Outcomes and Complications of Open Versus Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Multicenter Study

Category: Hindfoot; Other Introduction/Purpose: There remains a controversy for treatment of subtalar joint arthritis. Both open and arthroscopic techniques have been reported for successful treatment of subtalar arthritis; however, there is a little evidence to report prospective comparative outcomes between the two techniques. The purpose of this study was to compare clinical and functional outcomes including complications between the two techniques. Methods: A prospective, randomized collected data of 54 consecutive patients who were diagnosed with isolated subtalar joint arthritis and underwent either open (27 patients) or posterior arthroscopic (27 patients) subtalar arthrodesis between 2015 and 2019 in 2 institutions. A minimum follow-up to be included in the study was 12 months (mean, 24.2 months; range, 12 to 41 months). The primary outcome was union time. The secondary outcomes included visual analogue scale (VAS), Short Form-36 (SF-36), and FAAM, union rate, time to return to activity of daily living, sports, work, and complications. Pre- and post-operative SF-36, FAAM, and pain (Visual Analog Scale) were obtained and compared between the two groups using independent t-test and the same group with paired t-test. Results: There were 54 patients (42 male and 12 female) with mean age of 43.7 years (range, 21-68 years) and mean BMI of 25.7 kg/m2 (range, 18.3-33.6 kg/m2). Both techniques demonstrated significant improvement of post-operative functional outcomes (VAS, SF-36, and VAS (<em>p</em> < 0.001 all)) compared to pre-operative period; however, there was no significant difference between the two groups. The secondary outcomes between open and arthroscopic groups were time to return to activity of daily living (8.4 vs 10.8 weeks), works (10.6 vs 12.9 weeks), sports (24.9 vs 32.7 weeks), time to union using CT scan (9.4 vs 12.8 weeks), union rate (100% versus 96.3%), and complications included painful hardware (18.5% vs 22.2%), paresthesia (0 vs 7.4%), and no infection in both groups. Conclusion: Both open and arthroscopic techniques were demonstrated significant improvement in terms of functional outcomes as measured with the FAAM, SF-36, and VAS in patients with subtalar joint arthritis. Although there was no significant difference of short-term of functional outcomes measurement and complications, arthroscopic technique was better in term of fasten recovery time and time to union.

Download Full-text

2020 IFFAS Award for Excellence Winner: Outcomes and Complications of Open versus Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00077 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0007

Author(s):

Chamnanni Rungprai ◽

Aekachai Jaroenarpornwatana ◽

Yantarat Sripanich ◽

Nusorn Chaiprom

Keyword(s):

Functional Outcomes ◽

Subtalar Joint ◽

T Test ◽

Return To Sports ◽

Subtalar Arthrodesis ◽

Sf 36 ◽

Significant Difference ◽

Subtalar Arthritis ◽

Joint Arthritis

Category: Hindfoot Introduction/Purpose: Open subtalar arthrodesis is a standard treatment for subtalar joint arthritis. Recently, posterior arthroscopic subtalar arthrodesis (PASTA) has been introduced and gained increasing popularity due to fasten recovery time and better cosmesis. However, there is limited current studies to report outcomes and complications between the two techniques. The purpose of this study is to compare outcomes and complications between open and PASTA techniques. Methods: A prospective, randomized collected data of 56 consecutive patients who were diagnosed with isolated subtalar arthritis and underwent either open (28 patients) or PASTA (28 patients) between 2016 and 2019 were enrolled in this study. The minimum follow-up time to be included in this study was 12 months. The primary outcome was union rate which was confirmed by post-operative CT scan. The secondary outcomes were union time, VAS, SF-36, FAAM, tourniquet times, and complications. A paired sample t-test was used to assess statistical differences between pre- and post-operative functional outcomes (VAS, SF-36, and FAAM) in the same group of both open and PASTA techniques while an independent t-test was used to compare functional outcomes (VAS, SF-36, and FAAM) between the two techniques. Results were significance at p < 0.05. Descriptive statistics were used for the demographic variables. Results: There were 56 patients (44 male and 12 female) with mean follow-up time was 17.7 months and 17.5 months for open and PASTA. The union time was significantly shorter in PASTA (9.4 vs 12.8 weeks, p<0.05). PASTA demonstrated significantly fasten recovery times (p<0.05 all) including time to return to ADL (8.4 vs 10.8 weeks), work (9.4 vs 12.8 weeks), and sports (9.4 vs 12.8 weeks). Both Open and PASTA techniques demonstrated significant improvement of all functional outcomes (FAAM, SF- 36, and VAS (p<0.01 all)); however, there was no significant difference between the two techniques. Other outcomes were not significant difference including tourniquet times (55.8 vs 67.2 minutes) and union rates (96.3 vs 100%) and complications. Conclusion: Both open and PASTA techniques demonstrated significant improvement of pain and function for treatment of patients with isolated subtalar joint arthritis. Although there was no significant difference of short-term of functional outcomes and complications, PASTA technique was better in term of shorten time to union and fasten time to return to sports.

