Trigger Finger

2019 ◽  
pp. 963-968
Author(s):  
Rajiv Sood ◽  
Joshua M. Adkinson ◽  
Brett C. Hartman

Stenosing flexor tenosynovitis of the digits, commonly known as trigger finger, is one of the most common conditions affecting the hand. It is characterized by a painful locking or clicking of the finger during flexion or extension. This can lead to significant pain or eventual flexion deformity. Treatment varies based on the duration, severity, and etiology and can be either conservative or operative. The complication rate of surgical intervention remains low, with the most common being pain at the operative site. Treatment of trigger finger in the patient with rheumatoid disease should be approached with caution. Overall management of trigger finger, whether conservative or operative, is routinely successful with the final result of a satisfied patient.

2020 ◽  
Author(s):  
Weiwei Li ◽  
Zheng Liu ◽  
Xiao Xiao ◽  
Zhenchao Xu ◽  
Zhicheng Sun ◽  
...  

Abstract Background: To explore the therapeutic effect of early surgical interventions for patients of active thoracic spinal tuberculosis (TB) with paraplegia. Methods: Data of 118 patients with active thoracic spinal TB and paraplegia who had undergone surgeries at an early stage (within three weeks of paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade of neurological status, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects. Results: Mean operation time was 194.2 minutes, mean blood loss was 871.2 ml. The perioperative complication rate was 5.1%. Mean preoperative VAS score was 5.3, significantly decreased to 3.2 after operation, and continued decreasing to 1.1 at the follow up (P<0.05). All cases achieved at least one grade elevation after operation, specifically, 2 cases of ASIA grade A rose to grade B, 10 cases of ASIA grade A rose to grade C, 2 cases of ASIA grade A rose to grade E; 9 cases of ASIA grade B rose to grade D, 38 cases of ASIA grade B rose to grade E; all 57 cases of ASIA grade C rose to ASIA grade E. The rate of full neurological recovery for complete paraplegia patients was 14.3%, significantly lower than the rate (91.3%) for incomplete paraplegia patients. Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, insignificantly increased after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm /h and 2.6 ± 0.82 mg/L at the final follow up, respectively (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, significantly decreased to 6.5º after operation (P<0.05) and the kyphotic correction had not lost during the follow up (P>0.05). Mean duration of bone graft fusion was 8.6±1.3 months Conclusion: Early surgical intervention may be beneficial for patients with active thoracic spinal TB with and paraplegia, with surgical intervention being more beneficial for incomplete paraplegic recovery compared with that of complete paraplegia.


2007 ◽  
Vol 89 (4) ◽  
pp. 354-358 ◽  
Author(s):  
RS Dua ◽  
SA Wajed ◽  
MC Winslet

INTRODUCTION Surgical intervention has become a common component in the management of patients infected with the human immunodeficiency virus (HIV) or suffering from the clinical consequences of acquired immunodeficiency syndrome (AIDS). We investigated the evolution of this involvement at a tertiary referral centre for this condition over a 16-year period. PATIENTS AND METHODS Detailed retrospective examination of the medical records of HIV-positive patients treated at the Royal Free Hospital between 1986 and 2002 was undertaken. Clinical, pathological and operative details of those patients who underwent surgical intervention were recorded. RESULTS Of the 2100 cases reviewed, 477 patients underwent a combined total of 772 surgical procedures. Of the 772 operations, 95 (12.3%) were performed as emergencies. Anorectal surgery represented the highest group with a total of 195 procedures (25.26%) being undertaken. The majority of patients (59%) had AIDS at the time of surgery, and 27.04% had a significant co-existing medical problem. Overall postoperative complication rate was 10.1%, with the risk being significantly greater in those undergoing intra-abdominal surgery and emergency procedures. CONCLUSIONS This is the largest study to audit the impact of HIV/AIDS in general surgical practice in the UK retrospectively. Surgery for HIV patients can be safely conducted with a low complication rate for the diagnostic and anorectal procedures that comprise the vast majority of surgery in HIV/AIDS patients. Medical treatment for patients with HIV/AIDS has developed dramatically over the last two decades. In parallel, this has resulted in a heavy, new and varied workload for general surgeons, who have also had to adapt in order to deal with the challenging spectrum of this disease.


2020 ◽  
Vol 89 (3) ◽  
pp. 177-183
Author(s):  
J. Timmermans ◽  
B. Van Goethem ◽  
H. De Rooster

Urinary incontinence is a common condition in spayed, female dogs with a reported prevalence between 3.1% and 20.1%. In the majority of dogs with acquired urinary incontinence, urethral sphincter mechanism incompetence is the underlying cause. Approximately 15% of bitches that initially respond to medical therapy ultimately become refractory. Surgical intervention is indicated when patients do not respond or become refractory to medical treatment. Based on the current literature, placement of an artificial urethral sphincter, i.e. an inflatable cuff around the proximal urethra connected to a subcutaneous injection port, provides a very reliable and longterm incontinence resolution in bitches and has a low complication rate.


2020 ◽  
Author(s):  
Weiwei Li ◽  
Zheng Liu ◽  
Xiao Xiao ◽  
Zhenchao Xu ◽  
Zhicheng Sun ◽  
...  

