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Biomedical subjects

L Konradsen

Publications and source records attributed to L Konradsen.

At least 19 recordsLinked to original sources
PubMed2002

Sensori-motor control of the uninjured and injured human ankle.

This review focuses on the role of sensori-motor function in the healthy as well as the functionally unstable ankle. The concept functional ankle instability--a widely used term, which has no universally agreed upon definition-as well as the sources of peripheral afferent information measured with different sensori-motor tests are discussed. The protective mechanisms against sudden ankle inversion are reviewed, and models that directly connect deficits in kinaesthesia and peroneal reflex reaction to an increased risk of sustaining unprovoked ankle inversion injuries are presented.

Ankle Injuries↗
PubMed2002

Seven years follow-up after ankle inversion trauma.

During one year all ankle inversion injuries seen at the acute ward of our institution were divided into grades of severity and classified according to the maximal area of tenderness at the time of clinical examination. Seven years later 648 of the subjects (91%) evaluated their ankle with the help of a questionnaire. Location of maximal tenderness at the time of injury was: lateral fibular ligaments 61%, lateral midfoot ligaments 24%, base of the fifth metatarsal/peroneal tendons 5% and combined lesions 8%. 39% were considered minor, 46% were moderate, and 15% severe. All cases followed a functional treatment protocol. Seven years post- injury 32% reported chronic complaints of pain, swelling or recurrent sprains. 72% of the subjects with residual disability reported that they were functionally impaired by their ankle - in most cases a question of not performing sports at a desired level. 4% experienced pain at rest and were severely disabled. 19% were bothered by repeated inversion injuries - 43% of these subjects felt that they could compensate by using an external ankle support. There was no correlation between the severity of the sprain as judged at the time of injury and the frequency of residual disability or between the area of maximal tenderness at the time of injury and the area of maximal pain at the time of follow-up.

Adult↗
PubMed2000

Increased inversion angle replication error in functional ankle instability.

The inversion-angle replication error of the ankle joint was measured in subjects with a functionally stable or unstable ankle. Testing was performed as a passive set-active replication design. The absolute replication error on the unstable side of 23 unilaterally, functionally, and mechanically unstable subjects was found to be significantly greater (2.5 degrees) than the error on the healthy contralateral side (2.0 degrees ; P < 0.05) and the error in a group of 40 ankle healthy controls (1.7 degrees; P < 0.01). In 10 ankle-healthy high-level cross-country runners the replication error was reduced by 38% after warming up (P = 0.04).

Adult↗
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↗
PubMed1996

Acute midtarsal sprains: frequency and course of recovery.

In a prospective consecutive registration of 711 ankle inversion sprains, the dorsal ligaments and capsule of the midtarsal joints were involved in 237 of the cases (33%), and in 172 cases (24%) only these joints seemed to be injured. A total of 162 isolated midtarsal injuries and 161 cases of isolated lateral talocrural lesions selected at random were followed using questionnaires 1, 3, 6, 9, and 12 months after injury. The frequencies of pain after 1 month and swelling after 1 and 3 months were significantly lower in isolated dorsal midtarsal sprains compared with isolated lateral talocrural sprains. At the following controls, frequencies of both pain and swelling were the same for both groups. Functional instability appeared with the same frequency in both groups during the 12 months of follow-up. Regarding the social impact of the sprains, absence from work and sports did not differ between groups. When avulsions were present in midtarsal injuries recovery was slow, with two thirds of the patients experiencing pain after 6 months. We conclude that the dorsal midtarsal sprain is a common entity with a course of recovery and a frequency of residual symptoms very like the lateral talocrural lesions.

Acute Disease↗
PubMed1995

Are hard-copy prints from peroperative fluoroscopy images useful as documentation?

We have examined the applicability of peroperative image documentation, in promoting early mobilization after osteosynthesis and saving the standard X-ray examination. One hundred and twenty-three patients with proximal femoral fractures were included in the investigation. Hard-copy reprints were recorded from peroperative fluoroscopy images by Fuji Film Thermal Imaging System FTI 200. These reprints were compared with the standard X-rays to assess the quality of the osteosynthesis and possible restriction in mobilization. The specificity of finding an unstable osteosynthesis was 0.40, whereas the sensitivity of finding a stable osteosynthesis was 0.96. In all, four unstable osteosyntheses were overlooked on the hard copy reprints. The specificity of finding patients in need of restricted mobilization was 0.44 and the sensitivity of finding patients allowed free mobilization was 0.93. Eight patients needing restricted mobilization were overlooked on the reprints. Hard-copy images do not safely reveal unstable osteosynthesis and cannot replace the standard X-rays taken postoperatively.

