Extension Block Pinning versus percutaneous Fragment Reduction with a Towel Clip and extension Block Pinning with direct Pin Fixation for Treatment of Mallet Fracture

2021 ◽  
Vol 53 (05) ◽  
pp. 447-453
Author(s):  
Jae Hoon Lee ◽  
Duke Whan Chung ◽  
Jong Hun Baek

Abstract Purpose This study compared the clinical and radiographic results between extension block pinning (Group A) and percutaneous reduction of the dorsal fragment with a towel clip followed by extension block pinning with direct pin fixation (Group B) for the treatment of mallet fractures. Patients and Methods A total of 69 patients (group A = 34 patients, group B = 35 patients) who underwent operative treatment for mallet fractures from June 2008 to November 2017 with ≥ 6 months post-surgical follow-up were analysed retrospectively. The extent of subluxation of the distal interphalangeal joint, articular involvement of fracture fragment, fracture gap, and articular step-off were examined on plain radiographs before and after surgery. The functional outcomes were evaluated with the Crawford rating system. Results The postoperative step-offs were 0.16 mm in group A and 0.01 mm in group B. Group B had a significantly better anatomical outcome than group A. Five patients in group A had a loss of reduction. Among them, two had malunion and post-traumatic arthritis. Meanwhile, no patients in group B presented with loss of reduction and nonunion. The mean extension lags were 4.2° in group A and 1.6° in group B. However, functional outcome did not differ between the two groups at the final follow-up. Conclusion Fracture reduction using a towel clip and extension block pinning with direct pin insertion for mallet fracture facilitated the anatomical reduction of fragments, and allowed for stable fixation of fragments. Compared with extension block pinning technique, this technique has shown better anatomical results and stability, but not better clinical results.

Author(s):  
Renuka M. Tenahalli

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.


2020 ◽  
Vol 5 (03) ◽  
pp. 1-6
Author(s):  
Sandeep K ◽  
Guruprasad G ◽  
Veeraj Hegde

Due to present day lifestyle, a greater number of people are inclined to desk work and computer usage leading to many disorders. Manyasthamba is one among such disorders where the stiffness of neck with severe pain is the classical symptom which hampers our day to day life. While explaining treatment of Manyasthamba our Acharyas explained Rukshasweda and Nasya Karma as main line of treatment. Here a study was done by taking Gudashunti Yoga explained in Sharangadara Samhita indicated for Nasya and Kolakulattadi Churna indicated in Vatavyadhi explained in Ashtanga Sangraha for Ruksha Churna Sweda. A comparative clinical study of 40 patients suffering from Manyastambha were selected after thorough investigation. Patients were subjected to Nasya Karma in Group A and Ruksha Sweda and Nasya Karma in Group B for 7 days. Patients were assessed based on standard parameters before and after treatment and 7 days follow up. The statistical analysis revealed that there was a significant improvement in parameters like pain and stiffness. Hence proving the efficacy in the condition.


