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Biomedical subjects

J Wounlund

Publications and source records attributed to J Wounlund.

6 recordsLinked to original sources
PubMed1996

Chronic critical leg ischaemia must include leg ulcers.

OBJECTIVES: In a previous series on conservative treatment in patients with leg ulcers and severe arterial occlusive disease (systolic digital blood pressure (SDBP) < 30 mmHg) a 70% risk of leg amputation and a negligeable potential for ulcerhealing was found. This series assess the efficacy of arterial reconstruction in such patients. DESIGN: Retrospective study of consecutive patients in a department of vascular surgery and of dermatology in cooperation with the wound healing center. MATERIAL AND METHODS: Thirty-nine patients with 42 ulcerated legs underwent arterial revascularisation. 88% of the procedures were distal to the inguinal ligament. MAIN RESULTS: One patient died postoperatively (3%). Seven (18%) had wound complications, but none had graft infections. After 1 year the cumulative secondary patency was 90%, ulcer healing 70% and the limb salvage 90%. Thus only four legs (10%) had been amputated. CONCLUSIONS: Arterial revascularisation for leg ulcers is indicated when conservative treatment fails. Legs with ulceration and SDBP < 30 mmHg should be included in the concept of chronic critical ischaemia.

Aged↗
PubMed1995

[Atlanto-axial rotation-fixation in a child with clavicular fracture].

A case of an eight-year-old boy who had sustained both a fractured clavicle and rotatory atlanto-axial fixation is described. The last diagnosis was missed for four and a half months. The diagnosis was made in combination with cineroentgenography and computed tomography scanning. Conservative treatment with external traction was first attempted, after which the patient was operated twice with posterior fusion between C-1 and C-2. At six month follow-up the child was without pain, had neutral head holding and about two-thirds of normal rotation.

Atlanto-Axial Joint↗
PubMed1994

[Resection of the ulnar head in post-traumatic wrist pain].

In a retrospective study, the effect of distal ulnar resection using the Darrach procedure was evaluated in 42 patients with post-traumatic distal radio-ulnar disability. Thirty women and 12 men, mean age 43 years were seen an average of seven years after the operation. In 57% of the cases the primary trauma was a Colles fracture. The main indication for operation was pain radiating from the distal radio-ulnar joint (83%), but seven patients were without substantial pain. 79% of the patients felt relief of pain after the operation, but 62% still suffered from occasional wrist pain. Twenty-six patients had a supination and a pronation of > or = 150 degrees postoperatively. Thirty-three patients had a dynamic handpower of > 60% of the opposite hand postoperatively. Ten patients stopped working or changed to less physically demanding jobs after the primary trauma. Three patients from this group could after the operation return to their primary physically demanding jobs. Radiographs showed no progress of radiocarpal osteoarthritis during the follow-up period. The Darrach procedure could relieve post-traumatic distal radioulnar pain conditions without adverse effect on radiocarpal function and alignment. Patients who only had mild pain symptoms preoperatively presented unsatisfactory postoperative results.

Adolescent↗
PubMed1994

[Hallux valgus. A prospective study of staple fixation in Mitchell's osteotomy].

Twenty-two feet (17 patients) with hallux valgus were operated with a distal osteotomy of the first metatarsal bone ad modum Hawkins, Mitchell and Hedrick (1945). Fixation of the osteotomy was achieved using two staples driven into the bone by a pneumatic stapler (3M). Postoperatively the patients were treated without plaster bandage in a heel-shoe for two weeks and then allowed full weight bearing. There were two superficial infections, but no deep ones. Within six weeks all the osteotomies had healed without any secondary dislocation. Two staples had to be removed in local anaesthesia after healing. Staple fixation gives adequate support during healing of the osteotomy and allows early mobilisation without the need of a plaster bandage.

Adolescent↗
PubMed1993

[Late vascular lesions after cemented hip alloplasty].

We describe a case of a 69 year-old woman with rheumatoid arthritis, who following hip replacement surgery experienced a late migration of the cup of the hip arthroplasty into the pelvis, with ensuing vascular disaster. Procedures for treatment of intra-pelvine cup migration are briefly discussed.

Aged↗