Ruptures of the Plantar Fascia: A Systematic Review of the Literature

2020 ◽  
pp. 193864002097488
Author(s):  
Massimiliano Mosca ◽  
Mario Fuiano ◽  
Simone Massimi ◽  
Davide Censoni ◽  
Giuseppe Catanese ◽  
...  
Keyword(s):  
Systematic Review ◽  
Conservative Treatment ◽  
Operative Treatment ◽  
Cochrane Review ◽  
Rare Condition ◽  
Plantar Fascia ◽  
Asymptomatic Patients ◽  
Incidence Risk ◽  
Local Injections ◽  
History Of

Introduction Rupture of the plantar fascia is a rare condition. It can also occur spontaneously and with no history of disease of the plantar fascia, above all in athletes. This review aims to systematically analyze all cases described in the literature regarding the rupture of the plantar fascia, evaluating incidence, risk factors, and treatments, considering which procedures show the best outcomes and the highest success rate. Materials and methods A systematic review of PubMed, Google Scholar, and Cochrane review computerized databases was performed, focusing on articles about cases of rupture of the plantar fascia; 18 studies fulfilled all the criteria and were analyzed. There were no randomized controlled trials. Results A total of 155 patients (157 foot) were included in this systematic review. Considering all the studies included, 12 patients had a spontaneous rupture, 138 patients had a diagnosis of plantar fasciitis, and 130 patients were treated with local injections of corticosteroid before the rupture. Only 2 cases of bilateral rupture were reported. In all, 15 studies reported conservative treatment, with a total of 154 patients (156 feet) included. Operative treatment was reported in 3 studies, with 3 patients (3 feet) treated. Conclusions Ruptures of the plantar fascia are very rare in asymptomatic patients and more common in patients treated with injection of steroids in the plantar fascia. Conservative treatment, although not standardized in the literature, led to good outcomes in most cases. Chronic ruptures of the fascia should be considered for operative treatment. Levels of Evidence: Level III

scholarly journals Systematic review of clinical outcomes after prophylactic surgery

2016 ◽  
Vol 98 (6) ◽  
pp. 353-357 ◽  
Author(s):  
CR Davis ◽  
AEJ Trevatt ◽  
A Dixit ◽  
V Datta
Keyword(s):  
Systematic Review ◽  
Acute Appendicitis ◽  
Prophylactic Surgery ◽  
Cochrane Central Register ◽  
Short Term ◽  
Asymptomatic Patients ◽  
Central Register ◽  
Life Threatening ◽  
History Of

Introduction Prophylactic appendicectomy is performed prior to military, polar and space expeditions to prevent acute appendicitis in the field. However, the risk–benefit ratio of prophylactic surgery is controversial. This study aimed to systematically review the evidence for prophylactic appendicectomy. It is supplemented by a clinical example of prophylactic surgery resulting in life-threatening complications. Methods A systematic review was performed using MEDLINE® and the Cochrane Central Register of Controlled Trials. Keyword variants of ‘prophylaxis’ and ‘appendicectomy’ were combined to identify potential papers for inclusion. Papers related to prophylactic appendicectomy risks and benefits were reviewed. Results Overall, 511 papers were identified, with 37 papers satisfying the inclusion criteria. Nine reported outcomes after incidental appendicectomy during concurrent surgical procedures. No papers focused explicitly on prophylactic appendicectomy in asymptomatic patients. The clinical example outlined acute obstruction secondary to adhesions from a prophylactic appendicectomy. Complications after elective appendicectomy versus the natural history of acute appendicitis in scenarios such as polar expeditions or covert operations suggest prophylactic appendicectomy may be appropriate prior to extreme situations. Nevertheless, the long-term risk of adhesion related complications render prophylactic appendicectomy feasible only when the short-term risk of acute appendicitis outweighs the long-term risks of surgery. Conclusions Prophylactic appendicectomy is rarely performed and not without risk. This is the first documented evidence of long-term complications following prophylactic appendicectomy. Surgery should be considered on an individual basis by balancing the risks of acute appendicitis in the field with the potential consequences of an otherwise unnecessary surgical procedure in a healthy patient.

