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Biomedical subjects

K Herrlin

Publications and source records attributed to K Herrlin.

At least 19 recordsLinked to original sources
PubMed1992

The usefulness of nocturnal resting splints in the treatment of ulnar deviation of the rheumatoid hand.

Seven patients with definite RA and bilateral ulnar deviation of Fearnley grade I were included in a study of the usefulness of nocturnal resting splints. Each patient used the splint on average 17 months on one hand, randomly chosen, with the free hand as control. Joint mobility, grip strength, pain and radiographic findings were recorded at start and finish of the study. Splint treatment influenced grip strength positively, and most patients stated pain relief during the night. However, all but one patient showed progression of ulnar deviation in both hands, and there was no significant difference in progression between treated and nontreated hands. This study thus supported the use of resting splints at night for pain relief but not for prevention of ulnar deviation.

Aged↗
PubMed1992

Necrosis observed on CT enhancement is of prognostic value in soft tissue sarcoma.

Fifty-one patients with deep-seated soft tissue sarcoma of the extremities and trunk wall were examined with contrast-enhanced CT for presence of nonenhanced tumor areas (CT necrosis). After a median follow-up time of 3 years, 19 of the 41 patients with CT necrosis had developed metastases, compared to none of the 10 patients who had tumors without CT necrosis. Tumors with CT necrosis were larger than tumors without, but in tumors of similar size, absence of CT necrosis was a favorable prognostic sign.

Adult↗
PubMed1991

Diagnostic imaging.

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Diagnostic Imaging↗
PubMed1991

Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma.

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients--47 of whom had high-grade malignant tumors--had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.

Adult↗
PubMed1991

Spinal canal remodeling after thoracolumbar fractures with intraspinal bone fragments. 17 cases followed 1-4 years.

The long-term fate of nonreduced intraspinal bone fragments in 17 thoracolumbar fractures--three not operated on and 14 stabilized with Harrington's rods or a Hartshill rectangle--was studied with CT. The reduction of the spinal canal area was measured in conjunction with the trauma in the nonoperated on cases and immediately after surgery in the other cases. The mean reduction was 29 (10-70) percent. The reduction had decreased to 14 (0-30) percent at the follow-up examination 31 (12-44) months later. The restitution of the spinal canal did not differ in the nonoperated and operated on patients. Our findings indicate that stable thoracolumbar fractures with intraspinal bone fragments, but without neurologic symptoms, can be treated nonoperatively, irrespective of the size of the fragment, without risk of subsequent symptomatic neural compression.

Adult↗
PubMed1990

External fixation of femoral fractures: experience with 15 cases.

We report our experience with external fixation in 15 femoral fractures in 14 patients. Follow-up times ranged from 4 to 56 months. Thirteen patients had multiple injuries. All but two fractures healed. In one patient with a supracondylar fracture, a knee arthrodesis had to be performed. One septic osteomyelitis of the femur led to amputation. The range of active knee joint motion was greater than or equal to 90 degree in 13 knees. Only six knees, however, regained a flexion of greater than or equal to 120 degrees. Pin tract infection occurred in one case and resolved uneventfully after revision and systemic antibiotics. External fixation should not be routinely used for fixation of femoral fractures, but may be considered in multiply injured and critically ill patients or in case of extensive soft tissue injury.

Adolescent↗
PubMed1990

Secondary total hip replacement after fractures of the femoral neck.

We studied the rate of revision in 84 consecutive total hip replacements performed for failed osteosynthesis of femoral neck fractures and compared it with that for primary arthroplasty for osteoarthritis. The age and sex adjusted risk of prosthetic failure was 2.5 times higher after failure of fixation, but all the excess risk was in patients over 70 years of age. There were radiographic signs of loosening of the femoral component at five to 12 years after secondary arthroplasty in six of 33 survivors. In general, the results of secondary replacement were no worse than those obtained after primary arthroplasty for femoral neck fracture. We consider that internal fixation should be the primary procedure: total hip replacement is a safe secondary procedure when osteosynthesis fails.

