Augmented fascia temporalis sling for paralytic ectropion of the lower lid

2021 ◽  
pp. 112067212199574
Author(s):  
Abbas Bagheri ◽  
Mohadeseh Feizi ◽  
Ramin Sahebghalam ◽  
Mehdi Tavakoli
Keyword(s):  
Case Series ◽  
Lower Eyelid ◽  
Single Session ◽  
Temporalis Fascia ◽  
Before And After ◽  
The Mean ◽  
Prospective Case Series ◽  
And Function

Purpose: To report the effect of lower eyelid temporalis fascia sling combined with lateral canthoplasty and tarsorrhaphy for paralytic ectropion. Methods: Prospective case series of 10 patients with lower lid paralytic ectropion who were treated with lower eyelid fascia temporalis sling and lateral canthoplasty in addition to lateral tarsorrhaphy as a single-session procedure. Additional medial tarsorrhaphy was applied if the medial lower lid apposition was not adequate at the end of the procedures. Eyelid configuration and function were compared before and after surgery. Results: The mean age of patients was 65.8 ± 10 years. Mean marginal reflex distance 1 (MRD1) and MRD2 changed from 3.5 ± 1.4 and 8.6 ± 2.4 mm to 2.2 ± 1.4 and 5.3 ± 1.2 mm respectively ( p = 0.001 and 0.006). Mean pre-operative lagophthalmos improved from 9.2 ± 4.9 to 3.4 ± 1.3 mm ( p = 0.001). The mean follow-up was 28.9 ± 12.1 months. Three patients required additional medial tarsorrhaphy to address residual medial ectropion in the same session. Conclusion: Combination of lower lid fascia temporalis sling, lateral canthoplasty and tarsorrhaphy as a single-session procedure can effectively improve the functional and aesthetic complications of paralytic ectropion.

Modified Ilizarov technique for the treatment of forearm deformities in multiple cartilaginous exostoses: case series and literature review

2012 ◽  
Vol 38 (3) ◽  
pp. 288-296 ◽  
Author(s):  
S. H. Song ◽  
H. Lee ◽  
H. Youssef ◽  
S. M. Oh ◽  
J. H. Park ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Functional Status ◽  
Corrective Osteotomy ◽  
Case Series ◽  
Ilizarov Method ◽  
Ilizarov Technique ◽  
Before And After ◽  
The Mean ◽  
Multiple Cartilaginous Exostoses

The aim of this study is to evaluate the results of gradual ulnar correction and lengthening using the modified Ilizarov technique for the treatment of forearm deformities in patients with multiple cartilaginous exostoses. We retrospectively reviewed 23 forearms in 16 patients. Three different types of operative procedures were performed: (1) corrective osteotomy and gradual lengthening of the ulna, (2) corrective osteotomy of the radius, and (3) excision of exostoses. We evaluated the radiographs; range of motion of the wrist, forearm, and elbow; and functional status using a questionnaire before and after operation. During the clinical interview, post-operative functional status was significantly improved than pre-operative functional status, 12 patients stated that they had no difficulty in performing daily activities, 11 patients stated that they had no pain, and 11 patients stated that the post-operative appearance of the operated forearm was satisfactory. At time of final follow-up, the mean range of motion of the wrist in ulnar/radial deviation, forearm pronation/supination was significantly improved. Also, the radiographic parameters including radial articular angle, carpal slip, radial bowing, and ulnar variance were significantly improved at time of final follow-up. In conclusion, we achieved successful clinical and radiological outcomes in our patients with forearm deformities after treatment with the modified Ilizarov method. However, there could be a recurrence of ulnar shortening and deformity during growth periods in skeletally immature patients.

scholarly journals Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3692-3697 ◽  
Author(s):  
Hehua Ye ◽  
Jiming Zhang ◽  
Yiyong Qian
Keyword(s):  
Nd:Yag Laser ◽  
Case Series ◽  
Anterior Capsule ◽  
Long Term Study ◽  
Before And After ◽  
Long Term Follow Up ◽  
The Mean ◽  
Anterior Capsulotomy

