Low-profile plate fixation in arthrodesis of the first metacarpophalangeal joint

2011 ◽  
Vol 36 (6) ◽  
pp. 509-513 ◽  
Author(s):  
C. Rasmussen ◽  
S. Roos ◽  
M. Boeckstyns
Keyword(s):  
Patient Satisfaction ◽  
Plate Fixation ◽  
Metacarpophalangeal Joint ◽  
High Rate ◽  
Bone Union ◽  
Titanium Plate ◽  
Low Profile ◽  
Short Period ◽  
Primary Bone

Fifty-one consecutive arthrodeses (46 patients) of the first metacarpophalangeal joint were retrospectively reviewed, after fixation with a Leibinger low-profile titanium plate, using a cup-and-cone technique. Primary bone union was achieved in 98%. Three cases required removal of the plate and one case a tenolysis. Follow-up time was 13–92 months (mean 52). There was no correlation between patient satisfaction and position of fusion. We conclude that this technique gives a high rate of union, a short period of immobilization and rehabilitation, and a reliable position at the site of fusion.

scholarly journals Long-Term Sports Participation and Satisfaction After UCL Reconstruction in Amateur Baseball Players

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110275
Author(s):  
Robert A. Jack ◽  
Somnath Rao ◽  
Taylor D’Amore ◽  
Donald P. Willier ◽  
Robert Gallivan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Case Series ◽  
Sports Participation ◽  
High Rate ◽  
Return To Play ◽  
Baseball Players ◽  
Patient Reported ◽  
Rate Of Progression

Background: While the incidence of ulnar collateral ligament reconstruction (UCLR) has increased across all levels of play, few studies have investigated the long-term outcomes in nonprofessional athletes. Purpose: To determine the rate of progression to higher levels of play, long-term patient-reported outcomes (PROs), and long-term patient satisfaction in nonprofessional baseball players after UCLR. Study Design: Case series; Level of evidence, 4. Methods: We evaluated UCLR patients who were nonprofessional baseball athletes aged <25 years at a minimum of 5 years postoperatively. Patients were assessed with the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC), the Timmerman-Andrews (T-A) Elbow score, the Mayo Elbow Performance Score (MEPS), and a custom return-to-play questionnaire. Results: A total of 91 baseball players met the inclusion criteria, and 67 (74%) patients were available to complete the follow-up surveys at a mean follow-up of 8.9 years (range, 5.5-13.9 years). At the time of the surgery, the mean age was 18.9 ± 1.9 years (range, 15-24 years). Return to play at any level was achieved in 57 (85%) players at a mean time of 12.6 months. Twenty-two (32.8%) of the initial cohort returned to play at the professional level. Also, 43 (79.1%) patients who initially returned to play after surgery reported not playing baseball at the final follow-up; of those patients, 12 reported their elbow as the main reason for eventual retirement. The overall KJOC, MEPS, and T-A scores were 82.8 ± 18.5 (range, 36-100), 96.7 ± 6.7 (range, 75-100), and 91.9 ± 11.4 (range, 50-100), respectively . There was an overall satisfaction score of 90.6 ± 21.5 out of 100, and 64 (95.5%) patients reported that they would undergo UCLR again. Conclusion: In nonprofessional baseball players after UCLR, there was a high rate of progression to higher levels of play. Long-term PRO scores and patient satisfaction were high. The large majority of patients who underwent UCLR would undergo surgery again at long-term follow-up, regardless of career advancement.

Ulnar Shortening Osteotomy for Ulnar Abutment Syndrome: The Results of Metaphyseal and Diaphyseal Osteotomies

2020 ◽  
Vol 25 (04) ◽  
pp. 474-480
Author(s):  
Hirofumi Imai ◽  
Masatoshi Takahara ◽  
Mikiro Kondo
Keyword(s):  
Range Of Motion ◽  
Alternative Treatment ◽  
Bone Union ◽  
Cast Immobilization ◽  
Ulnar Shortening Osteotomy ◽  
Shortening Osteotomy ◽  
Primary Bone ◽  
The Mean ◽  
Temporary Decrease

