Acta orthopaedica Scandinavica. Supplementum
-
To evaluate epidemiology, prognosis and diagnostics in metastatic bone disease and identify risk factors for failure after operation for pathologic fracture. ⋯ To decrease the risk of reoperation, it is important to identify patients with a long expected survival. Patients with a good prognosis should be considered for wide resection and reconstruction as applied in primary malignant bone tumors.
-
Acta Orthop Scand Suppl · Feb 2001
Multicenter StudyLocal recurrence of soft tissue sarcoma. A Scandinavian Sarcoma Group Project.
The aim of this project was to investigate the diagnosis, treatment and consequences of local recurrence of soft tissue sarcoma (STS). It is based on patients reported to the Karolinska Hospital Sarcoma Register and the Scandinavian Sarcoma Group Register. Demographic and treatment data, based on 1613 adult patients reported to the Scandinavian Sarcoma Group Register by sarcoma centers in Norway, Sweden and Finland are presented. ⋯ Radiotherapy is indicated especially after a previous open biopsy or when a local recurrence might lead to an amputation. Furthermore, radiotherapy seems indicated after local recurrence, regardless of margin or grade. The most effective way of reducing costs and detriment associated with local recurrence is to increase referral to sarcoma centers before biopsy or surgery as primary surgical margins would then improve.
-
Acta Orthop Scand Suppl · Dec 2000
On the validity of the results from the Swedish National Total Hip Arthroplasty register.
The Swedish National Total Hip Arthroplasty Register contains more than 200,000 primary and secondary hip replacements. The failure end-point definition is revision. The aim of this thesis was to validate the results presented by the register and to study the outcome of hip replacement surgery in Sweden. ⋯ The clinical and radiographic failure rates were in several tests as high as the revision rates documented in the Swedish THA register. The clinical results were, however, dependent on demographics, the definition of clinical failure and the scoring system used. The results presented by the register with revision as failure end-point give an exact but limited information about the quality of hip replacement surgery in Sweden.
-
Acta Orthop Scand Suppl · Oct 2000
ReviewAlternative techniques in trochanteric hip fracture surgery. Clinical and biomechanical studies on the Medoff sliding plate and the Twin hook.
In allowing compression along the femoral shaft (uniaxial dynamization) and optional compression along the femoral neck (biaxial dynamization), the Medoff sliding plate (MSP) represents a new principle in the fixation of trochanteric hip fractures. The Twin hook with 2 apical hooks was designed as an alternative to the lag screw. In 3 prospective consecutive case series and 1 prospective randomized study together comprising 342 trochanteric fractures, these alternative techniques were investigated. 3 postoperative fixation failures occurred in the unstable intertrochanteric fractures treated with biaxial dynamization with the MSP (n = 194), and 5 in those treated with the sliding hip screw (n = 62) (p = 0.04). ⋯ Biaxial dynamization with the MSP appears to control fracture impaction effectively and minimizes the rate of postoperative fixation failure in intertrochanteric fractures. In subtrochanteric fractures, uniaxial dynamization prevents medialization of the femoral shaft and is therefore preferred to biaxial dynamization. The Twin hook appears to provide adequate fixation stability, and with potential for simplified intraoperative handling and reduced dissection, the Twin hook may pose advantages compared to the lag screw.