Treatment of Phalangeal Joint Stiffness Related to Proximal Phalangeal Bone Fractures: Therapeutic Effects on the Range of Motion and Finger Pain

Purpose: Proximal phalangeal bone fractures with displacement are treated using operative procedures. These fractures can cause stiffness of the interphalangeal or metacarpophalangeal joints, which can be relieved using various operative and nonoperative techniques. This study analyzed the range of motion (ROM) and pain after a combination therapy to treat finger stiffness following proximal phalangeal fractures.Methods: Fifty-two patients who underwent operative procedures for proximal phalangeal fractures and showed finger stiffness from March 2015 to January 2021 were included in this retrospective study. The patients in group 1 (n=24) performed elastic resistance exercises, while those in group 2 (n=28) underwent conventional exercise. ROM and pain score were measured at 5, 8, and 12 weeks postoperatively. Furthermore, a patient with a swan-neck deformity and intractable stiffness was treated using partial translocation of the extensor apparatus, and the postoperative outcome is presented.Results: Group 1 showed a larger ROM and less pain than group 2 at 12 weeks postoperatively (p<0.05). Patients in both groups exhibited notable improvements with regard to ROM and pain during the study period (p<0.05). In addition, the swan-neck deformity accompanying hyperextension of the proximal interphalangeal joint was significantly relieved.Conclusion: Proximal phalangeal bone fractures can lead to stiffness of the interphalangeal and metacarpophalangeal joints. Joint stiffness was relieved using an elastic resistance exercise protocol in the early postoperative period. Intractable stiffness showing a fixed joint angle can be treated with thorough tenolysis and corrective surgery.

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COMPARATIVE STUDY BETWEEN MEDIALAND LATERAL DISTAL TIBIAL LOCKING COMPRESSION PLATES FOR DISTAL THIRD TIBIAL FRACTURES

10.36106/ijsr/8003003 ◽

2021 ◽

pp. 1-4

Author(s):

Rajat Saini ◽

R. K. Verma ◽

S. P. Gupta ◽

Rajat Jangir ◽

Raj Kumar Bairwa

Keyword(s):

Open Reduction ◽

Bone Fractures ◽

Locking Compression Plate ◽

Tibial Fractures ◽

Plate Group ◽

Locking Compression Plates ◽

Compression Plate ◽

Lateral Plating ◽

Group 2 ◽

Group 1

Aim and objectives:to compare both the ways of xation in randomly selected cases in distal third tibia fractures to known the best way of xation technique & implant. Material and methods: In our study we have selected 40 patients with fractures of the distal third tibia, who attended the department of orthopaedics treated by open reduction and internal xation with using Medial/Lateral distal locking compression plates, in Mahatma Gandhi Medical College & Hospital, Jaipur during the year January 2019 to June 2020. The duration of follow-up to evaluate result was six months. We divided the distal leg bone fractures into two groups. Group 1: Include the distal third tibial fractures which are simple or comminuted treated as open reduction & internal xation with lateral locking compression plate. Group 2: Includes the distal third tibial fractures which are simple or comminuted, treated as open reduction & internal xation with medial locking compression plate. Results: There was no signicant difference in duration of surgeries and suture removal.In there were 3 cases of nonunion 1 case in lateral plating group and 2 cases in medial plating group. Group 1 were show 20% excellent, 45% good, 30% fair & 5% poor result. Group 2 were show 15 % excellent, 30% good, 45% fair &10% poor result according to Tenny & Wiss criteria. Conclusion: Lateral plating was much better in as a procedure and outcome wise.

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THE COMPARISON OF MUSCLE ENERGY TECHNIQUE AND INFRARED INTERVENTION WITH CONTRACT-RELAX STRETCHING AND INFRARED IN IMPROVING RANGE OF MOTION NECK JOINT ON ONLINE GAME PLAYERS WITH MYOFASCIAL PAIN SINDROME UPPER TRAPEZIUS MUSCLE IN DENPASAR

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i03.p05 ◽

2018 ◽

Vol 6 (3) ◽

pp. 17

Author(s):

Made Aditya Prawira Arthawan ◽

Nila Wahyuni ◽

I Gusti Ayu Artini

Keyword(s):

Range Of Motion ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Online Game ◽