Objective To investigate the long-term safety and efficacy of Nd:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Methods We retrospectively analyzed a consecutive case series of Nd:YAG laser anterior capsulotomy in patients with anterior capsular phimosis, who were treated between November 2012 and April 2014. Data collected included risk factors, interval between surgery and capsulotomy, best-corrected visual acuity (BCVA), and diameter of anterior capsule opening before and after Nd:YAG laser anterior capsulotomy. Results Eleven eyes of 11 patients were included in the study. The mean follow-up time was 30.1 ± 4.5 months (range: 26–42 months). At the last follow-up, the mean diameter of the anterior capsule opening was 5.1 ± 0.2 mm, which was significantly greater than the diameter before laser capsulotomy (2.2 ± 0.8 mm). BCVA remained stable or improved in nine eyes (81.8%) following capsulotomy. No patients experienced recurrence of phimosis. Conclusions In a long-term study of >2 years, we found that Nd:YAG laser anterior capsulotomy is safe and effective for the treatment of anterior capsule phimosis.

scholarly journals Treatment of atrophic nonunion via autogenous ilium grafting assisted by vertical fixation of double plates: A case series of patients

2019 ◽  
Vol 47 (5) ◽  
pp. 1998-2010 ◽  
Author(s):  
Liang Sun ◽  
Zhong Li ◽  
Teng Ma ◽  
Han-Zhong Xue ◽  
Qian Wang ◽  
...  
Keyword(s):  
Bone Healing ◽  
Case Series ◽  
Lower Limbs ◽  
Structural Environment ◽  
Tibial Nonunion ◽  
The Mean ◽  
And Function ◽  
Atrophic Nonunion ◽  
Humeral Nonunion

Objective To investigate the efficacy of the treatment of atrophic nonunion using structural autogenous ilium bone grafting in combination with vertical fixation of double plates. Methods This retrospective study analysed the clinical data from consecutive patients with atrophic nonunion who underwent autogenous ilium grafting in combination with double-plate vertical fixation. The injury type and the bone affected by nonunion, the duration of nonunion and the outcomes following surgery were recorded for all patients. Results The study enrolled 43 patients with atrophic nonunion of the upper and lower limbs: 17 patients with tibial nonunion, 21 with femoral nonunion, four with humeral nonunion and one with radial shaft nonunion. The mean duration of postoperative follow-up was 14.5 months (range, 8–28 months). A total of 43 of 43 patients (100%) achieved a healed nonunion fracture without the occurrence of complications such as infection, fracture of internal fixation or pain in the harvesting site. Comprehensive postoperative assessments of bone healing and function were observed to be good and/or excellent in all 43 patients. Conclusion Structural autogenous ilium grafting used in combination with double-plate vertical fixation can provide a stable structural environment for near optimal bone healing in patients with atrophic nonunion.

scholarly journals Femtosecond Laser Implantation of a 355-Degree Intrastromal Corneal Ring Segment in Keratoconus: A Three-Year Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Marwa Mahmoud Abdellah ◽  
Hatem Gamal Ammar
Keyword(s):  
Femtosecond Laser ◽  
Case Series ◽  
Corneal Neovascularization ◽  
High Rate ◽  
Spherical Equivalent ◽  
Clinical Trial Registry ◽  
Link Type ◽  
The Mean ◽  
Prospective Case Series

