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Biomedical subjects

T Barfred

Publications and source records attributed to T Barfred.

At least 19 recordsLinked to original sources
PubMed2000

Radial nerve palsy after simple fracture of the humerus.

Radial nerve palsy is a common complication of simple fracture of the humerus. The aim of this retrospective study was to assess the degree of spontaneous recovery and the need for exploration and repair of the nerve. The study included 26 patients with radial nerve palsy after simple fracture of the humerus. The male:female ratio was 3:1 and the median age was 21 years (range 9-79). Three patients had early exploration of the radial nerve in connection with osteosynthesis, and no appreciable damage to the nerve was found. Two other patients were explored later because they failed to recover. This exploration showed damage to the nerve which required further operation. Twenty-one patients were treated conservatively and all recovered well. None needed later operation. Because of the low incidence of nerve lesions we recommend an expectant policy initially.

Adolescent↗
PubMed1999

[Occupational hand injuries. A population-based description of the incidence and referral to casualty departments].

The overall incidence of self-reported occupational hand injuries in a Danish population was estimated to 4.7%, with the highest incidence among the youngest, men and employees in the production and building industries. The life-time risk were 93% for men and 73% for women. Age and gender were found to be independent risk factors for the occupational hand injuries. The proportion treated in the casualty department was 0.28, for injuries with disability and time off work the proportions were 0.46 and 0.69 respectively. No age, gender or occupation specific selection for attending the hospital was found. Prevention-trials against hand injuries should therefore have a high priority, and it is recommended that hospital data files are used increasingly in future prevention programs.

Accidents, Occupational↗
PubMed1999

Time off work after occupational hand injuries.

This study analysed the impact of several factors on the start and duration of time off work among 802 patients with occupational hand injuries, in order to identify prognostic indicators. The study showed that external factors such as work and social condition seemed to have less influence on time off work than expected, whereas advice from doctors, flashbacks and impairment symptoms were important determinants.

Attitude to Health↗
PubMed1998

[Trade-specific occurrence of occupational hand injuries].

The purpose of the investigation was to estimate the trade-specific incidence of occupational hand injuries, to estimate the trade-specific cumulative incidence proportion and to investigate whether age, gender and trade each were independent risk-indicators for occupational hand injuries. In a retrospective design, 823 patients with occupational hand injuries treated at Odense University Hospital were included in the investigation. The population at risk was 96,512 persons engaged in active employment within the municipality of Odense. The overall incidence of occupational hand injuries was estimated to 1.7 percent and 0.3 percent for significant injuries. The incidences in the production- and building industries were significantly higher than the incidence in the service industries. Gender and occupation were both found to be independent risk-indicators for occupational hand injuries, age only for the minor injuries. Occupational hand injuries seem to be so common, that prevention-trials should continuously be intensified. The target-groups should firstly be employees in the production industries, however prevention-trials directed against specific age- and gender behaviour patterns should also be considered.

Accidents, Occupational↗
PubMed1995

[Patient consultation via broad-band network--pilot project in hand surgery].

A pilot project launched at Esbjerg was designed to ascertain whether broad-band audiovisual transmission of clinical examination can replace direct contact between patient and physician, and if so to what extent. Provided the technique can be improved and simplified, video consultation is an obvious and economically advantageous alternative to referral to a specialised tertiary clinic. Not only will the technique need to be further tested and improved, however, but doctors will require training in the assessment of moving two-dimensional images and diagnosis via a visual display unit (VDU).

Cost-Benefit Analysis↗
PubMed1992

Total wrist arthroplasty. Experience with Swanson flexible silicone implants, 1982-1988.

In a study of the results of silicone rubber arthroplasty of the wrist 18 patients (19 operated wrists) were re-examined after a mean follow up of five years. Experience with the ulnar head implant was discouraging, and it was not used in the last eight wrists. This did not affect the outcome, patients having good supination and pronation without pain. The range of motion with the radiocarpal prostheses was 0-70 degrees, mean 39 degrees. Radiological results showed severe subsidence in all patients followed up for more than two years, and prosthetic fracture in five (26%), which was disappointing. Nevertheless the patients had a useful range of motion and all but two were relieved of pain. By the patients' own assessments 16 wrists were considered good, one fair, and two poor. Predictors of failure (prosthetic fracture) were poor alignment before operation, postoperative range of motion of more than 50 degrees, and rupture of the carpal extensor tendon. With these reservations we recommend the silicone spacer as the best solution for most patients with severe problems of the wrist as a result of rheumatoid arthritis.

Aged↗
PubMed1991

[Amputation and arthrodesis of the shoulder joint after brachial plexus lesions].

Nine patients with severe irreversible brachial plexus lesions were submitted to arthrodesis of the shoulder joint and/or amputation of the forearm, the latter with the object of fitting an artificial limb. In one patient, the arm was re-implanted and biceps function of strength M2 was obtained. Three patients were submitted to microsurgical interventions on the plexus. All of the patients were visited in their homes after an average period of observation of three years (1-8 years). Seven patients were equipped with prostheses, three of these with myoelectric prostheses. One patient employed an orthosis and one had been submitted to arthrodesis of the shoulder joint only. Three of the patients were fitted with prostheses 12 years after the accident but nevertheless obtained good prosthetic function. One of these patients had even been fitted with a prosthesis on the non-dominant side. Forearm amputation was chosen in order to control rotation and to avoid projection of the proximal part of the prosthesis up over the shoulder joint. The absent/reduced sensibility at the level of the amputation did not result in pressure problems from the prosthesis. All of the patients used their prostheses. Pain is not an indication for amputation surgery but does not hinder a good functional result.

