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Biomedical subjects

F Handelberg

Publications and source records attributed to F Handelberg.

At least 19 recordsLinked to original sources
PubMed2004

The role of the Rolimeter in quantifying knee instability compared to the functional outcome of ACL-reconstructed versus conservatively-treated knees.

The purpose of this study is to correlate the measurement of anterior knee laxity using the Rolimeter with the functional outcome of anterior cruciate ligament (ACL) deficient knees. We tested 29 patients (12 males/17 females) with an average age of 33 years (range 19-47) that had been treated for ACL rupture, either by reconstruction or conservatively. The average follow-up at time of testing was 33 months (range 6-67).Functional outcome was graded by means of a questionnaire based on the IKDC score, the sports activity rating scale (SARS), the Cincinnati knee-rating system and the activities of daily living (ADL) scale, and by two functional knee tests (the one-leg hop test and the cross-over hop test). The anterior knee laxity was measured for both knees with the Rolimeter, and the side-to-side difference was calculated. We have found no correlation between the joint laxity and the functional outcome score.(P>0.05). When we compared both groups, we found a significant, though very low, correlation between the laxity and the functional questionnaire for the reconstructed group. (r=0.51, P=0.036). Therefore, the joint laxity measurement does not necessarily reflect the functional outcome of ACL-deficient knees. An explanation can be found in the importance of the proprioception and neuromuscular control in compensating the ACL-deficient knee.

Adult↗
PubMed2000

CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex.

Interpretation of computed tomographic and magnetic resonance arthrograms of the shoulder is complicated by normal variants of the labrum and glenohumeral ligaments. A superior sublabral recess is located at the 12 o'clock position and represents a normal recess between the superior labrum and the cartilage of the glenoid cavity. A sublabral foramen is located at the 2 o'clock position and represents localized detachment of the labrum from the glenoid rim. Buford complex is characterized by absence of the anterosuperior labrum and cordlike thickening of the middle glenohumeral ligament. Imaging features of damage to the anterior labrum include absence or detachment of the labrum and an irregular frayed appearance. Superior labrum anterior-to-posterior (SLAP) lesions are classified as type I (tear confined to the superior labrum), type II (labrum and biceps tendon detached from the superior glenoid), type III (bucket handle tear of the superior labrum), or type IV (bucket handle tear of the superior labrum with lateral extension into the biceps tendon). Increased distance between the labrum and the glenoid, an irregular appearance of the labral margin, or lateral extension of the separation may suggest a SLAP lesion rather than a normal anatomic variant. However, differentiation between normal variants and pathologic conditions and between various types of SLAP lesions remains difficult.

Adolescent↗
PubMed1998

Medium-term results of percutaneous, arthroscopically-assisted osteosynthesis of fractures of the tibial plateau.

We carried out percutaneous, arthroscopically- and fluoroscopically-assisted osteosynthesis of fractures of the tibial plateau in 52 patients, of whom 38 were assessed using the HSS knee score and standing radiographs. We reviewed 31 AO type-B fractures and seven type-C fractures after a mean follow-up of five years (1 to 14). Fixation was achieved using percutaneous screws and/or an external frame; 33 associated intra-articular injuries, diagnosed in 21 out of the 38 patients, were treated arthroscopically. Subjectively, 94.7% of the patients reviewed were satisfied. According to the HSS knee score 78.9% of the results were excellent, 13.2% good, 7.9% fair and none was poor. Narrowing of the joint space was found in 28.9% of the injured and 5.3% of the unaffected knees and axial deviation of 5 degrees to 10 degrees in 15.8% of the injured and 10.5% of the unaffected knees. Of the 52 fractures, reduction was incomplete in one, and in two secondary displacement occurred, of which one required corrective osteotomy. Deep-venous thrombosis occurred in four cases. The technique has proved to be safe but demanding. It facilitates diagnosis and appropriate treatment of associated intra-articular lesions.

Adolescent↗
PubMed1998

Unusual evolution of a benign-looking cortical defect of the proximal humerus. A case of intracortical osteosarcoma?

A case of an osteosarcoma following a pathological fracture through a small benign-looking cortical lesion of the proximal humerus is described. The unusual evolution from a small cortical lesion to a malignant lesion raises the question whether this is a case of an intracortical osteosarcoma that has some distinct features from those of previously reported cases.

Bone Cysts↗
PubMed1998

Glenoid dysplasia: radiographic and CT arthrographic findings.

A 60-year-old man with dysplasia of the glenoid and a rotator cuff tear is reported on. Because of the tear, CT arthrography was performed, offering an opportunity to evaluate the various soft tissue abnormalities accompanying glenoid dysplasia. Marked thickening of the glenoid cartilage and labrum was apparent, as well as an abnormal posterolateral orientation of the glenoid cavity. A deep notch was observed along the central portion of the glenoid cartilage. Furthermore the middle glenohumeral ligament appeared thickened and cordlike.

Arthrography↗
PubMed1998

Objective roentgenologic measurements of the influence of ankle braces on pathologic joint mobility. A comparison of 9 braces.

