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Biomedical subjects

L Lidgren

Publications and source records attributed to L Lidgren.

At least 73 records · Page 4Linked to original sources
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↗
PubMed1989

Femoral head necrosis in juvenile chronic arthritis.

Radiographic signs of ischemic necrosis of the femoral head in terms of abnormal epiphysis and caput indices were found in 30/72 hips in 36 children with hip pain or limitation of motion among 206 children, consecutively admitted during 15 months because of juvenile chronic arthritis. Nine out of 10 hips with obvious signs of femoral head necrosis showed a sclerotic rim at the base of the femoral neck, confirming an earlier episode of ischemic damage to the epiphysis and growth plate. Femoral head necrosis in children with juvenile chronic arthritis seems to be more common than previously reported, and may be caused by circulatory disturbance secondary to increased intraarticular pressure due to synovitis and/or effusion, or to treatment with passive extension of the hip. This should be considered in the treatment and the follow-up of these children.

Adolescent↗
PubMed1989

Hip socket wear due to component mismatch. A case report.

A total hip replacement with loosening of the femoral component was revised. The original femoral component with a 35-mm head was exchanged for one with a 32-mm head. The mismatch caused extensive wear of the acetabular component. The importance of preoperative planning in revision surgery is stressed.

Hip Joint↗
PubMed1989

Failure of the Wadsworth elbow. Nineteen cases of rheumatoid arthritis followed for 5 years.

Nineteen Wadsworth elbow prostheses were inserted in 15 patients with rheumatoid arthritis during the 4 years 1979-1982. The patients were followed prospectively for an average of 5.7 years. Five elbows were revised because of mechanical loosening and one because of deep infection. Of the remaining 13 prostheses, there were radiographic signs of loosening in 8 cases.

Adolescent↗
PubMed1989

Treatment of infected knee arthroplasty.

Forty-eight patients with 51 infected knee arthroplasties were treated at the authors' institution between 1973 and 1986 and followed for 5.5 (range, 0-14) years. Six methods to treat the infections were employed: antibiotics only, soft-tissue surgery, removal of the prosthesis, revision arthroplasty, arthrodesis, and amputation. Failure of the initial surgical treatment led to second revision surgery in 20 patients. At the follow-up examination, three patients (five knees) had died from septic complications and two patients had had above-knee amputation. Two of 32 patients had been successfully treated with antibiotics with no additional surgery. Four patients had successful soft-tissue surgery. Following removal of the prosthesis, the infection healed in four patients. In 12 of 19 patients (13 knees) with revision arthroplasty the infection healed, but only seven of these had functioning prostheses. The infection healed in all but one of the 21 patients with arthrodeses, and all but two were fused. Infected compartmental prostheses with good bone stock can be treated with an exchange arthroplasty using a two-stage procedure with tricompartmental revision prostheses. Otherwise, an arthrodesis using a two-stage procedure is recommended for the treatment of infected knee arthroplasty.

Adult↗
PubMed1988

The shock-absorbing effect of soles and insoles.

The capacity of heel inserts of different plastic and rubber materials to attenuate heel-strike forces was analysed. The heel-strike response was recorded by accelerometers fastened on to the skin. Thirteen rheumatoid patients with a knee arthroplasty and five healthy controls were tested. Inlay material of 6 mm thickness did not significantly reduce the tibial deceleration produced by heel-strike. However, shoes with heels of polyurethane plastic of 20 mm thickness significantly lowered the amplitude of the tibial response compared with rubber-heeled shoes. The possible implications of this for patients with degenerative joint diseases or with joint implants is discussed.

Adult↗
PubMed1988

Palmoplantar pustulosis and sternocostoclavicular arthro-osteitis.

Seventeen patients with shoulder pain and radiographic involvement of the sternoclavicular or sternocostal joints, or both, are described. Eleven of these patients also had palmoplantar pustulosis. Histological examination of the joints showed chronic and subacute inflammation, increased osteoblastic activity, and cartilage degeneration. Propionibacterium acnes was cultured in tissue samples from seven of the 15 biopsied patients, a finding at variance with those of previous reports. The possibility that sternoclavicular arthro-osteitis is of infectious origin should be the subject of further investigation. Non-steroidal anti-inflammatory drugs (NSAIDs) may provide pain relief, possibly owing to their inhibitory action on osteoblasts. In cases of severely restricted movement or severe pain resection of the medial clavicle may be considered.

Adult↗
PubMed1988

Evaluation of the rheumatoid shoulder function after hemiarthroplasty and arthrodesis.

Rheumatoid arthritis frequently involves the shoulder. In the advanced stages of the disease the preferred treatment has been either arthroplasty or arthrodesis. The functional results of five shoulder arthrodeses have been compared with five hemiarthroplasties. The period of postoperative immobilization was shorter for hemiarthroplasty; both procedures relieved pain, but personal hygiene was easier to manage after hemiarthroplasty. Shoulder arthrodesis with a fixed internal rotation greater than 40 degrees makes it impossible to reach the face and the optimal position would seem to be 20-30 degrees of abduction. 20-30 degrees flexion and 20-30 degrees internal rotation.

Activities of Daily Living↗
PubMed1988

Individually adapted lightweight walking aids with moulded handles for patients with severely deforming chronic arthritis.