Author(s):  
Md Tanzil Ansari ◽  
Sukumar Ghosh ◽  
Shailendra Kumar Singh

Nowadays, people are more vulnerable to metabolic disorders due to their faulty dietary and behavioural habits. One such disorder is Vatarakta which causes functional impairment due to involvement of Sandhi (joints). It is manifested by Ruk, Toda, Sparsha asahatva, Shopha, Raga, Daha and Stabdhata in Sandhi. Vatarakta can be correlated with Hyperuricaemia or Gout due to similarity in their clinical features. Hyperuricaemia is defined as abnormally high level of uric acid in blood (i.e. >6mg/dl in female and >7mg/dl in male). On the other hand, Gout is an inflammatory response to monosodium urate crystals formed secondary to hyperuricaemia. Aims and objectives: 1. To evaluate the effectiveness of Trikarshika kwatha and lifestyle modification in the management of Vatarakta. 2. To compare the effects of Trikarshika kwatha with and without lifestyle modification in the management of Vatarakta. Materials and methods: Raw herbs of the research formulation were collected after proper identification and Kwatha was prepared for oral administration. For the clinical study, total 60 patients were selected on the basis of selection criteria. Selected patients were randomly divided into two groups. (i) Group A: 30 patients were treated with Trikarshika kwatha. (ii) Group B: 30 patients were treated with Trikarshika kwatha along with Lifestyle modification. Individual patient was treated for 45 days along with follow up at the interval of every 15 days. To assess the effectiveness of treatment, scoring pattern was followed for subjective and objective parameters. They were assessed before and after treatment. The collected data were analysed statistically by using Paired t-test. Results: On the basis of all statistical data, it can be said that patients of Group B showed better results in all parameters in comparison to patients of Group A. Conclusion: Both Trikarshika kwatha and Lifestyle modification are affective but Trikarshika kwatha with Lifestyle modification is more effective than Trikarshika kwatha without Lifestyle modification in the management of Vatarakta.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Jun-Beom Kim ◽  
Chi Ahn ◽  
Byeong-Seop Park

Category: Trauma Introduction/Purpose: The aim of this study was to evaluate and compare the clinical and radiological results of internal fixation with headless cannulated screw and locking compression distal ulna hook plate for the fracture at the base of fifth metatarsal bone, Zone 1. Methods: From April 2012 to April 2015, thirty cases (29 patients) were evaluated retrospectively. The mean follow up periods was 13 months. There were divided two groups based on use of the screw (group A, n=15) or the plate (group B, n=15).We measured the displacement to diastasis of the fracture on the foot oblique radiographs taken pre- and post-operatively in each group, checked the time to bone union and the difference of the reduction distance in each group. Clinical results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at 12 months postoperative. Results: In group A, the mean time to union was 54.2±9.3 days, the mean displacement to diastasis improved to 0.3±0.4 mm postoperatively (p<0.001), and the mean reduction distance was 2.9±1.0 mm. In group B, the mean time to union was 41.5±7.0 days, the mean displacement to diastasis improved to 0.06±0.2 mm postoperatively (p<0.001), and the mean reduction distance was 4.1±1.6 mm. AOFAS score was verified 97.7±3.4 in group A and 98.2±3.2 in group B. The time to union was significantly different between groups A and B (p=0.01).There were no complications. Conclusion: We suggest that the plate is more effective method for the shorter union time in surgical treatment of fifth metatarsal base fractures.


2012 ◽  
Vol 40 (11) ◽  
pp. 2440-2447 ◽  
Author(s):  
Yong Girl Rhee ◽  
Nam Su Cho ◽  
Chong Suck Parke

Background: When using a method of suture bridge technique, there may be a possibility of strangulation of the rotator cuff tendon at the medial row. The style of knots chosen to secure the medial row might conceivably be a factor to reduce this possibility. Purpose: To compare the clinical results and repair integrity of arthroscopic rotator cuff repair between a knotless and a conventional knot-tying suture bridge technique for patients with full-thickness rotator cuff tears and to evaluate retear patterns in the cases with structural failure after arthroscopic repair by magnetic resonance imaging (MRI). Study Design: Cohort study; Level of evidence, 2. Methods: After arthroscopic repair for medium-sized rotator cuff tears, 110 patients available for postoperative MRI evaluation at least 6 months were enrolled in this study. According to the repair technique, 51 shoulders were enrolled in a knotless suture bridge technique group (group A) and 59 shoulders in a conventional knot-tying suture bridge technique group (group B). The mean age at the time of the operation was 61.0 years (range, 44-68 years) in group A and 57.6 years (range, 45-70 years) in group B. The mean follow-up period was 21.2 months (range, 12-34 months) and 22.1 months (range, 13-32 months), respectively. Results: The Constant score of group A increased from the preoperative mean of 65.2 points to 79.1 points at the last follow-up ( P < .001). The corresponding figures for group B improved from 66.6 points to 76.3 points ( P < .001). The preoperative Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score was 21.1 points in group A and 18.3 points in group B. The UCLA score at the last follow-up was 31.0 points in group A and 27.9 points in group B ( P < .001, P < .001). Retear rate was significantly lower in group A (5.9%) than group B (18.6%) ( P < .001). In group B, retear occurred at the musculotendinous junction in 72.7%, but group A had no medial cuff failure. Conclusion: In arthroscopic suture bridge repair of full-thickness rotator cuff tears, clinical results of both a knotless and a conventional knot-tying group showed improvement without significant difference between the 2 groups. However, the knotless group had a significantly lower retear rate compared with the conventional knot-tying group. A knotless suture bridge technique could be a new supplementary repair technique to conventional technique.