Accidents, Traffic↗
PubMed1991

A double pulp flap technique for creating nail-folds in syndactyly release.

A method is described of creating nail-folds in the release of cases of complete syndactyly. A double pulp flap was used as a one-stage technique in 13 patients in whom webs were separated. All patients were reviewed after a minimum of one year. Fullness of pulp was achieved in all fingers. The nail-fold was considered normal in 14 of 18 fingers covered with a broad flap and in 8 of 18 fingers covered with a narrow flap. In the remaining cases the nail-fold was small but never absent. No flap loss was encountered and there was no late nail deformity from scarring.

Child, Preschool↗
PubMed1990

Principles of evaluation and results in microsurgical treatment of major limb amputations. A follow-up study of 26 consecutive cases 1978-1987.

A total of 26 microvascular extremity replantations/revascularizations with a survival rate of 85% were followed for an average of 4.5 years. The material consisted of 11 upper arms, 11 lower arms, 1 wrist and 3 feet. In this comparatively small and inhomogenous material there was no significant influence found on the functional results regarding level of amputation, time of ischaemia or age of the patients. Sharp injuries had the best outcome. The functional results were evaluated following the principles outlined by Chen & Yu and by Tamai. Good and excellent results were found in 63% of the upper extremities according to these classifications and in 47% according to our own classification. Some of the difficulties in establishing indications and contraindications to replantation are outlined. To facilitate comparison of materials a modified and more realistic version of the score system of Tamai is recommended as a standard for evaluation of functional results following above-wrist-replantation. This will enable early detection of progress in the treatment of extremity amputations.

Adolescent↗
PubMed1989

[Appointment to orthopedic surgical courses in 1983-1986].

The Danish orthopaedic surgical trainee arrangement with decentralized appointments was analysed after the first three years. A total of 591 applicants were involved and the majority of these had applied previously. Thus, 150 different qualified applicants sought 32 appointments. The postgraduate seniority of the applicants was 6.8 years. All of the applicants were found to be well qualified or optimally qualified for the positions concerned. No qualitative assessment was attempted of the scientific research made by the applicants but there was a definite tendency for more and more scientific studies to be necessary to obtain a trainee appointment. This tendency continued after the conclusion of the period under observation and the intensifying effect of this single criterion for appointment is emphasized.

Denmark↗
PubMed1989

[Functional results after replantation/revascularization of major parts of the extremities].

Twenty-five patients who were submitted to replantation or revascularization of a total of 11 upper arms, 11 forearms, one wrist and three feet were followed-up with the object of assessing the functional status. 85% of the replantated/revascularized parts survived. The follow-up examination included assessment of the level of amputation, mechanism of the injury, duration of ischaemia and the age of the patient in relation to the joint mobility achieved, strength, sensibility, cosmetic inconveniences and the return to previous employment. Out of 19 surviving upper limbs and three feet, the results were classified as excellent and good after Tamai's and Chen's methods. The best results were found after sharp lesions but the investigation revealed that even in severe avulsion lesions, it proved possible to obtain good results. It is thus not possible to establish definite directives for the indications for replantation. The final decision concerning reconstruction cannot be made until after contact with one of the departments in which replantation can be undertaken.

Adolescent↗
PubMed1988

Early mobilization after flexor tendon grafting for isolated profundus tendon lesions.

After reconstruction of a flexor profundus tendon with a free graft passed through or around an intact superficialis decussation, impaired function may result if adherences develop. In an attempt to avoid adherences, early mobilization using Kleinert's method was applied in 20 grafts. At follow-up, on average 36 months after operation, all the patients had improved ROM except one patient with tendinous infection one year postoperatively. On average the gain in DIP-joint flexion was 34 degrees, while six patients had a loss of 17 degrees and 12 patients a gain of 22 degrees in PIP-joint motion. Only nine patients required a few weeks of occupational therapy. It is concluded that early mobilization a.m. Kleinert after tendon grafting is a safe method for prevention of loss of PIP-joint motion due to the formation of adherences.

Adolescent↗
PubMed1988

Ulnar thumb in cleft-hand-type congenital deformity. Case report.

A twelve-year-old boy with a two-digit cleft hand was successfully treated by stabilization, rotation and activation of the floating ulnar digit. This ulnar thumb proved to be a useful tool for daily life, but an even better result might have been achieved if the treatment had been given at an earlier age.

Abnormalities, Multiple↗
PubMed1987

Conservative treatment of fingertip injuries.

In a prospective investigation of 81 consecutive patients with fingertip injuries conservative treatment was evaluated. Fingertip injuries were defined as lesions greater than or equal to 1 cm2 in the terminal phalanx without injury to the tendons or joints. All fingertip injuries were cleaned and covered by Vaseline gauze and left to heal. If less than 2 mm of soft tissue covered the bone a few millimetres of bone were nibbled away to allow good cover with soft tissue. The majority of injuries (64 per cent) occurred at work. The average healing time was 25 days. The main later complaints were intolerance of cold (36 per cent), numbness (36 per cent) and tenderness (26 per cent). None of the patients had stiff joints. On average, the two-point discrimination had increased by 1 mm in the injured fingertip. Conservative treatment is recommended as a safe and simple treatment of fingertip injuries, even when bone is exposed in the wound.

Adolescent↗
PubMed1986

Duplication of the extensor carpi ulnaris tendon.

Three cases are presented, in which an anomalous tendon slip between the extensor carpi ulnaris tendon and the extensor apparatus of the fifth finger was found. One of the patients was a violinist, who had serious impairment of the left wrist joint and the small finger due to the anomaly. The symptoms disappeared after excision.

Adult↗