Biomedical subjects

Vilhjalmur Finsen

Publications and source records attributed to Vilhjalmur Finsen.

12 recordsLinked to original sources

PubMed2006

Most scaphoid non-unions heal with bone chip grafting and Kirschner-wire fixation. Thirty-nine patients reviewed 10 years after operation.

BACKGROUND: Many recommend to operate scaphoid pseudarthroses with wedge grafts and screw fixation. These are difficult operations. We have employed a simpler procedure and wished to review our results with regard to healing and long-term clinical results. PATIENTS AND METHODS: We reviewed 39 unselected scaphoid pseudarthroses which had been operated with Kirschner-wire fixation and bone chip transplantation 10 (3.5-12) years previously. Postoperative cast treatment was 15 (11-30) weeks. RESULTS: Four pseudarthroses failed to unite, one of which was after a trans-scaphoid perilunar dislocation. In another the pins were dislocated by an injury while the arm was in plaster. There were no other complications. All 14 proximal pseudarthroses united. There was no loss of grip strength but some loss of key-pinch strength and wrist mobility. Most patients reported no or little pain and none used analgesics because of wrist pain. The disability of the arm, shoulder and hand (DASH) score was 2 (0-33). Very few cases of mild arthrosis had arisen after operation. Three patients would not have consented to operation if they had known the outcome in advance. CONCLUSIONS: Kirschner-wire fixation and bone chip grafting of scaphoid pseudarthroses is an undemanding operation with few complications that produces good long-term results. Results are excellent also for proximal pole pseudarthroses.

Adolescent↗

PubMed2006

Scratch lottery tickets are a poor incentive to respond to mailed questionnaires.

BACKGROUND: It has been demonstrated that the enclosure of money with a mailed questionnaire increases the response rate significantly. We evaluated scratch lottery tickets as an alternative to cash. METHODS: 1500 randomly selected Norwegians between the ages of 40 and 65 years were sent a short questionnaire. 250 received one lottery scratch ticket worth 20 Norwegian kroner (approximately 3 USD) together with the questionnaire, 250 received two scratch tickets, and 250 were promised two scratch tickets if they replied within one week. A fourth group of 250 persons received a 50 kroner banknote with the questionnaire. The remaining 500 letters served as controls. RESULTS: The overall response rate after 6 weeks was 77%. Logistic regression analysis showed that only the 50 kroner group had a response rate that was statistically significantly higher than the controls (p < 0.0001). It was also significantly higher than that in any of the other incentive groups (p < 0.0001, p < 0.004 and p < 0.0001 respectively). Female sex (p < 0.001) and age (p < 0.002) increased the response rate significantly. CONCLUSION: It is possible that the recipients scratched their cards before completing the questionnaire, and that it was a disincentive for the majority that they did not win anything. Lottery scratch tickets are no substitute for cash as an incentive to respond to a questionnaire.

Adult↗

PubMed2006

Carpal tunnel syndrome during pregnancy.

Carpal tunnel syndrome is common during pregnancy. The symptoms usually disappear after delivery, but how soon has not been established. Thirty pregnant women with the syndrome reported to us the degree of pain in their hands every week before, and daily after, delivery. Pain was graded on a scale from 0 (none) to 10 (worst imaginable). The prevalence of the syndrome during pregnancy was about 2%. The mean pain score was 5.6 (SD 2.0) at referral and this was reduced by 1.2 (SD 2.2) after wearing an orthosis for a week. After this, it stayed almost unchanged until delivery. The score fell by half during the first week after parturition and by half again during the next week. The reduction in score was strongly correlated with loss of the weight gained during pregnancy (r = 0.97; p <0.001). Although symptoms may persist for some weeks after delivery, the severity declines quickly.

Adult↗

PubMed2006

Long term results of arthrodesis of the wrist: a 6-15 year follow up of 35 patients.

