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Biomedical subjects

L M Hove

Publications and source records attributed to L M Hove.

At least 19 recordsLinked to original sources
PubMed2001

Intramedullary nailing in humeral shaft fractures. Mechanical behavior in vitro after osteosynthesis with three different intramedullary nails.

The aim of this in vitro study was to compare the mechanical behavior of fixation by the Russell-Taylor nail with the more recent Polarus nail. Fixation with an experimental nail made from polyacetal polymer was also included in the study. Thirty humeri were fractured and randomized to receive one of the three nail types. A four-point nondestructive bending test was performed, as well as torsional testing to failure. The torsional test was designed to record the amount of 'play' (uncontrolled rotation) in the bone/implant construct. The Polarus nail gave higher rigidity of the nail/bone construct than the two other types. The Russell-Taylor nailing exhibited a high degree of 'play' (uncontrolled rotation). The polyacetal nails allowed a large elastic deformation before failure.

Biomechanical Phenomena↗
PubMed2000

[Acute compartment syndrome--a clinical follow-up study].

BACKGROUND: The aim of this study has been to examine patients from 1985 to 1997 with acute compartment syndrome in the leg. We wanted to assess motor function, sensibility and aesthetic sequelae. MATERIAL AND METHODS: During this period, a total of 48 patients were treated by fasciotomy. 29 of these were examined in the follow-up study, after a mean follow-up time of 6.7 years. RESULTS: One of the patients had amputated his leg, two had extirpated necrotic muscle tissue. Another 20 patients had sequelae like drop-foot, claw toes, reduced dorsal flexion of the foot, loss of ability to walk on tiptoe, and limping. 14 patients had loss of sensibility beyond the scar area, and 24 patients had moderate or serious aesthetic sequelae. INTERPRETATION: The high number of patients in this study with sequelae from acute compartment syndrome may indicate an unacceptable delay in diagnosis and treatment.

Acute Disease↗
PubMed1999

Dynamic traction for unstable fractures of the distal radius.

We have designed a flexible distracter through which dynamic traction is applied to fractures of the distal radius. The distraction is maintained during flexion and extension as well as radial and ulnar deviation. The results in 30 patients showed that the majority of the fractures maintained reduction during the period of dynamic traction. In several patients the radiological variables even improved during dynamic traction. The median radial shortening was 0 mm, the palmar angulation 7 degrees, and the radial inclination 23 degrees. Continuous dynamic traction applied to fractures of the distal radius did not lead to redisplacement of the fracture, and the overall functional results were good.

Adult↗
PubMed1999

Clinicopathological characteristics of melanomas of the hand.

A 25-year clinicopathological review of 19 patients with malignant melanoma of the hand is reported. There were 11 women (median age 73 years) and eight men (median age 70 years). Eleven tumours were subungual, six on the dorsum of the hand, and two had a palmar location. Seven tumours were acral lentiginous melanomas, six were superficial spreading melanomas, and five were of the nodular subtype. Eleven patients presented with localized disease (clinical stage I), four with local spread (clinical stage II), and four with regional lymph node metastases (clinical stage III). Nine of the patients have died of the disease, with a median survival time of 30 months (range, 10-84 months). The subungual melanomas were thicker and the patients were older at presentation compared with the non-subungual sites. Review of our patients emphasized the need for early diagnosis.

Aged↗
PubMed1999

Epidemiology of scaphoid fractures in Bergen, Norway.

During a three-year period, 330 fractures of the scaphoid were diagnosed, 273 of these in subjects resident in Bergen, Norway. The population at risk was 211719, and 82% of the fractures occurred in male subjects. The mean (range) age was 25 (11-79) years. The annual incidence was 4.3/10000 people. The age-specific incidence for men was highest between the ages of 20-30 years followed by a rapid decrease. The age-specific incidence for men was significantly higher than the corresponding rates for women up to about 50 years of age, whereas the rates for men and women over 60 were similar. Fractures of the scaphoid accounted for about 2% of the total number of fractures in our area, 11% of the hand fractures, and 60% of the carpal fractures.

Adolescent↗
PubMed1999

Epidemiology of burns in Bergen, Norway.

We organised a prospective series to study, the epidemiology and causes of burns in the city of Bergen, Norway. We included 361 patients treated during one year at the casualty centre or at the burn centre at the hospital. Thirty-six per cent (n = 131) of the patients were less than 15 years old, and 9% (n = 33) were over 60. The incidence of burns was 17/10,000 inhabitants, 0.7 for patients who were admitted and 17 for outpatients. Burns were most common among male subjects aged 40 years or less, while women were more at risk in the older age groups. Almost half the injuries were caused by scalds, and 92 (26%) were from contact with hot surface. Scalds were more common among women than among men, while firework and flame burns were more common among men. Burns occurred at home in 227 patients (63%), at work in 58 (16%), and during leisure activities in 76 (21%). The mean surface area burned was 3.5% total body surface area (TBSA); patients who were admitted had a TBSA of 18% compared with 1.8% among those treated as outpatients.

