Biomedical subjects

S Svenningsen

Publications and source records attributed to S Svenningsen.

At least 19 recordsLinked to original sources

PubMed2006

The epidemiology and aetiology of Perthes' disease in Norway. A nationwide study of 425 patients.

A nationwide study of Perthes' disease in Norway was undertaken over a five-year period from January 1996. There were 425 patients registered, which represents a mean annual incidence of 9.2 per 100 000 in subjects under 15 years of age, and an occurrence rate of 1:714 for the country as a whole. There were marked regional variations. The lowest incidence was found in the northern region (5.4 per 100 000 per year) and the highest in the central and western regions (10.8 and 11.3 per 100 000 per year, respectively). There was a trend towards a higher incidence in urban (9.5 per 100 000 per year) compared with rural areas (8.9 per 100 000 per year). The mean age at onset was 5.8 years (1.3 to 15.2) and the male:female ratio was 3.3:1. We compared 402 patients with a matched control group of non-affected children (n = 1 025 952) from the Norwegian Medical Birth Registry and analysed maternal data (age at delivery, parity, duration of pregnancy), birth length and weight, birth presentation, head circumference, ponderal index and the presence of congenital anomalies. Children with Perthes' disease were significantly shorter at birth and had an increased frequency of congenital anomalies. Applying Sartwell's log-normal model of incubation periods to the distribution of age at onset of Perthes' disease showed a good fit to the log-normal curve. Our findings point toward a single cause, either genetic or environmental, acting prenatally in the aetiology of Perthes' disease.

Adolescent↗

PubMed1998

[Leg length inequality and rotational deformity after traction treatment of femoral shaft fractures in children].

87 patients who experienced femoral shaft fracture at the age of two to 14 years were reviewed, on average, seven (three to 12) years after the injury occurred. Three methods of treatment had been used: Bryant skin traction, and skeletal traction using either the Weber table or the Braun frame. Patients two to three years of age at the time of injury had significantly less leg length inequality than those aged four to ten years. The reason was that in the youngest group, where which 16 out of 21 patients had been treated with skin traction, the effect of traction was less efficient and there was therefore a larger overlap of the fragments at fracture healing than in the older group, where all patients had had skeletal traction. Among ten to 14 year olds there was also less leg length inequality than among four to ten year olds. This was because of lack of growth stimulation in the oldest patients after fracture healing. The results indicate that an initial overlap of approximately 10 mm should be aimed at in patients under 11 years of age, whereas overlap should be avoided in older patients. Rotational deformity, defined as side difference in anteversion angle of 15 degrees or more, occurred in seven patients (8%), but none of them had any complaints. We conclude that traction treatment gives good results, with few complications. Over-growth remains a significant problem in children under 11 years of age.

Adolescent↗

PubMed1997

External fixation versus percutaneous pinning for unstable Colles' fracture. Equal outcome in a randomized study of 60 patients.

60 patients > 20 years of age, with comminuted distal radial fractures of type Older 3 or 4, were randomly allocated to two treatment groups: external fixation a.m. Hoffmann or percutaneous Kirschner wire pinning combined with immobilization in a plaster cast. The groups were similar in age, gender, fracture type and dislocation. All patients were immobilized for 6 weeks and the outcome was assessed after 6 months. The groups showed similar results with respect to radiographic parameters and function. All fractures healed and no difference in complication rate was observed. We conclude that most unstable distal radial fractures, classified as Older's type 3 and 4, can be treated with percutaneous pinning and a plaster cast, which is simpler and cheaper than external fixation.

Adult↗

PubMed1996

[Unstable fractures of the distal radius. External fixation or percutaneous pinning?].

The results of treatment for distal radial fractures of types Older 3 with more than 5 mm shortening and Older 4 were studied in a prospective randomized series of 41 patients with regular follow-up to six months after operation. The patients were treated with closed reduction under anaesthesia and either external fixation ad modum Hoffman or percutanous pinning and a plaster cast for six weeks. Both treatment groups achieved a clinically and radiologically good result without any significant difference. There were no infections, and except for one patient with persistent signs of mild reflex dystrophy we experienced no serious complications. Owing to simplicity and treatment costs we generally prefer treatment by pinning and plaster cast.

Adult↗

PubMed1996

[Postoperative autologous transfusion in primary hip arthroplasties].

100 patients who underwent primary, total hip arthroplasty were consecutively included in this study. Their postoperative sanguineous wound drainage was reinfused, and the purpose of the study was to evaluate if such reinfusion reduced the use of homologous blood. 100 patients who were operated immediately prior to the reinfusion group were used as a historical control group. The mean volume reinfused was 426 milliliters. The mean haemoglobin of the wound drainage was 7.3 g/100 ml. There was no statistically significant reduction in the use of homologous blood. Nor was there any reduction in the number of patients exposed to such blood. Autotransfusion of postoperative sanguineous wound drainage does not seem to be indicated as a routine procedure in primary total hip arthroplasties.

