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Classification of distal radius fractures in children: good inter- and intraobserver reliability, which improves with clinical experience.

https://arctichealth.org/en/permalink/ahliterature127696
Source
BMC Musculoskelet Disord. 2012;13:6
Publication Type
Article
Date
2012
Author
Per-Henrik Randsborg
Einar A Sivertsen
Author Affiliation
The Department of orthopaedic surgery, Akershus University Hospital, Lørenskog, Norway. pran@ahus.no
Source
BMC Musculoskelet Disord. 2012;13:6
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Clinical Competence
Humans
Medical Staff, Hospital
Norway
Observer Variation
Orthopedics - methods
Predictive value of tests
Radius Fractures - classification - radiography
Reproducibility of Results
Time Factors
Abstract
We wanted to test the reliability of a commonly used classification of distal radius fractures in children.
105 consecutive fractures of the distal radius in children were rated on two occasions three months apart by 3 groups of doctors; 4 junior registrars, 4 senior registrars and 4 orthopedic consultants. The fractures were classified as buckle, greenstick, complete or physeal. Kappa statistics were used to analyze inter- and intraobserver reliability.
The kappa value for interobserver agreement at the first reading was 0.59 for the junior registrars, 0.63 for the senior registrars and 0.66 for the consultants. The mean kappa value for intraobserver reliability was 0.79 for the senior registrars, 0.74 for the consultants and 0.66 for the junior registrars.
We conclude that the classification tested in this study is reliable and reproducible when applied by raters experienced in fracture management. The reliability varies according to the experience of the raters. Experienced raters can verify the classification, and avoid unnecessary follow-up appointments.
Notes
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PubMed ID
22269925 View in PubMed
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Compensation after treatment for anterior cruciate ligament injuries: a review of compensation claims in Norway from 2005 to 2015.

https://arctichealth.org/en/permalink/ahliterature294189
Source
Knee Surg Sports Traumatol Arthrosc. 2018 Feb; 26(2):628-633
Publication Type
Journal Article
Date
Feb-2018
Author
Per-Henrik Randsborg
Ida Rashida Kahn Bukholm
Rune Bruhn Jakobsen
Author Affiliation
Department of Orthopaedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway. pran@ahus.no.
Source
Knee Surg Sports Traumatol Arthrosc. 2018 Feb; 26(2):628-633
Date
Feb-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Anterior Cruciate Ligament Injuries - surgery
Anterior Cruciate Ligament Reconstruction - legislation & jurisprudence
Compensation and Redress - legislation & jurisprudence
Female
Hamstring Muscles - transplantation
Humans
Insurance Claim Review
Male
Malpractice - economics
Middle Aged
Norway
Odds Ratio
Registries
Young Adult
Abstract
To assess the most common reasons for complaints following anterior cruciate ligament (ACL) injuries reported to the Norwegian System of Patient Injury Compensation (NPE), and to view these complaints in light of the ACL reconstructions (ACL-Rs) reported to the Norwegian Knee Ligament Registry (NKLR).
Data from the NPE and the NKLR were collected for the study period (2005-2015). The age and gender and type of complaint and reason for granted compensation were collected from the NPE, while the graft choice and total number of ACL-R were collected from the NKLR. Risk for successful grant was estimated for graft type.
18,810 primary ACL-Rs were reported to the NKLR during the study period. A hamstring graft was used in 12,437 (66.1%) but the bone-patellar tendon-bone (BPTB) became the graft of choice at the end of the study period. 240 patients filed a complaint to the NPE, of which 101 were granted compensation. The odds ratio for a claim being granted following a hamstring graft was 2.9 compared to that of a BPTB graft (p?=?0.002) The most common reason for compensation was a hospital-acquired infection in 39 patients (38.6%) followed by inadequate surgical technique (27, 26.7%) and delayed diagnosis (13, 12.9%). Of the 39 patients with infection, 27 had received a hamstring graft and six a BPTB graft (two patients were not reconstructed, data missing for three patients). Of the 27 patients who were granted compensation due to inadequate surgical technique, 24 had received a hamstring graft and three a BPTB graft.
Infection and inadequate surgical technique are the most common causes for granted compensation from the NPE following ACL injury. Hamstring grafts have a threefold risk of complication that yields compensation from the NPE compared to BPTB grafts. This information is relevant for patients and surgeons when choosing graft type. The trend of increased use of BPTB grafts is warranted based on the results from this study.
Level III.
Notes
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PubMed ID
29181559 View in PubMed
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Epidemiology of distal radius fracture in Akershus, Norway, in 2010-2011.

