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Adolfsson, Lars
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Publications (10 of 45) Show all publications
Adolfsson, L. (2018). Post-traumatic stiff elbow. EFORT open reviews, 3(5), 210-216
Open this publication in new window or tab >>Post-traumatic stiff elbow
2018 (English)In: EFORT open reviews, ISSN 2058-5241, Vol. 3, no 5, p. 210-216Article, review/survey (Refereed) Published
Abstract [en]

Post-traumatic and post-operative stiffness of the elbow joint is relatively common and may in pronounced cases markedly interfere with normal upper extremity function.Soft-tissue contractures and heterotopic bone formation are two major causes of limited movement.Extensive recent research has elucidated many of the pathways contributing to these conditions, but the exact mechanisms are still unknown.In the early phase of soft-tissue contractures conservative treatment may be valuable, but in longstanding cases operative treatment is often necessary.Several different options are available depending on the severity of the condition and the underlying offending structures. Surgical treatment may allow significant gains in movement but rarely complete restoration, and complications are not uncommon.The following presentation reviews the recent literature on pathomechanisms and treatment alternatives. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170062.

Place, publisher, year, edition, pages
British Editorial Society of Bone & Joint Surgery, 2018
Keywords
contracture release; heterotopic bone formation; post-traumatic contracture; stiff elbow; treatment
National Category
Medical Equipment Engineering
Identifiers
urn:nbn:se:liu:diva-155858 (URN)10.1302/2058-5241.3.170062 (DOI)29951258 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-03-29
Svernlöv, B., Nestorson, J. & Adolfsson, L. (2017). Subjective ulnar nerve dysfunction commonly following open reduction, internal fixation (ORIF) of distal humeral fractures and in situ decompression of the ulnar nerve. Strategies in trauma and limb reconstruction (Online), 12(1), 19-25
Open this publication in new window or tab >>Subjective ulnar nerve dysfunction commonly following open reduction, internal fixation (ORIF) of distal humeral fractures and in situ decompression of the ulnar nerve
2017 (English)In: Strategies in trauma and limb reconstruction (Online), ISSN 1828-8928, Vol. 12, no 1, p. 19-25Article in journal (Refereed) Published
Abstract [en]

The aim of this retrospective study was to investigate the frequency of persistent ulnar affection in patients who underwent open reduction and internal fixation (ORIF) of distal humeral fractures without ulnar nerve transposition or mobilisation. Eighty-two patients (53 women), mean age 62 years, were, at a mean of 48 months, reviewed through medical records and a subjective evaluation form concerning ulnar nerve problems. Ulnar nerve affliction, in most cases regarded as mild, was experienced by 22 patients (27%; 14 women) and significantly associated with multiple surgeries. Three patients had been operated with late neurolysis and one with transposition without reported improvement. The proportion of ulnar nerve dysfunction was equally common regardless of medial or lateral plating. ORIF with plate fixation and without ulnar nerve transposition seems to be an acceptable option for patients with distal humeral fractures. The frequency of ulnar nerve affection in our series does not appear higher than previously reported. Subjective ulnar nerve symptoms were, however, relatively common and appear related to the trauma itself, the surgery, or the post-operative management which highlights the need for further analysis of these factors.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Dellon; Fracture; Humeral; McGowan; ORIF; Transposition
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-146069 (URN)10.1007/s11751-016-0271-5 (DOI)27909969 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-04-27
Schilcher, J., Scheer, J. & Adolfsson, L. (2016). Transclavicular Osseous Sutures for the Treatment of Displaced Distal Clavicular Fractures in Children. Journal of Orthopaedic Trauma, 30(5), E181-E185
Open this publication in new window or tab >>Transclavicular Osseous Sutures for the Treatment of Displaced Distal Clavicular Fractures in Children
2016 (English)In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 30, no 5, p. E181-E185Article in journal (Refereed) Published
Abstract [en]

