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Biomedical subjects

T K Kristiansen

Publications and source records attributed to T K Kristiansen.

11 recordsLinked to original sources
PubMed1998

Plantar lateral dislocation of the medial cuneiform: a case report.

This case report describes an isolated plantar lateral dislocation of the medial cuneiform. We were able to find only one other similar case reported in the literature. That case had a delayed diagnosis of 5 months and with an associated an avulsion fracture of the second metatarsal base. Dines et al. reported an isolated dorsomedial dislocation at the medial cuneonavicular joint. An irreducible dorsomedial dislocation with the anterior tibialis tendon being trapped between the medial cuneiform and the navicular has been reported. A distal and lateral dislocation of the medial cuneiform was reported in association with displacement of the second to fourth metatarsal and medial fractures of the navicular and cuneiform. The current report differs from previous cases. There was not an associated fracture; the direction of the dislocation was unique and could be reduced closed.

Adult↗
PubMed1997

Acceleration of tibia and distal radius fracture healing in patients who smoke.

A low intensity ultrasound device was investigated as an accelerator of cortical and cancellous bone fracture healing in smokers and nonsmokers. Statistically significant reductions in healing time for smokers and nonsmokers were observed for tibial and distal radius fractures treated with an active ultrasound device compared with a placebo control device. The healing time for a tibial fracture was reduced 41% in smokers and 26% in nonsmokers with the active ultrasound device. Similarly, distal radius fracture healing time was reduced by 51% in smokers and 34% in nonsmokers with the active device. Treatment with the active ultrasound device also substantially reduced the incidence of tibial delayed unions in smokers and nonsmokers. The use of the active ultrasound device accelerates cortical and cancellous bone fracture healing, substantially mitigates the delayed healing effects of smoking, speeds the return to normal activity, and reduces the long-term complication of delayed union.

Adult↗
PubMed1997

Accelerated healing of distal radial fractures with the use of specific, low-intensity ultrasound. A multicenter, prospective, randomized, double-blind, placebo-controlled study.

A multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was conducted to test the efficacy of a specifically programmed, low-intensity, non-thermal, pulsed ultrasound medical device for shortening the time to radiographic healing of dorsally angulated fractures (negative volar angulation) of the distal aspect of the radius that had been treated with manipulation and a cast. Sixty patients (sixty-one fractures) were enrolled in the study within seven days after the fracture. The patients used either an active ultrasound device (thirty fractures) or a placebo device (thirty-one fractures) daily for twenty minutes at home for ten weeks. The two types of devices were identical except that the placebo devices emitted no ultrasound energy. Clinical examination was performed and radiographs were made at one, two, three, four, five, six, eight, ten, twelve, and sixteen weeks after the fracture by each site investigator. The time to union was significantly shorter for the fractures that were treated with ultrasound than it was for those that were treated with the placebo (mean [and standard error], 61 +/- 3 days compared with 98 +/- 5 days; p < 0.0001). Each radiographic stage of healing also was significantly accelerated in the group that was treated with ultrasound as compared with that treated with the placebo. Compared with treatment with the placebo, treatment with ultrasound was associated with a significantly smaller loss of reduction (20 +/- 6 per cent compared with 43 +/- 8 per cent; p < 0.01), as determined by the degree of volar angulation, as well as with a significant decrease in the mean time until the loss of reduction ceased (12 +/- 4 days compared with 25 +/- 4 days; p < 0.04). We concluded that this specific ultrasound signal accelerates the healing of fractures of the distal radial metaphysis and decreases the loss of reduction during fracture-healing.

Double-Blind Method↗
PubMed1995

Operative treatment of acute displaced intra-articular calcaneus fractures.

A retrospective study of 18 operatively treated calcaneal fractures was conducted. The fractures were all type II and type III fractures according to the classification system of Crosby et al. The average follow-up was 32 months and consisted of subjective and objective criteria. The findings were compared with the results of nonoperative treatment reported by Crosby et al. The findings suggests that type II fractures have a similar outcome when either operative or nonoperative treatment is used. Type III fractures, however, fared considerably better with operative intervention when compared with those treated with nonoperative techniques.