Upper Trapezius ◽

Muscle Energy Technique ◽

Muscle Energy ◽

Group 2 ◽

Group 1

ABSTRACT Pain is most commonly caused by myofascial pain syndrome, myofascial pain syndrome pain can affect the flexibility of the joints that will cause a decrease range of motion neck joint. The purpose of this study was to determine the comparison between muscle energy technique and infrared with contract relax stretching and infrared in increasing the range of motion neck joint on online game players with myofascial pain syndrome upper trapezius muscle in Denpasar. This research is an experimental research with pre and post test design group control design. The sample is an online game player of 22 people divided into two groups. Group 1 was given intervention of muscle energy technique and infrared, while group 2 was given contract relax stretching and infrared intervention. Result of hypothesis test with paired t-test, group 1 got difference average 6,36 ± 0,62 (p = 0,000) while group 2 got difference mean 5,00 ± 0,357 (p = 0,000). Differential test of improvement after group 1 and group 2 treatment using independent sample t-test showed that group 1 increase was higher than group 2 and this result was significantly different p = 0,019 (p <0,05) Keywords: Range of motion neck joint, myofascial pain syndrome, contract relax stretching, infrared

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MULLIGAN BENT LEG RAISE LEBIH MENINGKATKAN LINGKUP GERAK SENDI LUMBOSAKRAL DAN MENURUNKAN DISABILITAS DIBANDINGKAN DENGAN SLUMP STRETCHING PADA PENGRAJIN GENTENG DENGAN MECHANICAL LOW BACK PAIN DI DESA DARMASABA

Sport and Fitness Journal ◽

10.24843/spj.2017.v05.i03.p04 ◽

2017 ◽

Author(s):

I Made Dhita Prianthara ◽

I Made Jawi ◽

Wahyuddin ◽

I Nengah Sandi ◽

I Putu Adiartha Griadhi ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Range Of Motion ◽

Control Group ◽

Low Back ◽

Control Group Design ◽

Significant Difference ◽

Group 2 ◽

Lumbar Range Of Motion ◽

Group 1

Background: Mechanical low back pain is pain that resulting from poor posture which cause decreased disability and limitation of lumbar range of motion. Purpose: The purpose of this study was to prove mulligan bent leg raise more effective to increase lumbosacral range of motion and decreased disability than slump stretching among tile craftsman with Mechanical low back pain in Darmasaba village. Methods: This research was an experimental study with pre and post test control group design. Sample of this study is tile craftsman with mechanical low back pain with 20 samples aged 30-55. Samples were divided into two groups, which the first group (n = 10) was given Mulligan bent leg raise, while the second group was given slump stretching. Do exercise 3 times a week for 4 weeks. Lumbar range of motion was measured with modified-modified schober test while level of disability was measured with modified oswestry disability index. Result: Paired Sample T-test in Group 1 and Group 2 obtained p=0,000 that showed in each Group 1 and Group 2 there is significant difference. Independent Samples Test of Group 1 and Group 2 showed the result p=0,000 which mean that there is significant difference in increased lumbar range of motion and decreased disability. Conclusion: Mulligan bent leg raise more effective to increase lumbosacral range of motion and decreased disability than slump stretching to tile craftsman with mechanical low back pain in Darmasaba village.

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THE THE DEEP TRANSVERSE FRICTION INTERVENTION BETTER THAN THE MASSAGE EFFLEURAGE IN INCREASING THE RANGE OF CERVICAL MOTION DUE TO OF MYOFASCIAL PAIN SYNDROME OF UPPER TRAPEZIUS MUSCLE ON THE LAUNDRY’S WORKERS IN EAST DENPASAR

Majalah Ilmiah Fisioterapi Indonesia ◽

10.24843/mifi.2018.v06.i01.p11 ◽

2018 ◽

Vol 6 (1) ◽

pp. 35

Author(s):

Komang Putri Aprilia ◽

I Nyoman Adiputra ◽

Nila Wahyuni

Keyword(s):

Range Of Motion ◽

Myofascial Pain ◽

Intervention Group ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Upper Trapezius ◽