Download Full-text

Outcomes and Complications of Open vs Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study

Foot & Ankle International ◽

10.1177/10711007211047239 ◽

2021 ◽

pp. 107110072110472

Author(s):

Chamnanni Rungprai ◽

Aekachai Jaroenarpornwatana ◽

Nusorn Chaiprom ◽

Phinit Phisitkul ◽

Yantarat Sripanich

Keyword(s):

Functional Outcomes ◽

Recovery Time ◽

Subtalar Joint ◽

Complication Rates ◽

Union Rate ◽

Tourniquet Time ◽

Randomized Controlled ◽

Subtalar Arthrodesis ◽

Sf 36 ◽

Joint Arthritis

Background: Open subtalar arthrodesis is the standard treatment for subtalar arthritis. Posterior arthroscopic subtalar arthrodesis (PASTA) has recently gained increasing popularity due to a shorter recovery time and better cosmesis. However, studies comparing outcomes and complications between these 2 techniques are limited. Methods: In total, 56 patients with subtalar joint arthritis were prospectively randomized to 2 parallel groups to receive either PASTA (n = 28 patients) or open subtalar arthrodesis (n = 28 patients). The minimum follow-up period was 12 months. Primary outcome was union rate confirmed on postoperative computed tomography (CT) scan. Secondary outcomes were union time; visual analog scale (VAS), Short Form–36 (SF-36), and Foot and Ankle Ability Measure (FAAM) scores; tourniquet time; and complications. Results: Union time (9.4 vs 12.8 weeks) and recovery time (time to return to activities of daily living [8.4 vs 10.8 weeks], work [10.6 vs 12.9 weeks], and sports [24.9 vs 32.7 weeks]) were significantly shorter with PASTA than with the open technique ( P < .05 all). Both techniques led to significant improvements in all functional outcomes (FAAM, SF-36, and VAS scores; P < .01 all); however, there was no significant difference between the techniques in these outcomes ( P > .05 all). Other outcomes, including tourniquet time (55.8 vs 67.2 min), union rate (96.3% vs 100%), and complication rate, were not significantly different between the techniques. Conclusion: Both open and PASTA techniques led to significant improvements in pain and function in patients with isolated subtalar joint arthritis. Although short-term functional outcomes and complication rates were not significantly different between the techniques, the PASTA technique was better at shortening the union and recovery times. Level of Evidence: Level I, prospective multicenter randomized controlled trial.

Download Full-text

Long-term Follow-up Results of Buechel-Pappas Ankle Arthroplasty

Foot & Ankle International ◽

10.1177/1071100719828379 ◽

2019 ◽

Vol 40 (5) ◽

pp. 553-561 ◽

Cited By ~ 7

Author(s):

Sajeeban Krishnapillai ◽

Boudijn Joling ◽

Inger N. Sierevelt ◽

Gino M.M.J. Kerkhoffs ◽

Daniël Haverkamp ◽

...

