Biomedical subjects

N Egund

Publications and source records attributed to N Egund.

At least 73 records · Page 4Linked to original sources

PubMed1986

Computed tomography and ultrasonography for diagnosis of hip joint effusion in children.

Nineteen consecutive children with transient synovitis of the hip were examined for intracapsular joint effusion using computed tomography (CT) and ultrasonography (US). The two techniques were highly correlated in measurements of the anterior displacement of the joint capsule, indicating both to be reliable diagnostic tools. Such an effusion is clinically important because of the increase in intracapsular pressure with ensuing disturbance in the vascular supply to the proximal femoral epiphysis, as demonstrated experimentally and clinically in transient synovitis.

Child↗

PubMed1986

Sonography, arthroscopy, and intracapsular pressure in juvenile chronic arthritis of the hip.

Sonography was used in the preoperative evaluation of the hip joint in 14 patients with juvenile chronic arthritis (JCA). The joint capsule distension found at sonography and the intracapsular pressure were increased in patients with severe synovitis revealed at arthroscopy. Sonography and intracapsular pressure-recording can be recommended for assessments of synovitis of the hip joint in JCA.

Adolescent↗

PubMed1986

Hemarthrosis in undisplaced cervical fractures. Tamponade may cause reversible femoral head ischemia.

In eight undisplaced intracapsular fractures of the femoral neck, an intracapsular hematoma was diagnosed by computed tomography. 99mTc-MDP scintimetry revealed markedly reduced or absent blood supply to the head of femur. The intracapsular pressure was 23 (2.7-43) kPa with the hip in neutral position. Following aspiration of 12 (0.5-36) ml of blood, pressure was reduced to zero, and postaspiration scintimetry revealed restitution of blood supply to the femoral head. Hip joint tamponade in these patients has caused femoral head ischemia, reversible by aspiration.

Aged↗

PubMed1986

Cup arthroplasty of the rheumatoid shoulder.

Hemiarthroplasty of the humeral head, using a stainless steel cup, was performed in 26 shoulders of patients with rheumatoid arthritis who had severe pain and loss of function. All the shoulders were Larsen's radiographic Grade 4 or 5. After 2 (1-5) years, all the shoulders were painless and had satisfactory function. Partial radiolucent zones exceeding 1 mm were seen in three shoulders.

Adult↗

PubMed1986

Loosening of the porous coating of bicompartmental prostheses in patients with rheumatoid arthritis.

Thirty-four porous-coated anatomical (PCA) total knee arthroplasties in twenty-eight patients with rheumatoid arthritis were followed for an average of seventeen months. In these thirty-four knees, twenty-three tibial and fifteen femoral components were cemented. The rest were uncemented. At follow-up, more than half of the knees (nineteen of thirty-four) showed radiographic evidence of displacement of some of the beads from the porous coating. In fourteen knees the beads loosened more than three months postoperatively, and all of these knees had a radiolucent zone. Six knees had beads within the joint. Eight of nine non-cemented tibial components (excluding one tibial component) and five of the nineteen femoral components that were not cemented showed late loosening of beads (after three months). This study indicates that the metallurgical technique for porous coating with heat-sintered cobalt-chromium beads does not produce a coating that is sufficiently strong to prevent loosening in the case of the porous-coated anatomical prosthesis. The long-term clinical relevance of our findings is unclear. The mechanical strength of the porous coating on the prosthetic surface should be improved and the prosthesis should be tested in limited clinical studies before cementless fixation can be recommended.

Adult↗

PubMed1985

Supracondylar fracture of the humerus in children: review of closed and open reduction leading to a proposal for treatment.

Of 70 supracondylar fractures of the humerus in children, 25 were treated by open reduction and internal fixation, 24 by closed manipulation and plaster and 21 by plaster-of-Paris only. Three of the fractures were operated on because of suspected vascular injury (with or without neurological symptoms), another seven because of instability and/or extreme swelling and 15 after unsatisfactory closed reduction. Traction was used in 3 of the 24 patients treated by closed methods and among the other 21, three fractures had to be manipulated twice. Three to six years after the injury, 6 of the 25 patients operated on had reduced flexion-extension and/or deformity exceeding 10 degrees. Five patients treated by closed reduction had reduced movements or deformity exceeding 10 degrees and three patients with originally undisplaced fractures had deformity exceeding 10 degrees. In this study the most severe fractures were selected for operation but, in spite of this, the results were better than for fractures treated by closed reduction and plaster. Based on this and previous studies, a plan suitable for most departments is suggested for the treatment of this fracture.

Adolescent↗

PubMed1985

Traumatic hip joint tamponade. Two cases with femoral head ischaemia.

Two elderly patients had pain after hip trauma with no radiographic evidence of fracture. Computed tomography demonstrated capsular haematoma. Scintimetry revealed femoral head ischaemia. Intracapsular hip joint pressure in extension was 240 and 176 mm Hg, respectively, in neutral position and 280 and 360 mm Hg in internal rotation. The hip joints were aspirated for 8 ml and 5 ml of blood, respectively, leading to pain relief and regained radiotracer uptake in the femoral head. It is concluded that traumatic hip joint tamponade may cause femoral head ischaemia which may be reversed by aspiration.

