Magne Røkkum

Oslo University Hospital, Kristiania (historical), Oslo, Norway

Are you Magne Røkkum?

Claim your profile

Publications (55)72.46 Total impact

  • T. Vaksvik · M. Røkkum · J. R. Haugstvedt · I. Holm
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The natural course and predictors for decreased cold hypersensitivity were studied in 85 patients with severe hand injuries involving nerve lesions. Methods: Questionnaires including the McCabe Cold Sensitivity Severity scale (CSS 0-400) were collected after injury, and at 6-month, 12-month, 2-year, and 3-year follow-ups. Results: Between the 12-month and 3-year follow-up, there was a small decrease in cold hypersensitivity as measured by the CSS (median = 24; Q1-Q3 = -11-75; n = 85). Five of the patients recovered from cold hypersensitivity, and ∼ 40% of the patients were less affected by cold hypersensitivity in daily life. Little or no pain early after injury and higher CSS-scores 12 months after primary surgery were weakly associated with the reduced CSS-scores (R(2) = 0.20) at the 3-year follow-up. Six patients had changed work or did not work due to cold hypersensitivity, but the majority of the patients had kept their cold-exposed work. Conclusion: Cold-hypersensitive patients may have a reasonable chance for decreased cold sensitivity and cold-associated activity limitations over time, although the majority of the patients will experience persistent problems. Tools to predict improvement remain insufficient.
    No preview · Article · Sep 2015 · Journal of Plastic Surgery and Hand Surgery
  • T. Vaksvik · A. Ruijs · M. Røkkum · I. Holm
    [Show abstract] [Hide abstract]
    ABSTRACT: Study design: Case series. Introduction: A home treatment program using a classical conditioning procedure to decrease cold hypersensitivity has potential to reduce symptoms. Purpose: To evaluate a home treatment program for cold hypersensitivity using a classical conditioning procedure in patients who are cold hypersensitive after hand and arm injuries. Methods: A series of 22 patients followed a classical conditioning procedure consisting of exposing the body to cold outdoor temperatures and immersing the hands in warm water, every other day, for five weeks. The McCabe Cold Sensitivity Severity scale (CSS) was used to measure cold hypersensitivity twice before treatment, at four weeks, and at one year after treatment; Likert scales was used for the patients ratings of improvements. A cold stress test was performed to evaluate rewarming capacity in injured fingers. Results: From the 20 patients, who returned questionnaires at all assessment points, 9 reported a small and three reported a moderate improvement in cold hypersensitivity after treatment. There was a trend toward improvement in the CSS (median 36; interquartile range -19 to 60) and in the rewarming pattern of fingers that were initially slow to rewarm. The improvements were sustained or increased at one-year follow-up. Conclusion: These preliminary results suggest that the classical conditioning procedure to treat cold hypersensitivity has potential and should be further explored in a trial with more rigorous design. Level of evidence: IV.
    No preview · Article · Sep 2015 · Journal of Hand Therapy
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: About 2,000 patients annually incur a fractured scaphoid in Norway. Assessment and diagnosis can be difficult, and fractures are overlooked. Scaphoid fractures have traditionally been cast-immobilised, but for the last decade screw fixing has been used increasingly, and offers hope of a higher healing frequency and improved function. Some scaphoid fractures are not diagnosed in the acute phase and some do not heal after treatment. Patients may then end up with painful pseudarthrosis. The purpose of this article is to provide an overview of the assessment, treatment and outcomes of scaphoid fractures. Method: The article is based on literature searches in PubMed and the authors' own clinical experience. Results: Primary diagnosis of scaphoid fractures and subsequent plaster cast immobilisation yield very good clinical results. Surgery should be limited to displaced fractures, fractures forming part of more extensive wrist injuries and exceptional other cases. Results comparable a quality equivalent to cast immobilisation are achieved by experienced surgeons in this area. Untreated scaphoid fractures often result in painful pseudarthrosis with subsequent abnormal position of the carpal bones and secondary arthrosis. This outcome can be counteracted by surgery on old fractures with bone grafting, internal fixation and cast immobilisation. Interpretation: Norwegian procedures for treating scaphoid fractures/pseudarthrosis are consistent with internationally documented good practice. Assessment of wrist pain following falls can be improved by conducting clinical tests for scaphoid fracture and radiology with four wrist projections. In the event of clinical suspicion, but no X-ray findings, the patient should be referred for a CT or MRI scan.