Keyword(s):

Survival Rate ◽

Functional Outcomes ◽

Joint Disease ◽

Foot And Ankle ◽

Inflammatory Joint Disease ◽

Sf 36 ◽

Significant Difference ◽

The Mean

Background: Total ankle replacement (TAR) is gaining popularity as a treatment option for ankle osteoarthritis. Long-term implant survival is a critical outcome to determine the success of the TAR implant. The Buechel-Pappas (BP) implant is a second-generation mobile bearing implant. The aim of this study was to analyze the BP implant survivorship at 10-year follow-up, make a subanalysis between patient groups, and evaluate long-term functional outcomes. Methods: Data of 86 patients who received 101 BP implants between 1993 and 2010 were obtained from a prospectively documented database. Subanalyses were done for patients diagnosed with inflammatory joint disease and noninflammatory joint disease, and patients with preoperative tibiotalar neutral and nonneutral alignment. A Kaplan-Meier curve was used for survival analysis. Long-term functional outcomes were assessed with the following patient-reported outcome measures: Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), Short Form-36 (SF-36) Stand Version 2.0 Health Survey and 3 anchor questions. Results: The survival rate of the BP implant at 10 years was 86% (95% confidence interval, 78%-93%). A total of 31 patients (36%) required 55 reoperations, and in 13 patients (15%) a revision procedure was performed. In this series, no significant difference in 10-year survival rate was found between neither the inflammatory joint disease and noninflammatory joint disease group ( P = .47), nor the tibiotalar neutral and nonneutral alignment group ( P = .16). At a mean follow-up of 16.8 years for 21 patients, the mean FAOS activities of daily living (ADL) and FAAM ADL subscale scores were 75/100 and 56/100 points. The mean physical component summary (PCS) and mental component summary (MCS) of the SF-36 were 34/100 and 51/100 points, respectively. Conclusion: A survival rate of 86% was found at 10-year follow-up for the Buechel-Pappas implant. Our series demonstrated no significant difference in 10-year survival rates between the 2 patient subgroups. Long-term results of the various functional outcomes varied between poor and moderate. Level of Evidence: Level II, prospective cohort study.

Download Full-text

Aplicabilidade de testes de atividades de vida diária em indivíduos com insuficiência cardíaca

Revista Brasileira de Medicina do Esporte ◽

10.1590/s1517-86922011000500003 ◽

2011 ◽

Vol 17 (5) ◽

pp. 310-314 ◽

Cited By ~ 8

Author(s):

Ywia Danieli Valadares ◽

Krislainy de Sousa Corrêa ◽

Bruna Oliveira Silva ◽

Cintia Laura Pereira de Araujo ◽

Manuela Karloh ◽

...

Keyword(s):

Medical Research ◽

Daily Living ◽

Research Council ◽

Medical Research Council ◽

Activity Of Daily Living ◽

Sf 36 ◽

Insuficiencia Cardiaca

A limitação nas atividades de vida diária (AVD) por dispneia é um achado comum nos pacientes com insuficiência cardíaca (IC), classe funcional III e IV. A avaliação específica da limitação nas AVD poderia ser utilizada como parâmetro de evolução da doença e de resposta terapêutica. Entretanto, há uma escassez de instrumentos de avaliação das AVD nessa população. Dessa forma, o objetivo do estudo foi verificar a aplicabilidade da escala London Chest Activity of Daily Living (LCADL) e do teste de AVD-Glittre (T Glittre), na avaliação da limitação funcional de indivíduos com IC classe funcional III e IV. Participaram do estudo 10 pacientes (57 ± 9 anos; 27,5 ± 4,5kg/m²) de ambos os sexos com diagnóstico clínico de IC classe funcional III e IV e fração de ejeção do ventrículo esquerdo (FEVE) 34 ± 7%, foram avaliados: espirometria, índice de massa corpórea (IMC), escala LCADL, teste de caminhada de seis minutos (TC6min), T Glittre, escala Medical Research Council (MRC) e questionário SF-36. Os pacientes apresentaram, em média, escore da escala LCADLtotal de 27,7 ± 12,1 (LCADL%total: 41,5 ± 16,9) e tempo do T Glittre de 6,3 ± 4,8 minutos, encontrando-se correlação positiva entre eles (r = 0,88; p < 0,05). O LCADL%total correlacionou-se com o TC6min (r = -0,83), FEVE (r = -0,64), MRC (r = 0,68) e domínio capacidade funcional (CF) do SF-36 (r = -0,63), com p < 0,05. O T Glittre correlacionou-se com o TC6min (r = -0,90), FEVE (r = -0,66) e CF do SF-36 (r = -0,69), com p < 0,05. Conclui-se com o estudo que a escala LCADL e o T Glittre têm aplicabilidade em pacientes com IC classe III e IV, apresentando associação com a FEVE, com a distância percorrida no TC6min, grau de dispneia e qualidade de vida.