Aged↗

PubMed1995

[Idiopathic femur anteversion].

Intoeing is one of the most common reasons for referral of children to orthopaedic evaluation. The most frequent cause is increased femoral anteversion (AV). The AV-angles have traditionally been measured by radiographic methods. In recent years, ultrasonographic techniques for such measurements have been introduced. Relatively liberal indications for surgical correction of increased anteversion by derotational osteotomy have previously been practised in Norway. The indications are now much more restrictive, because several reports have documented spontaneous reduction of the AV-angles during growth. We think operative treatment should be considered if markedly increased AV-angles and serious complaints persist at age 10-12 years.

Child↗

PubMed1993

[Bacterial arthritis].

During the years 1980-89, 13 patients were hospitalized because of bacterial arthritis of the peripheral joints. There were five juvenile patients (under 15 years of age). The remaining eight patients were adults, of whom seven were older than 50 years. The mean delay in establishing the diagnosis was four days (0-10 days). Monarthritis was found in 12 patients, and in one patient two joints were involved. The most commonly affected joints were the shoulder (four cases), knee (four cases), ankle (three cases), hip (two cases) and toe (one case). A predisposing condition was found in five patients, and three cases suffered from reduced mobility of the joint at follow-up. Staphylococcus aureus was the most common etiologic agent.

Adolescent↗

PubMed1991

Leg-length discrepancy measured by ultrasonography.

Leg-length discrepancy was determined by real-time ultrasonography (ultrasound) in 45 patients, and the measurements were compared with those of erect-posture radiography. A special device for holding and moving the ultrasound transducer was constructed, and the leg length was measured as the highest level of the femoral head in the standing position. The correlation coefficient r between ultrasound and radiography was 0.94, the mean difference was -1.9 mm, and the limits of agreement (mean +/- 2 SD) were -9.1 to 5.3 mm. The mean difference between examiners 1 and 2 was 1.7 mm, and the 95 percent confidence interval was +/- 7 mm. We conclude that leg-length discrepancy can be reliably determined by ultrasound, although the accuracy is less than that obtained by radiographic methods. Because ultrasound is not limited by radiation hazards, our technique can be used for clinical screening.

Adolescent↗

PubMed1990

Effects of medullary reaming on fracture healing. Tibial osteotomies in rabbits.

Unilateral, midshaft tibial osteotomy was made in 16 rabbits. Reaming of the medullary canal was performed in half the animals, while the other half were operated on without reaming. Intramedullary fixation was accomplished with multiple Kirschner pins in both groups. Bone healing occurred with abundant peripheral callus in both groups. Mechanical testing after 6 weeks revealed higher strength of the osteotomized bones where reaming had not been performed compared with bones with reaming. We conclude that bone healing is delayed by medullary reaming, whereas the pattern of healing is similar in bones with and without reaming.

Animals↗

PubMed1990

Osteotomy for femoral anteversion. A prospective 9-year study of 52 children.

Fifty-two children with increased femoral anteversion had bilateral derotational subtrochanteric osteotomies at a mean age of 7 years. They were followed prospectively until at least 15 years of age; the mean observation time was 9 years. They were a subset of 95 children whose 2-year results were reported in 1989. The mean increase of femoral anteversion after the osteotomy was 6 degrees (0.7 degrees per year) and of the neck-shaft angle 5 degrees. The CE angle did not increase. Although we at present practice a more restrictive attitude towards operation of increased femoral anteversion, our study showed that a derotational osteotomy is effective in eliminating the intoeing gait and associated complaints, and the hip angles change only moderately during the remaining period of growth.

Adolescent↗

PubMed1990

Femoral anteversion in adolescents and adults measured by ultrasound.

Femoral anteversion (AV) was determined by ultrasound in 40 adolescent and adult patients with rotational disorders of the femur, and the results were compared with AV measurements by biplanar roentgenography. With the patients supine, their knees flexed 90 degrees, and their lower legs strapped in the vertical position, one scan only of the proximal femur was needed to measure the anteversion by ultrasound. The transducer was tilted until the desired measuring line appeared horizontal on the monitor screen. The angle of tilt of the transducer, which represented the AV angle, was measured with an attached clinometer. The correlation between ultrasound and roentgenographic AV angles was high, indicating that reliable results were obtained by ultrasound. The preferred reference line was the head-trochanter tangent, which is recommended for clinical use. Consistently greater AV values were measured by ultrasound than by roentgenography. Thus, 10 degrees should be subtracted from the ultrasound values in order to obtain the real AV angles. One of the benefits of ultrasound is the elimination of radiation hazards to the patients. Ultrasound is recommended as a screening technique for patients with rotational disorders of the femur.

