Publications by authors named "Toni Luokkala"

Aims: A review of the literature on elbow replacement found no consistency in the clinical outcome measures which are used to assess the effectiveness of interventions. The aim of this study was to define core outcome domains for elbow replacement.

Methods: A real-time Delphi survey was conducted over four weeks using outcomes from a scoping review of 362 studies on elbow replacement published between January 1990 and February 2021.

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Background And Objective: The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18-65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate.

Methods: The study population of this retrospective cohort study consisted of working-aged (18-65 years) patients with DRF who were treated with VLP between January 2010 and December 2020.

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Background: Surgery, needle fasciotomy, and collagenase injection are used to treat Dupuytren contracture. The treatment decision requires balancing initial morbidity and costs of surgery against its potential long-term benefits over needle fasciotomy and collagenase.

Objective: To compare the effectiveness of surgery, needle fasciotomy, and collagenase injection at 3 months and 2 years (secondary time points of the trial).

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Background And Purpose: Non-operative treatment is the most common treatment option for older patients with distal radius fracture (DRF). Traditionally, wrists have been placed in volar-flexion and ulnar deviation position (VFUDC). In recent years, there has been a trend towards using a functional position cast (FC).

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Introduction: Open reduction and internal fixation with volar locking plate has become the most common fixation method in the treatment of unstable distal radius fracture (DRF). There is, however, no consensus as to whether or for how long a wrist should be immobilised after operative treatment. To date, there have been relatively few studies that have evaluated the effect of immediate postoperative mobilisation on functional outcomes.

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Introduction: The incidence of olecranon fractures is growing in the elderly population. The traditional operative approach is giving way among the elderly to conservative treatment, which seems to provide a comparable functional outcome with a lower complication burden. However, there is still a lack of reliable evidence to support this shift.

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Background: Modern multistrand repairs can withstand forces present in active flexion exercises, and this may improve the outcomes of flexor tendon repairs. We developed a simple home-based exercise regimen with free wrist and intrinsic minus splint aimed at facilitating the gliding of the flexor tendons and compared the outcomes with the modified Kleinert regimen used previously in the same institution.

Methods: We searched the hospital database to identify flexor tendon repair performed before and after the new regimen was implemented and invited all patients to participate.

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Introduction: The purpose of this study was to evaluate the demographics, complications and prodromal symptoms (any pain or unpleasant sensation in the area distal biceps tendon preceding the injury) of distal biceps tendon tears (DBTTs) of patients treated with primary repair or Achilles allograft reconstruction.

Materials And Methods: 228 consecutive DBTTs in 226 patients from a single centre were evaluated. The demographic data, prodromal symptoms and postoperative adverse events were documented.

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Background: Tension band wiring and plate fixation are common techniques used to stabilize simple olecranon fractures and osteotomies of the olecranon. All suture fixation is an alternative technique but has not been compared previously to these traditional methods. The aim of this study was to compare the clinical and radiographic outcomes of the three techniques.

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Background: The aim of this study was to assess the sensitivity of distal biceps hook test - O'Driscoll hook test - in a retrospective series of acute and chronic distal biceps tendon tears and investigate the ability of the test to predict the need for graft reconstruction.

Methods: We retrospectively evaluated 234 consecutive distal biceps tendon tears operated in a single centre. The result of O'Driscoll hook test and perioperative findings of distal biceps were documented in standard fashion.

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We found no clear evidence of the clinical superiority of distal radius fracture surgery among older adults at one year.Surgical treatment, however, may yield a faster recovery to previous level of activity in elderly patients.With operative treatment, hardware-based problems may warrant secondary operations and implant removal, whereas in non-operative treatment, symptomatic loss of alignment and malunion can occur.

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Background: Distal radius fractures are common fractures and the cornerstone of treatment remains immobilization of the wrist in a cast. At present, there is a scarcity of studies that compare different cast immobilization methods. The objective of the study was therefore to compare volar-flexion and ulnar deviation cast to functional cast position in the treatment of dorsally displaced distal radius fracture among elderly patients.

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Background: The elbow is the second most commonly dislocated joint. Stability depends on the degree of soft tissue injury, with 2 proposed patterns, one starting laterally and the other medially. The purpose of this study was to describe the injured structures observed in magnetic resonance images (MRIs) in a prospective cohort of simple elbow dislocations.

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Purpose: Any loss of range of motion of the finger after flexor tendon repair is an impairment of function, but to what extent it causes disability is not properly understood. The aim of this study was to assess the correlation between perceived function (disability) and objectively measured loss of function (impairment), to understand what impairments are meaningful to patients.

Methods: We assessed 49 patients who underwent flexor tendon repair an average of 38 months after repair.

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Background: Elbow posterolateral rotatory instability occurs after an injury to the lateral collateral ligament complex (LCLC) in isolation or in association with an osteochondral fracture of the posterolateral margin of the capitellum (Osborne-Cotterill lesion [OCL]). The contribution to elbow stability of the posterolateral capsule, attached to this lesion, is unknown. This study quantified the displacement of the radial head on simulated posterior draw with sectioning of the posterior capsule (a simulated OCL) or LCLC.

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Background: In the literature, there are numerous studies that compare different surgical procedures in the treatment of distal radius fractures (DRF). It is, however, unknown whether operative treatment and better restoration of anatomy with volar locking plate yields a better functional outcome in the elderly population when compared with non-operative treatment.

Methods And Design: This study is a prospective, randomized, controlled, multi-center trial.

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Background: Distal radius fractures (DRFs) are the second most common fractures, after hip fractures, seen in clinical practice. The high incidence of low-energy trauma DRFs in elderly patients raises questions about the best treatment method in terms of function, pain, and quality of life. Although the majority of these fractures are treated non-operatively with cast immobilization, valid scientific evidence of the optimal cast immobilization is lacking.

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Objectives: To investigate the ability of individual surgeons [expert opinion (EO)] to predict distal radius fracture (DRF) healing above a threshold malalignment compared with the majority prediction of the group of surgeons ["majority rule," (MR)] and a statistically derived clinical prediction formula [Edinburgh wrist calculator (EWC)].

Design: Comparative diagnostic study from prospectively collected data of consecutive patients.

Setting: Two academic level 1 and 1 academic level 2 trauma centers.

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The repair of a segmental peripheral nerve injury is a clinical challenge. Several studies have been performed to determine superior methods for overcoming nerve gaps. The purpose of this study was to investigate if the inside-out slided epineurium of the distal segment of an injured nerve can serve as a conduit to bridge a short nerve defect (10 mm).

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