Palmar Wrist Ganglion: Does Intervention Improve Outcome A Prospective Study of the Natural History and Patient-Reported Treatment Outcomes

2003 ◽  
Vol 28 (2) ◽  
pp. 172-176 ◽  
Author(s):  
J. DIAS ◽  
K. BUCH
Keyword(s):  
Surgical Excision ◽  
Patient Evaluation ◽  
Recurrence Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Reported ◽  
Evaluation Measure ◽  
A Prospective Study

A prospective cohort study was undertaken to observe the long-term outcome of different treatments for palmar wrist ganglia. One hundred and eighty-two patients agreed to participate in the study. One hundred and fifty-five patients (88%) responded at 2 or 5 years. Seventy-nine had been treated by surgical excision, 39 by aspiration and 38 by reassurance alone. At 5 years no significant differences were observed in the recurrence rates which were 42% after excision of a palmar wrist ganglion and 47% (19 of 39) after aspiration. Twenty of the 39 untreated ganglia had disappeared spontaneously. Eighty-five per cent of the patients were satisfied irrespective of treatment. Patients having surgery had a complication rate of 20% and took more time off work (14 days). Significantly more patients in the untreated group felt the persistent ganglion was unsightly. The patient evaluation measure scores were similar. At 2 and 5 year follow-up, regardless of treatment, no difference in symptoms was found, regardless of whether the palmar wrist ganglion was excised, aspirated or left alone. One in four wrists remained weak regardless of treatment or disappearance of the ganglion.

Ten-year follow-up of stemmed hemiarthroplasty for acute proximal humeral fractures

2021 ◽  
Vol 103-B (6) ◽  
pp. 1063-1069
Author(s):  
Alexander Amundsen ◽  
Stig Brorson ◽  
Bo S. Olsen ◽  
Jeppe V. Rasmussen
Keyword(s):  
Revision Rate ◽  
Patient Reported Outcome ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Reported ◽  
Cumulative Revision Rate

Aims There is no consensus on the treatment of proximal humeral fractures. Hemiarthroplasty has been widely used in patients when non-surgical treatment is not possible. There is, despite extensive use, limited information about the long-term outcome. Our primary aim was to report ten-year patient-reported outcome after hemiarthroplasty for acute proximal humeral fractures. The secondary aims were to report the cumulative revision rate and risk factors for an inferior patient-reported outcome. Methods We obtained data on 1,371 hemiarthroplasties for acute proximal humeral fractures from the Danish Shoulder Arthroplasty Registry between 2006 and 2010. Of these, 549 patients (40%) were alive and available for follow-up. The Western Ontario Osteoarthritis of the Shoulder (WOOS) questionnaire was sent to all patients at nine to 14 years after primary surgery. Revision rates were calculated using the Kaplan-Meier method. Risk factors for an inferior WOOS score were analyzed using the linear regression model. Results Mean age at surgery was 67 years (24 to 90) and 445 (81%) patients were female. A complete questionnaire was returned by 364 (66%) patients at a mean follow-up of 10.6 years (8.8 to 13.8). Mean WOOS score was 64 (4.3 to 100.0). There was no correlation between WOOS scores and age, sex, arthroplasty brand, or year of surgery. The 14-year cumulative revision rate was 5.7% (confidence interval 4.1 to 7.2). Patients aged younger than 55 years and patients aged between 55 to 74 years had 5.6-times (2.0 to 9.3) and 4.3-times (1.9 to 16.7) higher risk of revision than patients aged older than 75 years, respectively. Conclusion This is the largest long-term follow-up study of acute proximal humeral fractures treated with hemiarthroplasty. We found a low revision rate and an acceptable ten-year patient-reported outcome. The patient-reported outcome should be interpreted with caution as we have no information about the patients who died or did not return a complete WOOS score. The long-term outcome and revision rate suggest that hemiarthroplasty offers a valid alternative when non-surgical treatment is not possible. Cite this article: Bone Joint J 2021;103-B(6):1063–1069.

