["Osteoporosis" and physiological variation].
Explore the source record for details and available documents.
Bone Density↗
Biomedical subjects
Knut Strømsøe
Publications and source records attributed to Knut Strømsøe.
Fractures in the proximal humerus: functional outcome and evaluation of 70 patients treated in hospital.
INTRODUCTION: Patients with proximal humeral fractures are mostly elderly. In addition to the proximal humeral fracture, they often have other injuries related to poor bone quality. The surgical treatment of proximal humeral fractures in elderly patients with comminuted fractures is associated with several problems and a high frequency of complications. The aims of this study were to evaluate patients with a proximal humeral fracture treated in a hospital, assess the outcome of the fracture treatment, and decide whether surgical treatment of displaced proximal humeral fractures is superior to conservative treatment or not. MATERIALS AND METHODS: Patients with fractures of the proximal part of the humerus treated in our hospital were followed during two different periods (14 and 10 months). The study in the first time period was retrospective in design, while in the second period the patients were followed prospectively. Seventy patients, (71% women) with a mean age of 71 years, were included in the study. A functional test was performed within 12-14 months after the injury using a modified Rowe shoulder score. Surgical treatment was performed in 15 patients (21%). Neither the surgical approach nor the implants used for osteosynthesis were standardized. Fifty-five patients (79%) were treated conservatively with a modified Velpeau bandage or a sling. RESULTS: The fractures were classified according to AO into type A (27%), type B (58%) and type C (14%). Osteoporotic risk factors were present in many of the patients, mainly characterized by other skeletal injuries than the proximal humeral fracture (43%). In the group of complex, displaced, non-impacted fractures B2, B3, C2, C3 included (20 fractures), the group treated conservatively had a mean Rowe score of 48/75 (64% of maximum score) and SD 16.8, while in the surgically treated group the mean score was 28/75 (38% of maximum score) and SD 8.1. The difference between the two treatments was significant, with a p-value of 0.01 in favour of the conservatively treated group. CONCLUSION: The number of patients in each of the fracture groups was low, but surgery did not benefit the patients with complex, displaced fractures in this study.
Adult↗
Fracture fixation problems in osteoporosis.
Osteoporosis, or loss of bone mass and microarchitectural deterioration of bone tissue, does not only enhance risk of fracture but also represents a problem in osteofixation of fractures in fracture treatment. Aging of the western population changes the epidemiology of fractures. An increasing socioeconomic interest in geriatric traumatology makes the need for much urgent study in the field of osteoporotic fractures self evident. It is no longer the province of only one medical group to look for fragmented solutions in the treatment of osteoporotic fractures. Efforts have to be united across professional boundaries to meet the challenge of this problem. Assessment of bone mineral may be used in evaluation of fracture risk but also in the choice of implant as well as in the design of implants used in fracture treatment. The differences in mechanical properties of different types of bone in the same individual have to be respected. Changes in the pattern of fractures and problems with implant anchorage in bone, due to a demographic increase in patients with osteoporosis remain problems requiring new solutions. Still basic principals in fracture treatment may not be eclipsed by new fixation devices.
Accidental Falls↗
Tricortical versus quadricortical syndesmosis fixation in ankle fractures: a prospective, randomized study comparing two methods of syndesmosis fixation.
OBJECTIVE: To assess short-term functional results in 2 types of syn-desmotic fixation, comparing the traditional rigid quadricortical syndesmotic screw fixation with a more dynamic tricortical screw fixation. DESIGN: : Prospective, randomized clinical study. SETTING: University clinic, level 1 trauma center. PATIENTS: Sixty-four patients with closed ankle fractures in which the syndesmosis was found to be unstable intraoperatively. INTERVENTION: The unstable syndesmoses were fixed with either one 4.5-mm cortical screw through both tibial cortices (n = 30) or two 3.5-mm cortical screws engaging only 1 cortex of the tibia (n = 34). The quadricortical screws were routinely removed after 2 months, whereas the tricortical screws were removed only in the case of discomfort. Rehabilitation was the same in both groups. RESULTS: The Olerud Molander functional score (0-100) was significantly higher in the tricortical group (77 points) compared with the quadricortical group (66 points) (P = 0.025) at 3 months. After 1 year, however, the functional score was not significantly higher (P = 0.192) in the tricortical group (92.6 points) compared with the quadricortical group (85.7 points). Pain was significantly lower in the tricortical group (P = 0.017) after 3 months, but there was no significant difference after 1 year. There was no significant difference in dorsiflexion between the groups at any point of time. No losses of fixation were detected. The tricortical screws were removed in 2 patients due to migration. CONCLUSIONS: Syndesmosis fixation with 2 tricortical screws is safe and improves early function. After 1 year, however, there were no significant differences between the 2 groups in functional score, pain, and dorsiflexion.
Adolescent↗