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Biomedical subjects

B Strömqvist

Publications and source records attributed to B Strömqvist.

At least 91 records · Page 5Linked to original sources
PubMed1986

Improved operations for femoral neck fracture. A radiographic evaluation.

A radiographic investigation was undertaken to determine whether an increased interest in femoral neck fractures improved the operative result. In 1977, all femoral neck fractures were operated on by any of 30 surgeons of the orthopedic department, but in 1981 all fractures were operated on by one of six specially devoted surgeons. Preoperative fracture classification was performed with three parameters and proved equal in the 1977 and 1981 groups of 105 and 114 fractures, respectively. The quality of fracture reduction, determined with four parameters, was improved somewhat. The position of the nail(s), also determined with four parameters, improved considerably. The technical result was better in Garden IV fractures than in Garden III fractures. An increased interest in femoral neck fracture treatment improved reduction and fixation.

Bone Nails↗
PubMed1985

The longest delay between femoral neck fracture and femoral head collapse?

Osteonecrosis and acute collapse of the femoral head occurred in a 79-year-old woman with a history of femoral neck fracture sustained 28 years previously. The occurrence of radiographic signs and clinical symptoms was associated with new functional demands on the hip because of a recent contralateral hip fracture. The femoral head collapse necessitated total hip arthroplasty. Determination of femoral head vitality at the time of arthroplasty implicated partial avascularity of the head as a cause of the collapse. With high probability, this partial avascularity was induced by the femoral neck fracture sustained 28 years earlier.

Aged↗
PubMed1985

Traumatic hip joint tamponade. Two cases with femoral head ischaemia.

Two elderly patients had pain after hip trauma with no radiographic evidence of fracture. Computed tomography demonstrated capsular haematoma. Scintimetry revealed femoral head ischaemia. Intracapsular hip joint pressure in extension was 240 and 176 mm Hg, respectively, in neutral position and 280 and 360 mm Hg in internal rotation. The hip joints were aspirated for 8 ml and 5 ml of blood, respectively, leading to pain relief and regained radiotracer uptake in the femoral head. It is concluded that traumatic hip joint tamponade may cause femoral head ischaemia which may be reversed by aspiration.

Accidents, Home↗
PubMed1985

A case of blackthorn synovitis.

A seven-year-old boy fell against a blackthorn bush and found that thorns had penetrated the skin over the left knee. Aseptic synovitis developed with repeated febrile episodes. With the suspicion of septic arthritis, the patient was treated with antibiotics on repeated occasions, two negative joint aspirations and a knee joint exploration were performed. Three months after the injury the correct diagnosis was made at a second arthrotomy when an intra-articular thorn was removed and synovectomy carried out, after which healing was uneventful.

Child↗
PubMed1985

Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results.

Different sized ROIs within the femoral head and different modes of calculation were used in [99mTc]MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence.

Aged↗
PubMed1984

Femoral head vitality at reoperation for femoral neck fracture complications.

In seven patients suffering redisplacement, nonunion or segmental collapse after nailing of femoral neck fractures, subsequent changes in the vitality of the femoral head were studied with tetracycline labeling and 99mTc-MDP scintimetry. At reoperation (total hip arthroplasty), the femoral heads were extracted and sawn into slices which were then analyzed. Vitality before nailing was totally lacking (tetracycline labeling) in one case (nonunion), and in the remaining cases moderate reduction was seen, most pronounced in the apical part of the head. In all cases, scintimetry 1-2 weeks after nailing showed reduced femoral head uptake of 99mTc-MDP, but scintimetry some hours before reoperation showed increased femoral head uptake. Isotope analysis of the slices from the extracted femoral heads showed marked reduction of uptake in the apical part of the head, moderate reduction in the distal and anterior parts, and satisfactory uptake in the posterior part of the head and the foveal region, though with individual variations. It was concluded that there is a genuine increase in uptake (revascularization) later in the course in postoperatively avascular heads, and that the apical part of the femoral head sustains the most pronounced vascular damage in femoral neck fracture and is probably the slowest to revascularize.

Aged↗
PubMed1984

Pre-operative and postoperative scintimetry after femoral neck fracture.

In 22 patients with femoral neck fractures 99mTc-MDP scintimetry was performed before operation and again shortly after operation; in 17 of these patients the investigation was repeated after four months. Six patients with increased uptake in the femoral head before operation and eight with decreased uptake had similar results at the first postoperative investigation. Of eight patients with an intermediate uptake before operation, two showed increased and six decreased femoral head uptake after operation. It is concluded that for the patients in the group with intermediate femoral head uptake before operation, the operative procedure probably influenced the postoperative blood supply of the femoral head.

Adult↗
PubMed1984

Hip fracture in rheumatoid arthritis.

