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S Olerud

Publications and source records attributed to S Olerud.

16 recordsLinked to original sources

Internal fixation of fractures of the neck of the femur using von Bahr screws and allowing immediated weight bearing: a prospective clinical study.

This article presents the results of von Bahr screw fixation in 103 patients, allowing immediate weight bearing. After a follow-up period of 1 year, a failure rate of 18% was recorded. Analysis of the series shows that the failures are due to inadequate reduction of the displacement during operation, especially when the head is in varus, and to bad positions of the screw. The high failure rate was not related to the initial displacement of the fracture.

Adolescent

[Ender nailing].

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Bone Nails

Ipsilateral fracture of the femur and tibia.

Thirty-two cases of simultaneous ipsilateral femoral and tibial fractures in thirty-one patients were treated by rigid internal or pin fixation of both fractures in fourteen cases, by rigid internal or pin fixation of one fracture in three, and by conservative management or non-rigid internal fixation in fifteen. Rigid internal or pin fixation of both fractures resulted in a lower incidence of complications and shorter duration of hospitalization and time to healing. An initially active surgical approach also produced considerably better functional end results: twelve of fourteen patients so treated resumed their former occupations, compared with four of thirteen patients treated conservatively.

Femoral Fractures

Arterial hypotension and hypoxaemia during total hip replacement: the importance of thromboplastic products, fat embolism and acrylic monomers.

Thirteen patients submitted to total hip replacement surgery by the Charnley technique were studied. Operations were performed under epidural analgesia with the patients awake and breathing air. During the surgical procedure, the magnitude of tissue-thromboplastic activity, the amount of fat globules, the presence of bone marrow cells and the concentrations of acrylic monomers were determined in the pulmonary arterial blood. Simultaneously, arterial blood gases and blood pressure were monitored. Marked reductions of the arterial blood pressure and arterial oxygen tension occurred after impaction of the femoral prosthesis, and minor depressions appeared after insertion of the acetabular prosthesis. A significant correlation was found between the release of tissue-thromboplastic products into the pulmonary circulation, i.e., products that initiate intravascular coagulation and the circulatory and respiratory reactions. The pulmonary fat droplets, per se, seem to be of minor importance, and the release of acrylic monomers is probably of no importance for these reactions.

Acrylates

Percutaneous pin fixation of open tibial fractures. Double-frame anchorage using the Vidal-Adrey method.

From 1970 to 1973, twenty-eight severe open tibial fractures in twenty-seven patients were treated with stable external transfixation by the Vidal-Adrey double-frame method. Excluding one patient who had an amputation because of vascular damage at the time of injury, wound healing was satisfactory in all patients with no primary soft-tissue or deep infection. There was one late infection following secondary intramedullary nailing three months after injury. Secondary skin and bone grafts were part of the original plan of treatment and were easily performed. All patients were able to start range-of-motion exercises in the early postoperative period. In the case of a severely comminuted tibial fracture combined with arterial injury, this method made it possible to observe the limb for a few days before amputation for vascular insufficiency. The average time in the frame was 4.9 months, and then a patellar-tendon bearing plaster case or splint was used. The mean time until full weight-bearing without external support was 7.9 months. In the twenty-two patients who could be assessed, the final result was excellent or good in seventeen and acceptable in five.

Adolescent

Cavus deformity of the foot after fracture of the tibial shaft.

Twenty-three cases of claw foot with limited talocrural and subtalar mobility were the result of muscle contracture of the leg after tibial-shaft fracture. A roentgenographic study including arteriography was performed. It was concluded that the typical short cavus foot is due to fibrous contracture of the muscles in the deep posterior compartment caused by vascular damage, swelling in the deep posterior compartment, or severe muscle laceration. On physical examination the distance between the lateral malleolus and the Achilles tendon was shortened in comparison with the sound side in all cases. This was found to be caused by dorsiflexion in the talocrural joint coincident with adduction in the mid-tarsal joint. The angulation of the foot forced the patients to rotate the leg outward in order to get the feet in parallel position for walking. This deformity could be misinterpreted as an inward malrotation of the tibial fracture. In severe cases a derotating three-dimensional wedge osteotomy of the distal part of the tibia was performed with promising results.

Adolescent

Treatment of pertrochanteric and subtrochanteric fractures of the femur by the Ender method.

The Ender method consists of insertion of round, flexible, condylocephalic intramedullary nails. In 104 patients with a median age of 77 years and 80% older than 70 years, the morbidity was high (owing to concomitant diseases in 73%). Follow-up examination of survivals showed good functional results. There was some tendency to shortening, more than 2 cm in 15% of the patients. External rotation deformity of more than 20 degrees was observed in 15% of patients. Towards the end of the series when precautionary measures were taken to avoid this, the number of patients with such deformity decreased. The advantages of the Ender method are: a short operation time, minor operative trauma and early mobilization and weight-bearing. Because of some rotational instability the method should be reserved for patients older than 65--70 years.

Adult