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Biomedical subjects

T Husby

Publications and source records attributed to T Husby.

At least 19 recordsLinked to original sources
PubMed2001

Long-term results after arthroscopic resection of lesions of the triangular fibrocartilage complex.

Thirty-five patients with central and radial lesions of the triangular fibrocartilage complex (TFCC) were treated by arthroscopic resection and debridement. Their median age was 36 years (range 11-52), and preoperative duration of symptoms 18 months (range 4-132). Fall on a hyperextended wrist was the most common injury (n = 15), and nine patients had had a previous fracture of the radius. Eighteen patients had an additional arthroscopic debridement of coexisting chondral lesions. There were no complications. At a median follow up time of 39 months (range 18-58), grip strength was recorded as a median of 94% (range 4-164), flexion-extension sector as 94% (range 50-107), and pronation and supination sector as 100% (range 50-112) of the uninjured side. At follow up eight patients were free of pain, 14 much better, eight somewhat better, five unchanged, and no patient had got worse. The Mayo Modified Wrist Score assessed 13 patients as excellent, 14 good, four fair, and one poor. Thirty-one patients returned to full-time work, and four were unemployed (partly because of reasons not relevant to the operation). Thirty-three patients reported they would have had the same procedure if they had known the outcome of the surgery. We find arthroscopic debridement of central or radial lesions of the TFCC to be safe and reliable with good pain relief.

Adolescent↗
PubMed2001

Acute postoperative swelling after hand surgery: an exploratory, double-blind, randomised study with paracetamol, naproxen, and placebo.

A model using volumetry to evaluate the effect of drugs on acute postoperative swelling after operations for primary Dupuytren's contracture (DC) and carpal tunnel syndrome (CTS) was established and validated. The temperature of the saline and time of measurement during the day influenced the volumetric readings. The error of measurement after volumetry of unoperated and operated hands after operations for DC was 0.7% and 0.6%, respectively. Naproxen (500 mg twice a day), paracetamol (1000 mg four times a day), or placebo were given postoperatively for three days to 35 patients after DC and 42 patients after CTS in a randomised, placebo-controlled study. Hand volume was measured preoperatively and 72 hours after surgery. There was a difference in swelling (p = 0.009) indicating different degree of development of swelling 72 hours postoperatively between the DC and CTS placebo groups, which invalidated pooling of the data. After operations for DC naproxen was slightly but not significantly superior to paracetamol and placebo, with paracetamol numerically superior to placebo. The power of the study, caused by the limited number of patients included, does not permit this difference to reach significance. Operations for CTS caused so little swelling that comparisons were invalidated. Naproxen treatment, irrespective of type of operation, did not require rescue analgesics, while two patients after CTS treated with paracetamol did. Two and six placebo-treated patients required rescue drugs after operations for DC and CTS, respectively. We conclude that naproxen might have a clinical relevant effect on swelling when used on minor surgery in the hand, unlike paracetamol. Naproxen might be a useful analgesic during the immediate postoperative phase.

Acetaminophen↗
PubMed1999

Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique.

We present the results of an arthroscopic suture technique for repairing peripheral tears (Palmer type 1 b) of the triangular fibrocartilage complex (TFCC). The 20 patients included in this study were 15-59 years of age; the most common mechanism of injury was a fall on a hyperextended wrist. After diagnosis of the tear in the TFCC we debrided the synovitis and repaired the tears by an arthroscopic suture technique. At follow up 23-59 months postoperatively, range of movement (sum of flexion-extension) was 90% (range 53%-108%) and grip strength was 83% (range 18%-122%) when compared with the uninjured side. All patients returned to work, though three changed occupations. The arthroscopic suture technique of peripheral TFCC repair produced seven excellent, seven good, four fair, and two poor results (grading based on a Mayo modification of the Green and O'Brien wrist score). As our results are comparable to others, we think that the technique described could be used in the repair of peripheral tears of the TFCC.

Accidental Falls↗
PubMed1997

Fixation of displaced femoral neck fractures with a sliding screw plate and a cancellous screw or two Olmed screws. A prospective, randomized study of 225 elderly patients with a 3-year follow-up.

BACKGROUND AND AIMS: To analyse the importance of fixation method in displaced femoral neck fractures and to identify factors predictive of failure of the fixation. MATERIAL AND METHODS: Two hundred and twenty-five patients were included in a prospective, randomised study and operated on for a displaced, subcapital fracture of the femoral neck with either a sliding screw plate and a parallel cancellous screw (SSP), or two Olmed screws. The median follow-up time was 39 (22-51) months, excluding reoperated and dead patients. RESULTS AND CONCLUSIONS: Operation and anaesthesia time was considerably longer for the SSP system. The risk of failure was significantly increased (odds ratio 6.6) for patients operated with SSP outside ordinary working time. Poor reduction was recognized as a risk factor of failure for both types of fixation (odds ratio 3.1). The rate of reoperation within 3 months was 18.5% in the SSP group and 9.4% in the Olmed screw group. The rates of nonunion were 6.2% and 8.5%, respectively. The rates of late segmental collapse, 18.0% and 19.5% of all united fractures, respectively, decreased with increasing age (odds ratio 0.88). Salvage operations (replacement with bipolar or total hip prosthesis) were made in 30.6% and 26.5% of the cases, and the total rates of reoperation were 37.0% and 29.1%, respectively. We conclude that both treatment methods result in an unacceptably high rate of failures and reoperations, and that alternative treatment, prosthesis replacement, should be considered in selected cases.

