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Biomedical subjects

S Eiskjaer

Publications and source records attributed to S Eiskjaer.

15 recordsLinked to original sources
PubMed1993

Survivorship analysis of hemiarthroplasties.

From 1976 until 1988, 679 hemiarthroplasties were inserted for displaced femoral neck fractures. Two hundred two were of the Austin Moore design (one-piece, noncemented), 209 of the Christiansen design (trunion bearing, cemented), and 268 of the Hastings design (bipolar, cemented). Five years after the hemiarthroplasty, the cumulative proportion of prostheses surviving was 90%, declining to 85% after ten years. A survivorship analysis indicated that the cemented bipolar Hastings prosthesis and old age (75 years or older) were two variables associated with significantly less failures. The survivorship analysis did not indicate that the group differences were influenced by improvements in surgical techniques over time. Gender and social setting had no influence on the survival of prostheses. Cemented bipolar hemiarthroplasty should be considered as an alternative in the internal fixation of displaced femoral neck fractures in the elderly.

Age Factors↗
PubMed1992

Years of potential life lost after hip fracture among postmenopausal women.

From January 1987 and onwards all cases of hip fracture in Arhus County, Denmark, were registered in a prospective multicenter investigation. Until December 1990, 2273 postmenopausal women (greater than 50 years) with first hip fractures were registered. Of these 643 sustained a hip fracture in 1988. Life tables were constructed for different age groups; the excess mortality (in comparison with the reference population) for each age group ranged from 10 to 20 percent. The years of potential life lost (YPLL) (life expectancy method) were calculated for the 1988 cohort and compared with the YPLL due to other selected conditions calculated from official vital statistics. The YPLL rates (per 1000 persons) were as follows: hip fracture 9.2, ischemic heart disease 73, cerebrovascular disease 29, breast cancer 20 and cancer of the uterus 6.7. We propose that hip fracture mortality data should be continuously registered and evaluated using the YPLL method to detect changes caused by the expected increase in the number of hip fractures.

Aged↗
PubMed1991

Biological tolerance of Logiparin, a low molecular weight heparin used in patients undergoing total hip replacement.

Two hundred ten patients scheduled for THR were randomized into two groups. Group A (105 patients) received Logiparin (Novo-Nordisk, Denmark) 50 mg/kg body weight once daily, and group B (105 patients) received placebo once daily. Injections started 2 hr preoperatively and continued for 7 days. Blood samples were collected preoperatively before medication and 3 hr after last injection on the seventh postoperative day. Two hundred three patients completed the study: 103 in group A, 100 in group B. In group A there was a significantly higher increase in ASAT (p = 0.0006) and APH (p = 0.0137) compared with group B. Significantly more patients in group A showed an increase from normal preoperative values to pathological postoperative values in ASAT (p = 0.0012) and APH (p = 0.025) compared with group B. All changes were found to be reversible within 2 weeks of termination of drug treatment. Although no conclusion about the mechanism leading to the increase in ASAT and APH is possible from this data, there is very good suggestive evidence that the liver is influenced by this agent.

Double-Blind Method↗
PubMed1991

Risk factors influencing mortality after bipolar hemiarthroplasty in the treatment of fracture of the femoral neck.

The hospital records of 204 patients (mean age 80 years, range 54-96 years) with a displaced intracapsular femoral neck fracture treated by cemented bipolar hemiarthroplasty were examined to record all available data on factors suspected of influencing mortality. The data were analyzed statistically using survival analysis (Cox model). The six months mortality rate was 20% and the one year mortality rate was 28%. The following factors, in order to decreasing importance, had significant influence on mortality: cardiac factors other than previous myocardial infarction; status as a nursing home patient; chronic pulmonary disease; serum creatinine level greater than 1.7 mg/100 ml; pneumonia; previous myocardial infarction; duration of surgery; and gender. The following factors had no significant influence on mortality: age, time delay from admission to surgery, mode of anesthesia, and cerebrovascular diseases. In conclusion, medical conditions were the most important determinants of survival in the present study. The time delay between admission and surgery did not influence the chances of survival. This does not mean that surgical delay beyond that essential for stabilizing the patient is not problematic, but indicates that ample time should be spent on assessment and resuscitation before surgery.

Aged↗
PubMed1990

Locked nailing of comminuted and unstable fractures of the femur.

Forty comminuted or unstable fractures of the femoral shaft were treated by closed intramedullary reaming and locked nailing. Twenty-four fractures were severely comminuted, and the other 16, in the distal or proximal third of the shaft, were classified as unstable. At 12 to 30 months postoperatively all the fractures had healed. Three patients had lateral rotation deformity of 5 degrees to 10 degrees, three had shortening of 1 to 2 cm and two had lengthening of about 1 cm. There were no infections or delayed unions. Closed intramedullary locked nailing can provide stability in fractures of the femoral shaft, irrespective of the degree of comminution and the site of injury.

