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Karlander, Lars-Erik
Publications (5 of 5) Show all publications
Rubensson, C., Ydreborg, K., Boren, L. & Karlander, L.-E. (2015). Flexor tendon repair after rupture caused by volar plate fixation of the distal radius. Journal of Plastic Surgery and Hand Surgery, 49(2), 112-115
Open this publication in new window or tab >>Flexor tendon repair after rupture caused by volar plate fixation of the distal radius
2015 (English)In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 49, no 2, p. 112-115Article in journal (Refereed) Published
Abstract [en]

Volar plate fixation of unstable fractures of the distal radius is preferred by a majority of surgeons today. One known complication is the rupture of flexor tendons. The aim of this paper is to present flexor tendon ruptures after volar plate fixation analysing the clinical outcome after tendon surgery, aetiology, and methods of prevention. Seventeen consecutive ruptures in 14 patients were included. The incidence was 1.4%. Three patients declined tendon surgery. Eleven patients were treated with a free tendon graft. Only two patients showed excellent results regarding mobility in the thumb and/or fingers. Analysis of radiographs demonstrated sub-optimal placement of plate or screws in all cases. Rupture of a flexor tendon is a serious complication where the functional outcome after surgical reconstruction is uncertain. Early removal of the plate when the placement is sub-optimal or when local volar tenderness appears would probably prevent many ruptures.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keywords
Hand; flexor tendon; tendon rupture; volar plate; outcome
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-117219 (URN)10.3109/2000656X.2014.951050 (DOI)000351350700009 ()25162925 (PubMedID)
Available from: 2015-04-22 Created: 2015-04-21 Last updated: 2017-12-04
Farnebo, S., Samuelsson, A., Henriksson, J., Karlander, L.-E. & Sjöberg, F. (2010). Urea clearance: a new method to register local changes in blood flow in rat skeletal muscle based on microdialysis. Clinical Physiology and Functional Imaging, 30(1), 57-63
Open this publication in new window or tab >>Urea clearance: a new method to register local changes in blood flow in rat skeletal muscle based on microdialysis
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2010 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 30, no 1, p. 57-63Article in journal (Refereed) Published
Abstract [en]

Pgreater thanIncreasing evidence suggests that local blood flow should be monitored during microdialysis (MD) as the recovery of analytes is affected by local blood flow. At present ethanol clearance is the standard technique for this purpose, but it is not functional at very low perfusion velocities. Here, we introduce a technique for MD whereby local tissue blood flow is recorded by the use of urea clearance (changes inflow/outflow concentration), in conjunction with measurements of tissue metabolism (glucose, lactate and puruvate). MD probes were inserted into the gracilis muscle of 15 rats and perfused with a medium containing urea (20 mmol l-1). Changes in muscle blood flow were made by addition of noradrenaline (5 mu g ml-1) to the perfusion medium at two perfusion velocities (0 center dot 6 and 0 center dot 4 mu l min-1). The clearance of urea from the perfusion medium was then calculated and examined in relation to the dose of noradrenaline and to the coexisting changes in extracellular metabolites. The results showed reproducible and dose-dependent changes in blood flow that were induced by noradrenaline. These were characterized by dose-dependent changes in the urea clearance as well as blood-flow-specific changes in the MD metabolic markers (reduction in glucose and increase in lactate). The sensitivity for blood flow changes as assessed by urea clearance (MD) was increased at 0 center dot 4 compared with the 0 center dot 6 mu l min-1 perfusion speed. The results indicate that inclusion of urea to the perfusion medium may be used to monitor changes in skeletal muscle blood flow at low perfusion velocities and in parallel assess metabolic variables with a high recovery (greater than 90%).

Keywords
extracellular fluid; glucose; lactate; metabolism; recovery
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-52899 (URN)10.1111/j.1475-097X.2009.00904.x (DOI)
Available from: 2010-01-13 Created: 2010-01-12 Last updated: 2017-12-12
Farnebo, S., Karlander, L.-E., Steinwall, I., Sjögren, F. & Sjöberg, F. (2009). Continuous assessment of concentrations of cytokines in experimental injuries of the extremity. International Journal of Clinical and Experimental Medicine, 2(4), 354-362
Open this publication in new window or tab >>Continuous assessment of concentrations of cytokines in experimental injuries of the extremity
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2009 (English)In: International Journal of Clinical and Experimental Medicine, ISSN 1940-5901, Vol. 2, no 4, p. 354-362Article in journal (Refereed) Published
Abstract [en]

