PubMed HealthSearch

Biomedical subjects

B Kristiansen

Publications and source records attributed to B Kristiansen.

At least 19 recordsLinked to original sources

[Hemi-alloplasty in the treatment of proximal humeral fractures].

Twenty-four cases of displaced proximal humeral fractures were treated by hemiarthroplasty. No postoperative infections were seen. Follow-up was 24 month (range 12 to 62) in 19 patients. Pain relief was satisfactory in all patients but one. Functional results according to a modified Neer score system were good in nine, fair in eight and poor in two cases. No statistical differences in results in relation to postinjury delay or other parameters were found. Hemiarthroplasty is thus a safe treatment for displaced humeral fractures with a satisfactory end result.

Aged

Operative treatment of clavicular nonunion.

Twelve patients treated for clavicular nonunion mainly with plate fixation and bone grafting were reviewed in order to evaluate the treatment. Follow-up was a median of 41 months (20-117). Nine out of 12 patients achieved a good end result, but the primary treatment failed in half of the cases, probably because of short (4-hole) semitubular plates and insufficient postoperative immobilization. We conclude that 4-hole semitubular plates cannot be recommended for treating clavicular nonunion because of a high risk of failure. Sufficient postoperative immobilization should follow plate fixation. If this is respected, plate fixation with bone grafting appears as a good method for treating clavicular nonunion.

Adult

[Conservative treatment of clavicular fractures].

The outcome of 99 clavicular fractures was examined retrospectively through a questionnaire and, in 20 cases, clinical examination. Primary treatment was in all cases a simple sling or a figure of eight bandage. The aim of the study was to examine prognostic factors in relation to the end-result. The fractures were classified, according to the roentgenograms, and the primary dislocation, primary shortening and secondary shortening of the shoulder were recorded. The end-result was expressed as the degree of pain. Statistically significantly more patients with group two type two fractures had a poor result. No other prognostic factors were found.

Adolescent

Fracture healing monitored with strain gauges. External fixation of 7 humeral neck fractures.

We measured healing in 7 cases of surgical neck fracture of the humerus by applying a strain gauge measuring bar between the external fixation pins. Repeated measurements provided a healing curve for the individual cases. The gradual decrease in deflection of the fracture zone reached a plateau of about 50 percent after 2 to 4 weeks in 6 cases. Removal of the frame at this time proved safe, as solid healing occurred. In one fracture no such decrease was seen and nonunion developed.

Aged

Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization.

In order to compare 1 and 3 weeks of immobilization following proximal humeral fractures a prospective controlled trial was performed in 85 patients. Clinical follow-up according to the Neer assessment system was done after 1, 3, 6, 12, and 24 months. One week of immobilization resulted in a better total score due to less pain during the first 3 months. After 6 months no difference in pain, function, or mobility was found and no further recovery of shoulder function was seen after 12 and 24 months.

Clinical Trials as Topic

Treatment of displaced fractures of the proximal humerus: transcutaneous reduction and Hoffmann's external fixation.

Experience with transcutaneous reduction and external fixation of displaced fractures of the proximal humerus is presented in a series of 28 cases followed for 1 year or more. In 18 cases near-anatomical fracture reduction was obtained, while no improvement of fracture position was seen in two cases. Loosening of the pins was a major complication in five cases, all in patients with severe osteoporosis or head splitting fractures, where fracture reduction was unsatisfactory. The functional results were satisfactory, and the method is considered a useful alternative in the treatment of these difficult fractures.

Adult

The Neer classification of fractures of the proximal humerus. An assessment of interobserver variation.

The reliability of the Neer classification of proximal fractures of humerus was examined by determining the agreement between pairs of observers using weighted kappa statistics. Anteroposterior and lateral radiographs of 100 surgical neck fractures were grouped independently by four observers. A low degree of agreement was found, especially between the most inexperienced observer and the rest. Considering the therapeutic consequences of a correct classification, these fractures should be assessed by experienced orthopedic surgeons or radiologists.

Humans

Multiple fractures in a young diabetic patient.

Multiple fractures in a patient with juvenile diabetes mellitus are reported. The fractures could be spontaneous due to osteopenia caused by reduced bone mass found in diabetic patients. Bone and joint changes had a severe progression due to diabetic neuropathy. The importance of clinical and radiological examination is emphasized.

Adult

Transcutaneous reduction and external fixation of displaced fractures of the proximal humerus. A controlled clinical trial.

A consecutive series of 31 displaced fractures of the proximal humerus were randomly selected for treatment either by closed manipulation or by transcutaneous reduction and external fixation. Follow-up assessed the quality of reduction and healing as well as the functional outcome. The external fixation method gave better reduction, safer healing and superior function.

Adult

External fixation of displaced fractures of the proximal humerus. Technique and preliminary results.

A new technique for the treatment of displaced fractures of the proximal humerus is described. Twelve fractures in 11 patients were managed by transcutaneous reduction using a Steinmann pin, and external fixation with a Hoffmann-type neutralising bar connected to two half-pins in the humeral head and three half-pins in the shaft. The pins were removed after four weeks. Two patients sustained redisplacement after a further injury, but in the others reduction was maintained. Two cases of pin-track infection resolved after antibiotics, but delayed union resulted. There were no neurovascular injuries and at follow-up of 6 to 12 months no refractures had been seen. The early functional results were excellent or satisfactory in nine cases.

Adult

Epidemiology of proximal humeral fractures.

In an urban population of half a million, all proximal humeral fractures were recorded in 1983. A total of 565 fractures, of which 77 per cent occurred in women, were seen. The overall incidence per 100,000 was 48 in men and 142 in women, with an exponential increase from the 5th decade of age. This rise was due to a higher incidence of minimally displaced fractures associated with moderate trauma, and thus of fractures associated with osteoporosis.

Age Factors

Proximal humeral fractures. Late results in relation to classification and treatment.

One hundred and eighty-eight proximal humeral fractures were reviewed retrospectively in relation to the Neer classification and the treatment given. The displacement criteria were found to have prognostic significance. Minimally displaced fractures had excellent outcome, whereas the results following any treatment of the displaced fractures were unsatisfactory in about one half of the cases. The indications for closed or open treatment can only be defined by prospective studies, and the methods of treatment should be improved.

Adult

External fixation of proximal humerus fracture. Clinical and cadaver study of pinning technique.

The risk of injuring important anatomic structures or interfering with motion of the glenohumeral joint by transcutaneous pinning of the proximal end of the humerus was investigated in 12 cadaver shoulders and in 23 patients with displaced fractures of the proximal humerus. In the cadavers, pinning of the proximal humeral shaft from laterally more than 20 mm below the surgical neck did not injure the neurovascular structures in any case. Pin insertions into the humeral head medial to the intertubercular groove endangered the cephalic vein and interfered with shoulder function by transfixing the subacromial bursa and by restricting internal rotation. Lateral pinning did not carry such risk. In the patients closed reduction and external fixation confirmed the low risk of neurovascular injuries. Lateral pinning of the humeral head resulted in an unrestricted passive mobility of the glenohumeral joint of the anesthetized patient, whereas anterior pinning carried the risk of mechanical restriction of the internal rotation.

Adult