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Biomedical subjects

K Strömsöe

Publications and source records attributed to K Strömsöe.

8 recordsLinked to original sources

Soft tissue problems in ankle fractures treated surgically. A prospective study of 154 consecutive closed ankle fractures.

We performed a prospective registration of primary soft tissue injuries and perioperative soft tissue complications the first 3 months after surgery in ankle fractures treated by open reduction and internal fixation. Open fractures and polytraumatized patients were excluded. The 154 consecutive patients (90 women) with an average age of 54.5 (S.D. 18.3) years were registered. Primary soft tissue injuries according to Tscherne's classification were noted in 22 patients (14.2%). Major perioperative soft tissue complications requiring revision occurred in five patients (3.2%). Minor perioperative soft tissue complications treated non-operatively occurred in 29 patients (18.8%). A significantly higher incidence of perioperative soft tissue complications occurred in alcohol abusers (P=0.043), after high-energy trauma (P=0.043), and after primary soft tissue injuries (P=0.004). Other possible risk factors such as age, gender, fracture type, diabetes, arteriosclerosis, coronary heart disease, and hypothyroidism had no statistically significant influence on the incidence of perioperative soft tissue complications.

Adolescent↗

The influence of perioperative soft tissue complications on the clinical outcome in surgically treated ankle fractures.

The influence of perioperative soft tissue complications on the functional outcome after open reduction and internal fixation of closed ankle fractures was investigated. Eighty-eight consecutive patients were followed 3.7 years (SD +/- 0.6) after the injury. Two major and 21 minor soft tissue complications were registered. Average dorsal extension was 29.9 degrees (range four to 54, SD +/- 9.5) of the fractured ankles and 37.2 degrees (range eight to 60, SD +/- 9.1) of the non-fractured ankles. The average subjective functional score was 84.6 (range 40 to 100, SD +/- 14.9). A significant difference was found with respect to the subjective functional score (p = 0.048, Kruskal-Wallis test) but not with respect to dorsal extension (0.358, Kruskal-Wallis test) when comparing groups of minor, major and no soft tissue complications. This study suggests that major soft tissue complications have a negative effect on the long-term functional outcome after surgical repair of an ankle fracture. Minor soft tissue complications, primary skin problems, the timing of primary surgery and fracture types according to AO/ASIF have no or minor influence on the long-term functional result. This study confirms previous reports that the presence of osteoarthritis is frequently associated with a reduced functional outcome.

Adult↗

The repair of a ruptured deltoid ligament is not necessary in ankle fractures.

We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and internal fixation to two treatment groups to examine the influence of the repair of a ruptured deltoid ligament. No differences were found except for a longer duration of surgery in the repair group. Our findings suggest that a ruptured deltoid ligament can be left unexplored without any effect either on early mobilisation or on the long-term result.

Adolescent↗

Retention of distal femoral osteotomy fixed with a AO condylar plate and Grosse-Kempf locked nail in relation to bone mineral in cadavers.

On the basis of previous studies showing good correlations between the structural strength of the femur and bone mass as assessed by single energy quantitative computed tomography, this study was scheduled to analyze the mode of failure of an oblique osteotomy in the distal femur in geriatric cadavers stabilized by an AO condylar plate and Grosse-Kempf locked intramedullary nail in axial eccentric loads and to relate the mode of failure to bone mineral content. A pilot study of two pairs of osteotomized, internally fixed femora were loaded axially and the loads correlated with bone mineral content. These correlations were used to calculate estimated failure load in 12 pairs of osteotomized femora (12 plated and 12 nailed specimens) which then were sustained to a cyclic eccentric axial load of 50% of the estimated failure load. The failure patterns in the two groups were different. Fixation failure occurred in all specimens in the plated group at the site of the osteotomy, while in the nailed group the fixation failures in 50% of the specimens were unrelated to the site of the osteotomy. The study suggests that locked intramedullary nailing of a distal femoral fracture in osteoporotic bone gives more secure fracture retention than fixation with a 95 degrees AO/ASIF condylar plate. Furthermore, it shows that bone mineral assessment by densitometric methods can be used to predict the mechanical strength of a bone/implant construct.

Aged↗

Interlocking intramedullary nailing in the treatment of tibial fractures. A report of 45 cases.

Forty-five tibial shaft fractures in 43 patients were treated with the Grosse-Kempf interlocking intramedullary nail. The material was highly selected because 49% of the fractures were due to high-energy trauma and 62% were located at the diaphyseal-metaphyseal junctions. The median time to full weight-bearing was 30 days, and 44 fractures healed by bridging callus in a median of 16 weeks. There was one nonunion, one deep, and one superficial infection. The results of the clinical and radiologic evaluations were excellent in 29 fractures, good in 13, fair in two, and poor in one. Interlocking intramedullary nailing proved to be efficient for comminuted, segmental, and unstable tibial fractures, especially in patients with multiple injuries. Compared with conventional intramedullary nailing, the locking procedure increases the stability at the fracture site and extends the indication for nailing to fractures in the proximal and distal diaphyseal-metaphyseal junctions.

Adolescent↗

[Recurrence frequency following traumatic shoulder dislocation].

99 cases of primary traumatic shoulder dislocation were evaluated in regard of the influence of the time of immobilization on recurrency. 3 weeks of strict immobilization gave a recurrency rate as low as 6.4% whereas a shorter immobilization resulted in 12% of recurrency within 1--6 years. A survey from 46 other clinics as well as the literature has given no evidence of clear rules of treatment and thus the discussion of treatment remains open.

Adult↗

[Herpes simplex encephalitis. A case report with support of the diagnosis by means of brain biopsy].

The pathogenesis, differential diagnosis and therapeutic problems of herpes simplex encephalitis are discussed. Early diagosis of herpes simplex as a leading, and possibly the sole, cause of acute necrotizing encephalitis is crucial to effective management. Decompressive craniotomy in the presence of fulminating cerebral swelling associated with acute onset of the disease is of value as an adjuvant to definitive therapy with antiviral agents.

Biopsy↗