Group 2 ◽

Cervical Motion ◽

Better Than ◽

Group 1

THE DEEP TRANSVERSE FRICTION INTERVENTION BETTER THAN THE MASSAGE EFFLEURAGE ININCREASING THE RANGE OF CERVICAL MOTION DUE TO OF MYOFASCIAL PAIN SYNDROME OF UPPER TRAPEZIUS MUSCLE ON THE LAUNDRY’S WORKERS IN EAST DENPASAR ABSTRACT Range of Motion (ROM) defined as the extent of joint’s movement that occurs when the joint was moved fromone position to another, either passively or actively. Bad habits that done by someone if it done repeatedly and for along time could trigger pain and tension around the neck as well as decrease in the flexibility of the neck muscles.Decrease in muscle flexibility would result in decreased the range of cervical motion that will interfere with a person'sdaily activities. The purpose of this study was to prove the intervention Deep Transverse Friction better than MassageEffleurage in increasing the range of cervical motion as a result of Myofascial Pain Syndrome in Upper Trapezius muscle.This research was an experimental design with pre and post two group design. These samples included 20 people whowere divided into two groups. Group 1 was given Deep Transverse Friction intervention while group 2 was givenEffleurage Massage intervention. Measurement range of motion was done by goniometer. This research was anexperimental design with pre and post test two group design. The result showed an increase Range of Motion in theintervention Group 1 amounted 4.65 and intervention group 2 amounted 1.35. Paired sample t-test showed a significantresult between intervention group 1 and intervention group 2 with p = 0.000. Difference test between group 1 and group2 using Mann Whitney U-test was obtained p = 0.000. It was concluded that Deep Transverse Friction intervention betterthan Effleurage Massage in increasing the range of cervical motion. Keywords: Range of cervical motion, Deep Transverse Friction, Massage Effleurage, Goniometer.

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Effects of muscle energy technique on pain, range of motion and function in patients with post-surgical elbow stiffness: A randomized controlled trial

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702519500033 ◽

2019 ◽

Vol 39 (01) ◽

pp. 25-33 ◽

Cited By ~ 1

Author(s):

Anood I Faqih ◽

Nilima Bedekar ◽

Ashok Shyam ◽

Parag Sancheti

Keyword(s):

Range Of Motion ◽

Controlled Trial ◽

Elbow Fracture ◽

Elbow Stiffness ◽

Rehabilitation Protocol ◽

Muscle Energy Technique ◽

Muscle Energy ◽

Group 2 ◽

And Function ◽

Group 1

Background: Elbow is a very functional joint. Elbow stiffness is a significant cause of disability hampering the function of the upper extremity as a whole. Muscle Energy Techniques (METs) are relatively pain-free techniques used in clinical practice for restricted range of motion (ROM). Objective: To study the effects of MET on pain, ROM and function given early in the rehabilitation in post-surgical elbow stiffness. Methods: An RCT was conducted on 30 patients post elbow fracture fixation. Group 1 was given MET immediately post removal of immobilization while Group 2 received MET 1 week later along with the rehabilitation protocol. Pain (Visual Analogue Scale), ROM (goniometry) and function (Disability of Arm, Shoulder and Hand questionnaire) were assessed pre and post 3 weeks. Results: Group 1 showed greater improvement than Group 2, mean flexion and extension change between groups being [Formula: see text], 95%CI(5.9,17.4) and [Formula: see text], 95%CI(4.4,12.7), respectively. VAS and DASH scores improved better in Group 1, mean change being [Formula: see text], 95%CI(0.6,1.8) and [Formula: see text], 95%CI(13.5,22.8) for VAS and DASH scores, respectively. Conclusion: MET can be used as an adjunct to the rehabilitation protocol to treat elbow stiffness and can be given safely in the early stages of post elbow fracture rehabilitation managed surgically with open reduction and rigid internal fixation.

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The outcome of a single percutaneous cannulated screw fixation in posterior malleolus fracture accompanied by medial or lateral malleolus fracture

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00379 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0037

Author(s):

Yoo Jung Park ◽

Yougun Won

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Screw Fixation ◽

Cannulated Screw ◽

Medial Malleolus ◽

Posterior Malleolus ◽

Significant Difference ◽

Group 2 ◽

Group 1

Category: Trauma Introduction/Purpose: Posterior malleolus fractures occur most commonly in the setting of a rotational ankle fracture. In the treatment of posterior malleolus fractures, the indications for the surgical procedure are determined by the size of the fragment and the articular congruity of the tibiotalar joint. In general, the size of the bone fragment is known to be an indication of surgery if it involves more than 25% of the joint surface, and if it is less than that, anatomical reduction and fixation of only lateral or medial malleolus was suggested. We evaluate the clinical and radiological results of fixation and early range of motion exercise using a single cannulated screw when the fragment of the posterior malleolus fracture is less than 25%. Methods: Among 60 patients with SER stage 3 or 4 who had undergone surgery from March 2010 to March 2014, percutaneous cannulated screw fixation was performed for posterior malleolus in 30 cases (Group 1). In the other 30 cases (Group 2), we did not perform the fixation for posterior malleolus fracture and only cast immobilization was done after fixation for lateral or medial malleolus. Mean follow-up period was 14.8 weeks(12~18) for the Group 1, 12.9 weeks(12~18) for Group 2. Mean age of patients was 46.6(19~78) for Group 1, 50.2(19~74) for Group 2. The range of motion was checked at week 2, 4, 12, and at last follow-up. Results: There was no significant difference of time to union and union rate between two groups, and AOFAS score between two groups also showed no significant difference(91.94(83~100) vs 90.8(85~100), p = 0.45). The range of motion of ankle joint at the final follow-up showed significant difference (Ankle ROM 52.7’ (45’~65’) vs 45.3’(35’~65’), (p<0.01) and complications between two groups also showed no significant difference. Conclusion: A single percutaneous cannulated screw fixation in posterior malleolus fracture accompanied by medial or lateral malleolus fracture can be performed in fractures with small fragment size and minimal displacement. We found that it can be a effective method to achieve early and wide range of motion of ankle joint after posterior mallolus fracture.