All patients with rheumatoid arthritis, admitted for hip fracture to a regional hospital during a 5-year period, were studied in retrospect. Of 1092 hip fractures, 16 cervical and nine trochanteric fractures occurred in rheumatics. Four cervical fractures were stress fractures. The mean patient age was lower than in a normal hip fracture material and the female predominance more pronounced. Of 14 surviving patients with cervical fractures, three had an uncomplicated 2-year healing, while 11 developed redisplacement, non-union or segmental collapse, in eight cases necessitating hip arthroplasty. Of eight surviving patients with trochanteric fractures, serious complications developed in two: non-union in one and septicaemia in one, necessitating nail extraction 1 week after the primary operation. The complication rate was higher than in an unselected femoral neck fracture material.

Aged↗
PubMed1984

Two-year follow-up of femoral neck fractures. Comparison of osteosynthesis methods.

For 14 consecutive months, all 152 femoral neck fracture patients greater than or equal to 50 years of age admitted to the Lund University Hospital were operated on with two hook-pins if born on an uneven date and a four-flanged nail if born on an even date. A clinical 2-year follow-up revealed a 35 per cent mortality. Among survivors, radiographic healing complications were seen in undisplaced fractures in 1/13 pinned and 5/14 nailed (p greater than 0.05) and in displaced fractures in 12/36 pinned and 23/32 nailed (p less than 0.01). This outcome correlated well with the early postoperative scintimetry. Reoperation within 2 years had been performed for seven pinned and 19 nailed fractures. In hook-pinning, thus, less than one patient out of 12 needed a reoperation with THR within 2 years. This figure is interpreted as strongly favouring hook-pinning before arthroplasty as the primary procedure in femoral neck fracture.

Aged↗
PubMed1984

External and biopsy determination of preoperative Tc-99m MDP femoral-head labeling in fracture of the femoral neck: concise communication.

In 30 fresh fractures of the femoral neck, the preoperative femoral-head tracer uptake in Tc-99m MDP scintimetry was compared with the uptake of peroperatively obtained femoral-head biopsies and correlated to intravital bone staining by tetracycline, infused concurrently. Bone uptakes of Tc-99m MDP and tetracycline were shown to correlate well. Total absence of Tc-99m MDP uptake in the femoral-head biopsy corresponded to a scintigraphic uptake ratio of 0.7 (fractured over contralateral head), whereas a normal Tc-99m MDP biopsy uptake corresponded to a ratio of 1.5. This suggests that in Tc-99m MDP scintimetry of a normal hip, less than half of the emission ascribed to the femoral head is derived from the femoral head itself.

Adult↗
PubMed1984

Femoral head vitality in femoral neck fracture after hook-pin internal fixation.

Femoral head vitality was evaluated by tetracycline labeling and 99mTc-MDP scintimetry in 317 femoral neck fractures before and after internal fixation with two hook-pins. The preoperative vitality was about the same as that observed by others using comparable methods. The postoperative vitality was reduced in five of 81 undisplaced fractures and in 76 of 236 displaced fractures. These data would predict a rate of avascular healing complications of 7% in undisplaced and 32% in displaced fractures treated with hook-pins.

Adult↗
PubMed1983

Femoral head vitality after femoral neck fracture. Comparison between pre- and peroperative tetracycline labeling.

Using fluorescence microscopy, a ratio between tetracycline labeling of the femoral head and of the greater trochanter was calculated for 370 femoral neck fractures. Sixty-three patients were given tetracycline on admission to hospital and 307 on the operating table after closed reduction. The following results were obtained: Visual grading of labeling correlated well to a distribution analysis based on a morphometric point-wave pattern. No significant difference concerning the degree of labeling between the pre- and peroperative groups was found. A redistribution into groups according to fracture displacement (Garden I-IV) did not alter this fact. In the total material, labeling was significantly better for undisplaced than for displaced fractures. No difference was found between different degrees of displacement. For patients less than 50 years of age, labeling values were significantly lower. Intact femoral head vascularization (ratio greater than or equal to 0.90) was found in less than three per cent of the total material.

Adolescent↗
PubMed1983

Scintimetric evaluation of nailed femoral neck fractures with special reference to type of osteosynthesis.

With the aid of Tc-MDP-scintimetry 1-2 weeks after nailing of femoral neck fractures, it is possible to distinguish fractures liable to complications. Due to the suspicion that frequent peroperative vascular damage was caused by the four-flanged nail (Rydell), a less traumatizing cylindric nail (Hansson) with an insertion instrument was used. In a prospective investigation in January 1981-February 1982, which included all intracapsular femoral neck fractures, the two above-mentioned methods of osteosynthesis were used randomly. Intravital staining with tetracycline showed the peroperative circulation equivalent in Rydell and Hansson groups. A significant difference in postoperative isotope uptake could be noted between the two groups in 37 patients with undisplaced fractures. In 34 of 45 displaced fractures in the Rydell group evidence of circulatory deficiency appeared in the postoperative scintimetry but in only 23 of 52 of the displaced fractures in the Hansson group, a statistically significant difference. The latter figure corresponds well to the incidence of peroperatively registered severe vascular injury evaluated by tetracycline labelling.

Adult↗
PubMed1983

Avascular necrosis associated with nailing of femoral neck fracture. Two cases examined pre- and postoperatively by tetracycline and radionuclide tracer techniques.

Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. Sr85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occurred during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures.

Adult↗