the following psychological tests: the Eysenck Personality Inventory (EPI), the rod and frame test (RFT), and the metacontrast technique (MCT). They also answered a pain questionnaire. Based on the results, we found that the nonconsulters differed from the consulters on many issues but had nevertheless rated their constant level of pain on two different occasions as being equally severe on a graphic rating scale (GRS). The groups differed as follows: The nonconsulters rated their work to be more stressful; had less frequently a spouse suffering or having suffered from chronic pain; had fewer abnormal pain drawings; woke up less frequently during the night; used sleeping pills less frequently; participated more often in sports; and had a higher frequency of repression on the MCT compared to a group of painless subjects.

Adult↗
PubMed1989

Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis.

Twenty-five patients (21 females and 4 males) with sacroiliac joint disorders were studied with roentgen stereophotogrammetry in physiologic positions as well as in the extreme of physiologic positions. There was a constant pattern of motion with different load, especially around the transverse axis. The rotations were small and in mean between position 2.5 degrees (0.8 degree-3.9 degrees). The translation was, mean, 0.7 mm (0.1-1.6 mm). There was no difference between symptomatic and asymptomatic joints.

Humans↗
PubMed1989

Bone mineral content, gender, body posture, and build in relation to back pain in middle age.

In 575 55-year-old residents of Malmö, Sweden, the authors studied the interrelationships between back pain and bone mineral content, degree of kyphosis and lordosis, height, and weight, and in women also the age of menarche and menopause, and number of childbirths. Men with back pain tended to be heavier than those without back pain. Back pain was not related to body height nor to degree of kyphosis or lordosis. In women, a positive correlation was found between the degree of kyphosis and lordosis and body weight. Body height in women also was correlated to degree of kyphosis, but not to the degree of lordosis. In men, the authors found no such relationships. Bone mineral content was not related to the occurrence of back pain but to body height and weight in men and in women. Back pain in women was not related to the age at menarche or menopause, nor to the number of children to whom they had given birth.

Back Pain↗
PubMed1989

Preoperative and postoperative instability in lumbar spinal stenosis.

Sixty-one patients operated on for spinal stenosis, without a fusion, were studied retrospectively. Preoperative instability, as revealed by functional myelography, was found to predict a poor prognosis (P less than 0.01). Women had less favorable results (P less than 0.05). The "slipping" group was significantly more often radically decompressed than the "nonslipping" group (P less than 0.01). Postoperative slipping was found in 26 patients, significantly more often in those with unsatisfactory results (P less than 0.001).

Adult↗