Download Full-text

Conservative versus Surgical Treatment for the Fifth Metatarsal Diaphyseal Fractures: A Retrospective Comparative Study

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00070 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0007

Author(s):

Warongporn Pongpinyopap ◽

Chamnanni Rungprai

Keyword(s):

Surgical Treatment ◽

Comparative Study ◽

Functional Outcomes ◽

Current Evidence ◽

Diaphyseal Bone ◽

Sf 36 ◽

Significant Difference ◽

Metatarsal Fracture ◽

Diaphyseal Fractures

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: The fifth metatarsal fracture is the most common metatarsal fracture accounting for 56-68% of all metatarsals. Most of the previous studies have focused on fractures of the proximal fifth metatarsal. Whereas the current evidence has still remained controversial regarding appropriate treatment for the fifth metatarsal diaphyseal fracture. To date, there has been no comparative study between nonsurgical and surgical management in such fractures. The purpose of this study was to compare the outcomes and complications following conservative versus surgical treatment for displaced diaphyseal fractures of the fifth metatarsal bone. The primary outcome was time to union. Secondary outcomes were functional outcome scores (SF-36 and FAAM), VAS, time to return to activities of daily living (ADL), sports activities as well as complications. Methods: A retrospective study with prospective outcomes measurement was performed by reviewing charts and collecting data between January 2016 and December 2018. We included patients aged 18 or over, diagnosed with closed isolated fracture of the fifth metatarsal diaphyseal bone, all fractures had more than 2 mm of displacement in any planes of radiographs (AP, oblique, lateral), treated within 3 weeks after injury, minimal follow-up time of 6 months. Exclusion criteria were previous history of ipsilateral fifth metatarsal diaphyseal bone, pathological or stress fracture, proximal fifth metatarsal fracture, underlying diabetes, neuropathy, inability to walk such as cerebrovascular disease. All patients in surgical group were treated with ORIF with plate and screws. Postoperatively, early ROM exercise and heel weight bearing in walking boot were instructed. Whereas, patients in conservative group were immobilized with short leg cast in first six weeks and subsequently changed to walking boot or hard- soled shoes. Results: There were forty-five patients enrolled in the study, twenty patients treated with ORIF and twenty-five patients treated with casting. No significant differences were demonstrated with regard to demographic data. The mean union time of ORIF group was 8.7+-1.8 weeks, which was significantly shorter than the casting group (16.0 +- 4.18 weeks) (p<0.001). There was a significant improvement of functional outcomes (SF-36, FAAM) in both groups (p<0.001) but no statistically significant difference between two groups (p>0.05). An average time to return to ADL was significantly faster in ORIF group (8.6+-3.1 weeks) (p<0.001). The overall complications in casting group were significantly higher (28%,p<0.05) including painful malunion (3 patients, 12%), delayed union (2 patients, 8%) and persistent pain from CRPS (2 patients, 8%). Conclusion: Both casting and ORIF demonstrated significant improvement of functional outcomes compared to pre-operative status as measured with VAS, SF-36, and FAAM. Even though there was no significant difference of functional outcomes between two groups. ORIF group had significantly faster union time, time to return to ADL, and lesser in overall complications. The authors prefer early surgical treatment in fractures with more than 2 mm displacement, active, high-demand patients. However, randomized controlled trials with longer follow-up would be required.