We describe a novel surgical technique for the treatment of displaced distal clavicular fractures in children. These fractures are rare, and recommendations on treatment vary. Conservative treatment might lead to persistent deformity and limitations of function. Previous reports of surgical treatment involve fracture fixation with K-wires. This requires a routine sequential reoperation to remove the implant and has been associated with serious complications in some patients. The surgical technique described here is based on osseous sutures through the clavicular shaft and coracoclavicular ligaments and is found successful for the treatment of distal clavicular fractures in children and may also be feasible for true acromioclavicular dislocations. The main principle of the technique is a fixation of the displaced clavicle through transclavicular drill holes, against the intact inferior periosteal sleeve at the insertion of the coracoclavicular ligaments. No temporary K-wire fixation is needed. To date, we have treated 7 patients with this technique. All fractures healed uneventfully with an excellent functional result and without skeletal deformity.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2016
Keywords
clavicular fracture; children; osseous suture
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-128739 (URN)10.1097/BOT.0000000000000527 (DOI)000374833200007 ()27101169 (PubMedID)
Note

Funding Agencies|Ostergotland County Council, Sweden

Available from: 2016-05-31 Created: 2016-05-30 Last updated: 2017-11-30
Adolfsson, L. (2015). Editorial Material: Is surgery for the subacromial pain syndrome ever indicated? in ACTA ORTHOPAEDICA, vol 86, issue 6, pp 639-640. Acta Orthopaedica, 86(6), 639-640
Open this publication in new window or tab >>Editorial Material: Is surgery for the subacromial pain syndrome ever indicated? in ACTA ORTHOPAEDICA, vol 86, issue 6, pp 639-640
2015 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 86, no 6, p. 639-640Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-124137 (URN)10.3109/17453674.2015.1099597 (DOI)000365484500001 ()26446801 (PubMedID)
Available from: 2016-01-22 Created: 2016-01-19 Last updated: 2017-09-04
Nestorson, J., Ekholm, C., Etzner, M. & Adolfsson, L. (2015). Hemiarthroplasty for irreparable distal humeral fractures: Medium-term follow-up of 42 patients. The Bone & Joint Journal, 97B(10), 1377-1384
Open this publication in new window or tab >>Hemiarthroplasty for irreparable distal humeral fractures: Medium-term follow-up of 42 patients
2015 (English)In: The Bone & Joint Journal, ISSN 2049-4394, E-ISSN 2049-4408, Vol. 97B, no 10, p. 1377-1384Article in journal (Refereed) Published
Abstract [en]

We report our experience of performing an elbow hemiarthroplasty in the treatment of comminuted distal humeral fractures in the elderly patients. A cohort of 42 patients (three men and 39 women, mean age 72; 56 to 84) were reviewed at a mean of 34.3 months (24 to 61) after surgery. Functional outcome was measured with the Mayo Elbow Performance Score (MEPS) and range of movement. The disabilities of the arm, shoulder and hand questionnaire (DASH) was used as a patient rated evaluation. Complications and ulnar nerve function were recorded. Plain radiographs were obtained to assess prosthetic loosening, olecranon wear and heterotopic bone formation. The mean extension deficit was 23.5 degrees (0 degrees to 60 degrees) and mean flexion was 126.8 degrees (90 degrees to 145 degrees) giving a mean arc of 105.5 degrees (60 degrees to 145 degrees). The mean MEPS was 90 (50 to 100) and a mean DASH score of 20 (0 to 63). Four patients had additional surgery for limited range of movement and one for partial instability. One elbow was revised due to loosening, two patients had sensory ulnar nerve symptoms, and radiographic signs of mild olecranon wear was noted in five patients. Elbow hemiarthroplasty for comminuted intra-articular distal humeral fractures produces reliable medium-term results with functional outcome and complication rates, comparable with open reduction and internal fixation and total elbow arthroplasty.