    Preview · Article · Jun 2015 · Tidsskrift for den Norske laegeforening
  • Olav Reikeras · Mona I Winge · Magne Røkkum
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare tibial fracture healing in rats with or without soft-tissue attachment. The left tibias of 30 Wistar rats were osteotomised and equally randomised into 3 groups. In the avascular segmental fracture group, an 8-mm bone segment were first removed and then immediately put back. In the vascular segmental fracture group, the 8-mm bone segment was not displaced, with periosteal and muscular attachments. In the simple fracture group, a simple fracture in the middle tibia was made. All tibias were then stabilised with an intramedullary nail through the patellar tendon, and the wound was closed with sutures. After 8 weeks, all left tibias and 9 of the intact right tibias were harvested. Bone mineral content and density of the calluses were assessed using dual energy X-ray absorptiometry scanning. The maximum torsional strength, rigidity, and energy to failure of the tibias were measured. All tibias healed (callus formation), without mal-union or pin migration. The 3 groups did not differ significantly in terms of torsional strength, rigidity, energy to failure, bone mineral content, and bone mineral density. The mean torsional strength of the 9 intact tibias was significantly higher than the healed tibias (14.9 vs. 10.6 Nmm, p=0.021). Soft-tissue detachment from bone segments did not impair bone healing in rats.
    No preview · Article · Apr 2015 · Journal of orthopaedic surgery (Hong Kong)

  • No preview · Article · Jan 2015 · Tidsskrift for den Norske laegeforening
  • Ole Reigstad · Magne Røkkum
    [Show abstract] [Hide abstract]
    ABSTRACT: Conversion of a failed total wrist arthroplasty to arthrodesis can be difficult. A custom-made titanium alloy peg was constructed to enable arthrodesis with the original arthroplasty components in situ. Two out of three patients were especially challenging cases with little bone available. Bony union was achieved in 2 to 3 months. The peg simplified a difficult revision situation and gave good, predictable results at follow-up.
    No preview · Article · Aug 2014
  • Ole Reigstad · Magne Røkkum
    [Show abstract] [Hide abstract]
    ABSTRACT: Earlier generations of wrist arthroplasty were limited to low demand patients. Bone fixation problems, excessive wear, and adverse designs resulting in loosening, imbalance, and dislocation led to the withdrawal of a number of models. Contemporary wrist prostheses aim at replacing wrist arthrodesis in the majority of patients with radiocarpal destruction, including high demand cases. Contraindications are wrist imbalance, insufficient soft tissue, or bone stock and infection. Various designs, fixation principles, bearing materials, and articulations have been employed. Some of the devises (RE-MOTION(TM), Motec(®)) demonstrate promising short- to midterm results, and calls for cautious optimism.
    No preview · Article · Jan 2014 · Hand Surgery
  • István Zoltán Rigó · Magne Røkkum
    [Show abstract] [Hide abstract]
    ABSTRACT: We compared the results of two methods for reinsertion of flexor digitorum profundus tendons retrospectively. In 35 fingers of 29 patients pull-out suture and in 13 fingers of 11 patients transverse intraosseous loop technique was performed with a mean follow-up of 8 and 6 months, respectively. Eleven and nine fingers achieved “excellent” or “good” function according to Strickland and Glogovac at 8 weeks; 20 and ten at the last control in the pull-out and transverse intraosseous loop groups, respectively. The difference at 8 weeks was statistically significant in favour of the transverse intraosseous loop group. Ten patients underwent 12 complications in the pull-out group (four superficial infections; one rerupture, one PIP and one DIP joint contracture, one adhesion, two granulomas, one nail deformity and one carpal tunnel syndrome) and four of them were reoperated (one carpal tunnel release, one teno-arthrolysis and two resections of granuloma). There was no complication and no reoperation in the transverse intraosseous loop group, the difference being statistically significant for the former. In our study the transverse intraosseous loop technique seemed to be a safe alternative with possibly better functional results compared to the pull-out suture.