Purpose. To evaluate the outcomes of femtosecond laser-assisted implantation of a 355-degree intracorneal ring (ICR) (Keraring) in patients with keratoconus in the three-year follow-up. Setting. Future Femtolaser Center, Sohag, Egypt. Design. Prospective interventional case series. Patients and Methods. A prospective case series of 38 eyes of 26 patients with keratoconus had implantation of the 355-degree ICR keraring after tunnel creation with a femtosecond laser. The uncorrected visual acuities (UCVA) and best-corrected visual acuities (BCVA), sphere, cylinder, and manifest refraction spherical equivalent (SE), and mean keratometry (K), K max, and K min were evaluated preoperatively and 3, 6, 12, 24, and 36 months postoperatively, and all complications were reported. Results. 38 eyes of 26 patients with mean age 25.92 ± 5.44 years were enrolled in the study, 11 were males (42.3%). The mean UCVA improved from 0.93 ± 0.21 to 0.63 ± 0.21 logMAR (P≤0.001) and the mean BCVA from 0.67 ± 0.22 to 0.43 ± 0.26 logMAR (P<0.001). The mean sphere, cylinder, and spherical equivalent have been changed dramatically from preoperative to 3 month postoperative, which is statistically significant (P≤0.001), and the changes between 1 and 2 years and 2 and 3 years are also considerable and statistically significant; the K max and K min and K mean improved and the changes were statistically significant (P≤0.001), and the changes between one, two, and three years were also statistically significant. The safety and efficacy indices were changed through the three-year follow-up. The complications were corneal neovascularization (36.84%), corneal melting (26.3%), and ring extrusion (31.5%) at the end of the study. Conclusions. Implantation of a 355-degree intracorneal keraring using femtosecond laser improved the visual, refractive, and topographic parameters in keratoconus patients, with a high rate of ICR extrusion and instability. The study has been registered for the Pan African Clinical Trial Registry (http://www.pactr.org) database within No: PACTR201810796878908 on 29 October 2018.

Pyrocardan Scaphotrapeziotrapezoid Joint Arthroplasty for Isolated Osteoarthritis: Results after a Mean Follow-Up of 5 Years

2021 ◽  
Author(s):  
Martin Cholley-Roulleau ◽  
Yves Bouju ◽  
Flore-Anne Lecoq ◽  
Alexandre Fournier ◽  
Philippe Bellemère
Keyword(s):  
Case Series ◽  
Preoperative Assessment ◽  
Contralateral Side ◽  
High Rate ◽  
Significant Difference ◽  
Flexion Extension ◽  
Functional Scores ◽  
Before And After ◽  
The Mean

Abstract Background Isolated scaphotrapeziotrapezoid (STT) osteoarthritis (OA) mainly develops in women over 50 years of age in a bilateral manner. Many surgical treatments are available, including distal scaphoid resection with or without interposition, trapeziectomy, and STT arthrodesis. However, there is a controversy about which procedure is the most effective. Purposes The purpose of this study was to report the outcomes of the Pyrocardan implant for treating STT isolated OA at a mean follow-up of 5 years. Patients and Methods Consecutive patients who underwent STT arthroplasty using the Pyrocardan were reviewed retrospectively by an independent examiner who performed a clinical and radiological evaluation. Results The mean follow-up time was 5 years (range 3–8 years). Thirteen patients (76%) were followed for more than 5 years. Between the preoperative assessment and the last follow-up, pain levels decreased significantly. There was no significant difference in the mean Kapandji opposition score. Grip and pinch strengths were 88 and 91% of the contralateral side. The active range of motion in flexion–extension and radioulnar deviation was not significantly different to the contralateral side (119° vs. 121° and 58° vs. 52°, p > 0.1). Functional scores were improved significantly. No identifiable differences were found in the radioscaphoid, capitolunate, and scapholunate angles before and after surgery. In three cases, the preoperative dorsal intercalated scapholunate instability (DISI) failed to be corrected. In one case, DISI appeared after the procedure. There was one asymptomatic dislocation of the implant. Calcification around the trapezium and/or distal scaphoid was found in four cases. The survival rate of the implant without reoperation was 95%. Conclusions In the medium term, Pyrocardan implant is an effective treatment for STT OA as it reduces pain, increases grip strength, and maintains wrist mobility. This is consistent with the results of other published case series using pyrocarbon implants. It provides a high rate of patient satisfaction. Nevertheless, the surgical procedure must be done carefully to avoid STT ligament damage, periarticular calcifications, or dislocation.

