[Decreasing number of skiing accidents in the Swedish mountains].
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Humans↗
Biomedical subjects
O Engkvist
Publications and source records attributed to O Engkvist.
Ultrasonography for the diagnosis of soft tissue conditions in the hand.
Six months' experience of ultrasonographic diagnosis of the hand has proved it to be a valuable method for diagnosis of ganglions, tendon ruptures, synovitis, tumours, and the presence of foreign bodies. We are exploring ways of increasing its scope, in the light of the technical innovations that are being made.
Adult↗
Osteoid osteomas of the hand. Report of three cases and review of the literature.
Osteoid osteoma is infrequently localized to the hand. Initially the lesion causes unspecific symptoms, and the radiographic changes are discrete. Three cases were seen during a period of 5 years. Bone scintigraphy was a useful diagnostic tool, and CT facilitated the identification of the nidus. One of the lesions was a double nidus osteoid osteoma of the scaphoid bone. Only 12 instances of multifocal osteoid osteomas have been reported, none of which was localized to the carpal bones.
Adolescent↗
Arthrodesis of the first carpometacarpal joint. 33 cases of arthrosis.
Thirty-three arthrodeses were performed for arthrosis of the first carpometacarpal joint in 29 patients. The patients were reexamined 5 (2-10) years after the operation. Twenty arthrodeses were clinically satisfactory, although two had failed to unite. Analysis of this group showed that a painless stiff carpometacarpal joint causes some functional impairment, considered negligible by most patients. The remaining 13 cases were unsatisfactory due to pain caused by arthrosis in the peritrapezoidal joints (7 cases), nonunion (4), radial nerve neuroma (1), and unknown reason (1).
Adult↗
Perichondrial arthroplasty using fibrin glue and early mobilization. An experimental study.
An experimental study was performed in rabbits to find out whether fibrin glue, used to simplify the procedure for graft fixation in perichondrial arthroplasty, would also allow earlier mobilization of the grafted joint, thereby reducing the risk for postoperative stiffness of the joint. The results indicate the possibility of reducing the time used for postoperative fixation from three weeks originally to one week, and still achieve the same results regarding graft healing and cartilage regeneration. Immediate post-operative mobilization caused loosening of the graft and endangered the results.
Animals↗
Closed dislocation of the scaphoid. A case report and review of the literature.
A case of traumatic dislocation of the scaphoid bone treated by open reduction is reported. The bone remained vital, being nourished by a slender connection to the surrounding tissue. Experience from the few cases reported in the literature shows that closed reduction is often successful. If surgery is necessary it seems that it should be limited to simple reduction of the dislocation and that there is no need for primary arthrodesis or arthroplasty. Stable fixation is necessary to avoid re-dislocation and later wrist instability.
Aged↗
The effect of regional intravenous guanethidine block in acute frostbite. Case report.
In the present report of a cold injury both feet showed symmetrical lesions. One foot was treated with medical sympathectomy by repeated regional intravenous guanethidine blocks, while the other foot served as control. No difference between the feet was observed with regard to pain, demarcating, healing or eventual loss of tissue.
Adult↗
Effects of regional intravenous guanethidine block in posttraumatic cold intolerance in hand amputees.
In twenty-four patients with intolerance to cold after partial or complete finger amputations, lower skin temperature together with cold and vibration allodynia (allodynia = pain due to a non-noxious stimulus to neural skin) were found in the cold intolerant area compared with the corresponding area in the uninjured hand. When treated with regional intravenous guanethidine block nine patients became free from symptoms for up to twelve weeks, which is longer than would be expected from the duration of the known pharmacological effects of guanethidine. The patients had several features in common with reflex sympathetic dystrophies, and we suggest that neurogenic rather than vascular disturbances are mainly involved in the post-traumatic cold intolerance syndrome.
Adult↗
Corrective osteotomy of malunited fractures of the distal end of the radius.
Thirty-nine patients with painful impaired forearm rotation and reduced grip strength after malunited fracture of the distal radius were treated with corrective osteotomy of the distal radius, bone grafting and internal fixation and followed for an average of 1.5 years. All patients stated that they were improved by the procedure. At follow-up 36 patients were graded as excellent or good, implying no pain, moderate limitation of motion and grip strength not less than 70% of the uninjured hand. Two patients were graded as fair and one as poor. It is concluded that surgical correction of the deformity is a good procedure when treating disabilities in the distal radio ulnar joint following malunited fractures of the distal end of the radius.
Adult↗
Nerve repair using a polyglactin tube and nerve graft: an experimental study in the rabbit.
Defects in a sectioned tibial nerve were bridged by a new method using a polyglactin mesh-tube and compared with conventional nerve grafting in the rabbit. The capability of healing was evaluated by morphometrical observations and repeated EMG-recordings. Only minor differences between the two different techniques were observed and the possible advantage of the polyglactin method is discussed.
Animals↗
Skiing injuries in children and adults: a comparative study from an 8-year period.