Download Full-text

Evaluation of effect of home cervical traction on patients with cervical spondylotic radiculopathy

KYAMC Journal ◽

10.3329/kyamcj.v9i2.38150 ◽

2018 ◽

Vol 9 (2) ◽

pp. 65-68

Author(s):

Abul Khair Ahmad Zaman ◽

Md Abdus Shakoor ◽

Md Moyeenuzzaman ◽

Muhammad Alamgir Mandal ◽

HN Mashuk Rahman

Keyword(s):

Daily Living ◽

Cervical Collar ◽

Neck Muscle ◽

Activity Of Daily Living ◽

Muscle Strengthening ◽

Cervical Spondylotic Radiculopathy ◽

Strengthening Exercise ◽

Significant Difference ◽

Exercise Activity ◽

Cervical Traction

Background: Patients with cervical spondylotic radiculopathy is more responding by application of cervical traction with NSAIDs, exercise and ADL than treating with NSAIDs, exercise and ADL.Objectives: Study is to know the effect of home cervical traction on patients with cervical spondylotic radiculopathy.Materials & Methods: A randomized controlled trial was conducted in the department of physical medicine and rehabilitation, BSMMU during the period of 3-9-2012 to 2-9-2013 to find out the effect of home cervical traction on patient with cervical spondylotic radiculopathy.Results: A total of 120 patients with cervical spondylotic radiculopathy attended the department. Sixty patients was treated with NSAID, Isometric neck muscle strengthening exercise, Activity of daily living advice (ADL) and soft cervical collar, other 60 patients was treated with NSAID, Isometric neck muscle strengthening exercise, Activity of daily living advice (ADL) and soft cervical collar with home cervical traction. The patients were treated for 6 weeks. There was marked improvement in both groups after treatment. But there was significant difference regarding improvement in treatment with home cervical traction (p=0.432).Conclusion: So, it can be concluded that the home cervical traction is effective in cervical spondylotic radiculopathy. Male and female ratio was 1.9:.6. In respect of occupation the maximum patient was housewife (27.5%) followed by businessman (25. 8%). Highest number of patients is in the 41-50 years age group.KYAMC Journal Vol. 9, No.-2, July 2018, Page 65-68

Download Full-text

Conservative Treatment Versus Repair Deltoid in SER Type IV Equivalent Ankle Fracture

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00004 ◽

2018 ◽

Vol 3 (2) ◽

pp. 2473011418S0000

Author(s):

Chamnanni Rungprai

Keyword(s):

Conservative Treatment ◽

Functional Outcomes ◽

Ankle Fracture ◽

Deltoid Ligament ◽

Medial Side ◽

Type Iv ◽

Sf 36 ◽

Fibular Fixation ◽

Return To Activity

Category: Trauma Introduction/Purpose: There remains a controversy to repair deltoid ligament in SER type IV equivalence of acute ankle fracture. Some surgeons prefer conservative treatment with casting while others prefer to repair deltoid ligament after distal fibular fixation. However, there is a little evidence to report comparative outcomes between the two methods. There remains a controversy to repair deltoid ligament in SER type IV equivalence of acute ankle fracture. Some surgeons prefer conservative treatment with casting while others prefer to repair deltoid ligament after distal fibular fixation. However, there is a little evidence to report comparative outcomes between the two methods. The purpose of this study was to report clinical and functional outcomes including complications between the two methods. Methods: A prospective, randomized collected data of 41 consecutive patients who were diagnosed with SER type IV equivalence acute ankle fracture and underwent either conservative treatment (20 patients) or deltoid repair (21 patients) between 2015 and 2017. A minimum follow up to be included in the study was 6 months (mean, 13.2 months; range, 6 to 30 months). The primary outcome was visual analogue scale (VAS), Short Form-36 (SF-36); physical and mental component scores, and FAAM; ADL and Sport. Pre- and post-operative SF-36, FAAM, and pain (Visual Analog Scale) were obtained and compared between the two groups using independent t-test. The secondary outcomes were time to return to activity of daily living, sports, work, and complications. Results: There were 41 patients (30 male and 11 female) with mean age of 29.7 years (range, 18-70 years) and mean BMI of 26.7 kg/m2 (range, 18.3-33.6 kg/m2). Both methods demonstrated significant improvement of post-operative functional outcomes (FAAM, SF-36, and VAS (p < 0.05 all)) compared to pre-operative period; however, there was no significant different between the two groups. Functional outcomes between casting and deltoid repair groups were time to return to activity of daily living (10.4 vs 11.7 weeks), works (12.1 vs 12.9 weeks), sport (25.9 vs 23.7 weeks), weight bearing medial clear space (2.9 vs 3.9 mm), and complications included medial side ankle pain (57 vs 15%) and painful scar (0 vs 15%) for cast and deltoid repair respectively. Conclusion: Both casting and deltoid repair were demonstrated significant improvement in terms of functional outcomes as measured with the FAAM, SF-36, and VAS in patients with SER IV equivalent ankle fracture. Although there was no significant difference of functional outcome in short term of follow-up, deltoid repair group was better in term of medial side ankle pain and lesser medial clear space widening.