scholarly journals Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique

2020 ◽  
Vol 47 (4) ◽  
pp. 347-353
Author(s):  
Emine Malkoc Sen ◽  
Kubra Ozdemir Yalcinsoy
Keyword(s):  
Recurrence Rate ◽  
Intraoperative Complications ◽  
Case Series ◽  
Lower Eyelid ◽  
New Technique ◽  
Before And After ◽  
A New Technique ◽  
The Right ◽  
Horizontal Eyelid Laxity

Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.

scholarly journals Arthroscopic treatment of subtalar joint injuries

2019 ◽  
Vol 13 (1) ◽  
pp. 22-27
Author(s):  
Felipe Ayusso Correa Sossa ◽  
Inacio Diogo Asaumi ◽  
Alfonso Apostólico Netto ◽  
Rafael Da Rocha Macedo ◽  
Donato Lo Turco ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
Case Series ◽  
Arthroscopic Treatment ◽  
Level Of Evidence ◽  
Before And After ◽  
Reduction Of Pain ◽  
Vas Scores ◽  
The Mean ◽  
Status Level

Objective: To evaluate the results of arthroscopic treatment of various subtalar joint pathologies. Methods: Retrospective study of patients undergoing arthroscopy of the subtalar joint from 2005 to 2013, totaling 10 cases over a mean follow-up of 27.1 months, in which the American Orthopedic Foot and Ankle Society (AOFAS) scale and pain visual analogue scale (VAS) scores before and after surgery were compared. Results: The preoperative AOFAS scores ranged from 35 to 74, with a mean score of 50.1 points, and the postoperative scores ranged from 82 to 100 points, with a mean score of 90.8 points. When comparing the scores, we observed an average gain of 40.1 points. The mean VAS score for the initial pain assessment was 6.5 points, and the mean postoperative score was 1.4 points. Conclusion: Arthroscopic treatment of the reported subtalar pathologies led to encouraging results, with a significant reduction of pain and improvement of functional status. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Five-Year Prospective Study on Implant Failure and Marginal Bone Remodeling Expected Using Bone Level Implants with Sandblasted/Acid-Etched Surface and Conical Connection

2022 ◽  
Author(s):  
Marco Tallarico ◽  
Aurea Maria Immacolata Lumbau ◽  
Silvio Mario Meloni ◽  
Irene Ieria ◽  
Chang-Joo Park ◽  
...  
Keyword(s):  
Survival Rate ◽  
Bone Remodeling ◽  
Case Series ◽  
Insertion Torque ◽  
Implant Survival ◽  
Bone Level ◽  
The Mean ◽  
Prospective Case Series ◽  
Gingival Biotype

Abstract Objective The purpose of the present prospective, case-series study was to report implant survival rate and marginal bone remodeling expected 5 years after loading using dental implants placed in daily practice. Materials and Methods This research was designed as an open-cohort, prospective, case-series evaluation. Any partially or completely edentulous patient, scheduled to receive at least one bone level implant, was considered eligible for this study. Primary outcome measurements were: implant and prosthetic cumulative survival rate and any complications experienced up to the 5-year follow-up. Secondary outcome measures were: thickness of gingival biotype, implant insertion torque, implant stability quotient, and marginal bone loss (MBL). Results Ninety consecutive patients (34 males and 56 females, aged between 24 and 81 years old [mean: 53.2 ± 15.4]) with 243 inserted implants were followed for at least 5 years after loading (mean: 65.4 ± 3.1 months; range from 60 to 72). At the 1-year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the 5-year examination. At the 5-year follow-up examination, six implants lost osseointegration (97.5%). In the same period, four prostheses failed (97.2%). Five complications were reported in five different patients (prosthetic success rate was 96.5%, at patient level). Five years after loading, the mean MBL was 0.41 ± 0.30 mm. The difference from the 1-year data was 0.04 ± 0.19 mm. A statistically significant higher MBL was found for smokers, and patients with thin gingival biotype. The mean implant insertion torque was 42.9 ± 4.8 Ncm (range from 15 to 45 Ncm). Two-hundred and three implants (83.5%) were inserted with an insertion torque ≥35 and ≤45 Ncm. Conclusions High implant survival and success rate could be expected with stable marginal bone remodeling up to 5 years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research studies are needed to confirm these results.

