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Biomedical subjects

O Kiviluoto

Publications and source records attributed to O Kiviluoto.

16 recordsLinked to original sources
PubMed1979

External fixation of unstable pelvic fractures.

The Hoffmann external fixator was used to stabilize unstable pelvic fractures in 56 patients with multiple injuries. It was applied under general anaesthesia and the dislocated pelvis reduced and secured with a single tie bar. In 16 cases residual dislocation of less than 1.5 cm was noted after the reduction and the reduced position was maintained in 48 out of 51 cases, a minor redislocation occurred in the remaining 3 patients. Few complications could be attributed to the method, infection was noted in one patient, the iliac crest was fractured in one case and an exostosis of the iliac crest occurred in one youth. Forty-three patients were symptom free with regard to the pelvis at the time of review whereas 5 patients had residual pain and 3 diffuse symptoms. The technique of application is simple but requires two surgeons at the time of reduction and fixation of the pelvis.

Adolescent↗
PubMed1979

Operative control of massive haemorrhage in comminuted pelvic fractures.

In 42 patients, massive haemorrhage following comminuted pelvic fractures was treated by operation through a mid-line, Pfannenstiel, anterior iliac crest-femoral or posterolateral approach, or using these in combination. The superior and inferior gluteal, pudendal and obturator arteries were the usual source of bleeding. Bleeding from the pelvic bone tissue was of minor importance. Temporary compression of the abdominal aorta was sometimes required to help control bleeding before ligation of injured vessels could be accomplished. An average of nine units of blood was given to each patient before operation and 30 units during or after the procedure. Of the 12 deaths, only three were attributable to bleeding from the pelvic fractures, indicating the value of operation in the treatment of massive haemorrhage from such injuries.

Adolescent↗
PubMed1979

Fractures of the calcaneum.

Sixty-seven patients with 86 fractures of the calcaneum were re-examined 2 to 6 years after their injury. These fractures of the calcaneum were of two types: thalamic, involving the posterior subtalar joint (85%); and nonthalamic, confined to the extra-articular area (15%). Treatment had been by functional therapy, plaster fixation, pin reduction, or open reduction. At followup, only 28 of the 86 heels were entirely painless. Pain was most common posterolaterally along the peroneal tendons; reduction of the tuber (Böhler) angle correlated significantly (p less than 0.001) with an abutment of the peroneal tendons. Motion in the subtalar joint was restricted in two thirds of the series, and in the talocrural joint in one third; a reduction of the tuber angle correlated significantly (p less than 0.001) with reduced mobility of these joints. The duration of sick leave was significantly (p less than 0.05) shorter after functional treatment of displaced thalamic fractures than after treatment with pin reduction and immobilization in plaster. Results were the same with both modes of treatment. The results of treatment of nonthalamic fractures were rewarding, whereas a common consequence of thalamic fractures was considerable impairment of ankle function. The significant correlation between a depressed tuber angle and unsatisfactory functional results suggests that closer attention should be paid to the accurate alignment of the posterior subtalar joint in the treatment of thalamic fractures of the calcaneum.

Adolescent↗
PubMed1978

Fractures of the olecranon. Analysis of 37 consecutive cases.

This study is based on 37 consecutive cases of fracture of the olecranon, treated during the period 1973-1975. The average follow-up time was 2 years. The treatment was operative in all but two of the cases. Superficial post-operative infection occurred in three cases and in three cases the internal fixation failed due to porotic bone. The transverse fractures healed more satisfactorily than the comminuted ones. A short post-operative immobilization of 3 weeks or less gave the best results (P less than 0.05). In the comparison of methods cerclage combined with two Kirschner wires gave better results than cerclage alone.

Adolescent↗
PubMed1978

Early complications of primary shoulder dislocations.

A prospective study of the complications of primary shoulder dislocation was carried out for the 3-year period 1973-1976. The clinical examination was made initially in the Casualty Department and the patient was re-examined in the Department of Physical Medicine. In the evaluation special attention was given to the condition of the rotator cuff, the blood vessels and the motor and sensory function of the affected extremity. Sixty-three out of 238 patients (26 per cent) presented with the following complications: 29 lesions of the brachial plexus, 21 of the axillary nerve and 28 ruptures of the rotator cuff tendon. Complications occurred more frequently in the age group over 50 years (P less than 0.001) and in manual labourers compared with office workers (P less than 0.05). If the humerus remained unreduced for more than 12 hours, the frequency of complications increased (P less than 0.01).