    No preview · Article · Dec 2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The most frequent type of fracture in Norway is the fracture of the distal radius, with an incidence of approximately 15,000 per year. Various treatment alternatives exist, but it remains uncertain which patients should be treated surgically, and which methods are best suited. As a result, there is a relatively large variation in practice in Norway. In this report, we have summarized the evidence on treatment and rehabilitation of distal radial fractures from the most recent available systematic reviews of high quality. Main findings are as follows: There is not enough evidence to decide which method of reduction is best. There is some evidence to support the use of percutaneous pinning, however the best methods of percutaneous pinning are not established. There is some evidence to support the use of external fixation compared to plaster cast. Though there is insufficient evidence to confirm a better functional outcome, external fixation reduces the incidence of redisplacement, gives better anatomical results and most of the surgically-related complications are minor. There is insufficient evidence to determine the relative effects of the various methods of external fixation. Bone scaffolding (bone transplantation or use of bone substitutes) may improve anatomical outcome compared with plaster cast alone, but there is insufficient evidence to conclude on functional outcome or complications. The same applies for other comparisons between different bone scaffolding methods. There is some evidence that supports the use of rehabilitation interventions for patients with distal radius fractures. However, the evidence did not allow us to calculate the relative effect of different rehabilitation methods. The evidence base for the management of distal radius fracture is limited. Further research should therefore be preceeded by agreement on the priority questions for the management of these fractures, and to be addressed through large multi-centre trials.
    Full-text · Chapter · Mar 2013
  • István Z Rigó · Magne Røkkum
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Arthrodesis of the thumb metacarpophalangeal (MP) joint exhibits good results in rheumatoid patients but is controversial in post-traumatic conditions. This study evaluated the subjective outcome after thumb MP joint arthrodesis in chronic injuries and non-rheumatoid degenerative disorders. Forty-six patients were evaluated retrospectively with a mean follow-up of 4.1 years (range 1.5-6.5). Both the Quick DASH score (mean 18.6; range 0-72.7) and Visual Analogue Scales (satisfaction, pain, stiffness, and impairment of ADL; mean 3.2, 3.0, 3.0, and 2.5; range 0-9.6, 0-9.1, 0-9.8, and 0-9.6, respectively) showed wide variations. Twelve patients regretted the operation and 37 experienced difficulties with one or more specific activities. Multiple regression analyses indicated that elderly patients with painless instability are the best candidates for thumb MP joint arthrodesis. In young patients with excessively painful thumb MP joints and involvement in Workers' Compensation Board claims, but without advanced degenerative changes, this study recommends avoiding arthrodesis and considering alternative treatment modalities. The importance of adequate preoperative information about the realistic expectations after arthrodesis of the thumb MP joint is emphasised.
    No preview · Article · Feb 2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: Trapezium components from two uncemented total joint replacements were compared in a three-dimensional finite element model. A 100 N axial and angular load was applied in a normal and an osteoporotic bone model. The axial deformation and maximum periprosthetic stress are greater for the Elektra(TM) than the Motec CMC(®) cup. The Motec CMC(®) design is less sensitive to changing bone quality. The Elektra(TM) cup transmits more stress to the cortical bone rim in all load conditions, but under angular loading the proportionate increase in stress is lower. The Motec CMC(®) design distributes the stress and contact pressure more evenly, whereas the Elektra(TM) transfers most of the load to the cortical bone rim and the screw hole base. The design features that are believed to be of greatest significance for the differences are the raised centre of rotation of the Motec CMC(®) cup and the collar acting as a lever arm.