The stabilizing effect of external support (taping and nine different ankle braces) was tested in a total of 220 functionally unstable ankles. A standard surface EMG controlled stress Roentgen test protocol was used, measuring talar tilt (TT) without support and with tape bandage or brace. Different levels of TT restraining by external support could be identified. Tape bandage and two braces had a highly significant influence on the talar tilt. The mean TT without support was decreased by using from 13.4 degrees to 4.9 degrees, by using one brace to 4.8 degrees and by using another brace to 5.9 degrees. These two braces are effective for protection during functional treatment. A classification into three grades of effectiveness is proposed. It is concluded that the stabilizing influence offered by bandages and braces should be measured before using the external support as a treatment device for acute ankle sprain and as a reliable protection against sprain injuries in daily living and sports.

Activities of Daily Living↗
PubMed1997

Imaging in sports-medicine--knee.

Since the last decade, the introduction of Magnetic Resonance Imaging has provided a powerful new tool for the clinician to diagnose sports-related knee injuries. The main objective of this paper is to familiarise the relevant specialists with the proven clinical indications and semiology of MRI of the knee. At the present time, the knee joint is the area in which the advantages of MRI are most spectacularly apparent. The MR appearances of meniscal tears in particular, are first discussed in detail, referring to recent literature and personal experience based on more than ten thousands MR examinations of traumatic knees. Also the mechanisms of injuries and the most commonly involved sports are described. The precise types of meniscal lesions, as visualised at arthroscopy, are abundantly illustrated on MR images: e.g., bucket-handle, radial and horizontal cleavage tears, meniscocapsular separations, discoid menisci and meniscal cysts. We discuss the numerous pitfalls due to neighbouring anatomical structures as well as non clinically or surgically significant intrameniscal hypersignals in athletes. Towards other imaging techniques, MRI is particularly suited for the diagnosis of ligamentous injuries, especially the cruciate ligaments. We develop the currently used direct and indirect signs of rupture, the diagnostic difficulties related to the age of trauma and the detection of associated lesions. Sport-induced tendinous and bursal pathology is another interesting indication of MRI, not only lesions of the more superficial extensor tendons but also the pes anserinus or hamstring tendons. We finally treat the recent developments of MRI in assessment of cartilage, subchondral and medullary bone disorders of traumatic or microtraumatic origin.

Athletic Injuries↗
PubMed1996

Treatment of isolated distal ulnar shaft fractures with below-elbow plaster cast. A prospective study.

In a prospective study 52 patients with an isolated fracture of the distal ulna were treated with a below-elbow plaster cast. The histories of 46 patients were reviewed after a mean follow-up of 3.5 years (ranging from 10 months to 7 years). Forty-three fractures united. There were two non-unions. One fracture displaced while in the plaster, so that there was no longer any bone contact between the fragments. The fracture was consequently treated by open reduction and internal fixation. The type of fracture, the initial displacement (all fractures had bone contact) or the initial angulation (maximum 10 deg) was not found to influence the final clinical results. Below-elbow plaster cast appeared to produce satisfactory results in 89% of the patients.

Adult↗
PubMed1996

Non-operative management of anterior cruciate ligament injuries in the general population.

The operative treatment of lesions of the anterior cruciate ligament (ACL) in athletes has been widely advocated and performed. We have investigated the outcome of non-operative management in a lower-demand, general population. We reviewed a consecutive group of 228 patients, which excluded professional and high-level athletes, for two to 12 years after an ACL lesion had been diagnosed by arthroscopy. There was a low incidence of secondary ACL and meniscal surgery, 5.4% and 3.5% respectively, and all these procedures were performed during the first three years after the ACL injury. We studied a subgroup of 109 patients with follow-up of at least five years (mean 8.5 years) and evaluated them using the IKDC score. The general outcome was reasonably satisfactory, with 23% in grade A, 50% in grade B, 21% in grade C and only 6.4% in grade D. We found no statistically significant prognostic effect within this group as regards age, activity levels, or the incidence of associated lesions.

Activities of Daily Living↗
PubMed1995

Distraction for ankle arthroscopy.

Distraction has proven to be usefull for arthroscopic visualisation and instrumental access to some ankle pathology. A distraction technique using a single calcaneal pin combined with the installation of the patient on a fracture table is described. The method has already been used by the authors in more than 100 ankle arthroscopy procedures without distraction-related complications.

Ankle Joint↗
PubMed1993

The rate of recurrence of traumatic anterior dislocation of the shoulder. A study of 154 cases and a review of the literature.

We have reviewed the history of 154 primary, traumatic dislocations of the shoulder in order to determine the risk of recurrence. We found a recurrence rate of 68% in patients under the age of 20, after a follow-up period of 1-9 years (average 4.5 years). There was a highly significant difference (p < 0.0001) in the recurrence rate of patients under, and above, 30 years of age. Twenty per cent of the patients had a concurrent minor fracture at the shoulder with 2 out of 39 of the recurrent cases (5%) and 29 of the 115 non-recurrent cases (25%); this is also a significant difference (p < 0.01). Neither the need for general anaesthesia at primary injury nor the occupation of the patient was a relevant factor in the final outcome of the dislocation. Four nerve injuries were encountered (3%), with no severe sequelae at follow-up. The young patient with no concurrent fracture at the time of the primary shoulder dislocation has a high risk of recurrence.