Accidental Falls↗
PubMed1990

Nonunion of the proximal humerus. A review of 25 cases.

Records of 25 patients with nonunion of the proximal humerus were reviewed retrospectively. The initial fractures included 19 two-part surgical neck fractures and six three-part fractures. Fourteen fractures were treated nonoperatively and 11 surgically. Nine of 11 of the initial internal fixations were unsatisfactory. At the time of fracture 16 patients had one or more significant medical illnesses. Nonunion of the proximal humerus was associated with considerable morbidity. Patients complained of pain, stiffness, and disability in association with shoulder dysfunction. Four treatment groups were evaluated. Patients who declined treatment and patients treated with nonreamed intramedullary nails had limited shoulder motion and pain without union. Patients treated with proximal humeral hemiarthroplasty had relief of pain but limited motion despite rotator cuff reconstruction. The best results of treatment occurred after open reduction with internal fixation and bone grafting. A tension band construction that fixed the rotator cuff and proximal humerus to a plate/shaft composite was used successfully in seven patients. Although satisfactory reconstruction of nonunion of the proximal humerus can be obtained, the results of treatment in this series were only fair. Only 48% (12 of 25 patients) had good results.

Adolescent↗
PubMed1990

Fractures in the skiing athlete.

Although certain fractures occurring in skiers have increased or decreased in incidence over the years, it is reasonable to expect that as long as individuals continue to challenge the slopes, fractures will occur. Skiers are healthy, motivated, and have high expectations regarding their recovery. These qualities make them good surgical candidates. Although closed treatment methods are adequate for most fractures, the examples presented in this article serve to illustrate the concept that an aggressive approach to more complicated fractures employing modern techniques generally yields the best results in skiers.

Fractures, Bone↗
PubMed1986

Retrieval of a broken intramedullary nail.

This is a report of an improvised useful instrument for retrieving the distal fragment of a fractured intramedullary nail. Using a modified Kuntscher reaming guide and closed technique, the method was successfully used in three cases.

Bone Nails↗
PubMed1984

Sacral fractures.

The sacral spine has received relatively little attention in the orthopedic and neurosurgical literature, in part because of the infrequency of developmental, degenerative, or neoplastic conditions of the sacrum requiring surgical intervention. This neglect is unwarranted in trauma, however, because sacral fracture and its associated neural deficit are both common and often complex problems. The sacrum and pelvis behave as a single functional unit; an understanding of the principles of sacropelvic stability has obvious relevance in planning the occasional resection of a sacral tumor and in dealing with the common problem of massive pelvic trauma. A classification of sacral fractures is reviewed along with the usual patterns of neurological involvement. Through analysis of an institutional series of cases, a specific attempt is made to correlate varying types of vertical sacral fractures with differing types of pelvic injury. The radiographic and physiological investigation of sacral fractures is reviewed, as are the various options for achieving the reduction, decompression, and stabilization of sacral fractures.

Biomechanical Phenomena↗
PubMed1981

Log splitter injuries to the hand.

Use of the powered log splitter in processing wood for fuel has emerged as an important source of disabling hand injury in the Vermont area. Thirteen such injuries are reviewed and two representative cases are presented. Physicians are advised of this new mechanism of injury and the public is warned of the danger in using these machines.

Accidents, Occupational↗
PubMed1978

Use of the Wagner apparatus in complicated fractures of the distal femur.

Five case histories are presented involving management of complicated fractures of the distal femur with the Wagner apparatus used for external fixation. The advantages of this method are that it involves less metal and less extensive surgical exposure than internal fixation devices. There is ample wound access, more rigid fixation, earlier ambulation, and increased patient comfort. Use of the device as an available alternative, especially in cases complicated by vascular or neurologic injury, soft-tissue, or bilateral injury, is advocated, based on this preliminary experience.

Adult↗