Aged↗
PubMed1995

[Children of psychiatric patients--what to do?].

Examination of the records of first admission patients at the acute ward of a psychiatric hospital indicated that contact was established with only 4% of the patients' children. A screening for assistance to patients' children at the acute wards of 21 hospitals showed, furthermore, that only one hospital offered such assistance as a routine. It is argued that this shows a relative neglect of a group (patients' children) with well documented mental health problems, whose only contact with the health services may be their parent's hospital, and whose problems may relate directly to the parent's problems.

Adolescent↗
PubMed1994

Free flaps in the reconstruction of foot injury. 4 (1-7) year follow-up of 24 cases.

We reconstructed in 24 patients, traumatic tissue loss in the foot with 10 lateral arm flaps and 14 scapular flaps. The mean follow-up was 4 (1-7) years. There was 1 flap loss, and 1 patient was amputated because of septic ankle arthrodesis. Healing with stable skin and scar was achieved in the remaining patients. Only patients with additional serious skeletal injury had reduced walking ability.

Adolescent↗
PubMed1993

Prediction of fixation failure in femoral neck fractures. Comminution and avascularity studied in 40 patients.

We performed 99m-Tc diphosphonate scintimetries in 40-elderly patients who had undergone screw fixation for a recent subcapital femoral fracture and analyzed their preoperative radiographs. The data were subjected to a logistic regression analysis. Both comminution of the calcar femorale and reduced scintimetric uptake were predictive for failure of the osteosynthesis during the first year. Fracture comminution was more predictive for early failures during 3 months and scintimetry for the later failures.

Aged↗
PubMed1992

Slotted versus non-slotted locked intramedullary nailing for femoral shaft fractures.

Experimentally, two slotted nails, the Grosse-Kempf nail and the AO/ASIF universal femoral nail, were compared to the non-slotted Grosse-Kempf nail and control bone using a cadaver femoral osteotomy. The stiffnesses and strengths of the osteotomies fixed with slotted nails in 10-30 degrees torsion were 6-8% and the values of non-slotted nails 40% of control bone. The maximal moments were 14-18% and 48%, respectively. In the "clinical range" of torsion, the implant-bone construct never failed or was deformed. Clinically, 46 femoral shaft fractures were randomized to treatment with Gross-Kempf nails, 24 with slotted nails and 22 with non-slotted nails. Four complications in the slotted nail group and three in the non-slotted nail group were considered to be independent of the choice of nail and did not affect the end result. Three splinterings of the distal fragment, one resulting in a change of the osteosynthesis implant to a condylar plate, were considered to result from the high stiffness of the non-slotted nail. Osteosynthesis of femoral shaft fractures using slotted nails has not resulted in healing disturbances, which could be accounted for by the high torsional elasticity of the nail; there seems to be no indication for high-stiffness nails in femoral fractures.

Adolescent↗
PubMed1992

Free tissue transfer for type III tibial fractures. Microsurgery in 19 cases.

We report 19 tibial fractures Types III B and C treated by free flaps. The fracture healed in 16 cases after 12 (3-54) months. In 3 cases a secondary amputation was carried out. Tibial malalignment or substantial shortening ensued in 1 case each. We conclude that coverage with free flaps, radical removal of dead bone, stable external fixation and transfer of vascularized bone may salvage the majority of Type III B and C tibial fracture with function superior to that after amputation.

Adolescent↗
PubMed1992

Implant holding power of the femoral head. A cadaver study of fracture screws.

The holding power against axial pull-out forces of eight different screws implanted in the femoral heads of cadavers was tested. The Olmed screw had the greatest resistance to pull-out forces followed by the recently designed Ullevaal screw with long threads, and the von Bahr screw. There were substantial differences in the holding power in the four sectors of the femoral head. The holding power was strongly correlated with the logarithm of the moment of inertia of the screw threads, which is a function of the area and number of the threads (r = 0.94, P = 0.0002).

Adult↗
PubMed1991

[Cooperation between physicians and pharmaceutical consultants. A questionnaire study].

The study is based upon a questionnaire sent by mail to 403 general practitioners and 174 pharmaceutical representatives in Norway. 62% of the general practitioners and 60% of the representatives replied. The results indicate that 92% of the general practitioners are satisfied with the representatives as a source of medical information. The general practitioners seem to be aware that the representatives are part of the marketing system, but accept this situation. 68% of the general practitioners do not think that the representatives influence their choice of drugs. 55% of the representatives think that being a 'salesman' is their most important function. 30% consider that providing information on their products is most important, while 15% believe that their most important job is to serve as a link between doctors and the pharmaceutical industry. The study suggests mutual understanding concerning practical contact between the general practitioners and representatives.

