Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

2020 ◽  
pp. 107110072096967
Author(s):  
Carlo Biz ◽  
Alberto Crimì ◽  
Ilaria Fantoni ◽  
Jacopo Tagliapietra ◽  
Pietro Ruggieri
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Radiographic Outcomes ◽  
Case Series Study ◽  
Significant Correction ◽  
The Mean ◽  
Series Study ◽  
Severe Hallux Valgus

Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.

scholarly journals Efficacy and long-term follow-up of IL-1R inhibitor anakinra in adults with Still's disease: a case-series study

2011 ◽  
Vol 13 (3) ◽  
pp. R91 ◽  
Author(s):  
Katerina Laskari ◽  
Athanasios G Tzioufas ◽  
Haralampos M Moutsopoulos
Keyword(s):  
Case Series ◽  
Still’S Disease ◽  
Still's Disease ◽  
Case Series Study ◽  
Long Term Follow Up ◽  
Series Study

scholarly journals Triple Procedure for Dense Cataractous Neovascular Glaucoma Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hossam M. Moharram ◽  
Shaaban Abd-Elhamid Mehany Elwan ◽  
Mahmoud M. Nassar ◽  
Mohamed F. Abdelkader
Keyword(s):  
Case Series ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
Case Series Study ◽  
Triple Procedure ◽  
Distant Visual Acuity ◽  
Pars Plana ◽  
The Mean ◽  
Series Study

Purpose. One of the most difficult refractory glaucomas is the neovascular type (NVG), and its association with dense cataract adds to this difficulty. This study aimed to provide results of the triple surgical procedure for such conditions. Methods. 12 eyes of 12 patients with NVG and dense cataract were included in this case series study. The mean age of patients was 57.25 ± 5.9 years. The mean preoperative intraocular pressure (IOP) was 47.25 ± 4.04 mmHg with maximum antiglaucoma therapy. The mean best corrected distant visual acuity (BCDVA) in LogMAR was 2.13 ± 0.38. All patients received intravitreal injection of 1.25 mg (0.05 ml) bevacizumab followed by phacoemulsification, pars plana vitrectomy (PPV) including panretinal photocoagulation (PRP), and trabeculectomy with mitomycin C (MMC). Mean IOP and BCDVA changes were the main outcome results of this study. Results. The follow-up period was 2 years. The mean BCDVA was improved to 1.22 ± 0.35, 1.13 ± 0.34, 1.12 ± 0.37, 1.06 ± 0.38, and 1.01 ± 0.37 at 1, 3, 6, 12, and 24 months, respectively, after this procedure. This improvement was statistically significant when compared with preoperative BCDVA (P<0.0001). The mean postoperative IOP was dropped to 20.08 ± 4.1, 17.08 ± 2.1, 17.17 ± 5, 15.75 ± 4.7, and 16.17 ± 6.1 mmHg, respectively. At the last follow-up, the mean IOP was statistically significantly lower than preoperative IOP (P<0.0001) at the previously mentioned time points. The success rate was complete in 90.9% of eyes and qualified in 100% of eyes. Iris and angle neovascularization had regressed significantly in all patients, and no serious complications occurred during the follow-up period. Conclusions. This triple surgery can safely improve patients with NVG and dense cataract regarding BCDVA and IOP control. This trial is registered with NCT04143620.

Operative Treatment for Hallux Valgus With Moderate to Severe Metatarsus Adductus

2019 ◽  
Vol 40 (6) ◽  
pp. 641-647 ◽  
Author(s):  
Hiroaki Shima ◽  
Ryuzo Okuda ◽  
Toshito Yasuda ◽  
Katsunori Mori ◽  
Momoko Kizawa ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Scale Score ◽  
Operative Treatment ◽  
Weight Bearing ◽  
Case Series ◽  
Limited Information ◽  
Significant Correction ◽  
Metatarsus Adductus ◽  
The Mean