Abstract Background: To explore the therapeutic effect of early surgical interventions for patients of active thoracic spinal tuberculosis (TB) with paraparesis and paraplegia.Methods: Data of 118 patients with active thoracic spinal TB and paraparesis and paraplegia who had undergone surgeries at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade of neurological status, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects.Results: Mean operation time was 194.2 minutes, mean blood loss was 871.2 ml. The perioperative complication rate was 5.1%. Mean preoperative VAS score was 5.3, significantly decreased to 3.2 after operation, and continued decreasing to 1.1 at the follow up (P<0.05). All cases achieved at least one grade elevation after operation, specifically, 2 cases of ASIA grade A rose to grade B, 10 cases of ASIA grade A rose to grade C, 2 cases of ASIA grade A rose to grade E; 9 cases of ASIA grade B rose to grade D, 38 cases of ASIA grade B rose to grade E; all 57 cases of ASIA grade C rose to ASIA grade E. The rate of full neurological recovery for patients with paraplegia was 14.3%, significantly lower than the rate (91.3%) for patients with paraparesis. Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, insignificantly increased after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm /h and 2.6 ± 0.82 mg/L at the final follow up, respectively (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, significantly decreased to 6.5º after operation (P<0.05) and the kyphotic correction had not lost during the follow up (P>0.05). Mean duration of bone graft fusion was 8.6±1.3 monthsConclusion: Early surgical intervention may be beneficial for patients with active thoracic spinal TB and paraparesis or paraplegia, with surgical intervention being more beneficial for paraparesis recovery compared with paraplegia recovery.


1998 ◽  
Vol 40 (6) ◽  
pp. 556-560 ◽  
Author(s):  
Ron Gorsche ◽  
J. Preston Wiley ◽  
Ralph Renger ◽  
Rollin Brant ◽  
Tara Y. Gemer ◽  
...  

1999 ◽  
Vol 14 (Suppl_3) ◽  
pp. 273-274
Author(s):  
B. Dilbaz ◽  
E. Aliskan ◽  
M.A. Narin ◽  
A. Haberal

2006 ◽  
Vol 88 (4) ◽  
pp. 405-407 ◽  
Author(s):  
P Pietzik ◽  
I Qureshi ◽  
J Langdon ◽  
S Molloy ◽  
M Solan

INTRODUCTION Ankle fractures are common and many require surgical intervention. It has been well documented that a delay in fracture fixation results in increased length of hospital stay and increased complication rate. Initial delay can also allow swelling or blistering to develop which may necessitate a further delay in operative fixation for up to 1 week. The aim of the current study was to review the length of hospital in-patient stay for operative ankle fractures over the previous 12-month period at our hospital and compare this to the length of hospital stay following the introduction of a fast-track system for the fixation of these fractures (all fractures fixed within 48 h). PATIENTS AND METHODS A retrospective review of all ankle fractures managed by open reduction and internal fixation over a 12-month period was undertaken. A protocol was then agreed to openly reduce and fix these fractures at the earliest possible opportunity over the next 6-month period. We then collected the data on all ankle fractures that needed open reduction and internal fixation over this 6-month period. The pre-protocol and post-protocol groups were then compared for total hospital length of stay and complication rate. RESULTS In the 12-month retrospective review, there were 83 ankle fractures that required surgical intervention. Sixty-two of these had surgery within 48 h (mean length of stay, 5.4 days), and 21 had surgery after 48 h (mean length of stay, 9.5 days). There were 39 ankle fractures in the post-protocol group who all had surgery within 48 h (mean length of stay, 5 days). There was no increase in complication rate after implementation of the fast-track system. CONCLUSIONS This study shows that early operative intervention for ankle fractures reduces the length of hospital stay. Intensive physiotherapy and co-ordinated discharge planning are also essential ingredients for early discharge. Early operative fixation for unstable ankle fractures has substantial cost-saving implications with no increase in complication rate.


2015 ◽  
Vol 40 (7) ◽  
pp. 720-728 ◽  
Author(s):  
A. M. Giladi ◽  
S. Malay ◽  
K. C. Chung

Pyogenic flexor tenosynovitis (PFT) is an aggressive closed-space infection that can result in severe morbidity. Although surgical treatment of pyogenic flexor tenosynovitis has been widely described, the role of antibiotic therapy is inadequately understood. We conducted a literature review of studies reporting on acute pyogenic flexor tenosynovitis management. A total of 28 case series articles were obtained, all of which used surgical intervention with varied use of antibiotics. Inconsistencies among the studies limited summative statistical analysis. Our results showed that use of antibiotics as a component of therapy resulted in improved range of motion outcomes (54% excellent vs. 14% excellent), as did using catheter irrigation rather than open washout (71% excellent vs. 26% excellent). These studies showed benefits of early treatment of pyogenic flexor tenosynovitis and of systemic antibiotic use. As broad-spectrum antibiotics have changed the management of other infectious conditions, we must more closely evaluate consistent antibiotic use in pyogenic flexor tenosynovitis management. Level of Evidence: Therapeutic, Level III


2016 ◽  
Vol 07 (01) ◽  
pp. 220-223 ◽  
Author(s):  
Joseph Ricci ◽  
Nirav Parekh ◽  
Naman Desai

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