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Complications of Resection Arthroplasty in Two-Stage Revision for the Treatment of Periprosthetic Hip Joint Infection

Journal of Clinical Medicine ◽

10.3390/jcm8122224 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2224 ◽

Cited By ~ 1

Author(s):

Irene K. Sigmund ◽

Tobias Winkler ◽

Nuri Önder ◽

Carsten Perka ◽

Nora Renz ◽

...

Keyword(s):

Blood Loss ◽

Bone Fractures ◽

Joint Infection ◽

Resection Arthroplasty ◽

High Rate ◽

Complication Rates ◽

Two Stage ◽

Free Survival ◽

Group 2 ◽

Group 1

Little data is available regarding complications associated with resection arthroplasty in the treatment of hip periprosthetic joint infection (PJI). We assessed complications during and after two-stage revision using resection arthroplasty. In this retrospective study, 93 patients undergoing resection arthroplasty for hip PJI were included. Patients were assigned to a prosthesis-free interval of ≤10 weeks (group 1; 49 patients) or >10 weeks (group 2; 44 patients). The complication rates between groups were compared using the chi-squared test. The revision-free and infection-free survival was estimated using a Kaplan–Meier survival analysis. Seventy-one patients (76%) experienced at least one local complication (overall 146 complications). Common complications were blood loss during reimplantation (n = 25) or during explantation (n = 23), persistent infection (n = 16), leg length discrepancy (n = 13) and reinfection (n = 9). Patients in group 1 experienced less complications after reimplantation (p = 0.012). With increasing severity of acetabular bone defects, higher incidence of complications (p = 0.008), periprosthetic bone fractures (p = 0.05) and blood loss (p = 0.039) was observed. The infection-free survival rate at 24 months was 93.9% in group 1 and 85.9% in group 2. The indication for resection arthroplasty needs to be evaluated carefully, considering the high rate of complications and reduced mobility, particularly if longer prosthesis-free intervals are used.

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Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04234-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

J.F. Schader ◽

I. Zderic ◽

D. Gehweiler ◽

J. Dauwe ◽

K. Mys ◽

...

Keyword(s):

Femoral Head ◽

Bone Fractures ◽

Orthopaedic Implant ◽

Pertrochanteric Fractures ◽

Femur Fractures ◽

Biomechanical Behavior ◽

Pertrochanteric Femur Fracture ◽

Group 2 ◽

Implant Testing ◽

Group 1

Abstract Background With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing. Methods Eight pairs of fresh-frozen human cadaveric femora aged 72.7 ± 14.9 years (range 48–89 years) were assigned in paired fashion to two study groups. In Group 1, stable pertrochanteric fractures AO/OTA 31-A1 were artificially created via constant force application on the anterior cortex of the femur through a blunt guillotine blade. The same fracture type was simulated in Group 2 by means of osteotomies. All femora were implanted with a dynamic hip screw and biomechanically tested in 20° adduction under progressively increasing physiologic cyclic axial loading at 2 Hz, starting at 500 N and increasing at a rate of 0.1 N/cycle. Femoral head fragment movements with respect to the shaft were monitored by means of optical motion tracking. Results Cycles/failure load at 15° varus deformation, 10 mm leg shortening and 15° femoral head rotation around neck axis were 11324 ± 848/1632.4 ± 584.8 N, 11052 ± 1573/1605.2 ± 657.3 N and 11849 ± 1120/1684.9 ± 612.0 N in Group 1, and 10971 ± 2019/1597.1 ± 701.9 N, 10681 ± 1868/1568.1 ± 686.8 N and 10017 ± 4081/1501.7 ± 908.1 N in Group 2, respectively, with no significant differences between the two groups, p ≥ 0.233. Conclusion From a biomechanical perspective, by resulting in more consistent outcomes under dynamic loading, standardized artificial stable pertrochanteric femur fracture creation may be more suitable for orthopaedic implant testing compared to osteotomizing the bone.