Fluoroscopy↗
PubMed1994

Epidemiology of sprains in the lateral ankle and foot.

The epidemiology of sprains in the lateral ankle and foot was investigated in a prospective study at the casualty ward at Hillerød County Hospital. During one year, 766 patients were registered. The overall sprain incidence was 7/1000 person-years. The incidence was highest for young males. After the age of 40 years, the incidence was higher for women than for men. Most sprains were sustained during sport, but, with increasing age, other activities became dominant. Sixty-one percent of the lesions were located around the lateral ankle, and 24% were located on the lateral midfoot.

Adolescent↗
PubMed1994

Pyoderma gangrenosum complicated by necrotizing fasciitis.

Necrotizing fasciitis is a potentially life-threatening infection that may resemble extensive pyoderma gangrenosum. The treatment of the two diseases is, however, different, and differentiating them is therefore essential. A case is presented in which necrotizing fasciitis appeared as a complication of pyoderma gangrenosum. The successful treatment is described, and the differential diagnosis of the two entities is presented. The need for early and aggressive treatment of necrotizing fasciitis is stressed.

Aged↗
PubMed1993

Proprioception at the ankle: the effect of anaesthetic blockade of ligament receptors.

Seven subjects with normal joints were tested for active and passive position sense of ankle inversion, peroneal reflex reaction time to sudden ankle inversion, and postural stability during single-leg stance. The tests were performed before and after regional block of the ankle and foot with local anaesthetic. Passive position sense, assessed with the muscles relaxed, was greatly impaired by anaesthesia but active position sense, with the calf muscles activated, was preserved, and the peroneal reaction time to sudden ankle inversion was not altered. The magnitude of postural sway during single-leg stance was also unchanged by anaesthesia of the ankle and foot. The results suggest that the afferent input from intact lateral ankle ligaments is important in sensing correct placement of the foot at heel-strike, but that this input can be replaced by afferent information from active calf muscles. Afferent input from these muscles seems also to be responsible for dynamic ankle protection against sudden ankle inversion and is adequate to allow stable single-leg stance.

Adult↗
PubMed1991

Long-term follow-up of the cemented Caffinière prosthesis for trapezio-metacarpal arthroplasty.

20 patients with 22 Caffinière prostheses in the trapezio-metacarpal joint were evaluated at a median of nine years after operation. The indication was degenerative osteoarthrosis in 20 cases and rheumatoid arthritis in two cases. We found 18 of the 22 (82%) original prostheses still in place, with satisfactory pain relief and good function. Three hands had been revised due to aseptic loosening, with replacement of two cups and one total prosthesis. Two of the revised prostheses were functioning well 6 1/2 and 10 years after the revision. We conclude that function does not deteriorate within the first nine years, that late loosening is not a significant problem with this prosthesis and that, if aseptic loosening occurs, it is possible to obtain good results by replacing the loose component.

Aged↗
PubMed1991

Prolonged peroneal reaction time in ankle instability.

The peroneal reflex time to sudden ankle inversion and the postural control of 15 athletes with functionally instable ankles were compared with 15 stable controls. A trapdoor produced sudden ankle inversion. Surface electrodes recorded electromyographic activity of the peroneal muscles. Postural sway was expressed by a transverse sway value obtained during single limb stance on a force plate. Increased postural sway was found in subjects with functional instability (p less than 0.01). This is in accordance with previous studies. Functionally instable subjects also displayed an increased peroneal reaction time (p less than 0.01) supporting the theory that functional instability is induced by a proprioceptive reflex defect. Nine of the 15 instable subjects were unilaterally instable and showed lower peroneal reaction time and postural sway values for the stable ankle, but the difference was not significant. There was a high degree of correlation between postural sway and peroneal reaction time (Spearman's rho = .92). In ten functionally instable athletes tested with and without ankle taping, it could not be verified that a reflex enhancing effect of taping occurs through stimulation of cutaneous afferents.

Adult↗
PubMed1991

Early mobilizing treatment for grade III ankle ligament injuries.