Adolescent↗
PubMed1978

Ectopic ossification after hip arthroplasty.

The incidence of radiographically visible ectopic ossification around the hip joint was redorded in 145 hip joints of 132 patients treated by endoprosthetic replacement. There were 56 total hip replacements with a McKee-Farrar and 39 with a Brunswik type of endoprosthesis; in a further 50 hips the femoral head was replaced with a Moore or Thompson prosthesis. An identical antero-lateral surgical approach was used in all, without detachment of the greater torchanter. The patients were re-examined 3, 6, and12 months after the operation. The extent of ectopic ossification was graded from 0 to III and correlated with pain and with the function and mobility of the operated hip. Ectopic ossification of varied extent was recorded in 37 % after total hip replacement and in 38 % after replacement of the femoral head. Of these ossifications 95 % were recognizable within 3 months; they did not increase in size, but often in density during the following months. One case of bony ankylosis was noted. Ectopic ossification of slight (grade I) to moderate (grade II) degree did not cause pain or affect the function of the operated hip, but reduced the mobility of the affected hip. The difference in mobility between grade I and grade II was significant (p less than 0.05), and between grade 0 and grade II highly significant (p less than 0.001).

Aged↗
PubMed1977

Primary operative fixation of long bone fractures in patients with multiple injuries.

Early mobilization is essential for patients with multiple long bone fractures associated with other injuries in order to avoid complications. Therefore, in 1969 we adopted a policy of rigid internal fixation of long bone fractures in such cases. To assess the results of this active treatment a number of consecutive patients were followed. The following conditions were necessary for the case to be included in this series: multiple injuries; treatment at the intensive care unit; and at least two long-bone fractures treated with internal fixation. During the period from 1969 to 1974 47 patients met all requirements. With primary operative fixation of long bone fractures of patients with multiple injuries it was possible to mobilize on crutches 29 patients out of 47 within 2 1/2 months of the accident, and 32 were allowed to leave the hospital within 3 months. With the exception of the death of an 80-year-old woman, no severe complications attributed to the operative treatment of these fractures occurred and 32 out of 47 patients returned to work within 16 months. The results in these 47 cases show that in patients with multiple injuries associated with several long bone fractures, primary internal fixation is preferable to the more conventional conservative methods.

Absenteeism↗
PubMed1977

Subcapital fractures of the femur treated with two thin Smith-Petersen nails.

The results of treatment of 71 patients with subcapital fractures of the femur, fixed with two thin Smith-Petersen nails, are presented, after a follow-up time of between 2 and 4 years. Excellent results of treatment were achieved in 39 out of 60 cases and good results in 11 cases. Six cases of ischemic necrosis of the femoral head were recorded, and there were four cases with pseudarthrosis of the femoral neck, one developed because of postoperative infection and three were attributed to an imperfect operative technique. The method is recommended for subcaptial femoral neck fractures amenable to closed reduction and internal fixation. Pseudarthrosis may be prevented by good reduction of the fracture and a careful nailing technique.

Adolescent↗
PubMed1977

Rubber band ligation of haemorrhoids. Analysis of 281 patients.

The problems and discomfort resulting from haemorrhoidectomy have led to the development of other forms of therapy. Rubber band ligation has become a popular method of treatment for internal piles. The results are comparable with those achieved by excisional surgery. The material consists of 281 consecutive patients with internal haemorrhoids treated with rubber band ligation. The average follow-up was 12 months. 239 of the 262 patients re-examined were entirely free of discomfort (91%). In all the eight cases with mucosal prolapse the ligation was not successful. In these as well as in patients with rubber allergy, other forms of treatment are suggested.

Adult↗
PubMed1976

Pertrochanteric fractures of the femur treated with a Küntscher trochanter nail.

Thirty-nine patients with pertrochanteric fractures were treated with the Küntscher trochanter nail. Six were males and 33 females. Their mean age was 76 years. Excellent or good results of treatment were recorded in 25 cases, and good union of the fracture was noted in 19 patients within 4 months and in 15 cases as early as 2 months after the operation. The primary mortality rate was of the same order as with other methods of nailing, 15% in this series. The operation is easy and short, and is suitable at least for stable pertrochanteric fractures of elderly patients.

Aged↗