Adolescent↗

PubMed1990

Pelvic inclination and spatial orientation of the acetabulum. A radiographic, computed tomographic and clinical investigation.

In a study of 40 young adults the pelvic inclination measured by a specially constructed inclinometer was found to be the same in the supine and standing positions when related to the horizontal and frontal planes, respectively. Consequently supine CT measurements of the hip are also representative of corresponding standing angles. The variations of the acetabular anterversion and the sector angles on CT of the hips in 5 adult corpses were measured by angulating the gantry in increments of 5 degrees to +/- 20 degrees. An approximate linear relationship was found for all parameters, the acetabular anteversion varied 0.5 degree with 1 degree pelvic rotation, and the sector angles 0.7 degree. A theoretic mathematical model for the variation of the acetabular anteversion outside the measured range employing a sine curve is introduced.

Acetabulum↗

PubMed1990

Hip rotation and in-toeing gait. A study of normal subjects from four years until adult age.

In a selected population, from four years old up to adult age, the function of 1522 hips of 761 apparently normal subjects of both genders were studied to define: (1) the lower and upper limits of normal hip rotation; and (2) the frequency of in-toeing gait related to age and gender. Internal and external rotation were measured with the subject lying prone with flexed knees. Presence of in-toeing gait was noted. A significant reduction of internal rotation with age was found in both females and males. In all age groups, females had significantly higher range of internal rotation than males. External rotation did not show the same age and gender dependency. Sixteen percent of all subjects had an in-toeing gait. The frequency decreased from 30% in the four-year-old group to 4% in adults. The subjects with in-toeing had a significantly increased internal rotation and decreased external rotation.

Adolescent↗

PubMed1989

Regression of femoral anteversion. A prospective study of intoeing children.

To study the spontaneous regression of femoral anteversion, 30 children referred to the outpatient clinic for intoeing were followed until at least 15 years of age. The mean observation time was 9 (7-12) years, and all the children were examined three times during the growth period. The mean radiographic angle at the first examination was 42 degrees, at the second examination 36 degrees, and at the last examination 28 degrees. The mean decrease of the AV angle per year was 1.5 degrees, with a considerable range (0.2-3.1 degrees). The mean internal rotation of the hip decreased from 74 degrees to 53 degrees during the observation period, and the external rotation increased from 19 degrees to 37 degrees. While all 30 children had an intoeing gait at the first examination, this disappeared in all but 5 children.

Bone Diseases, Developmental↗

PubMed1989

Osteotomy for femoral anteversion. Complications in 95 children.

Totally, 95 children with increased femoral anteversion had derotational substrochanteric osteotomy with plate fixation. The mean anteversion angle was reduced from 48 degrees to 4 degrees, internal hip rotation from 81 degrees to 42 degrees, and external rotation increased from 9 degrees to 48 degrees. All the osteotomies healed, but serious complications occurred in 13 of the 95 patients. Because of the risk for complications and the trend towards spontaneous regression of femoral anteversion with age, we recommend a much more conservative attitude with regard to operative treatment.

Adolescent↗

PubMed1989

Advancement of the tibial tuberosity for patellar pain. A 5-year follow-up.

During the period 1978-1984, 38 patients aged 23-55 years were treated for patellofemoral pain by the Maquet procedure. The mean postoperative observation time was 5(3-9) years. Thirty-three of the 38 patients were available for follow-up including functional and activity scoring, clinical examination, and Cybex II dynamometer muscle-strength measurement. Ten patients improved, 17 were unchanged, and 6 were worse. Characteristic for the improved group was Grades III and IV chondromalacia - mainly involving the lateral facet - whereas the group with no improvement or deterioration exhibited a low-grade chondromalacia, chiefly affecting the medial patellar facet.

Adult↗

PubMed1989

Hip motion related to age and sex.

In a selected population 4 years old to adult age, 1,522 hips in 761 healthy subjects of both sexes were studied. Arcs of passive motion of the hip were measured by the technique recommended by the American Academy of Orthopaedic Surgeons. The lower and upper limits of normal range of hip motion in all the planes were established for both sexes in the different age groups. We found that the amplitude of most hip motions decreased with age. Females had higher ranges of total hip motion, total rotation, internal rotation, and abduction compared with males.

Adult↗

PubMed1988

Osteopenia after plated and nailed femoral shaft fractures.

Twenty-six patients who had been operated for isolated femoral shaft fractures were studied. Fourteen had been treated with intramedullary nailing and 12 with AO plates. Only nailed patients were allowed early weight-bearing. Bone mineral density and muscle strength in knee extension and flexion were determined. There was a considerable loss of bone mineral in the distal femoral metaphysis and a moderate loss in the tibia. The mean loss was almost identical in the two groups. Muscle power in extension was better preserved in the nailed than in the plated patients. There was a significant correlation between loss of bone mineral and loss of muscle power.

Adolescent↗