Background: The purpose of this study was to report the results of metaphyseal and diaphyseal ulnar shortening osteotomies (USO) for the treatment of ulnar abutment syndrome (UAS). Methods: From 2011 to 2016, we performed metaphyseal USO in 8 patients (8 wrists) and diaphyseal USO in 6 patients (7 wrists). The results were investigated in terms of bone union and cast immobilization, wrist and forearm range of motion (ROM). The mean follow-up duration was 29 months. Results: All 14 patients had bone union. The mean duration of bone union in metaphyseal USO and diaphyseal USO were 3.5 months and 4.3 months and the duration of cast immobilization after surgery were 24.2 days and 29.2 days. The mean forearm ROM (degree) were 134.3 (pronation/supination: 66.7/67.6) and 169.3 (pronation/supination: 84.3/85.0) at 3 months after surgery and 173.4 (pronation/supination: 86.0/87.4) and 172.8 (pronation/supination: 87.1/85.7) at 6 months after surgery. Conclusions: The results from this study suggest that metaphyseal osteotomies are an effective alternative to diaphyseal osteotomies for the treatment of ulnar abutment syndrome. Although metaphyseal osteotomies were associated with temporary decrease of pronation, this discrepancy resolved at 6 months postoperatively. Metaphyseal USO has the potential to promote primary bone union and appears to be an alternative treatment for UAS.

scholarly journals Rigid Internal Fixation of Proximal Crescentic Metatarsal Osteotomy in Hallux Valgus Correction

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Andrew Stith ◽  
Matthew Griffin ◽  
Wesley Flint ◽  
Michael Coughlin
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Hallux Valgus ◽  
Hardware Removal ◽  
Metatarsal Osteotomy ◽  
Titanium Plate ◽  
Aofas Score ◽  
Low Profile ◽  
First Ray

Category: Bunion Introduction/Purpose: Proximal first metatarsal crescentic osteotomies are an effective means for correction of moderate to severe hallux valgus deformities. The originally described fixation construct included an intramedullary screw and a Kirschner wire which crossed the joint and required removal at 6 weeks. Elevation malunion of the first ray was also frequently noted postoperatively. The purpose of this study was to evaluate the outcomes of utilizing a low-profile titanium plate and screw construct for rigid fixation of proximal crescentic osteotomies. Methods: There were 53 patients (60 feet, 7 bilateral) with hallux valgus deformities enrolled in the study. They were all treated operatively with a proximal crescentic osteotomy and distal soft tissue correction with or without an Akin osteotomy. The crescentic osteotomy was fixed with a low-profile titanium plate and screws. Postoperatively patients were assessed at 3 months, 6 months and 1 year. Outcomes assessed included the need for hardware removal, change in elevatus of the first ray, as well as pre- and post-op VAS pain scores, radiographic evaluation, AOFAS score, MTP joint range of motion, and complications. Results: Of the 60 hallux valgus cases enrolled, 56 have completed their final follow-up (93%). At 1 year 55/56 patients had achieved radiographic union of their osteotomy. Nine patients had their hardware removed (16%). Range of motion at the 1st MTP joint decreased from 76.5 to 59.6 degrees. Hallux valgus angle improved from a mean of 28.8 to 9.6 degrees. The mean 1-2 intermetatarsal angle decreased from 14.1 to 6.4 degrees. Elevatus of the first ray increased from a mean of 2.5 mm pre-op to 3.2 mm (<1 mm) post-op. Mean VAS score improved from 4.43 to 0.68 (3.75 points). AOFAS score improved from 54.7 to 88.5 points. Complications included 4 superficial infections, 2 delayed wound healing cases and one DVT. Conclusion: Proximal crescentic metatarsal osteotomy with distal soft tissue repair is a safe and reliable method for operative treatment of hallux valgus. Utilization of a low-profile titanium plate and screw construct to rigidly fix the osteotomy yields a high rate of union and deformity correction with a low incidence of hardware removal and minimal increase in elevation of the first ray at final follow up.

Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports After Hamstring Tendon Autograft Reconstruction for Sternoclavicular Joint Instability

2020 ◽  
Vol 48 (4) ◽  
pp. 939-946 ◽  
Author(s):  
Lucca Lacheta ◽  
Travis J. Dekker ◽  
Brandon T. Goldenberg ◽  
Marilee P. Horan ◽  
Samuel I. Rosenberg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Joint Instability ◽  
Hamstring Tendon ◽  
High Rate ◽  
Return To Sports ◽  
Joint Reconstruction ◽  
Hamstring Tendon Autograft ◽  
Tendon Autograft

