Biomedical subjects

N Egund

Publications and source records attributed to N Egund.

At least 55 records · Page 3Linked to original sources

PubMed1990

Improved positioning of the femoral stem with a centralizing device.

Two series of patients operated on with total hip replacements for arthrosis are reported. The same prosthesis and operative and cementing techniques were used in both series, except that in Series 2 a centralizing device consisting of four triangular fins passed over the tip was also used to improve the positioning of the femoral stem. It was found that the position of the tip was more central in Series 2. No drawbacks were associated with the use of the device. We concluded that the centralizing device facilitated the positioning of the femoral stem tip.

Adolescent↗

PubMed1990

Revision after osteotomy for gonarthrosis. A 10-19-year follow-up of 314 cases.

During a 10-year period, 314 tibial osteotomies were performed for medial gonarthrosis. At follow-up after 10-19 years, 62 knees had been revised by arthroplasty (52 cases) or reosteotomy (10 cases). The revision rate was 54/170 in undercorrected knees and 8/144 in knees with normalization or overcorrection of the hip-knee-ankle angle. Our results confirm that tibial osteotomy for gonarthrosis requires proper indications and precise surgery. Perhaps, given another 10 years, our osteotomies will have outlived contemporary arthroplasties.

Female↗

PubMed1989

Anomalous lumbosacral articulations and low-back pain. Evaluation and treatment.

Eleven patients ranging from 13 to 76 years in age with low-back pain and asymmetric sacro-transverse joints were studied. Preoperatively, scintimetry was performed in eight of the patients, in all cases with normal results. Ten of the 11 patients had their sacrotransverse joint anesthesized in fluoroscopy. Nine of these experienced pain reduction or alleviation. Resection of the transverse process was performed in all cases. At follow-up, at 6 to 42 months postoperatively, seven patients reported total alleviation of pain, and two, significant improvement. Two patients had unchanged symptoms; one patient was 76 years of age, had associated degenerative changes of the spine, and had no effect of local anesthetics in his joint, and the other was a 13-year-old male competitive swimmer. The authors conclude that, in patients with anomalous unilateral lumbosacral articulations and low-back pain, in whom local anesthesia into the joint gives pain alleviation, resection of the transverse process may be a worthwhile procedure.

Adolescent↗

PubMed1989

Proximal closing wedge osteotomy and adductor tenotomy for treatment of hallux valgus.

After 2 to 4 years, 25 patients (27 feet) who had a proximal closing wedge osteotomy of the first metatarsal and an adductor tenotomy were reviewed. A total of 20 patients (22 of 27 feet) were completely satisfied; 5 patients not completely satisfied had metatarsalgia because of dorsal displacement of the first metatarsal head. Radiographic measurements showed a narrowing of the forefoot rather than a large change in the intermetatarsal angle. The recovery period was long, an average of 11 weeks. Pin inflammation occurred in 5 patients and incisional neuromas in 2 patients. The risk of these complications must be taken into consideration when using this operation.

Adult↗

PubMed1989

A guide instrument for high tibial osteotomy.

Fifty-two patients (52 knees) with medial gonarthrosis were subjected to high tibial osteotomy using the Tjörnstrand guide instrument. The intended wedge was calculated from a whole lower limb radiograph. The correction aimed at was an overcorrection of 4 degrees in valgus of the hip-knee-ankle angle. All but 1 case were corrected to +/- 3 degrees of the intended angle. All but two cases healed within +/- 3 degrees of the achieved surgical correction, i.e., a substantial improvement compared with our previous freehand technique where one fifth were outside this interval. We conclude that in knee surgery a guide is as important for osteotomies as for arthroplasties.

Adult↗

PubMed1989

Lateral meniscal lesions in patients with clinically suspected medial lesions.

Double-contrast arthrography and arthroscopy were performed in a prospective study on 46 consecutive patients clinically suspected of having a medial meniscal tear only. At arthrography, 38 torn medial menisci were found; four of them were, however, false-positive and another false-negative as compared with arthroscopic examination. Moreover, seven unsuspected lateral meniscal tears were diagnosed at both arthrography and arthroscopy. The diagnostic accuracy of the double-contrast arthrography was well above the clinical accuracy, and we conclude that arthrography is a reliable method for diagnosing both medial and lateral tears.

Arthrography↗

PubMed1989

Early knee mobilization after osteotomy for gonarthrosis.

In a prospective study, 32 knees in 32 patients were randomized to either a cylinder plaster cast (17 knees) or hinged cast-brace (15 knees) after high tibial osteotomy for medial gonarthrosis. At 6 weeks, 3 months, and still 1 year after surgery, the range of motion was better in the cast-brace group. There was no difference in the other clinical results at 3 months and at 1 year after surgery, nor in changes of osseous correction or in the final knee alignment. All the patients in the cast-brace group were satisfied with early motion.

Adult↗

PubMed1989

Function after tibial osteotomy for medial gonarthrosis below aged 50 years.

Twenty-seven patients (28 knees), with a median age of 42 (27-50) years treated with a high tibial osteotomy for early medial gonarthrosis (Ahlbäck's Stage I) were examined after 11 (7-18) years. Twenty-four were men; 18 knees had had previous meniscus and ligament lesions. At follow-up, 22 knees were satisfactory and 9 patients managed high-activity sports or heavy work. In 25/28 knees, the arthrotic process had not progressed radiographically.

Adult↗

PubMed1988

Preoperative diagnosis of soft tissue tumours.

