scholarly journals Asymmetrically increased femoral version with high prevalence of moderate and severe femoral anteversion in unilateral Legg-Calvé-Perthes disease

2021 ◽  
pp. 1-7
Author(s):  
Eduardo N. Novais ◽  
Kianna D. Nunally ◽  
Mariana G. Ferrer ◽  
Patricia E. Miller ◽  
James D. Wylie ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Planning ◽  
Femoral Anteversion ◽  
Perthes Disease ◽  
Ct Scans ◽  
Level Of Evidence ◽  
Unaffected Side ◽  
Future Studies ◽  
Femoral Version ◽  
High Prevalence

Purpose To determine and stratify femoral version in Legg-Calvé-Perthes disease (LCPD), and to compare the femoral version between the LCPD hip and the contralateral unaffected hip. Methods We performed a retrospective review of 45 patients with unilateral LCPD who had available CT scan through the hips and knees between January 2000 and June 2017. There were 34 (76%) male cases with a mean age of 14 years (sd 4.69). Two independent readers measured femoral version on the affected and the unaffected contralateral femur. Femoral version was classified as follows: severely decreased version (< 10°); moderately decreased (10° to 14°); normal femoral version range (15° to 20°); moderately increased (21° to 25°); and severely increased version (> 25°). Results LCPD hips had predominantly increased femoral version (38% severely increased anteversion, 24% moderately increased anteversion), while 51% of the contralateral unaffected hips had normal femoral version (p < 0.001). LCPD hips had higher mean femoral version than the contralateral, unaffected side (mean difference = 13o; 95% confidence iterval 10o to 16o; p < 0.001). As the version of the affected hip increased, so did the discrepancy between sides. No effect of sex on the LCPD femoral version was detected (p = 0.34). Conclusion This study included a selected group of patients with unilateral LCPD and available CT scans obtained for surgical planning. The femoral version was asymmetric, with a high proportion of excessive anteversion observed at later stages of disease in the affected hips. Future studies will be necessary to determine the pathogenesis of increased femoral version associated with LCPD. Level of Evidence Level IV, retrospective study.

scholarly journals Full-body MR imaging: a retrospective study on a novel diagnostic approach for children sustaining high-energy trauma

2021 ◽  
Author(s):  
Johanna Ludwig ◽  
Peter Heumann ◽  
Denis Gümbel ◽  
Ulrike Rechenberg ◽  
Leonie Goelz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Diagnostic Procedure ◽  
High Energy ◽  
Diagnostic Approach ◽  
Ct Scans ◽  
X Rays ◽  
Level Of Evidence ◽  
High Energy Trauma ◽  
Full Body

Abstract Purpose Severe accidents are the leading cause of long-term impairment and death in children. A common diagnostic procedure for children exposed to high-injury trauma is full-body contrast-enhanced CT (fbCT). However, the number of fbCT without detected injuries is relevant. In 2007, full-body MRI (fbMRI) was implemented as a diagnostic approach for children sustaining high-energy trauma. The aim of this cross-sectional retrospective study was to analyze fbMRI as a diagnostic tool for children after high-energy trauma focusing on feasibility, radiological findings, and limitations. Methods Diagnostics using fbMRI (from apex of the head to the pelvis) was performed if a child was stable and suffered a high-energy trauma in a Level I Trauma Center in Germany. 105 fbMRIs in patients exposed to high-energy trauma aged ≤ 16 years were performed between January 2007 and December 2018. Four fbMRIs were excluded as conducted for reasons other than trauma. Time between arrival in the emergency department and fbMRI, additional diagnostic procedures, injuries, and non-trauma related pathologies were analyzed. Results Mean time between arrival in the emergency department and fbMRI was 71 min (± SD 132 min). Two scans were discontinued and changed to a faster diagnostic procedure. 45% of children had additional X-rays and 11% CT scans. The MRIs showed intracranial abnormalities in 27%, extremities injuries in 26%, spinal injuries in 18%, pelvic, and thoracic injuries in 7% of the cases. Conclusion Overall fbMRI is a diagnostic alternative for hemodynamically stable, conscious children after high-energy trauma with the advantages of a radiation-free technique. However, MRI diagnostics take longer than CT scans. Prospective studies will be needed to identify the limiting factors of fbMRIs as primary diagnostic procedure compared to CT scans. Trial registration German Clinical Trials Register (DRKS; DRKS00017015). Level of evidence Case series, level of evidence V.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