The investigation is a retrospective analysis of 2756 skiing injuries from two centers in a Swedish skiing area during the years 1972 to, and including, 1979. The relative frequency of lower extremity injuries successively diminished, while a corresponding increase of upper extremity injuries was found. The relative frequency of ankle and foot injuries declined, while the frequency of knee injuries did not change, knee injuries still being the most common skiing injury. The relative frequency of fractures of the lower leg showed a statistically significant decrease, but, in children, constituted 16% of all injuries at the end of the investigation period. Further studies, with special regard to the children's prerequisites, seem to be necessary to define the desired characteristics of an optimally functioning safety binding for children.
Adolescent↗
A free vascularized fibular graft in lengthening of the humerus with the Wagner apparatus. Report of a case in a twenty-year old man.
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Adult↗
Rupture of the extensor pollicis longus tendon after fracture of the lower end of the radius--a clinical and microangiographic study.
The pathogenesis of the late post-traumatic rupture of the extensor pollicis longus tendon has never been satisfactorily explained. In the present series of fifty-nine ruptures two were partial, making possible an exact localization of the rupture. Microangiographic studies performed on amputated arms showed that this part of the tendon was poorly vascularized. Our study confirms earlier observations that ruptures most commonly occur after undisplaced fractures. It is suggested that increased pressure within the non-ruptured tendon sheath jeopardizes the blood flow in the already poorly vascularized parts of the tendon, leading to degeneration and rupture, usually within eight weeks. An haematoma inside the sheath interfering with the production of synovial fluid, could deprive the tendon of an alternative nutrition via diffusional pathways.
Adolescent↗
Perichondrial wrist arthroplasty in rheumatoid patients.
A new method is proposed for reconstruction of the wrist joint in rheumatoid arthritis. Perichondrial arthroplasty done in four patients with severe deformity of the wrist from rheumatoid arthritis gave functionally improved results. In one case biopsy of the reconstructed joint showed newly formed cartilaginous tissue four months after initial surgery.
Arthritis, Rheumatoid↗
Radiography in joint reconstruction with perichondrial grafts.
The radiographic findings in 13 joints successfully reconstructed with free perichondrial grafts from the rib are reported. Radiography was performed during a period of 13 to 40 months postoperatively. Definite cortical demarcation occurred after 8 to 11 months and had increased 11 to 16 months following surgery. In 3 cases the final examination of 2 metacarpophalangeal joints and one proximal interphalangeal joint was completed with arthrography which demonstrated that the articular surfaces appeared even although the cortical bone contours were somewhat irregular. The extent of the joint spaces largely resembled that in healthy controls.
Adult↗
Reconstruction of articular cartilage with free autologous perichondrial grafts. An experimental study in rabbits.
An experimental study in adult rabbits has been performed to find out whether the cartilage forming capacity of the perichondrium could be utilized in reconstruction of articular cartilage. The normal articular cartilage of the glenoid surface of the humero-scapular joint was completely removed. Auricular perichondrium was grafted to cover the exposed bony surface with the active chondrogenic layer of the perichondrial graft facing the joint cavity. The joint was not immobilized but the operated limb was amputated at wrist level to avoid weight bearing. The animals were sacrificed at different time intervals ranging from 1 to 17 weeks. In 12 out of 14 grafted rabbits regeneration of cartilage occurred. In 6 of 10 control cases where no perichondrium was grafted to cover the resected surface no cartilage was found. In the other 4, only small areas of mature cartilage were seen, probably remnants of the original articular cartilage.
Amputation, Surgical↗
The cartilaginous potential of the perichondrium in rabbit ear and rib. A comparative study in vivo and in vitro.
In an experimental study the cartilaginous protential of the rabbit ear perichondrium has been compared with that of the rib in vivo and in vitro. Perichondrium was transferred as free autologous grafts to the subcutaneous tissue on the scalp and as loose bodies into the knee joint. The presence of cartilage in the grafts was examined after six weeks. In vitro explants of rabbit perichondrium from the ear and the rib were maintained in an organ culture system. The presence of cartilage was analyzed after one to three weeks. Rabbit perichondrium from the rib appeared to have a greater cartilaginous potential than that from the ear both in vivo and in vitro. Chondrogenesis in perichondrium was demonstrated in vitro.
Animals↗
Reconstruction of patellar articular cartilage with free autologous perichondrial grafts. An experimental study in dogs.
The cartilaginous potential of the perichondrium has earlier been utilized to reconstruct articular cartilage in unloaded joints in adult rabbits. The present work in adult dogs has been performed to find out if the perichondrium can be used for the same purpose in joints subjected to pressure. In 13 knee joints the articular cartilage of the patella was excised completely and the resected surface was covered with an autologous perichondrial graft taken from the rib cartilage. After 3 weeks of immobilization the dogs were allowed to run freely until sacrifice 2 to 17 months later. In all 13 cases regeneration of cartilage took place. Within 8 months the regenerated cartilage showed no or only very slight degenerative signs but from 12 months and later such changes were common. In control cases where the resected surface was left without any graft no cartilage at all was found. Conclusively cartilage formation from grafted rib perichondrium is achieved in the knee joints of adult dogs, but it does not resist considerable pressure forces.
Animals↗