Age Factors↗
PubMed1990

Gadolinium-DTPA enhancement of soft tissue tumors in magnetic resonance imaging.

In a clinical study of 13 patients, gadolinium-DTPA (Gd-DTPA) was used for enhancement of soft tissue tumors at magnetic resonance imaging. Gd-enhanced T1 sequences were found to give additional information concerning tumor vascularity in 11 cases, tumor necrosis in 2 cases and tumor delineation in one case, compared with conventional T1 and T2 weighted spin echo sequences. If Gd-enhanced sequences were to be used as the only source of information, accurate assessment of tissue composition of the tumor would not have been possible. Furthermore, valuable information regarding tumor delineation towards surrounding fat may be lost.

Adult↗
PubMed1989

Trochanteric fractures--a clinical and radiologic evaluation of McLaughlin, Ender, and Richard's osteosynthesis.

Four hundred and thirty femoral trochanteric fractures operated with nail-plate (McLaughlin), Ender, or sliding screw-plate (Richard) osteosynthesis were followed up radiographically and clinically. For each method of osteosynthesis the initial nail position was correlated to the occurrence of late mechanical complications. Unstable fractures were associated with a higher incidence of one or more clinical complications such as repeated surgery, post-operative death, or increased pain. For Ender osteosynthesis correlations were found between several mechanical and clinical complications, while for Richard's osteosynthesis mechanical complications were significantly correlated to repeated surgery only. McLaughlin and Ender osteosyntheses had a higher incidence of reoperations than Richard's osteosynthesis, whereas the mobility and ADL function were the same at 4 months.

Bone Plates↗
PubMed1988

Silastic replacement of the trapezium for arthrosis--a twelve year follow-up study.

Thirty-three patients with 39 Swanson silastic trapezium implants have been studied. Three years after operation no dislocation or evidence of implant wear was found, but re-examination at an average of 12 years after operation revealed dislocations and implant wear in about half of the cases. Cyst formation in surrounding carpal bones was found in twenty cases. The result in terms of pain relief and thumb function was good and comparable to the three-year follow-up. A significant correlation was found between weakness of the pinch grip and dislocation of the implant. No correlation was found between pain and dislocation of the implants, nor between pain and presence of intraosseous cysts.

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↗
PubMedDate not supplied

Chronic progressive osteoblastic osteomyelitis: a new approach to treatment.

The clinical, histologic and radiographic picture in 16 cases in 15 patients with nonfistulating chronic progressive osteoblastic osteomyelitis of a long tubular bone which started in childhood is presented. All patients had severe pain at rest or weightbearing. Histology showed an increase of active osteoblasts. Low virulent bacteria were found in one-fourth of the patients. To reduce the osteoblastic activity, nonsteroidal antiinflammatory treatment was combined with surgical and antibiotic treatment. Eleven patients were pain-free at follow-up (average 47 months), 3 had reduced pain, and 1 patient did not respond to treatment.

Adolescent↗
PubMedDate not supplied

Space orientation of total hip prosthesis. A method for three-dimensional determination.

A method for in vivo determination of orientation and relation in space of components of total hip prosthesis is described. The method allows for determination of the orientation of the prosthetic components in well defined anatomic planes of the body. Furthermore the range of free motion from neutral position to the point of contact between the edge of the acetabular opening and the neck of the femoral component can be determined in various directions. To assess the accuracy of the calculations a phantom prosthesis was studied in nine different positions and the measurements of the space oriented parameters according to the present method correlated to measurements of the same parameters according to Selvik's stereophotogrammetric method. Good correlation was found. The role of prosthetic malpositioning and component interaction evaluated with the present method in the development of prosthetic loosening and displacement is discussed.

Arthrography↗
PubMedDate not supplied

Trochanteric fractures. Classification and mechanical stability in McLaughlin, Ender and Richard osteosynthesis.

Four hundred and thirty trochanteric fractures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group.

Bone Nails↗