Background: Instability of the sternoclavicular (SC) joint is a rare but potentially devastating pathologic condition, particularly when it occurs in young or active patients, where it can lead to persistent pain and impairment of shoulder function. SC joint reconstruction using a hamstring tendon autograft is a commonly used treatment option, but midterm results are still lacking. Purpose/Hypothesis: The purpose of this study was to assess the clinical outcomes, survivorship, and return-to-sports rate after SC joint reconstruction using a hamstring tendon autograft in patients suffering from SC joint instability. We hypothesized that SC joint reconstruction would result in good clinical outcomes, high rate of survivorship, and a high rate of return to sports. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent SC joint reconstruction with a hamstring tendon autograft for SC joint instability, with a minimum 5-year follow-up, were included. Patient-reported outcomes were assessed prospectively by the use of the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numerical Evaluation (SANE) score, short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, 12-Item Short Form Health Survey (SF-12) physical component summary (PCS), and patient satisfaction. Survivorship of reconstruction was defined as no further revision surgery or clinical failure such as recurrent instability or subluxation events. Return to sports and pain were assessed using a customized questionnaire. Results: A total of 22 shoulders that underwent SC joint reconstruction, with a mean patient age of 31.3 years (range, 15.8-57.0 years) at the time of surgery, were included. At the final evaluation, 18 shoulders, with a mean follow-up of 6.0 years (range, 5.0-7.3 years), completed a minimum 5-year follow-up. All clinical outcome scores improved significantly from preoperatively to postoperatively: ASES (50.0 to 91.0; P = .005), SANE (45.9 to 86.0; P = .007), QuickDASH (44.2 to 12.1; P = .003), and SF-12 PCS (39.4 to 50.9; P = .001). Median postoperative satisfaction was 9 (range, 7-10). The construct survivorship was 90% at 5-year follow-up. There were 2 patients with failed treatment at 82 and 336 days postoperatively because of instability or pain who underwent revision SC joint reconstruction and capsulorrhaphy. Another patient had a superficial wound infection, which was debrided once and resulted in a good clinical outcome. Of the patients who answered optional sports activity questions, 15 (17 shoulders, 77%) participated in recreational or professional sports before the injury. At final follow-up, 14 patients (16 of 17 shoulders, 94%) returned to their preinjury level of sports. The visual analog scale score for pain today ( P = .004) and pain at its worst ( P = .004) improved significantly from preoperatively to postoperatively. Conclusion: SC joint reconstruction with a hamstring tendon autograft for SC joint instability resulted in significantly improved clinical outcomes with high patient satisfaction and 90% survivorship at midterm follow-up. Furthermore, 94% of this young and high-demand patient population returned to their previous level of sports. Concerns in terms of advanced postinstability arthritis were not confirmed because a significant decrease in pain was found after a minimum 5-year follow-up.

Open Reduction and Internal Fixation of Calcaneal Fractures with a Low Profile Titanium Calcaneal Perimeter Plate

2003 ◽  
Vol 24 (3) ◽  
pp. 217-221 ◽  
Author(s):  
David B. Thordarson ◽  
Michael Latteier
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Titanium Plate ◽  
Calcaneal Fractures ◽  
Fracture Union ◽  
Lateral Aspect ◽  
Low Profile ◽  
Loss Of Reduction ◽  
Calcaneus Fractures

Forty-two intra-articular calcaneus fractures underwent open reduction and internal fixation with a low profile, titanium plate with a shape similar to the lateral aspect of the calcaneus. All 42 fractures healed without complication. There were no cases of hardware breakage. None of the patients were noted to have a loss of reduction. The plates were applied without bending and molded to the side of the calcaneus with tightening of the screws. No patient complained of symptomatic hardware during the follow-up period. With postoperative plain radiographs, the reduction was judged as anatomic in 35 patients, less than a 2 mm step off in six patients, and one patient with greater than 2 mm step off. Use of this new plate allows for easy application as it does not require contouring, is well tolerated without complaints of hardware prominence, and none of the hardware broke prior to fracture union.

scholarly journals Endovascular Treatment of Ruptured Wide-Necked Anterior Communicating Artery Aneurysms Using a Low-Profile Visualized Intraluminal Support (LVIS) Device

2021 ◽  
Vol 11 ◽  
Author(s):  
Gaici Xue ◽  
Peng Liu ◽  
Fengfeng Xu ◽  
Yibin Fang ◽  
Qiang Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Perioperative Complications ◽  
Class Ii ◽  
High Rate ◽  
Anterior Communicating Artery ◽  
Complete Occlusion ◽  
Low Profile ◽  
Angiographic Data ◽  
Low Rate

Objective: To evaluate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stent-assisted coiling for the treatment of ruptured wide-necked anterior communicating artery (ACoA) aneurysms.Methods: The clinical and angiographic data of 31 acutely ruptured wide-necked ACoA aneurysms treated with LVIS stent-assisted coiling between January 2014 and December 2018 were retrospectively reviewed.Results: All stents were successfully deployed. The immediate angiographic results were modified Raymond-Roy class I in 27 cases, modified Raymond-Roy class II in 2 cases, and modified Raymond-Roy class IIIa in 2 cases. Intraoperative thrombosis and postoperative aneurysmal rebleeding occurred in one case each. Two patients (6.5%) who were admitted due to poor clinical grade conditions died during hospital admission as a result of initial bleeding. Angiographic follow-up (mean: 12.9 months) was performed for 26 patients, the results of which demonstrated that 25 aneurysms were completely occluded and one was class II. The last clinical follow-up (mean: 25.3 months) outcomes demonstrated that 27 patients had favorable clinical outcomes and two had poor clinical outcomes.Conclusion: LVIS stent-assisted coiling for ruptured wide-necked ACoA aneurysms was safe and effective, with a relatively low rate of perioperative complications and a high rate of complete occlusion at follow-up.

