[Flexor tendon injuries of the hand and forearm].
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Biomedical subjects
Publications and source records attributed to B Munk.
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Widely regarded as the best collection of single-page AIDS fact sheets, these cover over 100 treatment-related topics; each is available in both English and Spanish, and is changed as necessary to remain current.
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We investigated the diagnostic value of two different ultrasound scanning methods for the early diagnosis of acute scaphoid fractures. Fifty-seven patients with ten scaphoid fractures were assessed within a week of injury. The accuracy of the ultrasound assessment was 84% and its specificity was 91%. However, its sensitivity was only 50%. We conclude that ultrasound examination is unreliable for the diagnosis of acute scaphoid fractures.
We compared the diagnostic and predictive value of magnetic resonance imaging (MRI) and clinical findings with arthroscopy in 61 knees in a prospective study. In meniscal tears, the accuracy and positive predictive value of MRI was found to be nearly twice that of clinical examination. The sensitivity, specificity, and negative predictive value of MRI were comparable to the figures found in other studies. We recommend MRI as a clarifying diagnostic tool when a clinical examination indicates a lesion of the meniscus. In our study, the clinical relevance of MRI in anterior cruciate ligament lesions and especially in cartilage lesions was more doubtful. The combination of clinical and MRI findings would reduce the number of blank arthroscopies to 5%. MRI is a valuable diagnostic tool in planning the type of anesthesia and treatment, and could significantly reduce the need for a second arthroscopy.
A 17 year old man presented with a five-month history of swelling of the distal phalanx and a small ulcer on the pulp of the right fifth finger. Despite biopsy the diagnosis was missed until more than six months after onset, when the lesion was excised and histological examination showed a dermal leiomyosarcoma.
In a prospective study of 79 patients with arthrographically verified acute ruptured lateral ankle ligaments we have evaluated the long-term results of three different treatments: operation and walking-cast, walking-cast alone and elastic bandage. The average follow-up period was 11 (9-13) years, and 32 parameters concerning interview, clinical and radiographic examinations were statistically analysed. The three kinds of treatment were found to be equal, since only one parameter showed significant difference at a 5% level using Fisher's exact and the Mann-Whitney test, and no difference by using the Kruskal-Wallis test for homogeneity. Residual disabilities and late complications, such as instability, pain on activity, and the number of secondary ligament reconstructions and talocrural arthroses were low. It was concluded that nonoperative treatment provided adequate results even after a decade.
In a prospective multicenter study of 1,052 patients with clinical signs of a scaphoid fracture, mammographic films and fine intensifying screens were used at the radiographic examination. 5 standardized projections including 3 special projections focused on the scaphoid were taken. 150 fractures were diagnosed at the first examination but in 10 cases the fracture was first diagnosed at a second radiographic examination after 10-14 days. The second examination still seems mandatory despite the use of high quality radiographs with optimal spatial resolution and contrast, and the value of supplementary special projections.
In a prospective study of 79 patients with arthrographically verified acute ruptured lateral ankle ligaments we have evaluated the long-term results of 3 different treatments: operation and walking-cast for 5 weeks, walking-cast alone, and elastic bandage. The follow-up period was 11 (9-13) years. Residual disabilities and late complications, such as instability, pain on activity, and the number of ligament reconstructions and talocrural arthroses were equally low in all 3 groups. We conclude that nonoperative treatment seems adequate.
During the decade 1980-90, seventy-nine Marmor arthroplasties were performed in 68 patients with unicompartmental femorotibial arthrosis. Six knees (7.6%) had been revised to a total knee arthroplasty. Nine patients were dead and four were lost to follow-up. Using The Hospital for Special Surgery knee-rating scale the 50 knees examined had an average score of 86 at a mean observation time of 6.8 years, and 92% were classified as "excellent" or "good" results. Acummulated success ratio was calculated to a 87% probability of having a prosthesis in situ without severe pain after an observation period of 10 years. It was concluded that, in selected cases, the Marmor knee arthroplasty is a valuable procedure in the treatment of unicompartmental arthrosis.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.