    No preview · Article · Jan 2013 · Hand Surgery
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty was implanted in 16 wrists with scaphoid nonunion advanced collapse (SNAC; grades 3 or 4) and 14 wrists with scapholunate advanced collapse (SLAC) in 30 patients (20 men) with severe (grades 3 or 4) post-traumatic osteoarthritis of the wrist. The mean age of the patients was 52 years (31 to 71). All prostheses integrated well radiologically. At a mean follow-up of 3.2 years (1.1 to 6.1) no luxation or implant breakage occurred. Two wrists were converted to an arthrodesis for persistent pain. Loosening occurred in one further wrist at five years post-operatively. The remainder demonstrated close bone-implant contact. The clinical results were good, with markedly decreased Disabilities of the Arm Shoulder and Hand (DASH) and pain scores, and increased movement and grip strength. No patient used analgesics and most had returned to work. Good short-term function was achieved using this wrist arthroplasty in a high-demand group of patients with post-traumatic osteoarthritis.
    No preview · Article · Nov 2012 · The Bone & Joint Journal
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract There is a need for a strong suture technique that allows early active mobilisation after repair of flexor tendons, but the best method has not yet been found. The aim of this study was to compare the modified Kessler suture biomechanically with a newer, two-strand suture. Eighteen porcine tendons were cut and repaired according to either the grasping modified Kessler suture or the combined side-locking loop technique (Yotsumoto) and interlocking horizontal mattress suture (Dona). The specimens were tested linearly to failure. The 2 mm gap force, yield force, ultimate force, stiffness, energy to yield, and energy to failure were all significantly higher (p value = 0.005, 0.003, <0.001, 0.001, 0.004, and 0.001, respectively) in the Yotsumoto-Dona group (median values (IQR): 30.9 (28.1-39.5) N, 82.7 (64.9-114.1) N, 82.7 (76.6-114.1) N, 12.5 (10-14.5) N/mm, 0.45 (0.2-0.5) J, and 0.45 (0.35-0.5) J) than in the modified Kessler group (25.8 (12.2-28.1) N, 35 (24.6-54.4) N, 50.9 (34.4-55.1) N, 7 (5.8-91) N/mm, 0.09 (0.06-0.18) J, and 0.21 (0.18-0.28) J). All Yotsumoto-Dona specimens had a yield force exceeding 35 N, while in the Kessler group only four did. The early yielding rate was 6/9 and 2/9 in the modified Kessler and the Yotsumoto-Dona groups, respectively (p = 0.15). Most of the core sutures failed by breakage, but three Yotsumoto knots loosened. All the simple running and six of the Dona epitendinous sutures failed predominantly by pulling-out, and by breakage at the intersections in three of the latter. The relatively easy two-strand Yotsumoto-Dona suture is likely to withstand the loads of active finger flexion, whereas the modified Kessler suture is probably not.
    No preview · Article · Aug 2012
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES:: Scaphoid non-union is relatively rare in children and adolescents, and no long-term follow-up has been reported. DESIGN:: retrospective follow-up study. PATIENTS:: Eleven patients (10 boys), mean 15.2 (13.9-15.9) years of age with scaphoid non-union and open growth plates were operated with bone grafting, Kirchner-wire fixation and 12 weeks of cast immobilisation. MAIN OUTCOME MEASUREMENTS:: Bony union, degenerative wrist changes and restoration of the carpal architecture was assessed with CT and radiographs. Clinical parameters included active ROM, grip strength, key pinch strength and subjective outcome scores (QDASH, VAS). RESULTS:: the patients were followed up after mean 6.9 (3.1-15.1) years, all attended. Radiographs and CT confirmed healing of all non-unions, the carpal anatomy was restored and the wrists were rated SNAC 0, without degenerative changes. The clinical result was excellent with VAS at rest = 1, at activity = 6 and QDASH score =3.3. Active ROM and grip strength were insignificantly reduced (14° and 2 kgs), the key pinch strength remained similar. CONCLUSION:: Healing of a scaphoid non-union can be expected in adolescents after open reduction, K-wire fixation, bone grafting and plaster immobilisation, resulting in pain relief and excellent wrist function without degenerative changes after longer term follow-up. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    No preview · Article · Aug 2012 · Journal of orthopaedic trauma