Author(s):  
Ashvini Dineshrao Pardhekar ◽  
Sadhana Misar(Wajpeyi) ◽  
Vinod Ade

Background: Sthoulya is Medovaha Strotodushtijanya vyadhi, which includes abnormal and excessive accumulation of Medodhatu in the body. This is caused by lack of physical and mental activity, daytime sleep, excessive intake of madhur (sweet), snigdha ahar (oily diet) results in  increase Kaphadosha and meda which results in Sthoulya (overweight) having symptoms of mild dysponea, thirst, drowsiness, excess sleep, appetite, offensive smell from the body, incapability to work and incapability to participate in sexual intercourse. Aim: Comparative clinical efficacy of Tryushanadi Guggul and Navaka Guggul in Sthoulya (overweight). Materials and methods: Total 60 patients of Sthoulya will enrolled and will divided into two groups (each group contains 30). Patients in group A (experimental group) will be given 1 gram Tryushanadi Guggul two times a day after meal with honey and in group B (control group)1 gram Navaka Guggul will administered two times a day after meal with honey for 30 days. Dietary changes and walking (30 minutes) will be advised to patients of both groups. Follow up will be taken on 15th day and 30th day. Assessment of subjective parameters like kshudrashwasa (exertional dyspnoea), swedadhikya (perspiration), atikshudha (increased appetite), nidradhikya (increased sleep) and objective parameters like body weight, B.M.I., mid arm circumference, waist-hip ratio and lipid profile will be done before and after treatment. Results: Subjective and objectives outcomes will be assessed by statistical analysis. Conclusion: It will be drawn from the result obtained.


2021 ◽  
pp. 112067212110334
Author(s):  
Bu Ki Kim ◽  
Young Taek Chung

Purpose: To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Setting: Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Design: Retrospective case series. Methods: This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). Results: At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B ( p < 0.001), and when ICL was horizontally and vertically implanted in group C ( p = 0.021), respectively. And the mean SE was −0.11 ± 0.30, −0.34 ± 0.42, −0.3 ± 0.56 and −0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B ( p = 0.039), and when the ICL was horizontally and vertically implanted in group C ( p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. Conclusions: The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Dominik Odrobina ◽  
Iwona Laudańska-Olszewska ◽  
Piotr Gozdek ◽  
Mariusz Maroszyński ◽  
Michael Amon

Purpose. To analyze microstructural changes in the external limiting membrane (ELM) and photoreceptor layer before and after early and late conventional laser treatment in central serous chorioretinopathy (CSC) in 12 months follow-up study.Methods. A retrospective observational study included Group A: 19 patients (19 eyes) with symptomatic acute CSC and Group B: 16 patients (16 eyes) with symptomatic chronic CSC. Retinal microstructural changes were analyzed with SD-OCT paying a particular role in examining the photoreceptor layer and ELM.Results. The length of the photoreceptors, prior to treatment, was approximately 84 μm in Group A and 82,5 μm in Group B. Twelve months after laser treatment, photoreceptor length was approximately 49 μm in Group A and 43 μm (range 20–55 μm) in Group B. No patients in Group A had noticeable photoreceptor defects nor ELM defects, but in 15 eyes in Group B photoreceptor and ELM defects were detected ().Conclusions. When analyzing the photoreceptor layer and ELM during active CSC, it is not possible to evaluate any irreversible changes which have already occurred in this layer. Damage to the photoreceptor layer and ELM in patients with chronic CSC was only found after laser treatment and the absorption of subretinal fluid.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii335-iii335
Author(s):  
Takao Tsurubuchi ◽  
Shingo Takano ◽  
Ai Muroi ◽  
Kei Hara ◽  
Masahide Matsuda ◽  
...  