Adolescent↗
PubMed1999

Salvage of failed resection of the distal ulna. Case report.

A 45-year-old woman completely lost the ability of active supination of the forearm after a Darrach resection for malunited fracture of the distal radius. A three-component reconstruction was performed to stabilise the distal stump of the ulna and prevent convergence between the two forearm bones. The procedure combined advancement lengthening osteotomy of the ulna, longitudinal intramedullary tenodesis of the extensor carpi ulnaris tendon, and dorsal transfer of the pronator quadratus through the interosseous space. Four months after the salvage procedure she again had full active supination of the forearm and she returned to work two months later.

Female↗
PubMed1998

Posterior tibial tendon transfer for drop-foot. 20 cases followed for 1-5 years.

From 1991 to 1997 we performed 20 tibialis posterior tendon-transfer operations in 17 patients with drop-foot, in 11 of peripheral neurogenic origin and in 6 because of neuromuscular disease. Postoperatively, all patients could walk without an ankle-foot orthosis. At follow-up after mean 2 (1-5) years, all patients had active dorsiflexion of the foot and toes, with a median active ankle dorsiflexion of 5 degrees (-15-10 degrees). The median active plantar flexion was 40 degrees (10-45 degrees), and the total range of movement was 40 degrees (15-50 degrees). At follow-up, the gait was good in 15 and improved in 2 of the 17 patients.

Adolescent↗
PubMed1997

[Achilles tendon rupture. Surgical or non-surgical treatment].

Opinions differ about the proper treatment of Achilles tendon rupture. 38 patients with acute total rupture of the Achilles tendon were included in a comparative study of operative as against non-operative treatment. 21 of the patients were treated operatively and 17 non-operatively. The follow-up time was 6-53 months. Three of the non-operated patients but none of the operated group experienced major complications. Ten of the non-operated patients and 14 of the non-operated group experienced minor complications. In the non-operated patients the plantar-flexion range was significantly reduced in the injured foot compared with the other foot (p = 0.03). Because of more re-ruptures and reduced muscle strength in the non-operative group, operative treatment is recommended for active persons. Non-operative treatment may be considered for older people.

Achilles Tendon↗
PubMed1997

Corrective osteotomies after injuries of the distal radial physis in children.

Six children had corrective osteotomies of the distal forearm because of growth disturbance from post-traumatic closure of the distal radial physis. Lengthening osteotomy of the radius was performed in three patients with grafts from the iliac crest. All osteotomies healed in a satisfactory position. Three patients had only moderate mal-angulation of the radius and were treated by shortening of the ulna. The median postoperative palmar angulation of the distal radius was 4 (0-13) degrees, the radial inclination 22 (15-28) degrees, and the ulnar variance was -2 (-4(-)+2) mm. The postoperative pain relief was complete in all patients and the total range of motion was 96 (93-100)% compared with the opposite side.

Adolescent↗
PubMed1997

Closed reduction and external fixation of unstable fractures of the distal radius.

The anatomical and functional outcome and complications after closed reduction and external fixation of unstable fractures of the distal radius were reviewed in 29 patients. The fractures were reduced by longitudinal traction and closed manipulation under fluoroscopic control, and the reduced position was retained by a standard half-frame Hoffmann external fixator for six to eight weeks. The mean follow-up time was four (3-7) years. The reduction failed in three patients after too early removal of the fixator (three to five weeks). For the rest of the patients the dorsal angulation, the radial length, the articular step-off, and the intra-articular gap between fragments were significantly improved. Twenty-two patients had excellent or good anatomical alignment and in seven it was fair. One patient had a superficial pin infection, six patients had transient paraesthesias, and one patient transient mild dystrophia. At follow-up one patient had some finger stiffness; this was the only persistent complication. The median Gartland and Werley functional score was 3. The functional end result was excellent or good in 22 patients, fair in four, and poor in three.

Adult↗
PubMed1997

Open reduction and internal fixation of displaced intraarticular fractures of the distal radius. 31 patients followed for 3-7 years.

We have used open reduction and internal fixation with a T-plate in 31 displaced, intraarticular fractures of the distal radius which were judged irreducible or in which closed reduction failed. The mean follow-up time was 4 (3-7) years. The dorsal angulation, the radial length, the articular step-off and the intraarticular gap between fragments were substantially improved after surgery. 30 patients had excellent or good extraarticular alignment, and only 1 patient had a postoperative intraarticular step-off of 2 mm. The function was excellent or good in 26 patients at follow-up. Complications occurred in 6 patients: 1 compartment syndrome, 1 postoperative wound infection, 2 ruptures of the extensor pollicis longus tendon, and 2 patients had median nerve paresthesias.