https://arctichealth.org/en/permalink/ahliterature299626
Source
J Orthop Surg Res. 2018 Aug 13; 13(1):199
Publication Type
Journal Article
Date
Aug-13-2018
Author
Håkon With Solvang
Robin Andre Nordheggen
Ståle Clementsen
Ola-Lars Hammer
Per-Henrik Randsborg
Author Affiliation
The Department of Orthopedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway.
Source
J Orthop Surg Res. 2018 Aug 13; 13(1):199
Date
Aug-13-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Female
Fracture Fixation, Internal - methods
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Radius Fractures - classification - epidemiology - etiology - surgery
Treatment Outcome
Young Adult
Abstract
Several studies published over the last decade indicate an increased incidence of distal radius fractures (DRF). With Norway having one of the highest reported incidence of DRFs, we conducted a study to assess the epidemiology of DRFs and its treatment in the catchment area of Akershus University Hospital (AHUS).
Patients 16 years or older who presented to AHUS with an acute DRF during the years 2010 and 2011 were prospectively recorded and classified according to the AO fracture classification system. The mechanism of injury and treatment modality were noted.
Overall, 1565 patients with an acute DRF presented to the institution in 2010-2011, of which 1134 (72%) were women. The overall annual incidence was 19.7 per 10,000 inhabitants 16 years or older. Women had an exponential increase in incidence after the age of 50, though the incidence for both genders peaked after the age of 80 years. There was an even distribution between extra- and intra-articular fractures. Falling while walking outside was the most common mechanism of injury. Of the 1565 registered, 418 (26.7%) patients underwent surgery, with a volar locking plate being the preferred surgical option in 77% of the cases.
The overall incidence of distal radius fractures was lower in our study than earlier reports from Norway. Postmenopausal women had a higher risk of fracture than the other groups, and low-energy injuries were most dominant. 26.7% were treated operatively, which is higher than earlier reports, and might reflect an increasing preference for surgical treatment.
PubMed ID
30103788 View in PubMed
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Focal cartilage defects in the knee - a randomized controlled trial comparing autologous chondrocyte implantation with arthroscopic debridement.

https://arctichealth.org/en/permalink/ahliterature278284
Source
BMC Musculoskelet Disord. 2016 Mar 08;17:117
Publication Type
Article
Date
Mar-08-2016
Author
Per-Henrik Randsborg
Jan Brinchmann
Sverre Løken
Heidi Andreassen Hanvold
Tommy Frøseth Aae
Asbjørn Årøen
Source
BMC Musculoskelet Disord. 2016 Mar 08;17:117
Date
Mar-08-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Arthritis, Rheumatoid - diagnosis - physiopathology - surgery
Arthroscopy - adverse effects
Cartilage, Articular - diagnostic imaging - surgery
Cells, Cultured
Chondrocytes - transplantation
Clinical Protocols
Debridement - adverse effects - methods
Disability Evaluation
Female
Humans
Knee Joint - diagnostic imaging - physiopathology - surgery
Magnetic Resonance Imaging
Male
Middle Aged
Norway
Osteoarthritis, Knee - diagnosis - physiopathology - surgery
Physical Therapy Modalities
Prospective Studies
Recovery of Function
Research Design
Surveys and Questionnaires
Time Factors
Transplantation, Autologous
Treatment Outcome
Young Adult
Abstract
Focal cartilage injuries in the knee might have devastating effect due to the predisposition of early onset osteoarthritis. Various surgical treatment options are available, however no statistically significant differences have been found between the different surgical treatments. This supports the suggestion that the improvement might be a result of the post-operative rehabilitation rather than the surgery itself. Autologous chondrocyte implantation (ACI) has become a recognized treatment option for larger cartilage lesions in the knee. Although ACI has been compared to other surgical treatment such as microfracture and mosaicplasty, it has never been directly compared to simple arthroscopic debridement and rehabilitation alone. In this study we want to increase clinical and economic knowledge about autologous chondrocyte implantation compared to arthroscopic debridement and physical rehabilitation in the short and long run.
We will conduct a randomized controlled trial to compare ACI with simple arthroscopic debridement (AD) and physiotherapy for the treatment of cartilage lesions in the knee. The study will include a total of 82 patients, both men and non-pregnant women, with a full thickness cartilage defect in the weight bearing area of the femoral condyles or trochlea larger than 2 cm2. The lesion must be symptomatic, with a Lysholm score less than 75. The two treatment groups will receive identical rehabilitation protocol according to a modification of Wondrasch et al., which is an active rehabilitation and education program divided into 3 phases: accommodation, rehabilitation and return to activity. The patients will be followed for 24 months, with additional late follow-ups at 5 and 10 years to monitor the potential onset of osteoarthtitis. The primary outcome measure will be the difference in the KOOS knee-related quality of life (QoL) subscore in the ACI group compared to the AD group at 2 years. A combination of self-explanatory questionnaires, clinical parameters, clinical hop tests and radiographs and Magnetic Resonance Imaging (MRI) will be used as secondary endpoints.
This is the first study with a high level of evidence to compare ACI with simple debridement and physiotherapy for the treatment of isolated symptomatic full thickness lesions of the knee.
ClinicalTrial NCT02636881 (21 December 2015).
Notes
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PubMed ID
26956476 View in PubMed
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Fractures in children: aspects on health service, epidemiology and risk factors.