Acute Total Knee Replacement in Rheumatoid Arthritis Patients with Proximal Tibial Fractures: A Case Series

2020 ◽  
Author(s):  
Fardin Mirzatolooei ◽  
Ali Tabrizi ◽  
Mir Bahram Safari ◽  
Seyed Amir Mahlisha Kazemi Shishavan
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Case Series ◽  
Normal Activity ◽  
Tibial Fractures ◽  
Proximal Tibial Fractures ◽  
Total Knee ◽  
The Mean ◽  
And Function

AbstractManagement of proximal tibial fractures is a challenging issue in patients with rheumatoid arthritis (RA). In the present study, we aimed to describe our experience of acute total knee replacement in RA patients.This case series included 11 RA patients with simultaneous insufficiency fractures of the proximal tibia, who were treated by acute total knee replacement. Midterm functional results, severity of pain, Hospital for Special Surgery (HSS), and Knee Society Score (KSS) parameters were evaluated in this study. The patients were followed up for 24 months.Eleven women with proximal tibial fractures and history of RA (mean age: 54.3 ± 4.7 years) were enrolled in this study. The mean score of Tegner activity scale was 2.2 ± 1.4 preoperatively, which significantly improved to 4.3 ± 1.4 postoperatively (p < 0.001). The two sections of KSS (knee and function section) averaged 88.7 ± 5.4 and 59.4 ± 8.2, respectively. There wasn't poor outcome and excellent result was in knee section 54.5% and function section 36.3% based on KSS. The mean score of pain severity during normal activity before fracture was 65.2 ± 12.3, which significantly reduced to 35.5 ± 11.3 in the final follow-up (p = 0.02). The score of HSS scale improved from 42 (range: 16–58) in the preoperative stage to 78 (range: 72–91) after surgery (p < 0.001). In the 6-month follow-up, deep vein thrombosis was reported in two patients. The time required to return to normal activity was 5.5 ± 2.3 months.Based on the findings, total knee replacement therapy in patients with RA and proximal tibial fractures produced excellent clinical outcomes, which led to rapid return to normal activity. This is a Level IV, therapeutic study.

scholarly journals Reconstruction of medial patellofemoral ligament arthroscopically assisted: a prospective case series with short-term clinical follow-up

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0019
Author(s):  
Germán A. Jaramillo ◽  
Diego F. Luna ◽  
Narly V. Gómez ◽  
Rubén D. Arias
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Surgical Techniques ◽  
Case Series ◽  
Short Term ◽  
Access Method ◽  
Before And After ◽  
Arthroscopically Assisted ◽  
Safe Technique ◽  
Prospective Case Series

The medial patellofemoral ligament (MPFL) is one of the most important anatomical structure that stabilize the patella, during its injury a repetitive dislocation occurs. The reconstruction of this ligament, it seeks to avoid the recurrence of these episodes, for which there are various surgical techniques, one of these the arthroscopy, it can reduce adverse events of the procedure. The aim of this study is to describe the clinical follow-up of patients who had a reconstruction of the MPFL arthroscopically assisted. This is a prospective case series carried out in two hospitals of Medellín city, between 2010 and 2016. For the clinical follow-up, Lysholm, Kujala and Tegner knee scores were performed before and 12 months after the surgical procedure. Were applied Shapiro Wilk tests to evaluate normality and T-student to compare the results of the scores. We follow fifteen patients, 16 reconstructions of MPFL, of these 12 were female. The average time between the first dislocation and surgery was 12 months. Statistically significant differences were found when comparing the three scores before and after surgery (p= <0.05). Most patients improved pain and no patient required reoperation in the follow-up period. The reconstruction of MPFL arthroscopically assisted is a minimal access method that allows identifying the anatomical insertions of the MPFL, and is a safe technique that causes low morbidity and satisfactory clinical evolution of the patients.

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