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A COMPARATIVE STUDY BETWEEN EFFICACIES OF USG GUIDED BOTULINUM TOXIN INJECTION INTO THE SUBSCAPULARIS MUSCLE AND THE CONSERVATIVE TREATMENT IN HEMIPLEGIC SHOULDER PAIN

10.36106/ijsr/3718365 ◽

2021 ◽

pp. 16-20

Author(s):

Subhadeep Batabyal ◽

Saumen Kumar De ◽

Rathindra Nath Haldar

Keyword(s):

Botulinum Toxin ◽

Conservative Treatment ◽

Range Of Motion ◽

Shoulder Pain ◽

External Rotation ◽

Botulinum Toxin Injection ◽

Subscapularis Muscle ◽

Group 2 ◽

Group 1

Introduction: Hemiplegic shoulder pain (HSP) is a common complication after stroke. HSP inhibits recovery and rehabilitation and impairs the quality of life of stroke survivors. Although the etiology of HSP is not well known, it has been suggested that multiple factors contribute to HSP. Our approach is to compare the efcacy of USG guided Botulinum toxin injection into the subscapularis muscle and conservative treatment in case of intractable hemiplegic shoulder pain. Material and methods: In this Parallel Group Open Level Randomized Controlled Trial, conducted in the Department of Physical Medicine and Rehabilitation, IPGME&R, SSKM Hospital, Kolkata between September, 2017 to September, 2018 (Twelve months) on 34 (17 in each group) patients with intractable (persistent pain for more than 3 months) hemiplegic shoulder pain. In group 1, Botulinum toxin injection was given in subscapularis muscle by USG guided lateral approach. In group 2, managed conservatively with Physical therapy (stretching, passive range of motion exercise), Modality (hot pack, infrared, IFT), pain medications (NSAIDS, oral opioids) and Neuromuscular electrical stimulation of shoulder. Parameters used: 1. Pain intensity - measured by Numerical Rating Scale (NRS) [Score 0- 10], 2. Spasticity measured by - Modied Ashworth Scale (MAS) [score 0-4], 3. Shoulder range of motion - External rotation (ER) [score 0- 90] assessed. The patients attending the Physical Medicine and Rehabilitation OPD at IPGME&R and SSKM Hospital, Kolkata were included and studied if they fullled the inclusion and nd exclusion criteria after getting Institutional Ethics Committee clearance and informed written consent. After initial visit, followed up on 2 week, th th 4 week and 12 week. Comparison done considering all the parameters considering basal and follow up data to compare the efcacy of intramuscular botulinum toxin injection and those with in group 2, managed conservatively. Results: All the data collected during this study period were analyzed by using statistical software Statistica vertsion 6 [Tulsa, Oklahoma: StatSoft Inc., 2001] and GraphPad Prism version 4 [San Diego, California: GraphPad Software Inc., 2005]. There was statistically signicant difference (group 1 is statistically superior than group 2) between two groups at 2nd, 4th and 12th week in respect to NRS, MAS of subscapularis and ER of shoulder joint (p value<0.05). Conclusion: There was signicant short-term improvement of shoulder pain, spasticity of shoulder internal rotator(subscapularis) and range of motion in the form of external rotation after Botulinum toxin injection compared to conservative treatment. But in terms of intermediate-term and long-term follow-up although both groups showed signicant improvement but Botulinum toxin injection group was statistically superior than conservative treatment.

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Outcomes of Surgical Treatment of Fractures in Concomitant and Multiple Injuries in Children

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200916272-75 ◽

2009 ◽

Vol 16 (2) ◽

pp. 72-75

Author(s):

Tokhir Sidikovich Musaev ◽

N N Tolipov ◽

F A Masharipov ◽

T S Musaev ◽

N N Tolipov ◽

...

Keyword(s):

Surgical Treatment ◽

Treatment Duration ◽

Simple Technique ◽

Bone Fractures ◽

Locomotor System ◽

Surgical Interventions ◽

Fixation Devices ◽

Duration Of Hospitalization ◽

Group 2 ◽

Group 1

Outcomes of surgical treatment of 72 children with concomitant (55) and multiple (17) injuries of locomotor system were analyzed. In 53 patients (group 1) surgical interventions for bone fractures were performed in early terms (within 3 days after trauma), in 19 patients (group 2) the interventions were postponed. In group 1 good and satisfactory result was achieved in 92% of patients (63 segments), in group 2 - in 85.2% of patients (23 segments). Duration of hospitalization made up in two groups 11.5 and 14.5 days, respectively. Application of pirod external fixation devices facilitated the treatment course due to the reduction of treatment duration and traumatization, as well as use of more simple technique of long bones and pelvis osteosynthesis.

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