scholarly journals ALTERNATIVE TO THE INVERTED “Y” INCISION IN SCOLIOSIS SECONDARY TO MYELOMENINGOCELE

2019 ◽  
Vol 18 (1) ◽  
pp. 14-16
Author(s):  
Diego Veiga Bezerra ◽  
Luis Eduardo Munhoz da Rocha ◽  
Dulce Helena Grimm ◽  
Carlos Abreu de Aguiar ◽  
Luiz Müller Ávila ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Spina Bifida ◽  
Postoperative Period ◽  
Medical Records ◽  
Surgical Intervention ◽  
Case Series ◽  
Material Failure ◽  
Spinal Deformities ◽  
Level Of Evidence ◽  
Skin Conditions

ABSTRACT Objective: To evaluate the healing of the modified inverted “Y” incision in patients with scoliosis due to myelomeningocele. Methods: Retrospective study through medical records review of patients with myelomeningocele surgically treated with a modified inverted “Y” approach between January 2013 and December 2015. Results: We analyzed the medical records of six patients. Two patients progressed with skin complications in the immediate postoperative period and only one of them required surgical intervention for debridement and suturing. In another patient, it was necessary to perform two surgical reviews due to material failure without skin complications in these interventions. Conclusions: The modified inverted “Y” technique is a great alternative to traditional incision and inverted “Y” because it has good results in patients with spina bifida associated with poor skin conditions treated surgically for correction of spinal deformities. Level of Evidence IV; Case series.

Effectiveness of Combining Manual Therapy and Acupuncture on Temporomandibular Joint Dysfunction: A Retrospective Study

2007 ◽  
Vol 35 (02) ◽  
pp. 203-208 ◽  
Author(s):  
Byung-Cheul Shin ◽  
Chung-Hyo Ha ◽  
Yung-Sun Song ◽  
Myeong Soo Lee
Keyword(s):  
Retrospective Study ◽  
Temporomandibular Joint ◽  
Manual Therapy ◽  
Randomized Clinical Trials ◽  
Combined Treatment ◽  
Mouth Opening ◽  
Temporomandibular Joint Dysfunction ◽  
Future Studies ◽  
Before And After ◽  
Maximal Mouth Opening

This retrospective study investigated the effects of combining manual therapy and acupuncture on the pain and maximal mouth opening (MMO), which were associated with temporomandibular joint dysfunction (TMD). The 49 TMD patients (15 men, 34 women; mean age = 30.47 years, SD = 13.52 years) were treated with a combination of acupuncture and manual therapy two or three times a week at the hospital. The pain and maximal mouth opening were assessed before and after 1 and 4 weeks of treatment. The combination therapy produced significant changes in pain levels ( p < 0.001) and mouth opening ( p < 0.001). All pairwise non-parametric comparison showed a significant improvement in pain ( p < 0.05 for all pairs) and MMO ( p < 0.05 for all pairs). These findings suggest that combining manual therapy and acupuncture decreases the pain level and increases the MMO of TMD patients. However, future studies should further investigate the efficacy of combined treatment on TMD with more rigorous randomized clinical trials.

scholarly journals Over one third of patients with symptomatic femoroacetabular impingement display femoral or acetabular version abnormalities

2021 ◽  
Author(s):  
Zaki Arshad ◽  
Henry David Maughan ◽  
Karadi Hari Sunil Kumar ◽  
Matthew Pettit ◽  
Arvind Arora ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Original Research ◽  
Distribution Analysis ◽  
Inclusion Criteria ◽  
Acetabular Version ◽  
Level Of Evidence ◽  
Femoral Version ◽  
Normal Mean ◽  
The Relationship