Background: Operative treatment is indicated for patients who have symptomatic hallux valgus (HV) with moderate to severe metatarsus adductus (MA). However, there is limited information available on the operative procedures and outcomes for the treatment of HV with MA. We aimed to investigate the average 10-year follow-up clinical and radiologic outcomes. Methods: Seventeen patients (21 feet, average age: 60.1 years) with symptomatic HV with moderate to severe MA were operatively treated. Mean postoperative follow-up duration was 114.4 (24-246) months. All feet had metatarsus adductus angle ≥20 degrees on dorsoplantar weight-bearing radiograph. The procedure included a proximal crescentic osteotomy of the first metatarsal and abduction osteotomy of the proximal third of the second and third metatarsals. Results: The mean American Orthopaedic Foot & Ankle Society scale score improved significantly postoperatively ( P < .001). The mean postoperative visual analog scale score (17 feet) was 2.0 (0-6). Preoperative metatarsalgia was severe in 2 feet, moderate in 17, and mild in 2. At the most recent follow-up evaluation, 11 feet had no pain, 9 had mild pain, and 1 had moderate pain. The mean hallux valgus angle, intermetatarsal angle, and metatarsus adductus angle significantly decreased postoperatively ( P < .001 for all). Recurrence of HV (HV angle ≥ 20 degrees) was observed in 4 feet. Conclusion: The clinical and radiologic results indicated that our novel operative treatment for HV with moderate to severe MA can achieve significant correction of HV with MA deformities and significant improvement in pain and function. Level of Evidence: Level IV, retrospective case series.

Partial capitate shortening for Kienböck’s disease

2014 ◽  
Vol 40 (9) ◽  
pp. 957-960 ◽  
Author(s):  
A. Citlak ◽  
U. Akgun ◽  
T. Bulut ◽  
M. Tahta ◽  
B. Dirim Mete ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Magnetic Resonance Images ◽  
Stage Ii ◽  
Pinch Strength ◽  
Case Series Study ◽  
The Mean ◽  
Series Study ◽  
Carpal Height

The purpose of this study was to report our experience of partial capitate shortening in seven patients with a median 38 months follow-up. Staging was made by the Lichtman classification system and stage II and III-A patients were included in the study. The mean age was 34 years (range 22–52). Patients were assessed for pain, range of motion, grip and pinch strength, and satisfaction was recorded using a scale between 0 and 4. All these parameters showed improvement after surgery. The Lichtman stage, lunate height index and carpal height index were determined radiographically. Magnetic resonance images of the wrist were studied for lunate revascularization at the final follow-up and occurred in all patients. According to our study, partial capitate shortening seems an effective treatment for Lichtman stage II and III-A patients. Level IV case series study.

scholarly journals The impact of bilateral endoscopic inferior turbinoplasty with or without adenoidectomy on the quality of life of children: a retrospective case series study

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Ahmed Mourad ◽  
Hussein Jaffal ◽  
Ismaeel El-Hakim ◽  
Hamdy El-Hakim
Keyword(s):  
Quality Of Life ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
The Impact ◽  
Series Study

Abstract Background Inferior turbinoplasty (IT) and adenoidectomy (Ad) are frequently resorted to in children with chronic rhinitis (CR) refractory to medical therapy. The aim of this study is to document the long-term improvement in quality of life (QOL) in children with CR following endoscopic IT with or without Ad. Methods A retrospective case series study was conducted. We searched a prospectively kept surgical database for children ≤18 years old who had CR who underwent endoscopic IT with or without Ad between 2009 and 2016 at a tertiary care children’s center. Patients with sinonasal pathologies other than CR, had craniofacial syndromes or dysmorphism and had other sinonasal procedures or trauma were excluded. Collected data included demographics, secondary diagnoses, duration of follow-up, and complications of procedures. The Glasgow Children’s Benefit Inventory (GCBI) was administered by phone to assess QOL improvement. Results One hundred sixty-five eligible subjects were identified. Eighty-nine subjects met the inclusion criteria. Data was collected for the 60 subjects that were reached. Forty-two patients had IT only while 18 had IT and Ad. The mean age was 10.7 ± 2.7 years, with 31 males and 29 females. The median duration of follow-up (25th, 75th percentile) was 38.1 months (24.6, 55.8). The median GCBI score (25th, 75th percentile) was 22.9 (6.3, 39.6) revealing an overall positive benefit in all domains. There was only one complication. Conclusions This study validates prior findings regarding improvement of QOL and safety of IT with or without Ad for children with CR and indicates it is maintained in the long term.