A total of 40 wrists in 35 patients were investigated 10.5 (range 6-15) years after arthrodesis. The most common diagnosis was rheumatoid disease. There were 21 Mannerfelt, and 21 plate, arthrodeses. The patients were assessed clinically and up-to-date radiographs obtained. Two Mannerfelt arthrodeses had failed to fuse. Pain during the last week before review and total satisfaction with the operation were excellent in 28 and 30 wrists, respectively. The mean score on the "Disability of arm, shoulder and hand" (DASH) questionnaire was 38 (range 2-75). Plate arthrodeses gave better results than Mannerfelt arthrodeses for all variables studied. Wrists plated in dorsal extension gave the best scores for function and strength. We conclude that either method gives good long term results. Although few of the individual differences were statistically significant, we think that fusion with plates, and in particular plates with dorsal extension, is preferable.

Adult↗

PubMed2005

[Does insight influence the frequency of operations?].

BACKGROUND: The number of elective operations continues to go up. In some cases this may possibly be due to a lack of insight among patients. Doctors are those who best know the possible benefits and risks of surgery. A difference in the number of operations among doctors and in the general population could shed light on to what degree knowledge influences the decision to undergo surgery. MATERIAL AND METHODS: The frequencies of eight common and often elective operations were determined by replies to questionnaires from 1182 members of the general public aged 40 to 65, and from 1510 medical practitioners. RESULTS: There was little difference in the number of operations between doctors and the general public, and between doctors in general and surgeons. Fewer children of doctors than of members of the public had had tonsillectomies performed (p < 0.001). The parents of surgeons had undergone more operations than the parents of doctors in general and the parents of doctors in general more operations than the parents of members of the public. In the general population 6.2% of the children were borne by caesarean section, among doctors in general 10.0% (p < 0.001) and among obstetricians 14.9% (p < 0.001). INTERPRETATION: Doctors are no more reluctant to undergo surgery than members of the general public and surgeons no more reluctant than doctors in general. The numbers of operations performed are unlikely to fall if the general public acquires the knowledge that doctors have of the risks and benefits of surgery.

Adult↗

PubMed2004

Dupuytren's disease in Bosnia and Herzegovina. An epidemiological study.

BACKGROUND: It is generally held that Dupuytren's disease is more common in northern than in southern Europe, but there are very few studies from southern European countries. METHODS: We examined the hands of 1207 men and women over the age of 50 years in Bosnia and Herzegovina. RESULTS: The prevalence of Dupuytren's disease was highly age-dependent, ranging from 17% for men between 50-59 years to 60% in the oldest men. The prevalence among women was lower. The great majority only had palmar changes without contracture of the digit. The prevalence was significantly lower among Bosnian Muslim men than among Bosnian Croat and Serbian men and significantly increased among diabetics. No association could be detected between Dupuytren's disease and smoking, alcohol consumption or living in rural or urban areas. CONCLUSION: We conclude that, contrary to previous opinion, Dupuytren's disease is common in Bosnia and Herzegovina.

Aged↗

PubMed2004

Hip fracture incidence in central norway: a followup study.

Studies in the 1980s, including one from central Norway, in most cases showed that the incidence of hip fractures was increasing. In the 1990s, however, studies from Sweden and the United States indicated that the increase may have stopped. We report the current incidence of hip fractures in subjects in central Norway and compare it with that previously reported. The number of cervical and trochanteric fractures in a defined region of Central Norway in 1992 to 1993 and in 1997 to 1998 was found by a thorough search and collation of the hand written surgery reports, the reports from radiology departments, and hospital discharge reports. One thousand three hundred twelve hip fractures were sustained during 1997 to 1998, 10% more than in the preceding period. This was almost entirely attributable to aging of the population. In contrast to the highly statistically significant increase in the actual incidence of 2% per year previously reported between 1972 to 1973 and 1983 to 1984, there was no statistically significant increase in incidence between 1983 to 1984 and 1997 to 1998 (0.55% per year). The incidence of hip fractures was 18% higher in subjects in urban areas than in subjects in rural areas in 1992 to 1993, and 33% higher in 1997 to 1998. Whereas the proportion of trochanteric fractures was 32% in 1972 to 1973 and in 1983 to 1984, it increased to 44% in 1992 to 1993 and to 68% in 1997 to 1998. There has been an insignificant increase in hip fracture incidence since 1983 to 1984. The lower incidence of hip fractures in subjects in rural areas persists, and there has been a dramatic increase in the proportion of trochanteric fractures.

Age Distribution↗

PubMed2003

[Surgical treatment of Morton's neuroma].