Eighty patients with grade III lateral ligament ruptures were treated either with total immobilization in a walking plaster cast or early mobilization in a stabilizing orthosis. The criterion for entrance was a talar tilt of more than 9 degrees and an anterior translation of more than 10 mm at stress radiography, a previously stable ankle, and a contralateral ankle showing normal stress radiographic values. Ninety-one percent of the patients were evaluated at 7 weeks, 3 months, and 1 year postinjury. While functionally treated patients reached normal mobility and resumed work and sports earlier than immobilized patients there were no differences between the treatment groups in ankle stability or symptoms during activity after 1 year. Ninety-five percent of the ankles in either group were mechanically stable after treatment. Residual symptoms were present 1 year postinjury in 13% of the functionally treated ankles and in 9% of the cast-mobilized ankles. In lateral ankle ligament ruptures causing gross mechanical instability early mobilization results in a better early functional result; however, at 1 year postinjury there was no statistically significant difference in outcome as compared to cast-immobilized ankles.

Adolescent↗
PubMed1990

Ankle instability caused by prolonged peroneal reaction time.

The reaction of 15 functionally unstable ankles to sudden inversion was described by monitoring muscle activity, joint motion, and alternation of the body center of pressure. The results were compared with those of 15 stable controls. Stable and unstable subjects showed a similar reaction pattern to sudden inversion: first, a peripheral reflex action, namely, a contraction of the peronei counteracting the ankle inverting momentum, and, then, a centrally elicited pattern, namely, a flexion of the hip, knee, and ankle relieving the vertical pressure on the ankle and producing ankle eversion. Unstable subjects did not show a defect in their central processing of afferent input. In contrast, a prolonged reaction time (median 84 msec compared with 69 msec in stable subjects) suggested a partial deafferentation of the reflex stabilization of the ankle and substantiated the theory of a proprioceptive deficit being responsible for ankle instability.

Ankle Joint↗
PubMed1990

Functional treatment of metacarpal fractures 100 randomized cases with or without fixation.

Totally, 100 hundred subcapital or diaphyseal fractures of the second through the fifth metacarpal were randomized to either a dorsal/ulnar plaster cast immobilizing the wrist and the joints of the involved digits or a functional cast allowing the wrist and the digits a free range of motion. Due to better retaining ability, functional casting reduced volar angulation by two thirds for metacarpal shaft fractures and by one third for metacarpal neck fractures when compared with plaster cast immobilization. Restriction of wrist, metacarpophalangeal, and interphalangeal joint movements was more frequent in the cast group, but did not influence the overall function 3 months postinjury. Sick leave was reduced by two thirds after functional casting compared with the plaster cast group.

Adolescent↗
PubMed1988

Epidermal growth factor in plasma, serum and urine before and after prolonged exercise.

The substance concentration of epidermal growth factor immunoreactivity (EGF IR) and certain other components were studied in plasma, serum and urine from 25 individuals before and after a 2 h cross-country run. The substance concentration of plasma EGF IR increased from a median of 0.10 nM (range 0.04-0.26 nM) to a median of 0.16 nM (range 0.10-0.36 nM) after 2 h of exercise, while serum EGF showed no change. The values obtained for B-platelets were a median of 192 x 10(9)/litre (range 109-282 x 10(9)/litre) before the run, and a median of 265 x 10(9)/litre (range 216-387 x 10(9)/litre) after the run. No correlation was observed between the values obtained for B-platelets and the values for plasma or serum EGF IR. The substance concentration of EGF IR in urine increased from a median of 3.2 nM (range 0.5-7.7 nM) to a median of 7.0 nM (range 1.5-15.7 nM) after the run. Expressed relative to the output of carbamide the output of urinary EGF IR increased with a median factor of 2 following the run. Expressed relative to the output of creatinine no increase was observed.

Adolescent↗
PubMed1988

Human salivary epidermal growth factor, haptocorrin and amylase before and after prolonged exercise.

The concentration of epidermal growth factor (EGF), amylase, haptocorrin, total protein, sodium and potassium was studied in mixed saliva collected from 25 individuals before and after a 2 h-long cross-country race. The concentration was higher following the run for all components studied. The concentrations obtained before and after the run, given as extreme values and median, are 0.2-1.3 (0.4), 0.3-1.5 (0.8) nmol/l for EGF, 15-72 (25), 23-162 (58) nmol/l for haptocorrin and 24-502 (120), 155-5,030 (1,200) kU/l for amylase. The increased concentration of the components studied is most probably caused by an increased adrenergic and VIP'ergic tonus of the individuals after the run.

Adolescent↗