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bio-medical implants release metallic elements during the long periods of time while inserted in the human body. The chemical interactions between the tissues and surface of the implants, and the mechanical friction of implants cause the release of metals into the human tissues. In this study we investigated the distribution and the chemical-state of the metallic elements in the tissues around a failed implant system using PIXE (proton induced x-ray emission) and SR-XRF (synchrotron radiation x-ray fluorescence) spectroscopies. The specimens were from the cases of patients with diagnosed arthritis. The implant consisted of a stem and a metal backing made of Ti-6Al-4V, an implant head made of stainless steel, and a polyethylene (PE) cup. Both the stem and the metal backing had a plasma-sprayed HAp surface coating. Distribution and concentration of dissolved elements in tissues surrounding implants were examined and quantified using PIXE analysis. Similar specimen from the same case was further investigated using SR-XRF analysis. Chemical-states of the dissolved elements ware also studied by XAFS (x-ray absorption fine structure) analysis. From results of these measurements, it is confirmed that the tissues surrounding implants contained metallic elements such as Fe, Cr, Ni, and Ti. These elements are originated from the implant. Furthermore, it was made clear that the chemical-state of Fe had changed as a consequence of dissolution of Fe in the organic tissues.
    No preview · Article · Apr 2012 · International Journal of PIXE
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scaphoid injury and subsequent non-union is a well documented and researched subject. This article gives an overview of the epidemiology and results of the patients we have treated for scaphoid non-union at a University Hospital. 283 scaphoid non-unions in 268 patients (83% men) were operated upon, 230 as a primary and 47 as a secondary. The median age at time of surgery was 27 years. One-third of the non-unions were located in the proximal part of the scaphoid and the remaining two-thirds in the middle part. Of the 146 patients (55%) who contacted a doctor at the time of injury, 53 fractures where diagnosed (20%). Fourteen (5%) were operated primarily while 39 (15%) (seven dislocated) were immobilized in plaster casts. Thirty-two (12%) were under the age of 16 at the time of injury. The average time from the injury to the initial non-union surgery was 1.5 years with 2.8 years to the second procedure. The risk of osteoarthritis increased time from injury to surgery (both primary and secondary procedures). The greatest potential for the reduction of scaphoid non-union is an increased awareness amongst younger men. There is also potential for improved accuracy in the diagnosis of scaphoid fractures (better clinical tests, the use of radiographs, CTs and MRIs) in order to identify the fracture and evaluate dislocation at the initial injury. Early diagnosis and treatment of fractures and non-unions will reduce the development of degenerative wrist changes.
    No preview · Article · Jan 2012 · Hand Surgery
  • Arild Aure · Karl R Hetland · Magne Rokkum
    [Show abstract] [Hide abstract]
    ABSTRACT: Posterior sternoclavicular dislocation is a rare injury that involves a risk of concomitant injuries to mediastinal structures. We report a 23-year-old man who underwent open reduction and fixation with a plantaris tendon graft after 13 weeks. The clinical and radiologic outcome was good.
    No preview · Article · Oct 2011 · Journal of orthopaedic trauma
  • [Show abstract] [Hide abstract]
    ABSTRACT: Applying bioactive coatings on orthopedic implants can increase the fixation and long-term implant survival. In our study, we compared a resorbable electrochemically deposited calcium phosphate coating (Bonit®) to a thin (40 μm) plasma-sprayed hydroxyapatite (HA) coating, applied on grit-blasted screw-shaped Ti-6Al-4V implants in the cortical region of rabbit tibia, implanted for 6, 12, and 52 weeks. The removal torque results demonstrated stronger bone-to-implant fixation for the HA than Bonit-coated screws at 6 and 12 weeks. After 52 weeks, the fixation was in favor of the Bonit-coated screws, but the difference was statistically insignificant. Coat flaking and delamination of the HA with multinucleated giant cell activity and bone resorption observed histologically seemed to preclude any significant increase in fixation comparing the HA implants at 6 versus 12 weeks and 12 versus 52 weeks. The Bonit-coated implants exhibited increasing fixation from 6 to 12 weeks and from 12 to 52 weeks, and the coat was resorbed within 6 weeks, with minimal activity of multinucleated giant cells or bone resorption. A different fixation pattern was observed for the two coatings with a sharper but time limited increase in fixation for the HA-coated screws, and a slower but more steadily increasing fixation pattern for the Bonit-coated screws. The side effects were more serious for the HA coating and limiting the expected increase in fixation with time.