Impaired Extension of the Digits due to Bilateral Idiopathic Intrinsic Contracture: A Case Report

2019 ◽  
Vol 24 (03) ◽  
pp. 383-385
Author(s):  
Yuki Kawasaki ◽  
Soichi Ejiri ◽  
Michiyuki Hakozaki ◽  
Shinichi Konno
Keyword(s):  
Eating Disorder ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Medical History ◽  
Rare Condition ◽  
Tendon Sheath ◽  
Past Medical History ◽  
Thenar Muscle ◽  
History Of

Idiopathic intrinsic contracture (IIC) with no history of trauma, ischemia, or spasticity is extremely rare. We report herein a case of impaired extension of the digits due to bilateral IICs occurred in a 30-year-old woman with a past medical history of eating disorder and amenorrhea. Although no previous case has been reported in the literature, eight similar cases of IIC have been presented at Japanese domestic conferences. In these eight cases and the present case, resection of the thenar muscle cords and unilateral resection of the lateral band were effective. Since IIC in patients with an eating disorder is a rare condition, it would be treated conservatively at first as tendon sheath inflammation or locking. However, this condition may be resistant to conservative treatment, and surgical treatment should be considered in such cases.

Good results for treatment of flexor hallucis longus (stenosing) tenosynovitis: a systematic review

2017 ◽  
Vol 2 (6) ◽  
pp. 325-331 ◽  
Author(s):  
Kim T M Opdam ◽  
Johannes I Wiegerinck ◽  
C Niek van Dijk
Keyword(s):  
Systematic Review ◽  
Conservative Treatment ◽  
Operative Treatment ◽  
Treatment Options ◽  
Return To Sport ◽  
Population Characteristics ◽  
Successful Outcome ◽  
Flexor Hallucis Longus ◽  
Number Of Patients ◽  
Stenosing Tenosynovitis

ImportanceNowadays, it is unclear what kind of non-operative and operative treatment protocols exist for flexor hallucis longus (FHL) (stenosing) tenosynovitis and to what extent conservative treatment is effective.ObjectiveThe purpose of this study was to evaluate the literature on treatment of FHL (stenosing) tenosynovitis and to provide an overview of the different treatment options as well as an analysis, evaluation and comparison of their outcomes.Evidence reviewA structured systematic review of literature was performed to identify non-operative and operative therapeutic studies reporting on five or more patients with FHL (stenosing) tenosynovitis. Medline, Embase (Classic), Cumulative Index to Nursing and Allied Health Literature, Sportdiscus and Pedro databases were searched. Two reviewers independently performed data extraction. Extracted data consisted of population characteristics, treatment, outcome of treatment. The primary outcome was success rate. The secondary outcomes were patient satisfaction, complication rate, return to sport and the time to achieve return to sport or full activity after treatment. The Coleman score was used to assess the methodological quality of the studies.FindingsSix articles were included. The number of patients in these studies totalled 138 with 151 affected ankles. Overall good results were found for treatment of FHL (stenosing) tenosynovitis. Specific exercises to stretch the FHL are successful in 64%. An injection with 1% lidocaine to inflate the FHL tendon sheath is successful in 33%. If conservative treatment fails, operative treatment can offer a solution. There are open and endoscopic techniques for release of the FHL tendon and all the techniques have a successful outcome. All athletes return to sport after an average of 5 weeks and 90% of the athletes have a full return to sport after a mean time of 4 months.ConclusionThere are many conservative treatment options mentioned for FHL tenosynovitis; nevertheless only outcomes of stretching and lidocaine injections are reported. If conservative treatment does not give sufficient relief of symptoms, operative treatment, by releasing the FHL by an arthroscopic or open technique, offers a safe and effective solution. Thereby, arthroscopic techniques are promising; however, there is a paucity of literature on this issue.RelevanceIt is important to know what kind of conservative and operative treatments are effective for FHL (stenosing) tenosynovitis.Level of evidenceLevel IV.