Download Full-text

Posterior Achilles Tendon-Splitting Approach and Intramedullary Nailing versus Lateral Trans-Fibular Approach with Fixed-Angle Plating for Tibiotalocalcaneal Arthrodesis

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000302 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Ryan Mulligan ◽

Samuel Adams ◽

James DeOrio ◽

Mark Easley ◽

James Nunley

Keyword(s):

Achilles Tendon ◽

Subtalar Joint ◽

Direct Access ◽

Categorical Variables ◽

Union Rate ◽

Fixed Angle ◽

Soft Tissue Envelope ◽

Significant Difference ◽

Lateral Plating ◽

Im Nailing

Category: Ankle, Ankle Arthritis, Hindfoot Introduction/Purpose: A variety of operative approaches and fixation techniques have been described for tibiotalocalcaneal (TTC) arthrodesis. As a durable, load-sharing device with favorable biomechanical properties, the intramedullary (IM) nail is commonly used. Lateral, fixed-angle plating continues to be popular as well, due to ease of use and lack of significant clinical inferiority. A lateral approach with distal fibula resection allows for direct access to the tibiotalar and subtalar joints, but the posterior, Achilles tendon-splitting (PAS) approach offers a robust soft tissue envelope. The purpose of this study was to compare the results of TTC arthrodesis with either PAS approach and IM nailing or lateral, trans-fibular (LTF) approach with lateral, fixed- angle plating. Methods: Following institutional review board approval, all patients who underwent simultaneous tibiotalar and subtalar arthrodesis were identified with minimum one year clinical and radiographic follow up. A retrospective review of all clinic notes, operative details, and radiographs was performed by a fellowship-trained orthopaedic foot and ankle surgeon not associated with the procedures. Patients were excluded if they underwent TTC arthrodesis through an approach other than PAS or LTF, and received fixation without an IM nail or lateral, fixed-angle plate. Primary outcomes examined were union rate and complications. Statistical analysis was performed with student’s t-test for continuous data and Chi-square test for categorical variables. P-values less than 0.05 were considered significant. Results: 38 patients underwent TTC arthrodesis with a PAS approach and IM nailing, and 28 with a LTF approach and lateral plating. The overall union rate for the PAS/IM nail group was 76.3% (29 of 38), and 64.3% (18 of 28) for LTF/lateral plating group (p=0.41). 15.8% (6 of 38) in the PAS/IM nail group underwent revision arthrodesis versus 7.1% (2 of 28) in the LTF/lateral plating group (p=0.45). Nonunion at the subtalar joint occurred in 25.0% (7 of 28) in the LTF/lateral plating group and 5.3% (2 of 38) in the PAS/IM nail group (p=0.03), but there was not a significant difference in tibiotalar union. Patients were allowed to bear weight 3 weeks earlier in the PAS/IM nail group (11.2 vs 14.4 weeks, p=0.01). Conclusion: Despite similar overall union rates, nonunion of the subtalar joint was significantly increased in the LTF/lateral plating group. This could be due to disruption of blood supply during exposure, insufficient stability, or inadequate compression of the arthrodesis site. However, revision arthrodesis rates were similar between groups because some nonunions were not symptomatic enough to warrant correction. Patients were allowed to fully weight bear significantly earlier in the PAS/IM nail group. PAS approach and IM nailing for TTC arthrodesis may allow for quicker recovery and increased likelihood of radiographic union at the subtalar joint.