    No preview · Article · Oct 2011 · Journal of Biomedical Materials Research Part B Applied Biomaterials
  • [Show abstract] [Hide abstract]
    ABSTRACT: Untreated scaphoid nonunions are a hazard to the wrist, resulting in deteriorating function and radiologic degenerative changes with increasing time. Long-term results after surgery of scaphoid nonunion reporting clinical, radiologic, and subjective outcomes are scarce. Retrospective follow-up study. From 1990 to 1998, 53 patients were operated on for persistent scaphoid nonunion; three patients were excluded from the follow-up (one expelled foreigner, another died of an unrelated cause, one never appeared after surgery), leaving 50 patients eligible for follow-up. All patients were operated on with open reduction and internal fixation; the majority also received a bone graft. Radiology and computed tomography verified union, degenerative wrist changes, and final salvage treatment. Range of motion, grip strength, key pinch, and subjective outcome (QuickDASH, visual analog scale). Fifty patients were followed up after a mean of 12.2 years (standard deviation [SD], 3.0), 47 by clinical and radiologic examination; three were interviewed by telephone and completed QuickDASH and visual analog scale forms. Union was achieved in 45 of 50 scaphoids and an additional two after a second attempt. Five patients (one persistent and four healed nonunions) underwent salvage procedures. Grip strength (41 vs 45 kg, P = nonsignificant), key pinch (11.5 vs 12.4, P = nonsignificant), and active range of motion (186° vs 214°, P < 0.001) were slightly reduced compared with the uninjured side. The subjective outcome was good (mean visual analog scale = 7, mean QuickDASH = 9.1). Minor degenerative changes were seen in nine wrists at surgery and 22 at follow-up. Healing of a scaphoid nonunion provides long-term pain relief, excellent wrist function, and halts degenerative changes in the majority of patients. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    No preview · Article · Sep 2011 · Journal of orthopaedic trauma
  • [Show abstract] [Hide abstract]
    ABSTRACT: Wrist prostheses have never achieved the sort of clinical outcomes found with those of hips and knees. We have developed a novel uncemented modular wrist prosthesis with screw fixation, metal-on-metal coupling, and ball-and-socket articulation. Eight patients admitted for wrist arthrodesis to treat primary or secondary osteoarthritis (not rheumatoid) were operated on. The prosthesis reduced the amount of bone removed and spared the distal radioulnar joint. After 7 to 9 years we found that the fixed centre of the ball-and-socket articulation provided good stability and mobility, and relief of pain and grip strength were satisfactory. We saw no luxations, metacarpal fractures or cut-outs, or mechanical failures of the implants. Two distal screws loosened (revised with new distal screws), and one early inflammation and one late infection occurred (revised to arthrodesis). We propose modifications to the implant with reduction in the diameter of the screws and the height of the threads, and rounding of the distal tip. The technique should include release of the third carpometacarpal joint, alignment of the capitate and the third metacarpal, and arthrodesis of the joint with bone chips.
    No preview · Article · Jun 2011

Publication Stats

666 Citations
72.46 Total Impact Points


  • 2009-2015
    • Oslo University Hospital
      • Department of Orthopaedic Surgery
      Kristiania (historical), Oslo, Norway
  • 2000-2012
    • University of Oslo
      • • Department of General Internal Medicine
      • • Department of Orthopaedics (ORTHO)
      Kristiania (historical), Oslo County, Norway
  • 2011
    • Diakonhjemmet Hospital (Norway)
      Kristiania (historical), Oslo, Norway