Crescentic Proximal Metatarsal Osteotomy for Moderate to Severe Hallux Valgus: A Mean 12.2 Year Follow-Up Study

2001 ◽  
Vol 22 (10) ◽  
pp. 817-822 ◽  
Author(s):  
J.P. Veri ◽  
S.P. Pirani ◽  
R. Claridge
Keyword(s):  
Hallux Valgus ◽  
Long Term Results ◽  
Soft Tissue Reconstruction ◽  
Short Term ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
The Mean ◽  
Severe Hallux Valgus

The senior author's (R.C.) first 25 patients (37 feet) treated with a combination proximal crescentic osteotomy and distal soft-tissue reconstruction made up the patient cohort. All 25 patients were reviewed at a minimum of one year post-op (short-term follow-up) and 20/25 (31/37 feet) were reviewed again at a mean 12.2 years (range 11.4 to 13.0 yrs) post-op (long-term follow-up). This allowed for a comparison of short- and long-term results and led to a long-term follow-up rate of 84% (31/37 feet, mean 12.2 yrs). Clinical, radiographic and patient outcome measures were obtained and compared pre-op and at short- and long-term follow-up. The mean preoperative hallux valgus (HVA) and intermetatarsal angles (IMA) were 37° and 16° respectively. The mean HVA correction was 24° and IMA correction 10° at long-term follow-up with no tendency toward recurrence. Sesamoid position and first MTP subluxation was markedly improved postoperatively and the correction was maintained at long-term follow-up. Patients were asked about their satisfaction in terms of pain, appearance and motion. At long-term follow-up, more than 90% of patients were completely satisfied with pain and motion and greater than 80% with their appearance. Ninety-four percent of patients said they would have the operation again. The AOFAS clinical rating scale for the hallux was calculated retrospectively for pre-op and short-term follow-up and prospectively for long-term follow-up. The mean pre-op score was 37/100 (16 to 60) which significantly improved to 92/100 (67 to 100) at both follow-up periods, suggesting no evidence of decrease in outcome over time. Complications included two patients (5%) that were over-corrected into varus (one symptomatic, one asymptomatic), and four patients (11%) that were undercorrected, developing asymptomatic recurrences (>10° increase HVA) at long-term follow-up. In addition, two patients (5%) developed new transfer lesions postoperatively, likely related to technical error (one varus overcorrection, one dorsiflexion malunion). In conclusion, the long-term results, with a mean follow-up of 12.2 years, of the resection realignment procedure for moderate to severe hallux valgus are generally excellent and the complication rate is low and acceptable. Attention to detail, avoiding both undercorrection, which can lead to recurrence, and overcorrection, which can cause symptomatic varus, is essential.

scholarly journals Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

2019 ◽  
Author(s):  
Yi Qu ◽  
Xinshu Liu ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Case Series ◽  
Subconjunctival Injection ◽  
Retrospective Case ◽  
Case Series Study ◽  
Uveitic Macular Edema ◽  
The Mean ◽  
Series Study

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome was central macular thickness. The secondary outcomes included the best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1, 2, 3 and 6 months postinjection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, which was controlled with topical IOP-lowering agents in 14 eyes, whereas 7 eyes got subconjunctival TA deposit surgically removed. Conclusion: subconjunctival TA injections appear to be safe and effective for UME.Key Words: Triamcinolone acetonide; subconjunctival injection; uveitis; macular edema

scholarly journals Surgical treatment of hallux valgus using a modified Reverdin-Isham technique

2021 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Luiz Lara ◽  
Lúcio Torres Filho ◽  
Gabriel Cervone ◽  
Juan Grajales ◽  
Glaucia Bordignon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Head ◽  
Level Of Evidence ◽  
Valgus Angle ◽  
Significant Correction ◽  
The Mean ◽  
American Orthopaedic