https://arctichealth.org/en/permalink/ahliterature114491
Source
Acta Orthop Suppl. 2013 Apr;84(350):1-24
Publication Type
Article
Date
Apr-2013

Fractures in children: epidemiology and activity-specific fracture rates.

https://arctichealth.org/en/permalink/ahliterature115005
Source
J Bone Joint Surg Am. 2013 Apr 3;95(7):e42
Publication Type
Article
Date
Apr-3-2013
Author
Per-Henrik Randsborg
Pål Gulbrandsen
Jurate Saltyte Benth
Einar Andreas Sivertsen
Ola-Lars Hammer
Hendrik F S Fuglesang
Asbjørn Arøen
Author Affiliation
Department of Orthopedic Surgery, Akershus University Hospital, 1478 Lørenskog, Norway. pran@ahus.no
Source
J Bone Joint Surg Am. 2013 Apr 3;95(7):e42
Date
Apr-3-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Athletic Injuries - epidemiology
Child
Child, Preschool
Confidence Intervals
Female
Fractures, Bone - epidemiology
Humans
Incidence
Male
Norway - epidemiology
Prospective Studies
Risk factors
Abstract
Approximately one-third of pediatric fractures occur during sport or recreational activity. In this paper, we investigate the incidence and causes of pediatric fractures in our region and quantify the fracture rate per exposure time for the most common sport and recreational activities.
We prospectively evaluated all children younger than sixteen years who presented to our institution with a new fracture within a twelve-month period. Exposure time to the most common childhood activities was measured by means of interviewing random parents from the study population. The main outcome measures were the annual fracture incidence in the population and fracture rates per 10,000 hours of exposure to various sports and recreational activities.
A total of 1403 fractures were included. The overall annual incidence was 180.1 fractures per 10,000 children younger than sixteen years. The distal part of the radius was most often fractured (436 fractures, 31.1%). Snowboarding was associated with the highest activity-specific fracture rate, estimated to be 1.9 (95% confidence interval [CI], 1.16 to 2.60) fractures per 10,000 hours of exposure. In comparison, the fracture rate per 10,000 hours of exposure was 0.79 (CI, 0.42 to 1.09) for handball, 0.44 (CI, 0.35 to 0.52) for soccer, and 0.35 (CI, 0.23 to 0.47) for trampolining.
The distal part of the radius is the most common fracture site in childhood. Fracture rates differ between various physical activities. The fracture rate for snowboarding was four times higher compared with that for other common childhood sport and recreational activities in our region.
PubMed ID
23553305 View in PubMed
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Source
Tidsskr Nor Laegeforen. 2015 May 19;135(9):866-8
Publication Type
Article
Date
May-19-2015
Author
Per-Henrik Randsborg
Source
Tidsskr Nor Laegeforen. 2015 May 19;135(9):866-8
Date
May-19-2015
Language
Norwegian
Publication Type
Article
Keywords
Fellowships and Scholarships
General Surgery
Great Britain
Humans
Knee - surgery
London
Norway
PubMed ID
25991626 View in PubMed
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7 records – page 1 of 1.