Background. Inflammation plays an important part in the healing process. Little is known about the extent local inflammatory trauma response interacts with the central circulation and inflammation produced by central organs. The aim of the present study was to examine whether high cut-off microdialysis catheters offer potential to in real time assess interstitial cytokines variations in conjunction to markers of metabolism distal to a blunt vascular contusion. Methods. In a standardised contusion trauma model, microdialysis catheters (high MW (100kDa)) were inserted in the gracilis muscle distal to the trauma for the local assessment of IL-6, IL-8, TNF-a, total protein and the metabolic mediators (glycerol, puruvate and lactate). The contra lateral uninjured leg served as control of the centrally mediated inflammation propagated to the extremities. Results. The trauma led to a significant and quantitatively large (8-10 fold) increase in inflammatory cytokines (IL6 and 8) as measured both in the injured and control legs. There was only a minor, and not significant increase in concentrations of cytokines in the injured leg compared to the control leg.. There were no signs of ischemia in either leg. Conclusion. The new finding in this study is that both central, and local, inflammatory responses as well as metabolic mediators may be assessed continuously in skeletal muscle tissue distal to a major injury in an animal model. The findings suggest that the large trauma elicits a generalised inflammatory response to trauma rather than propagating a local one distal to the trauma.

Place, publisher, year, edition, pages
e-Century Publishing Corporation, 2009
Keywords
Blunt trauma; Inflammation; Microcirculation; Microdialysis; Rat
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57062 (URN)20057979 (PubMedID)
Available from: 2010-06-11 Created: 2010-06-09 Last updated: 2010-12-28
Karlander, L.-E., Henriksson, J. & Sjöberg, F. (2005). Acidosis in muscle tissue distal to vascular contusion despite unchanged global blood flow in rats: An uncoupling of microvascular blood flow and metabolism?. Microvascular Research, 70( 1-2), 111-115
Open this publication in new window or tab >>Acidosis in muscle tissue distal to vascular contusion despite unchanged global blood flow in rats: An uncoupling of microvascular blood flow and metabolism?
2005 (English)In: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 70, no 1-2, p. 111-115Article in journal (Refereed) Published
Abstract [en]

Studies using a contusion trauma model have shown that the femoral artery of the rat remains patent in 85% despite a severe vessel injury. A significant increase in tissue oxygenation (PtO2) has been found despite only a minor effect on blood flow (<20% decrease) on the muscle surface distal to the injury indicating a disturbed relationship between microvascular blood flow and metabolism. The aim of the present study was to further study the interplay between microvascular blood flow and metabolism within the distal muscle using an ethanol clearance technique (blood flow) in conjunction to the determination of an ischemia marker (lactate) by use of microdialysis. Although skeletal muscle blood flow remained unaltered as assessed by ethanol clearance, skeletal muscle lactate levels increased significantly (P < 0.001) post-trauma in both legs. The increase was initially higher, faster and the increase over time larger in the trauma leg as compared to the control leg (P < 0.001). These findings indicate a systemic effect of the trauma. Further, it suggests a functional impairment of the relationship between microvascular blood flow and/or muscle metabolic processes when the trauma is directed towards the supplying blood vessel. The reason for this anaerobic insult as found in this study compared to the presence of a local increase in PtO2 in the trauma leg as shown in our previous study is suggestive of an microvascular blood flow and tissue metabolism uncoupling. © 2005 Elsevier Inc. All rights reserved.

Keywords
blood flow, blunt trauma, ethanol clearance, lactate, microdialysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31539 (URN)10.1016/j.mvr.2005.06.003 (DOI)17339 (Local ID)17339 (Archive number)17339 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Karlander, L.-E., Gustavsson, U., Lidman, D. & Sjöberg, F. (2000). Severe contusion of the femoral vessels in rats alters tissue oxygenation and microvascular blood flow regulation in the skeletal muscles of the limb. Journal of Trauma - Injury, Infection and Critical Care, 48(2), 286-291
Open this publication in new window or tab >>Severe contusion of the femoral vessels in rats alters tissue oxygenation and microvascular blood flow regulation in the skeletal muscles of the limb
2000 (English)In: Journal of Trauma - Injury, Infection and Critical Care, ISSN 1079-6061, Vol. 48, no 2, p. 286-291Article in journal (Refereed) Published
Abstract [en]

Background: Severe contusion of an artery often presents clinical problems in that it affects flow distal to the injury. However, the effect of a contusion on the microvascular flow regulation in the distal part of the limb is still largely unknown. Methods: A multipoint microelectrode technique was used to assess both tissue oxygenation (P(t)O2) and microflow (hydrogen clearance) on the skeletal muscle surface in a standard contusion injury to the femoral vessels in rats. Results: A significant increase in and an altered distribution of (P(t)O2) as well as a reduction in and altered distribution of microflow on the muscle surface distal to the injury was found in all animals (n = 27) compared with the uninjured control leg. These findings could not be reproduced experimentally by sympathectomy or when the adjacent skeletal muscle alone was injured. Conclusion: The results suggest that the changes observed distal to the injury are of vascular origin, possibly as a result of endothelial damage at the site of the contusion.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25038 (URN)9463 (Local ID)9463 (Archive number)9463 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-14
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