scholarly journals Frozen Shoulder: Current Concept of Management

2021 ◽  
Vol 9 (F) ◽  
pp. 58-66
Author(s):  
Tito Sumarwoto ◽  
Seti Aji Hadinoto ◽  
Musa Fasa Roshada
Keyword(s):  
Conservative Treatment ◽  
Operative Treatment ◽  
Musculoskeletal Disorder ◽  
Glenohumeral Joint ◽  
Frozen Shoulder ◽  
Current Evidence ◽  
History Of Surgery ◽  
Manipulation Under Anesthesia ◽  
First Choice ◽  
History Of

BACKGROUND: Frozen shoulder is a musculoskeletal disorder resulting from chronic inflammation of the capsule subsynovial layer and characterized with capsular thickening, progressive fibrosis, and contracture of the glenohumeral joint capsule. This condition is a relatively common condition that mimics other condition and its management requires deliberate consideration of patient’s condition. REVIEW ARTICLE: This article reviews and summarize latest findings of frozen shoulder. The diagnosis of frozen shoulder is described from the patient history, physical examination in look, feel, and move sequence to the supporting examinations. The current evidence of managements of frozen shoulder is described, from the nonoperative to the surgical approach. CONCLUSION: Most of frozen shoulder cases resolve spontaneously thus conservative treatment should be the first choice of frozen shoulder. However, for cases that failed with conservative treatment and had a debilitating effect to patient’s daily life or cases with history of surgery, operative treatment should be considered. Operative treatment is aimed to release the capsule either by manipulation under anesthesia, by arthroscopy, or by open surgery. Physical rehabilitation following every procedure is mandatory and key to maintain range of motion years following the surgery.

scholarly journals Type III Acromioclavicular Joint Injuries: Conservative or Operative Treatment? A Systematic Review of Recent 10-year Studies

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0046
Author(s):  
Agung Kenji Arnaya ◽  
Putu Astawa
Keyword(s):  
Systematic Review ◽  
Conservative Treatment ◽  
Operative Treatment ◽  
Functional Outcomes ◽  
Age Group ◽  
Ac Joint ◽  
Joint Injury ◽  
Type Iii ◽  
Oxford Shoulder Score ◽  
Shoulder Score

Introduction: Commonly found in daily practice, acromioclavicular (AC) joint injury mostly presents as minor sprains and occurs five times more frequently in men than in women, with the highest incidence in the 20 to 30 years old age group. The management depends on its grade and severity but the treatment of choice for type III AC joint injury remains unclear. Considering the absence of an algorithm for correctly diagnosing and treating type III injuries, this systematic review aims to compare the conservative and operative treatment for this pathology. Materials and Methods: This systematic review was conducted based on the PRISMA guideline. Literature research was primarily performed using Pubmed, EMBASE, and Cochrane Library to search for studies on the management of type III acromioclavicular injuries up to July 23 rd, 2019. The inclusion criteria were type III acromioclavicular injuries type III, with the intervention of conservative as compared to operative management. Outcomes were measured radiologically and by functional assessment using subjective questions (Poigenfurst’s Criteria and the Oxford Shoulder Score). Studies with the pathologies other than type III acromioclavicular injuries were excluded from the analysis. Results: A list of inclusion and exclusion criteria previously agreed by the authors was utilized to screen the full text. This selection process yielded 5 final articles from 2011-2017 to be included in this systematic review, with 173 patients undergoing conservative (68) and operative treatment (105). One of the studies were of level II. The mean basic data ranges of the studies were as follows: patients’ age was 25-54 years old, and the follow-up time ranged from 3 – 10 years. Surgical techniques are done by modified Weaver and Dunn technique, tight rope system, K-wire fixation, and coracoacromial ligament suturing, double button technique, and hook plate fixation. Three of the study reported that conservative treatment was superior and one study reported that nonoperative was better in radiographic evaluation, but not significant. Two studies that only performed operative treatment reported that the patient can return to normal activity around a few months and one study told that after removing hook plat the Constant-Murley shoulder function scores is significantly raised. Calcification as the complication happened more than 70% of patients in operative treatment and 30% in conservative. Discussion: Acromioclavicular joint injuries present mostly minor sprains, with the highest incidence in the 20-30 year old age group. The difficulty lies in the different definitions of type III acromioclavicular injuries used in the current studies. There are multiple classifications for the description of AC injuries and the common classifications for AC injuries are using Rockwood et al. classifications. Treatment for type 1 and 2 is conservative and type 4–6 is mainly surgical, but there is no clear consensus on treatment of type 3 injuries. Four study reported conservative treatment was superior and had better radiographic results (poigenfurst’s criteria and the oxford shoulder score). Operative treatment was comparable, but was associated with more complications, such as calcifications. Conclusion: This systematic review reports successful outcome from 4 studies using conservative treatment. However, this review showed no conclusive evidence for the treatment. Therefore more study is expected in the future in order to assess the functional outcomes, using standard and validated measures, including patient assessed functional outcomes, as well as resource implications.

