Dorsiflexion Osteotomy in Freiberg's Disease

Foot & Ankle ◽  
1989 ◽  
Vol 9 (5) ◽  
pp. 226-231 ◽  
Author(s):  
Patrick Kinnard ◽  
Richard Lirette
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Average Duration ◽  
Clinical Findings ◽  
Minimal Loss ◽  
Freiberg’S Disease

A retrospective study of the postsurgical results of 10 patients who had dorsiflexion osteotomy was undertaken. Patient satisfaction, clinical findings, and roentgenographic measurements were all carefully evaluated after an average duration of follow-up of 36.5 months. The procedure gave excellent results for all patients, with minimal loss of metatarsophalangeal motion and an average radiological metatarsal shortening of 2.3 mm and no postoperative metatarsalgia. The authors believe that the dorsiflexion osteotomy is a reasonable treatment for symptomatic Freiberg's disease. The procedure is reliable and not destructive, should further treatment be necessary.

A Comparison between Chevron and Mitchell Osteotomies for Hallux Valgus

Foot & Ankle ◽  
1984 ◽  
Vol 4 (5) ◽  
pp. 241-243 ◽  
Author(s):  
Patrick Kinnard ◽  
Douglas Gordon
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Hallux Valgus ◽  
Postoperative Period ◽  
Load Distribution ◽  
Clinical Findings ◽  
Corrective Surgery ◽  
Chevron Osteotomy

A retrospective study of 15 Mitchell and 15 Chevron osteotomies was undertaken in order to compare the efficacy of these two procedures in the correction of hallux valgus. Patient satisfaction, clinical findings, and roentgenographic measurements were all carefully evaluated after follow-up periods of 21 ± 5 months for the Chevron and 34 ± 8 months for the Mitchell procedures. Differences observed were a better correction of the angle between the first and second metatarsals by the Mitchell osteotomy (2.3 vs 5.5 degrees) and a tendency to loose the correction in the immediate postoperative period for the Chevron osteotomy. However, no clinical superiority could be demonstrated, nor did patient satisfaction differ in the two techniques. The authors conclude that these procedures give essentially equivalent results. Although the outcome was generally considered satisfactory by the patient, nearly 40% of both groups had metatarsalgia in the lateral rays, which stresses the importance of carefully considering load distribution across the foot in planning any corrective surgery.>

Implants Placed in the Nasopalatine Canal to Rehabilitate Severely Atrophic Maxillae: A Retrospective Study With Long Follow-up

2014 ◽  
Vol 40 (6) ◽  
pp. 699-706 ◽  
Author(s):  
David Peñarrocha ◽  
Eugenia Candel ◽  
Jose Luis Calvo Guirado ◽  
Luigi Canullo ◽  
Maria Peñarrocha
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Success Rate ◽  
Class V ◽  
Nasopalatine Canal ◽  
Level Of Satisfaction ◽  
Early Failures ◽  
Analogue Scales ◽  
Discrimination Method

To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell's class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prostheses.

Long-term follow-up of heel spur surgery. A 10-year retrospective study

1999 ◽  
Vol 89 (2) ◽  
pp. 81-88 ◽  
Author(s):  
PK Vohra ◽  
RJ Giorgini ◽  
E Sobel ◽  
CJ Japour ◽  
MA Villalba ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Postoperative Outcome ◽  
Heel Pain ◽  
Heel Spur ◽  
Conservative Care ◽  
Factors Influencing ◽  
Long Term Follow Up

A comparative retrospective study of 48 open heel spur surgeries and 20 endoscopic plantar fasciotomies was conducted involving 59 patients over a 10-year period. There was a significant reduction in heel pain at the time of follow-up (average, 3 years) for both groups. Overall, 85% of procedures were associated with patient satisfaction with the results, and patients said that they would recommend heel spur surgery for relief of severe heel pain in 94% of cases. Factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity, are discussed.