Adolescent↗
PubMed1989

Component motion in bipolar cemented hemiarthroplasty.

A total of 17 patients with a cemented bipolar Hastings hemiarthroplasty were examined clinically and radiologically between 1 and 3 years after being treated for a displaced femoral neck fracture. Only a minor part of the motion in the Hastings prostheses took place between the metal femoral head and the polyethylene liner (intraprosthetic). In seven cases, no "true" intraprosthetic motion weightbearing was observed (including five cases with intraprosthetic motion caused by impingement). The relative amount of intraprosthetic motion did not decrease with weightbearing. The functional result was not correlated to the relative amount of intraprosthetic motion with weightbearing. In conclusion, the short-term success of the bipolar prostheses is probably not accomplished by a reduction in extraprosthetic motion caused by the biarticular design but by other factors, including the optimal indications for hemiarthroplasty (high age, low activity level), the consistent use of acrylic bone cement, and the shock-absorbing effect of the polyethylene liner.

Aged↗
PubMed1989

Alternatives in the treatment of ipsilateral fractures of the hip and femur.

Eight cases of ipsilateral femoral neck and shaft fractures were reviewed. The diagnosis of the femoral neck fracture was delayed in two cases. Seven of the femoral shaft fractures were comminuted. In six cases, both fractures were treated with rigid internal fixation. A combination of traction and internal fixation was used in two cases. Two cases of avascular necrosis of the femoral head were observed. The fracture reduction was insufficient in both cases and the diagnosis of femoral neck fracture was delayed in one case. A radiograph of the pelvis is mandatory in high-velocity trauma victims. Ipsilateral fractures of the femoral neck and shaft should be stabilized by internal fixation as early as possible. Intramedullary locked nailing seems to be an attractive alternative in the treatment of the comminuted femoral shaft fracture.

Accidental Falls↗
PubMed1989

Fractures of the femoral neck treated with cemented bipolar hemiarthroplasty.

Seven of 59 (12%) bipolar hemiarthroplasties for displaced femoral neck fracture were classified as failures at the 3-year follow-up examination. Two prostheses dislocated, 4 had loose femoral stems, and 1 was revised to a total hip arthroplasty because of pain. No patients developed acetabular erosion or deep infection. Only four of 15 patients examined by fluoroscopy shared movement between outer metal/cartilage and inner metal/polyethylene surfaces. All movement occurred at the outer metal/cartilage surface in the remaining nine patients. We conclude that the low failure rate, which compares favorably with the best results after internal fixation, is caused by the optimal selection of patients for this operation (high age, low activity level) and the use of bone cement. The bipolar design is less important, since most of these prostheses function as ordinary unipolar prostheses after some time.

Aged↗
PubMed1988

The significance of hemarthrosis of the knee in children.

Diagnostic arthroscopy was performed in 40 consecutive patients under 16 years of age with hemarthrosis of the knee. The age of the patients ranged from 10 to 15 years, median 13.7 years. Eighteen patients had ruptures of the anterior cruciate ligament; seven ruptures were partial. Only two cases of fractures of the tibial spine were encountered. Seven patients had midsubstance tears of the anterior cruciate ligament. Eleven patients had patellar dislocations. Six patients had minimal capsular disruptions as the cause of hemarthrosis. Three patients had osteochondritis dissecans of the knee and two patients had isolated ruptures of the medial collateral ligament. Twenty-eight of the patients underwent some form of operative repair. The clinical diagnosis was confirmed at arthroscopy in 17 of the 40 cases. The appearance of hemarthrosis of the knee usually signifies a serious knee injury and should be treated with the same importance as in adults, and as a rule arthroscopy should be carried out.

Arthroscopy↗
PubMed1987

Arthroscopy of the knee in children.

Diagnostic arthroscopy was performed in 174 consecutive patients under the age of 18 years. Eight arthroscopies were bilateral. The clinical diagnosis was confirmed in only three of 17 knees in children under aged 14 years and in 44 per cent of the knees in older children. The most commonly disproved diagnoses were torn meniscus and chondromalacia patella. Arthroscopy seldom changed the diagnosis in cases of osteochondritis dissecans. In 38 per cent of the knees, arthroscopy revealed no surgical treatable abnormality, and unnecessary arthrotomy was avoided. Arthroscopy in acute hemarthrosis revealed that ligamentous tears are rather common in children; in nine of 25 knees a partial or complete tear of the anterior cruciate ligament was demonstrated at arthroscopy. The clinical diagnosis was confirmed in eight knees in cases of hemarthrosis. There was no significant difference between the hemarthrosis group and the remaining group as regards a disproved clinical diagnosis. We conclude that arthrotomy should always be preceded by diagnostic arthroscopy in children and adolescents if the clinical diagnosis leaves any doubt.

Acute Disease↗