Accidents, Home↗

PubMed1985

Intracapsular pressure in transient synovitis of the hip.

Fourteen consecutive children with symptoms of transient synovitis of the hip were examined with sonography regarding intracapsular effusion, with scintimetry regarding blood-flow in the proximal femoral epiphysis (PFE) and with intracapsular pressure recording and aspiration. All patients had an intracapsular effusion. Intracapsular pressure was found to depend on the position of the hip. The mean pressure with hips in extension and inward rotation was 22.6 kPa (170 mm Hg) whereas in 45 degrees of flexion it was 2.3 kPa. In two cases scintimetry demonstrated reduced blood flow to the PFE; after aspiration, isotope uptake returned to normal, indicating that increased intracapsular pressure has a harmful effect on circulation to the PFE. Children with transient synovitis should be treated with the hips in 45 degrees of flexion to reduce intracapsular pressure. Forcing the hip in extension causes a risk of ischaemia of the PFE.

Adolescent↗

PubMed1985

Radiographic loosening after revision with gentamicin-containing cement for deep infection in total hip arthroplasties.

Seventy-two infected total hip arthroplasties were revised with cement containing gentamicin and were followed up with regular radiograms for periods of up to six years. The infection healed in 61 cases and persisted in 11. An analysis of the radiographic changes in regard to the signs of loosening showed that about half of the cases with a healed infection had a minimal demarcation between bone and cement. In about one-third of the patients, a radiolucent zone of up to 2 mm in thickness developed during the first one to two years and then seemed to remain stable. In the other cases, a progressive resorption, indicating true loosening, was observed. All the cases with remaining infection (except one patient who died of heart disease) exhibited progressively increasing resorption zones. Progress, however, was possibly slowed by the effects of the gentamicin cement and the systemic antibiotic treatment.

Aged↗

PubMed1984

Femoral anatomy described in cylindrical coordinates using computed tomography.

A new method, which describes the femoral anatomy in terms of angles and distances is presented. Primary data are obtained from CT and reduced to cylindrical coordinates by a computer program. The approach yields rotational angles for the entire shaft and demonstrates the limitation of conventional measurements of the anteversion angle. The method is proposed as a generalized technique for measurement of rotation in orthopedic radiology.

Biomechanical Phenomena↗

PubMed1984

Ultrasonography in hip joint effusion. Report of a child with transient synovitis.

In a 7-year-old boy with clinical symptoms of transient synovitis of the hip, an intracapsular effusion was diagnosed with computed tomography and ultrasonography. An intracapsular pressure of 50 mmHg was recorded prior to aspiration of 5.5 ml of clear fluid. Repeated ultrasonography immediately after aspiration verified a reduction in effusion, and serial examinations on the following days did not reveal any recurrence of the effusion.

Biopsy, Needle↗

PubMed1983

Late cerebral arterial spasm: the cerebrovascular response to hypercapnia, induced hypertension and the effect of nimodipine on blood flow autoregulation in experimental subarachnoid hemorrhage in primates.

1. Late cerebral arterial spasm was induced by repeated injections of autologous blood in a total amount of 14-33 ml into the basal cisterns of baboons to mimick subarachnoid hemorrhage (SAH). Regional cerebral blood flow (CBF), sagittal sinus pressure, cerebral arterial caliber from angiograms, and cerebral metabolic rate of oxygen (CMRO2) were measured before and after the experimental SAH to determine responses to hypercapnia and induced hypertension. The effect of the calcium antagonist, Nimodipine, on CBF autoregulation pre- and post-SAH was tested. 2. One week after the blood injections were started there was about 10-20% reduction, depending on territory measured, in the arterial diameter of the carotid and vertebral systems. This was associated with an 18% reduction in CBF and 9% decrease in the brain metabolism. 3. During hypercapnia before and after experimental SAH the flow increased with a mean of 3.7 and 1.8 ml, respectively, for each mm Hg elevation of PaCO2. In control animals, graded angiotensin-induced hypertension did not overtly affect CBF. Following SAH, the CBF autoregulation was impaired in 5 of 6 animals tested. 4. I.v. infusion of Nimodipine markedly curtailed the CBF autoregulation in pre-SAH animals and, to a somewhat slighter extent, also in post-SAH animals.

Animals↗

PubMed1983

The vertical position of the patella.

A new radiographic method for estimation of the vertical position of the patella in extension is presented. The vertical position of the patella determined by this method and the length of the ligament, patella and its surface were all found to be related to body-height. The vertical position of the patella may thus be expressed as its ratio to body-height: the vertical index of the patella.

Adolescent↗

PubMed1983

Migration of the tibial component in successful unicompartmental knee arthroplasty. A clinical, radiographic and roentgen stereophotogrammetric study.