BACKGROUND: We have resected the nerve when surgery is indicated for Morton's neuroma and wanted to compare our results with results reported after decompression. MATERIAL AND METHODS: 33 patients with 37 operated feet filled in a questionnaire 17 (8-27) months after surgery. They were asked to indicate their pain on a visual analogue scale (VAS: 0 = no pain, 100 = worst imaginable pain). RESULTS: Patients' mean age was 44 (17-76) at the time of operation. The average VAS score for pain was 81 (35-100) before operation and 7 (0-52) at review. 28 said the pain had disappeared (VAS 0). CONCLUSION: Three quarters of our patients had no pain at review. This is comparable to reported results after decompression.

Adolescent↗

PubMed2003

Two-stage grafting of digital flexor tendons: a review of 43 patients after 3 to 15 years.

We reviewed 9 (3-15) years postoperatively all 43 two-stage flexor tendon transplantations in fingers that had not otherwise been severely injured that we had operated on during the years 1984 to 1996. One digit had been reconstructed in each patient. The interval between the first and second stage operations was 19 (14-51) weeks. Time away from work was 44 (4-140) days after the first procedure and 101 (38-297) days after the second stage operation. After the second stage, 26 further procedures had been done in 18 of the 43 fingers. These included seven resutures of the transplanted tendon (three in the same finger), five tenolyses, two capsulotomies of the proximal interphalangeal (PIP) joint, three arthrodeses of the distal interphalangeal (DIP) joint (two combined with reinsertion of the tendon to the middle phalanx), one DIP + PIP arthrodeses, and three amputations of PIP. One further finger will be amputated and two patients do not wish treatment for ruptured transplants. There were 15 excellent, six good, nine fair, and 12 poor results at review. A total of 31 of the 43 patients said they would have had the operation if they had known the outcome in advance. Reconstruction of a flexor tendon takes a long time and causes many complications. Even so, it is indicated in motivated and fully informed patients because of a lack of other viable options.

Adult↗

PubMed2003

Surgery for trigger finger.

One of the two English-language reports on the results of surgery for trigger finger reported frequent complications and poor results and the other, few complications and good results. We reviewed 72 patients with 84 operated digits 8(1/2) (7-11) years after surgery. One patient was re-operated because of persisting symptoms, and another had a moderate recurrence. There were two transitory neuropraxias, but no permanent nerve damage could be detected. It was concluded that in cases where symptoms persist after steroid injection, surgery may be recommended. However, the risk of troublesome complications, even after this minor operation, should be borne in mind.

Adolescent↗

PubMed2002

The prevalence of Dupuytren's disease among 2 different ethnic groups in northern Norway.

Dupuytren's disease is common in Norway and northern Europe but rare in individuals who are not of European descent. The aboriginal Sami of the northernmost parts of Scandinavia are ethnically distinct from most Norwegians. The occurrence of Dupuytren's contracture is unknown among the Sami. Data were collected on 456 individuals older than 50 years who were living in an area 750 km north of the arctic circle. Dupuytren's disease was found in 31 men and 3 women. The prevalence was lower among Sami than Norwegian men of all ages. The prevalence of having a grandson with Dupuytren's disease was also lower among Sami than Norwegian grandparents. Although none of the differences reached statistical significance, the results show that the prevalence is not very low among Sami men but probably lower than among ethnic Norwegians living in the same area, confirming the importance of a genetic disposition to the disease.

Aged↗

PubMed2002

Abductor pollicis longus tendon interposition for arthrosis in the first carpometacarpal joint: 55 thumbs reviewed after 3 (1-5) years.

We have performed an interposition arthroplasty using the abductor pollicis longus (APL) tendon for arthrosis in the basal joint of the thumb in our department since 1995. Before this, we had been using an interposition with the flexor carpi radialis (FCR) tendon. We re-examined 47 patients (55 thumbs) after a median follow-up of 41 (16-60) months. The pain relief was excellent in 32 thumbs, and 25 patients improved their ability to perform daily tasks. Mobility was well preserved. Key pinch and grip strengths averaged 78% and 89%, respectively, of those in unaffected hands. An excellent general result was reported by 34 patients, while 4 patients would not have consented to the operation if they had known the outcome in advance.

Adult↗