Download Full-text

Comparison on different strategies for treatments of hypertensive hemorrhage in the basal ganglia region with a volume of 25 to 35ml

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502012001000010 ◽

2012 ◽

Vol 27 (10) ◽

pp. 727-731 ◽

Cited By ~ 3

Author(s):

Wei Zheng ◽

Chunpu Zhang ◽

Dapeng Hou ◽

Chunguang Cao

Keyword(s):

Basal Ganglia ◽

Conservative Treatment ◽

Cerebral Hemorrhage ◽

Daily Living ◽

Activity Of Daily Living ◽

Curative Effect ◽

Surgical Interventions ◽

Significant Difference

PURPOSE: To compare curative effect of different treatments for hypertensive cerebral hemorrhage of 25 to 35ml. METHODS: In this study, 595 cases were enrolled and grouped regarding treatments including conservative treatment, evacuation with microinvasive craniopuncture technique within 6h and 6-48h after the attack. RESULTS: After follow up for three months after the attack, the assessment based on the Activity of Daily Living (ADL) indicated no significant difference among conservative treatment and surgical interventions (p>0.05). However, surgical interventions showed advantages of shorter hospitalization, quick removal of hematoma and obvious reduction of cost. CONCLUSION: The microinvasive craniopuncture technique to drain the hematoma within 6-48h may be a good way in treating hypertensive hemorrhage of basal ganglia region.

Download Full-text

TL 18097 - Role of bone graft and bone graft substitutes in isolated subtalar joint arthrodesis

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1059 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 80S

Author(s):

Alexandre Leme Godoy-Santos ◽

Ibukunoluwa Araoye ◽

Osama Elattar ◽

Sameer Naranje ◽

Cesar de Cesar Netto ◽

...

Keyword(s):

Risk Factors ◽

Bone Graft ◽

Subtalar Joint ◽

Bone Grafts ◽

Union Rate ◽

Subtalar Arthrodesis ◽

Significant Difference ◽

Subtalar Arthritis ◽

Bone Graft Substitutes

Introduction: Subtalar joint (STJ) arthrodesis is a well-established operative procedure in the treatment of subtalar arthritis and hindfoot deformities. Nonunion remains an important complication, with an incidence and role of risk factors varying in the literature. Recent reports have highlighted a decrease in overall union rates between 96% and 100% to 84%, further strengthening the need for an understanding of risk factors that may be implicated in nonunion rates. Some possible factors have been identified, including smoking, revision surgery, the presence and extent of devascularized bone, and previous ankle joint fusion. Current practice suggests that using bone grafts or bone graft substitutes decreases the risk of its occurrence. Objective: To compare union rates of isolated subtalar arthrodesis with and without the use of bone grafts or bone graft substitutes. Methods: We retrospectively reviewed 135 subtalar fusions with a mean follow-up of 18 ± 14 months. The standard approach was used for all operations. Graft materials included β-tricalcium phosphate, demineralized bone matrix, iliac crest autograft and allograft and allograft cancellous chips. Successful subtalar fusion was determined clinically and radiographically. Results: There was an 88% (37/42) union rate without graft and an 83% (78/93) union rate with bone graft use. The odds ratio of union for graft versus no graft was 0.703 (95% CI, 0.237-2.08). The average time to union in the graft group was 3 ± 0.73 months and 3 ± 0.86 in the nongraft group, with no statistically significant difference detected (p = 0.56). Conclusion: Graft use did not improve union rates for subtalar arthrodesis.

Download Full-text