Over a period of 3 years in Southern Sweden 35 patients were seen with deep-seated limb sarcomas without metastases, 30 of whom were referred before any operation had been carried out. Thirty seven patients with deep-seated benign lesions were referred during the same period because of suspected malignancy. A preoperative diagnosis considered sufficient for a definitive operation was made from the clinical findings, aspiration cytology and radiographic examination, but without open biopsy, in 59 of these 67 cases. The differentiation between a benign and a malignant tumour was correct in all but one. The extent of excision necessary to achieve adequate margins for a soft-tissue sarcoma can often be reduced if open biopsy is avoided, with preservation of function. We conclude that treatment without open biopsy is possible in the great majority of patients with soft-tissue sarcoma.

Adult↗

PubMed1988

Computed tomographic sinography in orthopedic radiology.

Twenty-one computed tomographic (CT) and 17 conventional sinographies were performed on 17 patients with lesions in the musculoskeletal system. The CT sinography was superior to the conventional examination in all cases, giving detailed information on the relationship between the sinuses and neighboring soft tissue and skeletal structures. CT sinography is recommended as the primary method for examination of musculoskeletal sinuses.

Adult↗

PubMed1988

Gadolinium-DTPA enhancement of soft tissue tumors in magnetic resonance imaging--preliminary clinical experience in five patients.

In a preliminary report of a clinical trial of gadolinium-DTPA (Gd-DTPA) for enhancement of soft tissue tumors in magnetic resonance imaging (MRI), experience of the first five cases is presented. Enhancement was found to give better delineation of the tumor in richly vascularized parts of the tumors, compressed tissue immediately surrounding the tumor, and in atrophic, but richly vascularized, muscle.

Adult↗

PubMed1988

Intracapsular pressures in undisplaced fractures of the femoral neck.

We studied intracapsular pressure in 50 patients with Garden Grade I and II subcapital fractures. Before operation pressures varied from zero to 320 mmHg, 16 patients having an intracapsular pressure of over 80 mmHg. The pressure was increased considerably by medial rotation and decreased by lateral rotation and especially by semi-flexion. From zero to 36 ml of blood was aspirated; the amount did not correlate with the intracapsular pressure. Of 25 patients who were also examined by scintimetry, 13 had reduced uptake at the femoral head before aspiration, and nine of these showed a marked increase in uptake after aspiration. Intracapsular tamponade of the hip may be one reason for the occasional occurrence of segmental collapse of the femoral head after subcapital fracture with minor displacement.

Adult↗

PubMed1988

Hemarthrosis after femoral neck fracture fixation.

In 34 femoral neck fractures, CT was performed within 1-32 days after internal fixation. All the cases except one showed an increased distance between the femoral neck and the anterior aspect of the joint capsule as compared with the intact side, indicating varying degrees of hip joint effusion and/or synovitis. Hip joint aspiration in 11 patients revealed increased intracapsular pressure varying between 10 and 112 mmHg and volumes of aspirated joint effusion up to 23 ml. Pain relief and increased joint motion after drainage of the intracapsular effusion was observed in 3 patients whose postoperative mobilization was facilitated.

Aged↗

PubMed1988

Acetabular fracture causing hip joint tamponade. A case report.

An 81-year-old woman had severe hip pain after a fall. Radiography was normal, but computed tomography and sonography showed a minor, displaced acetabular fracture and hemarthrosis. Aspiration of 15 ml of blood reduced the intracapsular pressure in the neutral position from 30 kPa to atmospheric pressure with relief of pain and increased joint motion. This case confirms that acetabular fracture may escape radiographic diagnosis and cause hip joint tamponade. Aspiration should be considered as a palliative and possibly therapeutic measure.

Acetabulum↗

PubMed1988

The PCA unicompartmental knee. A 1-4-year comparison of fixation with or without cement.

Totally, 93 knees were operated on with the PCA unicompartmental knee for gonarthrosis Stages I-III according to Ahlbäck. The clinical findings for 84 arthroplasties with 1-4 years' follow-up showed 82 excellent or good results. The mean postoperative flexion was 124 degrees. The position of the tibial component was respectively 86 degrees and 89 degrees in the AP and lateral views. The mechanical axis was slightly undercorrected. There were two failures, both with persistent pain on walking. One failure was among 43 uncemented knees, whereas the other was among the 41 cemented arthroplasties. Four uncemented arthroplasties had a first steps' problem but were satisfactory otherwise. There was no infection or clinical loosening. A reoperation was performed in 1 case, in which a symptomatic osteophyte was removed. When compared with our earlier Marmor series, the PCA unicompartmental arthroplasties were better. The cemented arthroplasties had a somewhat higher frequency of complete pain relief. An uncemented arthroplasty should only be considered in special situations.

Aged↗

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

Recurrent shoulder dislocation and screw failure after the Bristow-Latarjet procedure. A case report.

A 22-year-old male was operated on with coracoid transfer according to the Bristow-Latarjet procedure because of recurrent anterior dislocation of his right shoulder. Nine months later the patient sustained a repeat shoulder dislocation after moderate trauma. The screw was radiographically found to be bent. Subscapularis shortening according to Putti-Platt was performed. No repeated episodes of dislocation and no instability has been experienced by the patient since then. However, one year later, he awoke with pain dorsal to the humeroscapular joint. Radiographs showed the screw to be broken. The proximal part of the screw was located underneath the humeroscapular joint and was removed. After this, the patient was free of pain and returned to work as a carpenter.

Adult↗

PubMed1987

Sonography and joint pressure in synovitis of the adult hip.

Sonography was successfully used to diagnose an effusion in the hips of three adults with septic arthritis and four with aseptic synovitis. The effusions were confirmed by aspiration. All the patients had markedly increased intracapsular pressure which, in the extended position, exceeded the systolic blood pressure and could well compromise the blood supply to the head of femur. Aspiration reduced pain and intracapsular pressure, as did flexion of the hip to 45 degrees.

Adolescent↗