Objective: To evaluate the postoperative results of patients who underwent surgical treatment of hallux valgus with a modified Reverdin-Isham (RI) technique and to compare the achieved correction with that reported by studies using the original technique. Methods: This is a retrospective study with patients with mild to moderate hallux valgus who underwent surgery from June 2010 to July 2019. All patients were operated using the modified RI technique. Data were collected through the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire, in addition to pre and postoperative radiographic studies of the intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA). Results: The mean postoperative follow-up was 30.1 months, and the mean age of patients was 56.4 years. The median AOFAS score in the postoperative period was increased by 56 points. The mean HVA was reduced in 16.5°, the mean IMA was reduced in 4.3°, and the mean DMAA was reduced in 10°. There were no cases of displacement or deviation of the first metatarsal head during the postoperative follow-up. Conclusion: The modified RI technique provided considerable stability to the osteotomy, in addition to a significant correction of the measured angles and an improvement in AOFAS scores, demonstrating itself as an effective technique for correcting mild to moderate hallux valgus. Level of Evidence IV, Therapeutic Studies, Case Series.

scholarly journals Optimal Ki67 cut-off for luminal breast cancer prognostic evaluation: a large case series study with a long-term follow-up

2016 ◽  
Vol 157 (2) ◽  
pp. 363-371 ◽  
Author(s):  
Sara Bustreo ◽  
Simona Osella-Abate ◽  
Paola Cassoni ◽  
Michela Donadio ◽  
Mario Airoldi ◽  
...  
Keyword(s):  
Case Series ◽  
Luminal Breast Cancer ◽  
Prognostic Evaluation ◽  
Case Series Study ◽  
Long Term Follow Up ◽  
Large Case Series ◽  
Series Study ◽  
Large Case

scholarly journals Volar Scaphoid Plating for Nonunion: A Multicenter Case Series Study

2020 ◽  
Vol 09 (03) ◽  
pp. 225-229
Author(s):  
Kevin Eng ◽  
Stephen Gill ◽  
Simon Hoy ◽  
Vivek Shridar ◽  
Natasha Van Zyl ◽  
...  
Keyword(s):  
Case Series ◽  
Visual Analogue Score ◽  
Rotational Stability ◽  
Volar Aspect ◽  
Number Of Patients ◽  
Case Series Study ◽  
Structural Graft ◽  
The Mean ◽  
Series Study

Abstract Background The volar scaphoid plate from Medartis (Medartis AG, Austrasse, Basel, Switzerland) is a variable angle titanium locking plate, preformed for the volar aspect of the scaphoid. It does not have compressive capability, and may act as a bridging device. It may provide an advantage over a compression screw where the pathoanatomy is less favorable to such a device with increased rotational stability. It may act as a buttress plate for correction of humpback deformity for example. It has been used in nonunions and with vascularized grafts. Questions Our study aims to assess the results of our patients with scaphoid nonunion treated with scaphoid volar plating over a larger number of patients. We aim to identify techniques to increase the success of plating. Methods Patients from our cohort were retrospectively reviewed. Operations were performed by three hand fellowship trained surgeons and in two centers. Inclusion involved a scaphoid plate procedure for a nonunion of the scaphoid with a minimum of 6 months of follow-up. Exclusions were those who had less than 6 months of follow-up. Data included demographics, patient-rated wrist evaluation (PRWE), a quick disabilities of the arm, shoulder, and hand (qDASH), visual analogue score, and range and grip. Radiology was reviewed. Results Thirty-two eligible patients were assessed. The mean age was 25 years (range 13–46), 2 were female and 15 were smokers. Mean follow-up postsurgery was 18 months. Twenty-nine of 32 patients united (90.6%) on computed tomography scan. Clinical assessment was performed in the 25 patients. The mean qDASH score was 12.5 (range 0–42) and mean PRWE was 11 (range 0–54). The mean arc of motion was 115 degrees. The mean grip strength was 39 kg compared with 41 kg on the nonoperated side. Conclusion We postulate that the plate acts like an internal bridging device, acting over a small distance, and inherent stability of the construct with structural graft and accurate reduction prior to plating is advantageous. Potential problems include plate impingement on the volar lip of the radius, particularly when trying to plate more proximal fractures. Ideally, it is utilized for mid to distal waist fractures.

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