Place, publisher, year, edition, pages
BRITISH EDITORIAL SOC BONE JOINT SURGERY, 2015
National Category
Clinical Medicine Orthopaedics
Identifiers
urn:nbn:se:liu:diva-122788 (URN)10.1302/0301-620X.97B10.35421 (DOI)000363600600013 ()26430013 (PubMedID)
Available from: 2015-11-23 Created: 2015-11-23 Last updated: 2018-02-20Bibliographically approved
Scheer, J. & Adolfsson, L. (2015). Non-union in 3 of 15 osteotomies of the distal radius without bone graft. Acta Orthopaedica, 86(3), 316-320
Open this publication in new window or tab >>Non-union in 3 of 15 osteotomies of the distal radius without bone graft
2015 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 86, no 3, p. 316-320Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Open-wedge osteotomies of the distal radius create a void that is usually filled with either iliac crest bone graft or bone substitute. Previous studies have suggested that this is unnecessary. We investigated the safety of omitting the filling procedure. Patients and methods - We included 15 patients with a dorsal malunion of a distal radius fracture. A palmar approach and angle-stable plates were used. The patients were followed until there was radiographic and clinical healing. Results - Non-union occurred in 3 of the 15 patients. The study, which had been planned to include 25 patients, was then discontinued. 6 osteotomies created a trapezoid void (no cortical contact); 3 of these did not unite after the index procedure (p = 0.04), but did subsequently, after autogenous bone grafting. A trapezoid void was significantly associated with non-union (p = 0.04). Interpretation - When a trapezoid defect is created, one should consider bone substitute or autogenous bone graft. This has been shown to be safe in other studies.

Place, publisher, year, edition, pages
Informa Healthcare: Creative Commons Attribution Non-Commercial / Informa Healthcare, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-120057 (URN)10.3109/17453674.2015.1007415 (DOI)000355976700009 ()25619425 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland; Linkoping University, Sweden

Available from: 2015-07-06 Created: 2015-07-06 Last updated: 2017-12-04
Björnsson Hallgren, H., Holmgren, T., Öberg, B., Johansson, K. & Adolfsson, L. (2014). A specific exercise strategy reduced the need for surgery in subacromial pain patients. British Journal of Sports Medicine, 48(19), 1431-1436
Open this publication in new window or tab >>A specific exercise strategy reduced the need for surgery in subacromial pain patients
Show others...
2014 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, no 19, p. 1431-1436Article in journal (Refereed) Published
Abstract [en]

Background and purpose A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome. Patients and methods 97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls). After 3 months of exercises, the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up. 1 year after inclusion or 1 year after surgery, the number of patients who decided to have surgery in each group was compared. The choice of surgery was related to the baseline Constant-Murley score, ultrasound and radiographs taken at inclusion. Results All patients had improved significantly (pless than0.0001) in the Constant-Murley score at the 1-year follow-up. Significantly more patients in the control group decided to have surgery (63%) than those in the specific exercise group (24%; pless than0.0001). Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear. Patients with partial tears did not differ from those with intact tendons. Interpretation The positive short-term results of specific exercises were maintained after 1 year, and this exercise strategy reduces the need for surgery. Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2014
Keywords
Shoulder injuries, Physiotherapy, Eccentric exercise, Tendon, Ultrasounds
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-111441 (URN)10.1136/bjsports-2013-093233 (DOI)000341947200009 ()24970843 (PubMedID)
Note

Funding Agencies|Linkoping University Hospital

Available from: 2014-10-21 Created: 2014-10-17 Last updated: 2017-12-05
Adolfsson, L. (2014). Fractures of the Distal Humerus: Total Elbow Arthroplasty (Hemi-Arthroplasty) (3ed.). In: George Bentley (Ed.), European Surgical Orthopaedics and Traumatology: (pp. 1407-1422). Heidelberg: Springer Berlin/Heidelberg
Open this publication in new window or tab >>Fractures of the Distal Humerus: Total Elbow Arthroplasty (Hemi-Arthroplasty)
2014 (English)In: European Surgical Orthopaedics and Traumatology / [ed] George Bentley, Heidelberg: Springer Berlin/Heidelberg, 2014, 3, p. 1407-1422Chapter in book (Other academic)
Abstract [en]

This important reference textbook covers the surgical management of all major orthopaedic and traumatological conditions. The book will act as the major source of education and guidance in surgical practice for surgeons and trainees, especially those preparing for higher surgical examinations and the Board of Orthopaedics and Traumatology examinations within and beyond Europe. The emphasis throughout is on the application of current knowledge and research to technical problems, how to avoid operative problems, and how to salvage complications if they occur. The didactic text is complemented by abundant illustrations that highlight the essentials of each clinical scenario. The authors are all recognized international authorities active at congresses and workshops as well as in universities and hospitals across the world. ​