Abstract PURPOSE We evaluated the relapse patterns of CNS germinomas before and after introducing neuroendoscopic biopsy in 2000. METHODS We retrospectively assessed the relapse patterns of 57 patients treated as pure germinoma or germinoma with STGC between 1980 and 2019 at University of Tsukuba, partially containing the patients of the previous report (Takano S et al., World Neurosurg, 2015). Median age was 15 y.o.(7y.o.~38y.o.), and men was 80.7%. Tumor locations were pineal 35, sellar 19, basal ganglia 3, others 11. Group A;1980~1999 was 20, and group B;2000~2019 was 37. From 1980 to 1994, whole brain irradiation(WB) 30.6 Gy plus whole ventricle irradiation(WV) 19.8 Gy. From 1995 to 1999, WV 26~30.6 Gy with Chemotherapy(Chem) or Chem alone. Since 2000, Chem for 3 kurr with WV 24~30.6 Gy, and 6–19.8 Gy as local boost to residual lesion. RESULTS Follow up periods were median 121 M(4.5M~386M; group A), and median 89 M(4 M~231 M; group B). Six patients(30%) recurred in the group A, as ex field 4(1;brain and extramedullary, 1;brain and paranasal sinus, 1;LV & third ventricle, 1;extramedullary), in field 1(LV). Chem only 1(LV & third ventricle). Two patients(5.4%) recurred in the group B, as ex field 2(1;intramedullary, 1;extramedullary). The group A showed CR;18, PR;1, Dead;1(Dissemination), and the group B showed CR;35, PR;1 Dead;1(Encephalopathy). CONCLUSION WV and Chem prevented extrafield recurrence keeping good quality of life. Neuroendscopy biopsy with ETV did not increase CSF seeding.


2020 ◽  
Author(s):  
Kai Huang ◽  
Xiaohui Fang ◽  
Guijun Li ◽  
Jiajun Yue

Abstract Background: Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. The incidence of avascular necrosis and nonunion rates remain relatively high despite the progress in our understanding and surgical technique. The purpose of this study was to evaluate the clinical efficacy of gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults. Methods: A retrospective analysis was made on 67 cases from May 2013 to March 2019. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). The incidence of avascular osteonecrosis of the femoral head ( AVN ) and the Harris scores of hip joints were compared in three groups at the last follow-up. Results: The mean follow-up period after surgery was 22.5 ± 11.3 (range, 11–34) months. There were 21 cases (mean age,49.7 ± 11.6) in group A, 24 cases (mean age, 48.6 ± 11.3) in group B, 22 cases (mean age,48.3 ± 12.4) in group C. No significant difference in general preoperative demographics (P>0.05). The incidence of avascular necrosis of femoral head in Group A, B, and C was 19.05%,20.83%, and 22.73 %, respectively, showing no significant difference between groups(P=0.156). The mean Harris hip scores at the final follow-up for groups A (85.6±6.7)and B (84.5±6.2) were significantly higher than group C (74.3±8.3), and the difference was statistically significant(P=0.043). The incidence of femoral neck shortening in group A and group B was significantly lower than that in group C in postoperative one year, and the difference was statistically significant (P<0.05). Conclusions: Gotfried positive buttress reduction and fixation for femoral neck fracture may lead to similar clinical results with anatomic reduction, but much better than Gotfried negative buttress reduction. For the patients of femoral neck fracture with severe displacement and difficulty reduction, it is not necessary to pursue anatomical reduction。 Achieving positive valgus reduction can also obtain satisfactory clinical results, and should try to avoid negative buttress.


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