Communication↗
PubMed1991

Assessment of bone mineral content in the internal bone volume.

A method for assessing values related to bone density and mass is described. Mean attenuation and pixel area are measured in pixels selected on the basis of CT units. The method is to a large extent computerized and not dependent on manual positioning or outlining of a region of interest. Because it is not dependent on a comparatively large volume of homogeneous bone it can be used to make assessments even in very heterogeneous bones including cortical bone. The method is adaptable for measurement in all parts of the skeleton and values related to both bone density (DRV) and bone mass (MRV) are derived. The measurements in the femoral condyles were shown to have a precision of approximately 0.25 to 0.30 Z-score units (standard deviation of the measurements expressed in Z-score units). The agreement between chemically analyzed calcium density (weight of calcium per volume) and DRV was little less than 0.50 Z-scores and 0.30 Z-scores for the chemically determined calcium mass and the MRV. The agreement with mechanical bone strength was 0.78 Z-scores for DRV and 0.64 for the MRV. Altering scan parameters or measuring approaches gave systematic differences in measurements. There were, however, good linear correlations between the measurements which show that these different measuring approaches essentially gave identical measurements.

Bone Density↗
PubMed1990

[Physicians' contact with the drug industry. An interview among general practitioners].

Seventy-eight general practitioners were interviewed by questionnaire on the subject of contact between general practitioners and the pharmaceutical industry. There seemed to be a certain discrepancy between the existing working instructions of the pharmaceutical industry and the needs of the general practitioners. Nevertheless, the overall contact seemed to be satisfactory. Most general practitioners wished to be visited by representatives of the pharmaceutical industry, preferably qualified ones. The opinions of male and female doctors were generally the same.

Consultants↗
PubMed1990

Femoral cortical/cancellous bone related to age.

The femoral cancellous/cortical relationship with age has been determined in 53 dissected femoral specimens. By means of computed tomography (CT) values related to bone density and mass were assessed in the femoral head, neck, trochanter, shaft, and condyles. In the neck and trochanter separate measures were made in cortical and cancellous bone. The results were analyzed by means of correlation and regression analyses. There were significant negative linear correlations between the CT measures and age for all measures except for the isolated cancellous measures in the femoral neck and trochanter. Our results indicate that in the femoral neck and trochanter the cortical bone mass constitutes a substantial amount of the total bone mass. We conclude that, since bone strength to a large part is a function of the total bone mass, loss of cortical bone may be more important than loss of cancellous bone.

Aged↗
PubMed1989

Rotational strength of the femoral neck. Computed tomography in cadavers.

The mean bone density of the femur at different levels was determined by means of quantitative computed tomography (QCT) in 50 pairs of normal cadaveric femora and related to the rotational strength of the femoral neck. All the femora fractured vertically and spirally in the neck. The bone-mass-related measures at different levels were calculated from QCT densities and volumes. Cancellous bone was defined with threshold limits ranging from 50-500 Hounsfield units (HU), and attenuation values exceeding 500 HU were assessed as cortical bone. The recorded QCT mass-related measures of cortical and cancellous bone separately and as total bone masses gave significant right/left correlations. Correlations were found between the ultimate torsional strength of the femoral neck and QCT recordings of bone mass at all the femoral levels. The best correlations were demonstrated between the rotational strength of the femoral neck and the total bone-mass-related measures in the femoral shaft and condylar area. Bone mass of the femur measured by computed tomography may become useful as an index of the mechanical strength of the femoral neck.

Aged↗
PubMed1989

Stability of femoral neck osteosynthesis. Comparison of fixation methods in cadavers.

Fixation of vertical femoral neck osteotomies in 50 cadavers was performed with either von Bahr screws or a sliding hip compression screw. One specimen from each pair of femora was used for the osteotomy, the other serving as an intact control. At 0.05 r of torsion the load-deformation test showed that three von Bahr screws provided the strongest fixation, and this was confirmed by the the ultimate torsional moment test. Regardless of positioning, even two von Bahr screws were stronger than the sliding compression screw with or without an additional lag screw. The results indicate that the best torsional stability in femoral neck fractures can be obtained with three 5.5-mm screws.

Bone Plates↗
PubMed1989

Quantification of bone mineral measured by single-energy computed tomography.

Twenty cadaver femoral condyles were examined with single-energy quantitated computed tomography (QCT), and the composition of the bone scanned was analyzed chemically. The calcium concentration correlated well with the QCT density (r = 0.89, P less than 0.001). The highest correlation was recorded between the total calcium content in the scanned slices and the bone mass-related measures recorded by QCT (r = 0.96, P less than 0.001). Single-energy computed tomography thus provides an accurate measure of total bone mineral content.

Aged↗