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Biomedical subjects

G O Sjödén

Publications and source records attributed to G O Sjödén.

10 recordsLinked to original sources
PubMed1999

3D-radiographic analysis does not improve the Neer and AO classifications of proximal humeral fractures.

The Neer and AO fracture classifications for fractures of the proximal humerus have shown poor reproducibility based on plain radiography. We wanted to investigate whether the addition of 3-dimensional (3D) reconstructions would increase the reproducibility of classification. 7 observers independently classified 24 fractures of the proximal humerus using both plain radiographs, CT and 3D and the classification was repeated 2 months later. There was a moderate interobserver agreement when using the Neer classification, but only a fair agreement with the AO classification. The Neer system had a mean kappa value of 0.44 and the AO had a value of 0.32 for the first assessment. In the second assessment, the mean kappa values were 0.49 and 0.34, respectively. Intraobserver reproducibility was fair to substantial agreement for Neer (kappa range 0.27-0.73) and for AO (kappa range 0.29-0.74). In conclusion, the addition of CT and 3D to plain radiographs did not improve the reproducibility of the classifications of Neer and AO of the proximal humerus.

Humans↗
PubMed1998

Poor function after shoulder replacement in fracture patients. A retrospective evaluation of 29 patients followed for 2-12 years.

We evaluated the functional outcome 3 (2-12) years after arthroplasty in 29 proximal humerus fractures. The patients' average age at the time of surgery was 71 (47-87) years. The follow-up included a full clinical examination by an independent observer, a questionnaire concerning activities of daily living and pain, and radiographs. The shoulders had a marked reduction of performance, with a Constant score mean of 38 (16-69). All patients were able to eat with utensils, 10 could comb their hair, 19 managed to wash the contralateral armpit, 3 could reach the back pocket and 12 were able to take care of the perineal area. On the VAS-scale (0-100 mm), pain at rest was mean 21 (0-53) mm and on motion 47 (0-91) mm. The patients were stratified regarding surgical treatment within 3 weeks (18 acute vs. 11 late) and prosthetic design (14 Neer II vs. 14 Global modular) without significant differences, as assessed by the Constant scores. We conclude that the treatment of severe proximal humerus fractures with a prosthesis does not give complete pain relief and results in impaired shoulder function.

Activities of Daily Living↗
PubMed1997

Poor reproducibility of classification of proximal humeral fractures. Additional CT of minor value.

Fractures of the proximal humerus can be described using the Neer and AO fracture classifications. To assess the reproducibility and reliability of these classifications, we investigated 26 proximal humeral fractures with both plain radiographs and CT. 5 specialists in orthopedic surgery and 5 specialists in radiology independently classified all radiographs on 2 occasions. There was a moderate agreement between the observers when using the Neer classification, but only a fair agreement with the AO classification. The Neer system had a kappa value of 0.42 and the AO had a value of 0.31 in the first assessment. In the second assessment the kappa values were 0.45 and 0.30, respectively. Intraobserver reproducibility was slight to almost perfect agreement with Neer (kappa range 0.20-0.85) and slight to moderate agreement with AO (kappa range 0.16-0.60). The observers most familiar with shoulder fracture radiographs and shoulder fracture treatment were more consistent in their classifications. We conclude that even with CT, the fracture classifications of Neer and AO have a low consistency. Neither classification system is reproducible enough to allow comparisons of different studies.

Humans↗
PubMed1995

Late results of the Souter-Strathclyde total elbow prosthesis in rheumatoid arthritis. 6/19 implants loose after 5 years.

We performed total elbow replacement, using the Souter-Strathclyde prosthesis in 19 elbows of 18 patients with rheumatoid arthritis and followed the patients for 5 (1-11) years. Pain relief was achieved initially in all patients. The average range of flexion-extension was increased by 12 degrees and pronation-supination by 40 degrees. There were no infections. 1 patient sustained an intraoperative fracture of the medial epicondyle, 3 patients developed neuropathies and 1 patient had an immediate postoperative dislocation of the joint. At follow-up, 6 prostheses had radiographic loosening, with sagittal titling and migration of 4 humeral components. 2 patients had clinical symptoms of loosening.

Aged↗
PubMed1985

The effect of 1 alpha-hydroxyvitamin D2 on calcium metabolism in glucocorticoid-treated rats.

Intestinal calcium transport and renal calcium and phosphate excretion have been measured in normal and prednisolone-treated rats. Prednisolone treatment reduced intestinal calcium transport and increased phosphate excretion, causing a reduction in serum phosphate. Both 1 alpha-hydroxyvitamin D2 and 1 alpha-hydroxyvitamin D3 normalized phosphate excretion, whereas 1 alpha-hydroxyvitamin D3 was not fully effective in serum phosphate. Prednisolone treatment also caused a decreased bone density that was prevented both with 1 alpha-hydroxyvitamin D2 and 1 alpha-hydroxyvitamin D3. 1 alpha-hydroxyvitamin D2 appeared at least as effective as 1 alpha-hydroxyvitamin D3 in correcting the bone disturbance.

Animals↗
PubMed1984

Effects of 1 alpha OHD2 on bone tissue. Studies of 1 alpha OHD2 and 1 alpha OHD3 in normal rats and in rats treated with prednisolone.

Three months old male rats were fed a diet containing 0.3% calcium and 0.5% phosphate. Prednisolone was added to the diet at a dose of 1.5 mg a day and the effect of oral treatment with 0.5 micrograms 1 alpha OHD2 or 0.5 micrograms 1 alpha OHD3 was studied. After 6 weeks rats given prednisolone had a lower bone mass and bone density. The serum phosphate concentration was also lower. Rats given 1 alpha OHD3 had an increased serum calcium concentration even when simultaneously treated with prednisolone. 1 alpha OHD2 did not cause hypercalcaemia. The decrease in bone density caused by prednisolone was prevented by the administration of 1 alpha OHD2. Rats receiving 1 alpha OHD3 together with prednisolone still exhibited a lower bone density. Furthermore, 1 alpha OHD3 decreased bone mass in normal rats and caused a higher mean value of osteoclasts/area whereas 1 alpha OHD2 reduced the number of osteoclasts/area. The study indicates that 1 alpha OHD2 is an effective vitamin D analogue with a lower tendency to cause bone resorption.

Animals↗