scholarly journals Patient Satisfaction After Biceps Tenotomy

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770773 ◽  
Author(s):  
Brett D. Meeks ◽  
Natalie M. Meeks ◽  
Andrew W. Froehle ◽  
Emily Wareing ◽  
Kevin F. Bonner
Keyword(s):  
Patient Satisfaction ◽  
Case Series ◽  
Shoulder Surgery ◽  
High Rate ◽  
Older Individuals ◽  
Middle Aged ◽  
Level Of Evidence ◽  
Biceps Tenotomy ◽  
Patient Reported

Background: Biceps tenotomy and tenodesis are frequently performed for proximal biceps lesions; however, there continues to be debate as to which method is superior. This study examined patient-reported outcomes after biceps tenotomy. Hypothesis: Biceps tenotomy in the setting of concomitant shoulder pathology is a reasonable option with high satisfaction rates and a low incidence of pain and cramping in middle-aged to older individuals. Study Design: Case series; Level of evidence, 4. Methods: A total of 104 patients (mean age, 63.5 years; range, 40-81 years) were evaluated at the time of surgery and at a mean follow-up of 38.4 months (range, 22-57 months). Biceps tenotomy was performed as a component of more extensive shoulder surgery in all patients. Patient satisfaction, frequency of cramping and spasms, biceps pain, weakness, and cosmetic deformity were evaluated at over 1-year follow-up. Results: Ninety-one percent of patients were satisfied or very satisfied with their surgical outcome, and 95% would have their surgery again. Three patients who reported being unsatisfied or very unsatisfied had either advanced glenohumeral arthritis or an irreparable rotator cuff tear. Cosmetic deformity occurred in 13% of patients. Twenty percent reported spasms and cramping in their biceps, and 19% reported some biceps pain; however, frequency of spasms and cramping was typically once weekly, and biceps pain was reported as severe or very severe in only 2 patients. Subjective biceps weakness was reported in 17% of patients. Age had no effect on outcome measures, and female sex was associated with less limitation and greater satisfaction after tenotomy compared with men. Conclusion: Our results indicate that patient-reported downsides to biceps tenotomy were usually mild and/or infrequent and did not affect patient satisfaction. We conclude that biceps tenotomy is a viable option that can lead to a high rate of patient satisfaction and outcomes in middle-aged to older individuals undergoing shoulder surgery with biceps pathology.

Outcome Measures Following Metacarpophalangeal Joint Replacement

2000 ◽  
Vol 25 (6) ◽  
pp. 601-603 ◽  
Author(s):  
K. SYNNOTT ◽  
H. MULLETT ◽  
H. FAULL ◽  
E. P. KELLY
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Outcome Measures ◽  
Joint Replacement ◽  
Hand Function ◽  
Metacarpophalangeal Joint ◽  
Assessment System ◽  
High Rate ◽  
Modest Improvement ◽  
Objective Outcome

We used the Jebsen–Taylor hand function assessment system to prospectively study the effect of metacarpophalangeal joint replacement on overall hand function in 29 hands. In addition pain relief, subjective improvement in hand function, appearance and overall patient satisfaction were assessed. There was modest improvement in the number of Jebsen–Taylor tasks performed (1.8 to 3.1), and pain relief was good or excellent in 18 of 24 patients. Eleven patients felt their hand function had improved by more than 50%, and the majority of patients (22 of 24) were very satisfied with the procedure. This study demonstrates that despite limited improvements in objective outcome measures, this procedure is reliable in producing a very high rate of patient satisfaction.

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.

Severe Head Injury linked to Subsequent Development of Malignant Brain Tumour within a Short Period- A Case Report

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Head Injury ◽  
Brain Tumour ◽  
Severe Head Injury ◽  
Case Reports ◽  
Subsequent Development ◽  
Malignant Brain Tumour ◽  
Tumour Development ◽  
Short Period ◽  
The Brain

There have been a few case reports of head injury leading to brain tumour development in the same region as the brain injury. Here we report a case where the patient suffered a severe head injury with contusion. He recovered clinically with conservative management. Follow up Computed Tomography scan of the brain a month later showed complete resolution of the lesion. He subsequently developed malignant brain tumour in the same region as the original contusion within a very short period of 15 months. Head injury patients need close follow up especially when severe. The link between severity of head injury and malignant brain tumour development needs further evaluation. Role of anti-inflammatory agents for prevention of post traumatic brain tumours needs further exploration.

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