Natural history of adrenal incidentalomas with and without mild autonomous cortisol excess; a systematic review and meta-analysis

2018 ◽  
Author(s):  
Yasir Elhassan ◽  
Fares Alahdab ◽  
Alessandro Prete ◽  
Danae Delivanis ◽  
Aakanksha Khanna ◽  
...  
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Meta Analysis ◽  
Adrenal Incidentalomas ◽  
History Of

Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

2020 ◽  
Author(s):  
Judd Sher ◽  
Kate Kirkham-Ali ◽  
Denny Luo ◽  
Catherine Miller ◽  
Dileep Sharma
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Drug Therapy ◽  
Dental Implant ◽  
Case Series ◽  
Cochrane Central Register ◽  
Bisphosphonate Treatment ◽  
Implant Placement ◽  
Increased Risk ◽  
History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

Clinical outcomes and prognostic factors for cavernous hemangiomas of the spinal cord: a retrospective cohort study

2019 ◽  
Vol 31 (2) ◽  
pp. 271-278 ◽  
Author(s):  
Narihito Nagoshi ◽  
Osahiko Tsuji ◽  
Daisuke Nakashima ◽  
Ayano Takeuchi ◽  
Kaori Kameyama ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Surgical Intervention ◽  
Lesion Size ◽  
Sudden Onset ◽  
Neurological Function ◽  
Neurological Injury ◽  
Prognostic Indicators ◽  
Asymptomatic Patients ◽  
Surgical Data ◽  
Unstable Gait

OBJECTIVEIntramedullary cavernous hemangioma (CH) is a rare vascular lesion that is mainly characterized by the sudden onset of hemorrhage in young, asymptomatic patients, who then experience serious neurological deterioration. Despite the severity of this condition, the therapeutic approach and timing of intervention for CH remain matters of debate. The aim of this study was to evaluate the clinical characteristics of CH patients before and after surgery and to identify prognostic indicators that affect neurological function in these patients.METHODSThis single-center retrospective study included 66 patients who were treated for intramedullary CH. Among them, 57 underwent surgery and 9 patients received conservative treatment. The authors collected demographic, symptomology, imaging, neurological, and surgical data. Univariate and multivariate logistic regression analyses were performed to identify the prognostic indicators for neurological function.RESULTSWhen comparing patients with stable and unstable gait prior to surgery, patients with unstable gait had a higher frequency of hemorrhagic episodes (52.4% vs 19.4%, p = 0.010), as assessed by the modified McCormick Scale. The lesion was significantly smaller in patients who underwent conservative treatment compared with surgery (2.5 ± 1.5 mm vs 5.9 ± 4.1 mm, respectively; p = 0.024). Overall, the patients experienced significant neurological recovery after surgery, but a worse preoperative neurological status was identified as an indicator affecting surgical outcomes by multivariate analysis (OR 10.77, 95% CI 2.88–40.36, p < 0.001). In addition, a larger lesion size was significantly associated with poor functional recovery in patients who had an unstable gait prior to surgery (8.6 ± 4.5 mm vs 3.5 ± 1.6 mm, p = 0.011).CONCLUSIONSOnce a hemorrhage occurs, surgical intervention should be considered to avoid recurrence of the bleeding and further neurological injury. In contrast, if the patients with larger lesion presented with worse preoperative functional status, surgical intervention could have a risk for aggravating the functional deficiencies by damaging the thinning cord parenchyma. Conservative treatment may be selected if the lesion is small, but regular neurological examination by MRI is needed for assessment of a change in lesion size and for detection of functional deterioration.

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