The Natural History of Untreated Dorsal Wrist Ganglia and Patient Reported Outcome 6 Years after Intervention

2007 ◽  
Vol 32 (5) ◽  
pp. 502-508 ◽  
Author(s):  
J. J. DIAS ◽  
V. DHUKARAM ◽  
P. KUMAR
Keyword(s):  
Surgical Excision ◽  
Patient Reported Outcome ◽  
Postal Questionnaire ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Treatment Groups ◽  
Patient Reported ◽  
History Of ◽  
Term Benefit

We have evaluated the long-term outcome of excision, aspiration and no treatment of dorsal wrist ganglia prospectively in 236 (83%) of 283 patients who responded to a postal questionnaire at a mean of 70 months. The resolution of symptoms was similar between the treatment groups ( p>0.3). Pain and unsightliness improved in all three treatment groups. The prevalence of weakness and stiffness altered only slightly in all three treatment groups. More patients with a recurrent, or persistent ganglion complained of pain, stiffness and unsightliness ( p<0.0001). Patient satisfaction was higher after surgical excision ( p<0.0001), even if the ganglion recurred. Twenty-three of 55 (58%) untreated ganglia resolved spontaneously. The recurrence rate was 58% (45/78) and 39% (40/103) following aspiration and excision, respectively. Eight out of 103 patients had complications following surgery. In this study, neither excision nor aspiration provided significant long-term benefit over no treatment.

Long-term outcome of modified radical mastoidectomy

2004 ◽  
Vol 118 (8) ◽  
pp. 612-616 ◽  
Author(s):  
Payal Mukherjee ◽  
Nicholas Saunders ◽  
Richard Liu ◽  
Paul Fagan
Keyword(s):  
Bone Conduction ◽  
Radical Mastoidectomy ◽  
Recurrence Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Surgical Access ◽  
Modified Radical Mastoidectomy ◽  
Hearing Result

The primary aim of treatment of cholesteatoma is to attain a dry, safe, stable ear, free of disease. Maintaining or improving hearing is important but the pursuit of a hearing result should not compromise this primary aim. This study reviews the long-term outcome of 133 patients, suffering from advanced disease, who underwent modified radical mastoidectomy between 1995 and 2000. Of these, 49 per cent had had previous mastoid surgery elsewhere. A dry, waterproof ear was attained in 95 per cent of patients. In 77 per cent of patients, hearing was unchanged or improved. In this period, there were two cases of significant post-operative loss in bone conduction, including one dead ear secondary to suppurative labyrinthitis. There were epithelial pearls on follow up in two per cent. These results indicate that when properly performed, modified radical mastoidectomy provides safe surgical access and clears disease with low recurrence rates while mostly maintaining or improving hearing.

Remission and recurrence of depression in the maintenance era: long-term outcome in a Cambridge cohort

2003 ◽  
Vol 33 (5) ◽  
pp. 827-838 ◽  
Author(s):  
N. KENNEDY ◽  
R. ABBOTT ◽  
E. S. PAYKEL
Keyword(s):  
Psychological Treatment ◽  
Severe Depression ◽  
Severity Of Illness ◽  
Recurrence Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Recent Cohort ◽  
Course Of Depression

Background. Long-term studies of severe depression have described high rates of non-recovery, recurrence, chronic incapacity and mortality. A more recent cohort was followed-up to ascertain whether the course had improved given developments in pharmacological and psychological treatments in the last 15 years.Method. Subjects from a cohort of 70 mainly severe recurrent depressives originally recruited to a shorter follow-up study from 1990–1992 were followed-up after 8–11 years. Data included longitudinal information on course of depression and other psychiatric disorders, pharmacological and psychological treatment and social functioning during follow-up.Results. Sixty-nine (99%) subjects were successfully followed-up, with 61 of 66 living subjects interviewed and detailed follow-up data obtained in total on 65. Sixty (92%) of 65 subjects recovered during follow-up, with two-thirds subsequently suffering a recurrence. Eleven (17%) suffered from an episode of chronic depression of at least 2 years duration during follow-up. Social function at follow-up was good and there were high levels of pharmacological and psychological treatment. Greater severity of illness was the most consistent predictor of poor outcome. Times to recovery and recurrence and recovery and recurrence rates were very similar to older studies.Conclusions. The long-term outcome of depression still shows high recurrence rates and does not appear to have changed in the last 20 years.

scholarly journals Long-term outcome of surgery for perianal Crohn’s fistula

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
M Schaad ◽  
D Hahnloser ◽  
A Schoepfer ◽  
J -B Rossel ◽  
G Rogler
Keyword(s):  
Activity Index ◽  
Perianal Fistula ◽  
Fistula Closure ◽  
Recurrence Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Additional Surgery ◽  
Seton Drainage