Adolescent↗
PubMed1995

Anatomical and functional results five years after remanipulated Colles' fractures.

During 1988 we recorded all Colles' fractures (n = 530) in a prospective study in the city of Bergen. According to defined criteria, the fractures were treated by immobilisation in plaster cast with or without reduction; reduction and immobilisation by a Hoffman external fixation device; or open reduction and internal fixation. Included in the present study were 26 patients with secondary displacement after immobilisation in a plaster cast (8% of the reduced fractures). The fractures were remanipulated and splinted in a new cast for four more weeks. The patients were followed up five years after the fracture, and underwent subjective, radiographic, and functional evaluation. The anatomical end result was significantly improved compared with the initial deformity. The dorsal angulation improved significantly compared with the "slipped' position, whereas the radial length did not. The functional end result was excellent or good in 20 patients (77%). The total movement in all directions was correlated negatively with ulna plus, and the grip strength correlated negatively with the degree of osteoarthrosis. There were no other significant linear relationships between anatomical and functional variables. Total pronation and supination correlated with the initial radial length and dorsal angulation, and the total movement in all directions correlated with the initial radial length.

Casts, Surgical↗
PubMed1995

Nerve entrapment and reflex sympathetic dystrophy after fractures of the distal radius.

In a series of 542 conservatively-treated fractures of the distal radius 30 patients (5,5%) developed compression neuropathy: of the median nerve (n = 23), of the ulnar nerve (n = 5), and of the radial nerve (n = 2). Three patients required decompression of the carpal tunnel, and one patient's ulnar symptoms were relieved after shortening osteotomy of the ulna. The remaining neuropathies resolved spontaneously over a period of three months. Five patients developed typical reflex sympathetic dystrophy with diffuse pain, loss of hand function, and significant autonomic dysfunction. None of them had specific signs of compression neuropathy anteceding the development of reflex dystrophy. All five had their joints mobilised under regional intravenous block combined with regional perfusion of soluble corticosteroid.

Autonomic Nervous System Diseases↗
PubMed1995

Fractures of the distal radius in a Norwegian city.

During a prospective one-year study (1988) all fractures of the distal radius in people over 20 years old were registered in Bergen, Norway. Six hundred patients with 609 fractures were treated. The incidence was 38/10000 population, and 79% of the fractures occurred in women. The age-specific incidence in women increased rapidly after the menopause and reached a maximum between 60 and 69 years. The incidence for women over 60 years of age is the highest reported. Among women over 50 years the incidence of fractures caused by minor falls varied depending on the season. The mean number of fractures was 3.6 times higher on days when there was snow on the ground compared with days when there was no snow. More than half the distal radial fractures occurred while out walking. Possible strategies to prevent fractures must include prevention of falls, in particular among postmenopausal women on winter days.

Adult↗
PubMed1994

Simultaneous scaphoid and distal radial fractures.

Simultaneous fractures of the distal radius and scaphoid are uncommon. In a prospective 3-year study we registered 2,330 distal radial fractures and 390 scaphoid fractures, and 12 were combined. Ten of these had high energy trauma; six were styloid fractures, four Colles' fractures, one was a greenstick fracture and one Salter-Harris Type 2 epiphyseal fracture. All but one of the 12 scaphoid fractures were stable and healed without problems, and one was a trans-scaphoid, trans-styloid peri-lunate fracture-dislocation. The study supports the opinion that the distal radial fracture constitutes the principal injury that determines the outcome and hence the treatment. If the scaphoid fracture is unstable or dislocated, we recommend internal fixation of the scaphoid. Only a small proportion of these injuries represent a more serious disruption with carpal instability.

Adult↗
PubMed1994

Prediction of secondary displacement in Colles' fracture.

In a prospective study, 645 consecutive Colles' fractures treated conservatively were followed until union. The fractures subsequently lost some of their manipulated position during the immobilization period. However, the anatomical end result was significantly improved compared with the initial deformity. The mean shortening of the radius during plaster-cast treatment was 3 mm, and the mean increase of dorsal angulation was 7 degrees. Multiple regression analyses showed that initial dorsal angulation, age, and Older type were important predictor variables for the end result of dorsal angulation. Initial radial length, age and initial dorsal angulation were of importance for the end result of radial length. The strongest linear relationship was found between the end result of radial length and the initial radial length (r = 0.67). This may indicate that the patients who will malunite with radial shortening are those with significant radial axial shortening at the initial presentation. Thus, these patients should be treated with a more stable fixation device.

Bone Malalignment↗