Patients with severely deforming rheumatoid arthritis and impaired function of the upper extremity are often unable to use conventional walking aids. This report describes 42 such patients who were equipped with altogether 75 individually manufactured, lightweight walking aids (12 crutches, 12 forearm-crutches, 39 crutch-sticks and 12 sticks). A plaster cast of the patient's grip as well as analysis of the integrated function of the shoulder-elbow-wrist was used when preparing the walking aid. It was thereby possible to produce suitable walking aids for all but one patient. At follow-up after 12-18 months, of use, most patients belonging to functional classes II and III were satisfied with their walking aid(s) and 22 considered it/them indispensable. However, in 4 patients, progressive disease with increased disease activity/deteriorating hand function and in 3 patients increasing shoulder pain reduced their usability. Lack of motivation was one reason for low use intensity. Follow-up demonstrated that most patients were able to use these walking aids without detectable negative effects on the upper extremity. The durability of the walking aid was satisfactory. Thus an individually moulded handle on an adapted lightweight walking aid is important helping patients with severely deforming arthritis to maintain independent ambulation, and should be made more widely obtainable.

Activities of Daily Living↗
PubMed1988

Treatment of hip fractures in rheumatoid arthritis.

Of 1100 femoral neck fractures observed through an eight-year period, 27 occurred in rheumatoid conditions. The complications and functional results were compared with unselected femoral neck fracture data of nonrheumatoid patients. At two-year follow-up examinations, five of 27 surviving rheumatoid patients had had undisplaced fractures; one of the five developed segmental femoral head collapse. Nineteen of 20 patients with displaced fractures lost position or developed non-union or segmental femoral head collapse; 14 required total hip arthroplasty. In the control non-rheumatoid group, six of 27 undisplaced fractures and 34 of 67 displaced fractures developed complications. In displaced fractures, complications occurred more often in rheumatoid patients (p less than 0.0004). Because in rheumatoid patients internal fixation in displaced fractures is associated with an unacceptably high failure rate, primary hip arthroplasty may prove to be the procedure of choice.

Adult↗
PubMed1987

The potential of computed tomography in visualising structures inside the metal cup in surface-replacement total hip arthroplasty.

Computed tomography (CT) was employed to evaluate the femoral component of the prosthesis in surface-replacement total hip arthroplasty in seven patients suffering from rheumatoid arthritis. Image reconstruction using the high frequency filter resulted in an image of the cement-bone interface inside the cup which allowed the detection of bone resorption. This new application of CT could prove to be a valuable complement to conventional methods in the radiological assessment of metal cup arthroplasties.

Adult↗
PubMed1987

Neurovascular injury complicating displaced proximal fractures of the humerus.

Three cases with injury of the axillary artery and brachial plexus complicating a displaced proximal fracture of the humerus are presented. In two patients the arterial injury was not recognized on admission. Vascular repair had to be carried out in all three cases. Two patients showed a persistent neurological deficit. In two of the cases, the arterial injury may have been caused by an attempt at closed reduction of the fracture. The possibility of axillary arterial injury should be considered in proximal fractures of the humerus with severe medial displacement of the shaft of the humerus.

Aged↗
PubMed1987

Bone cement improved by vacuum mixing and chilling.

Two mixing methods, hand and vacuum mixing, were compared using high viscosity, high molecular, antibiotic containing polymethylmethacrylate kept at two different temperatures, 4 degrees C and 21 degrees C, prior to mixing. The mechanical properties, i.e., fracture strength, maximum deflection, modulus of elasticity and hardness, were improved by vacuum mixing when compared with hand mixing at both temperatures. The fatigue life was 10 times longer after vacuum mixing. Chilling prior to mixing made the mixing easier and improved the handling characteristics. Vacuum mixing delayed the setting time by 1 minute, but also decreased the peak temperature. Radiographic analysis showed that vacuum mixing mainly reduced the microporosity, but also the macroporosity. The mechanical properties deteriorated slightly after 2 months in Ringer's solution, but the differences between the mixing procedures remained unchanged.

Bone Cements↗
PubMed1987

Cefuroxime prophylaxis in trochanteric hip fracture operations.

In a double-blind randomized study of antibiotic prophylaxis in trochanteric fractures operated on with a nail and plate, a 24-hour intravenous administration of cefuroxime 0.75 grams thrice daily (Group B) was compared with the previous regimen of cefuroxime for 24 hours plus 6 days of oral cephalexin (Group A). In each group, 56 (Group A) and 65 (Group B) patients could be evaluated. One deep infection occurred in Group B with growth of Staphylococcus aureus, and another 4 patients had discharge and cultures of which 2 showed S. aureus. In Group A, 6 patients had signs of an infection, and in 3 patients cultures were taken but were negative. There were no differences between the groups. We concluded that the prophylaxis time need not be longer than 3 days.

Aged↗
PubMed1987

Hematogenous infection after knee arthroplasty.

Twenty-five hematogenously infected knee arthroplasties in 20 patients (17 with rheumatoid arthritis and 3 with arthrosis) were followed for 3 years. Staphylococcus aureus was the major infecting organism. Three patients with four arthroplasties died of sepsis. Two patients had removal of the arthroplasty, one of which resulted in an above-the-knee amputation. Four out of five arthrodeses fused. Two knees healed after early debridement and two healed without surgery. Ten knees had successful revision arthroplasty. Rheumatoid arthritis and constrained prostheses increase the risk of hematogenous infection. Any infection and especially cutaneous lesions in a patient with a knee arthroplasty should be treated vigorously.

Adult↗