Migration of the tibial component in unicompartmental Marmor knee arthroplasty was measured by conventional radiography and roentgen stereophotogrammetry during a 2-year follow-up of six patients operated on for femoro-tibial arthrosis. The clinical course was satisfactory for all six patients. A radiolucent zone developed in all cases, the width of which was greater than 2 mm in one case. By radiography movements of two of the six prosthetic components could be detected. Roentgen stereophotogrammetry showed significant rotational and translatory movements in all six tibial components. In four cases these movements were small not exceeding 1 mm for translation and 1.5 degrees for rotation. The remaining two components showed larger migrations with maximum values of 2.7 mm for translation and 12.6 degrees for rotation. Five of the components tilted backwards about the transverse axis, four tilted away from the centre of the knee about the sagittal axis, and four rotated with the anterior part away from the centre of the knee about the vertical axis. The small movements of the four tibial components may be due to a semi-rigid fixation by connective tissue in the bone-cement interface. Since all knees were asymptomatic, neither the zones nor the minor movements seemed to have any clinical significance within the follow-up period.

Aged↗

PubMed1983

Internal fixation of supracondylar and bicondylar femoral fractures using a new semielastic device.

Previous reports of failures following surgery of distal femoral fractures prompted the development of a semielastic internal fixation device suitable for the mechanically weak bone of the elderly. The fixation device consists of intramedullary elastic Ender-type nails connected to cancellous screws at each condyle by a special coupling piece. Thus, the intercondylar fracture is rigidly stabilized by screws and adjusted to the supracondylar fracture by connected elastic nails. The device is easily applied through small incisions. During a two-year period 54 fractures of the distal third of the femur were treated. Most patients were elderly and suffered from concurrent diseases or previous ipsilateral fractures. The goal was twofold: to avoid traction in bed and to start early mobilization. Fifteen undisplaced fractures were treated by plaster or cast-brace. Five fractures were treated by traction. Thirty-four displaced supracondylar and bicondylar fractures were operated on using the new fixation device. No deep infections or osteomyelitis occurred. Immediate mobilization was possible in all 34 cases, most with an external support of plaster for two weeks and a hinged cast-brace for eight weeks. Twenty-nine patients were followed up to union; results in these displaced supracondylar and bicondylar femoral fractures were excellent in 12, good in nine, fair in five, and poor in three patients. The semielastic character of the system seemed to prevent the failures observed with the use of rigid internal fixation in osteoporotic bone.

Adolescent↗

PubMed1982

Anteversion measurements in trochanteric fractures of the femur.

The anteversion of the femur was measured in trochanteric fractures operated upon with nail-plate or Ender osteosynthesis, and the results were compared with a normal material. A significant reduction in anteversion was found in the cases with Ender osteosynthesis as a possible explanation for the outward rotation of the operated limb commonly observed in these patients. No difference in anteversion was found between cases operated upon with conventional Ender technique, i.e. without anteversion of the nails, and those operated upon with a modified technique where the nails had been anteverted if considered appropriate at the operation.

Biomechanical Phenomena↗

PubMed1982

Use of a guide instrument for compartmental knee arthroplasty.

To improve the positioning of the tibial component in compartmental knee arthroplasty a guide instrument was introduced. With the guide instrument the position in the frontal plane significantly improved from a mean medial slope of 10 degrees to 2 degrees. In the sagittal plane the change from a mean posterior slope of 5 degrees to 3 degrees was insignificant. The mean value for the Hip-Knee-Ankle angle (HKA) (ideal 180 degrees) was 186 degrees after "free-hand" operation and 183 degrees with the modified operative technique. Thus, it is possible with the aid of a guide instrument to improve the precision in compartmental knee arthroplasty.

Aged↗

PubMed1982

Deformities, gonarthrosis and function after distal femoral fractures.

Sixty-two patients treated for distal femoral fractures from 1969-1976 were re-examined, after a mean follow-up period of 5 years, to study deformities, gonarthrosis and function. These fractures occur mainly in elderly persons with bone fragility due to age and disease. The deformities were analysed from precisely defined radiographic projections. An anatomical classification into supracondylar, unicondylar and bicondylar fractures, with subdivisions for undisplaced and displaced fractures was used. A special group for transcondylar fractures was included. Displaced bicondylar fractures mostly healed with varus and anterior angulation, medial unicondylar fractures with varus and lateral unicondylar fractures with valgus angulation. Most of the healed supracondylar fractures showed varus angulation. Three patients developed arthrosis in both the femoro-tibial and patellar compartments, and eleven only in the patellar area. Intercondylar or transcondylar diastasis, or difference of level in the joint surface exceeding 3 mm, caused a significant degree of gonarthrosis. Function was assessed using the Knee Disability Sheet prepared at the Hospital for Special Surgery. The necessity of radiographic examination of the patellar joint in the axial projection on admission is stressed. Accurate reduction and adequate stabilization of intra-articular fractures seem to be important for reducing the risk of gonarthrosis and later impairment of function.

Adolescent↗