Osteoplastic Macroscopic and Microscopic Frontal Sinus Surgery

1994 ◽  
Vol 8 (5) ◽  
pp. 247-252 ◽  
Author(s):  
Rainer Weber ◽  
Wolfgang Draf ◽  
Janni Constantinidis
Keyword(s):  
Retrospective Study ◽  
Functional Outcome ◽  
Frontal Sinus ◽  
Average Duration ◽  
Abdominal Fat ◽  
Sinus Surgery ◽  
Double Vision ◽  
Forced Air ◽  
Indications For Operation

In a retrospective study we evaluated 75 osteoplastic frontal sinus operations performed in Fulda between 1979 and 1992. Indications for operation were fractures (43), infections (19), tumors (11), and pneumatosinus (2). An obliteration with abdominal fat was done in 31 cases. The average duration of follow-up was 3.8 years. The overall aesthetic and functional outcome was very good. Revision was necessary in only one case. The patient had forced air into the frontal sinus by blowing his nose too early, so that there was threat of infection. No serious complications such as surgery-related meningeal damage, impaired vision, or double vision occurred.

Clinical features and outcomes of patients with microscopic polyangiitis: experience of two centers

2020 ◽  
Keyword(s):  
Retrospective Study ◽  
Clinical Features ◽  
Microscopic Polyangiitis ◽  
Renal Involvement ◽  
Clinical Findings ◽  
Consensus Conference ◽  
Immunological Parameters ◽  
The Mean ◽  
Definition Of

Background and Aim: Microscopic polyangiitis (MPA) is a rare necrotizing vasculitis that involves predominantly the small-caliber blood vessels. In this retrospective study, we aimed to evaluate the clinical findings, prognostic factors, and outcomes of MPA patients followed in two different centers. Material and Method: In this retrospective study, a total of 38 patients diagnosed and followed with MPA in two different centers between January 2005 and December 2019 were included. Medical records of the patients were reviewed retrospectively. The diagnoses were based on the definition of MPA in the Chapel Hill consensus conference (CHCC-2012). In addition to the socio-demographic characteristics, clinical features, laboratory and immunological parameters; time passed for the diagnosis, treatment, outcomes, and follow-up time were recorded for each patient. The Five Factor Scores (FFS; Revised FFS 2009) and Birmingham Vasculitis Activity Score (BVAS; Version 3) were applied in all patients. Results: In a total of 38 patients (10 females, 28 male) were included in the study. The mean age of the participants was 54.52 ± 8.21 (range: 32-74) years. The mean time passed for the diagnosis was 2.93 ± 2.03 (0.50-11) months and the mean follow-up period was 55.0 ± 30.51 (2-124) months. At admission, the mean BVAS was 18.28 ± 5.73 (8-35). The FFS results were as follows; 0 in 4 (10.5%) patients, 1 in 27 (71.1%) patients, 2 in 7 (18.4%) patients. The most common symptoms at admission were dyspnea, cough, and hemoptysis. Renal failure was present in 31 (81.5%) of the patients, at admission. The most common immunologic finding was the p-ANCA positivity in 26 (68.4%) patients. Among all patients, 25 (65.8 %) did not have any other attacks after the diagnosis. In follow-ups, 12 (31.5%) patients were passed away and vasculitis associated mortality rate was 18.4%. The effects of some factors on mortality including age ≥ 65 years, male gender, renal involvement, p-ANCA positivity, decreased oxygen saturation (< 90%), having anemia at admission, having FEV1/FVC < 70 in spirometry, having a FFS score of 2, and having a BVAS > 18 were examined (Table 6). Only having an FFS score of 2 and BVAS > 18 were determined as the factors significantly affecting mortality (P: 0.01). Conclusion: Pulmonary symptoms are more predominant in MPA. Though many patients did not have any other attacks after the diagnosis, the vasculitis associated mortality may reach about 20%. BVAS and FFS are still the best determinants of mortality.

Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao
Keyword(s):  
Acute Appendicitis ◽  
False Positive ◽  
False Positive Rate ◽  
Accurate Method ◽  
Clinical Findings ◽  
Pathological Findings ◽  
Lower Quadrant ◽  
Predictive Values ◽  
Positive Rate

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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