Place, publisher, year, edition, pages
Heidelberg: Springer Berlin/Heidelberg, 2014 Edition: 3
National Category
History
Identifiers
urn:nbn:se:liu:diva-117189 (URN)978-3-642-34745-0 (ISBN)978-3-642-34746-7 (eReference) (ISBN)978-3-642-34747-4 (ISBN)
Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2015-04-27
Holmgren, T., Öberg, B., Adolfsson, L. & Johansson, K. (2014). Minimal important changes in the Constant Murley score in patients with subacromial pain. Journal of shoulder and elbow surgery, 23(8), 1083-1090
Open this publication in new window or tab >>Minimal important changes in the Constant Murley score in patients with subacromial pain
2014 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 23, no 8, p. 1083-1090Article in journal (Refereed) Published
Abstract [en]

Objective: The purpose of this study was to determine the minimal important change (MIC) of improvement in the Constant‐Murley score (CM score) in patients with longstanding subacromial pain and in subgroups of patients with subacromial pain with and without rotator cuff ruptures.

Method: The MIC was estimated by using the visual anchor‐based MIC distribution method, which integrates an anchor‐ and distribution‐based approach: the optimal cut‐off point of the receiver operator characteristic curve (MIC ROC) and the 95% limit cut‐ off point (MIC 95%limit). The study population consisted of 93 patients included in a randomized clinical trial evaluating the effect of a specific exercise strategy in patients with longstanding subacromial pain.

Results: The MIC ROC was found at a mean change of 17 points in the CM score. The MIC 95% limit was found at a mean change of 24 points. In the subgroup analysis the MIC ROC was found at a mean change of 19 points and the MIC 95% limit at 18 points in patients with an intact rotator cuff. In patients with rotator cuff ruptures the MIC ROC was found at a mean change of 15 points and the MIC 95% limit at 30 points.

Conclusion: The CM score is able to detect the minimal important change in individual patients with long‐standing subacromial pain when the rotator cuff is intact. In all patients with longstanding subacromial pain, the MIC value was dependent on the subgroup as well as the choice of statistical analysis. The estimated MIC values could be used as an indication for relevant changes in the CM score in clinical practice and guide the clinician in how to interpret the results of specific treatments for patients with longstanding subacromial pain.

Place, publisher, year, edition, pages
Mosby-Elsevier, 2014
National Category
Health Sciences Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-90020 (URN)10.1016/j.jse.2014.01.014 (DOI)000341135000006 ()
Available from: 2013-03-15 Created: 2013-03-15 Last updated: 2017-12-06
Holmgren, T., Björnsson Hallgren, H., Öberg, B., Adolfsson, L. & Johansson, K. (2014). Republished research: Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. British Journal of Sports Medicine, 48(19), 1456-1457
Open this publication in new window or tab >>Republished research: Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study
Show others...
2014 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, no 19, p. 1456-1457Article in journal, Editorial material (Other academic) Published
Abstract [en]

STUDY QUESTION Can a specific exercise strategy improve shoulder function and pain in patients with subacromial impingement syndrome, thereby decreasing the need for arthroscopic subacromial decompression? SUMMARY ANSWER Compared with a control exercise group, patients in the specific exercise group had significantly greater improvements in shoulder function and pain and fewer patients needed surgery at the three month assessment. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Different exercise programmes are used as first line treatment in patients with subacromial impingement syndrome, but conclusive evidence to support the efficacy for these programmes is lacking. This specific exercise strategy proved effective in improving shoulder function and pain in patients in whom earlier conservative treatment had failed.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2014
National Category
Clinical Medicine Health Sciences
Identifiers
urn:nbn:se:liu:diva-111443 (URN)10.1136/bjsports-2014-e787rep (DOI)000341947200013 ()25213604 (PubMedID)
Note

Republished research from the BMJ

Available from: 2014-10-21 Created: 2014-10-17 Last updated: 2017-12-05
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