Abstract Objective Perianal fistulizing disease is a problem in patients with Crohn’s disease (CD) because they often need repetitive surgeries. Among the various available procedures, none of them proves to be superior. In addition, the long-term outcome of fistula Seton drainage is not well described. The aims of this study were to analyze the long-term healing and recurrence rates of perianal fistulas in CD patients, stratified according to the first procedure performed. Methods Database analysis of a prospective Swiss cohort of patients with perianal CD. Results 365 patients with 576 interventions and a median follow-up of 7.5 years (0 - 12.6) were analyzed. 39.7% of patients required more than one surgery. The first surgical interventions were fistulectomies (58.4%), Seton drainage (26.9%), fistula plugs (2.2%) and combined procedures (9.9%). Fistulectomy patients required no more surgery in 67.6%, one additional surgery in 25.4% and more than one additional surgery in 7.7%. In these 3 groups of patients, after a median follow-up of 12.1 years, perianal fistula closure was achieved in 77.1%, 74.1% and 66.7%, respectively. In patients with Seton drainage as index surgery, 50.3% required no more surgery and over 75% achieved fistula closure after 10 years. 49.7% of patients with Seton required one or more surgeries. At median follow up of 7.5 years, closure rates were 64.2% and 60.5% in patients with one and more than one surgeries, respectively. There was no difference in demographics in Seton patients with closed or not closed fistulas. Non-closure patients had a higher Crohn Disease Activity Index (33 vs. 6) and more frequent anti-TNF medication (57.4% vs. 48.1%). Conclusion First line fistulectomies achieved the highest healing rates in perianal CD but 1/3 of patients require additional surgeries and 1/4 patients will remain with a fistula at 10 years. Initial seton drainage and concurrent medical therapy can achieve fistula closure in 75%. However, in 50% of patients more surgeries are performed with a seton staying in place up to 5 years and fistula closure in only 2/3 patients.

Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients

2009 ◽  
Vol 10 (5) ◽  
pp. 458-465 ◽  
Author(s):  
Salvatore Chibbaro ◽  
Giuseppe Mirone ◽  
Orphée Makiese ◽  
Bernard George
Keyword(s):  
Spinal Canal ◽  
Japanese Orthopaedic Association ◽  
Spinal Stability ◽  
Safe Procedure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Oblique Corpectomy ◽  
A Prospective Study

Object The multilevel oblique corpectomy (MOC) allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not require vertebral stabilization or fusion. In the present study, the authors' goal was to demonstrate the long-term efficacy and safety of MOC in the treatment of selected cases of spondylotic myelopathy. Methods The authors conducted a prospective study in a series of 268 patients who underwent MOC for cervical spondylotic myelopathy over a 14-year period. Preoperative and postoperative neurological functioning were evaluated with the modified Japanese Orthopaedic Association scale. Spinal stability was assessed in all patients on serial plain and dynamic cervical radiographs at the last follow-up. The degree of canal expansion after MOC was also measured using the spinal canal/vertebral body ratio, and directly by measuring the diameter of osseous canal on pre- and postoperative CT scans and high-resolution MR images. Results At a mean follow-up of 96 months, clinical improvement was recorded in 86.6% of patients with a global recovery rate of 87.6%, clinical stability in 8%, and worsening in 5%. Long-term spinal stability was demonstrated in 98% of patients. Conclusions Multilevel oblique corpectomy was demonstrated to be a safe procedure that provided good results in terms of improved functional status and long-term spinal stability.

Medium- to long-term outcomes of anatomical reconstruction of the radioulnar ligament to the ulnar fovea

2016 ◽  
Vol 42 (4) ◽  
pp. 352-356 ◽  
Author(s):  
T. Nakamura ◽  
K. Abe ◽  
M. Nishiwaki ◽  
T. Iwamoto ◽  
K. Sato
Keyword(s):  
Clinical Results ◽  
Bone Tunnel ◽  
Anatomical Reconstruction ◽  
Reconstruction Technique ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Patient Reported

We examined the medium- to long-term outcome of the original reconstruction technique of the radioulnar ligament using a half-slip of the extensor carpi ulnaris tendon for chronic foveal avulsion of the triangular fibrocartilage complex. We treated 37 wrists in 36 patients with a minimum follow-up of 5 years. Of 36 patients, 12 had more than 10 years follow-up. At final follow-up, 30 patients (31 wrists) reported no pain, five patients (five wrists) reported mild occasional pain and one patient reported severe persistent pain. Two patients had lost 30° of supination. Complete stability of the distal radio-ulnar joint was achieved in 31 wrists, moderate instability was noted in five and severe distal radio-ulnar joint instability remained in one. The size of the bone tunnel was assessed radiologically: in two it had enlarged; in 23 it was unchanged; and in 12 it appeared to have closed over the tendon graft. The overall clinical outcomes were 28 excellent, four good, four fair and one poor. The 12 wrists with more than 10 years follow-up had seven excellent, three good and two fair clinical results. This reattachment technique appears to work and last over the medium- to long-term. Level of evidence: IV

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

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