Adolescent↗
PubMed1993

Surgical treatment of acute type-V acromioclavicular injuries in athletes.

In a prospective study, 18 consecutive athletes with an acute type-V acromioclavicular sprain were treated with a coracoclavicular repair using a double velour Dacron graft. All patients were reviewed after a mean follow-up period of 6 years (range: 2-9 years). At follow-up, 12 patients (66.7%) showed a good or excellent result according to the Imatani evaluation system, and six patients (33.3%) demonstrated a fair or poor result according to the same system. Loss of reduction was encountered in eight shoulders (44.4%) despite an initial anatomical reduction. No correlation was seen between the overall scores at follow-up and the degree of residual dislocation, between the overall scores and the presence of coracoclavicular calcifications or ossifications, between the overall scores and the development of post-traumatic arthritic changes, or between the overall scores and the presence of osteolysis of the distal clavicle.

Acromioclavicular Joint↗
PubMed1993

Cemented acetabular reconstruction with the Müller support ring. A minimum five-year clinical and roentgenographic follow-up study.

In a previous study, the results of cemented acetabular reconstruction with a Müller support ring were reported after a mean follow-up period of 40 months. The current report concerns a minimum five-year follow-up study of the same 43 patients. Two early failures at four months and at 17 months were related to poor surgical technique. The latest overall functional results, according to the Merle d'Aubigné rating scale, were excellent, very good, or good in 81.82% of the hips: a drop from 86.67% since the previous report. Sequential roentgenographic analysis demonstrated a high incidence of nonprogressive radiolucencies at the cement-bone interface. These nonprogressive radiolucencies did not correlate with the overall functional results. The progression of a radiolucency at the cement-bone interface, however, or the appearance of radiolucencies around the screw threads, always resulted in clinical failure.

Acetabulum↗
PubMed1992

Biodegradable rods versus Kirschner wire fixation of wrist fractures. A randomised trial.

In a prospective trial, biodegradable polyglycolic acid rods were compared with Kirschner wires for fixation of wrist fractures (Frykman types I, II, V and VI). Fifteen patients were randomly assigned to each treatment group. There was no significant difference between the groups with regard to age, sex ratio and fracture type. Kapandji's pinning technique was used in all cases. There were no significant differences in the results obtained in both groups at final follow-up. At three months and six months the functional results of the Kirschner-wire group were, however, significantly better (p < 0.05), due to numerous transient complications from foreign-body reactions to the polyglycolic acid rods. The use of polyglycolic acid rods is therefore not recommended for the fixation of distal radial fractures.

Adult↗
PubMed1992

Surgical treatment of acute type V acromioclavicular injuries. A prospective study.

In a prospective study, 28 consecutive patients with an acute Type V acromioclavicular sprain were treated with a coraco-clavicular repair using a double velour Dacron graft. All patients were reviewed after a mean follow-up period of 5.1 years (range: 1 to 9 years). At follow-up, 20 patients (71.4%) showed good or excellent results, according to the Imatani evaluation system, and 8 patients (28.6%) demonstrated a fair or poor result according to the same system. Loss of reduction was encountered in 11 shoulders (40%), despite an initial anatomical reduction. No correlation was seen between the overall scores at follow-up and the degree of residual dislocation, between the overall scores and the presence of coraco-clavicular calcifications or ossifications, between the overall scores and the development of posttraumatic arthritic changes, or between the overall scores and the presence of osteolysis of the distal clavicle.

Acromioclavicular Joint↗
PubMed1992

Magnetic resonance imaging (MRI) of the ankle and hindfoot.

While Magnetic Resonance Imaging (MRI) has become a routine diagnostic method to deal with pathology of the knee, little has been published about foot and ankle lesions. This is probably due to the anatomic complexity of bone and ligamentous structures of these small joints, necessitating the use of very thin slices from various orientation planes (orthogonal and oblique planes). A special technique is needed allowing a 3-dimensional (3D) analysis, using inframillimetric slices and more sophisticated equipment than for 2-dimensional (2D) MRI (high fields with good homogeneity, specialized image processors...). An initial potential indication of the method is the precise diagnosis of lateral ligamentous components in severe sprains. MRI may determine if surgical therapy is needed. The ligamentous components are reconstructed along their specific planes thanks to the 3D method. Furthermore, assessment of the ligamentous damage is also possible in chronic ankle instability (elongation, fibrotic appearance...). Thanks to the multiplanar approach, associated lesions of articular cartilage can be revealed in ankle sprains. The high sensitivity of MRI in slight modifications of medullary bone allows the early diagnosis of "occult" fractures (not seen on conventional radiographs), osteonecrosis, osteochondrosis and reflex sympathetic dystrophy syndrome. Finally, MRI easily displays all ankle and foot tendons and fascia and is particularly helpful in depicting partial tears and postoperative complications.

Adult↗