Abstract Purpose The aim of this study was investigate the relationship between version and torsional abnormalities of the acetabulum, femur and tibia in patients with symptomatic FAI. Methods A systematic review was performed according to PRISMA guidelines using the EMBASE, MEDLINE, PubMed and Cochrane databases. Original research articles evaluating the described version and torsional parameters in FAI were included. The MINORS criteria were used to appraise study quality and risk of bias. Mean version and torsion values were displayed using forest plots and the estimated proportion of hips displaying abnormalities in version/torsion were calculated. Results A total of 1206 articles were identified from the initial search, with 43 articles, involving 8861 hips, meeting the inclusion criteria. All studies evaluating femoral or acetabular version in FAI reported ‘normal’ mean version values (10–25 °). However, distribution analysis revealed that an estimated 31% and 51% of patients with FAI displayed abnormal central acetabular and femoral version, respectively. Conclusion Up to 51% of patients presenting with symptomatic FAI show an abnormal femoral version, whilst up to 31% demonstrate abnormal acetabular version. This high percentage of version abnormalities highlights the importance of evaluating these parameters routinely during assessment of patients with FAI, to guide clinical decision-making. Level of evidence IV.

scholarly journals Convolutional Neural Networks and Geometric Moments to Identify the Bilateral Symmetric Midplane in Facial Skeletons from CT Scans

Biology ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 182
Author(s):  
Rodrigo Dalvit Carvalho da Silva ◽  
Thomas Richard Jenkyn ◽  
Victor Alexander Carranza
Keyword(s):  
Neural Network ◽  
Neural Networks ◽  
Surgical Planning ◽  
Good Accuracy ◽  
Bilateral Symmetry ◽  
Ct Scans ◽  
Facial Skeleton ◽  
Intact Side ◽  
Geometric Moments ◽  
The Face

In reconstructive craniofacial surgery, the bilateral symmetry of the midplane of the facial skeleton plays an important role in surgical planning. Surgeons can take advantage of the intact side of the face as a template for the malformed side by accurately locating the midplane to assist in the preparation of the surgical procedure. However, despite its importance, the location of the midline is still a subjective procedure. The aim of this study was to present a 3D technique using a convolutional neural network and geometric moments to automatically calculate the craniofacial midline symmetry of the facial skeleton from CT scans. To perform this task, a total of 195 skull images were assessed to validate the proposed technique. In the symmetry planes, the technique was found to be reliable and provided good accuracy. However, further investigations to improve the results of asymmetric images may be carried out.

scholarly journals Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study

2013 ◽  
Vol 4 (1) ◽  
pp. 1-5
Author(s):  
Neizekhotuo Brian Shunyu ◽  
Judita Syiemlieh
Keyword(s):  
Head And Neck Cancer ◽  
Retrospective Study ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Neck Region ◽  
The State ◽  
Civil Hospital ◽  
High Prevalence ◽  
Total Body

ABSTRACT In India, 20 to 40% of all cancer arises in the head and neck region. The highest rate is seen in the eastern and southern regions of our country. The alarming high prevalence of head and neck cancer (HNC) in this region has prompted us to undertake this retrospective study. This study is to give the picture on the prevalence of HNC in the region, as such studies are lacking, till date. This is a 5 years retrospective study of cancer patients from 2007 to 2011 who have been registered in Civil Hospital, Shillong. The period of study is short as registry before 2007 was not properly recorded, but the high prevalence of cancer especially HNC warranted the need to undertake this retrospective study. During the 5-year period, there were a total of 3,123 cancer patients, registered in Civil Hospital, Shillong. In this study, HNC and esophageal cancer constitute 2,207 (70.67%) cases of the total body malignancy (TBM) which is much higher than other studies done in other parts of the country. Fourth decade is the most common age group comprising of 471 cases which accounts for 32.72% of all HNC. This high prevalence of HNC in the young population of the region is alarming and hence needs a comprehensive afford to meet this challenge. This paper, therefore, is an attempt to quantify the spectrum of HNC in the region hoping that this paper will help the health professionals to understand the burden of HNC in the region, so as to generate strategies for future planning. How to cite this article Shunyu NB, Syiemlieh J. Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study. Int J Head and Neck Surg 2013;4(1):1-5.

scholarly journals Schwannoma of the medial plantar nerve: a case report

2021 ◽  
Vol 15 (2) ◽  
pp. 171-174
Author(s):  
Adriano Machado Filho ◽  
Jefferson Soares Martins ◽  
Paulo Victor de Souza Pereira ◽  
Ademir Freire de Moura Júnior
Keyword(s):  
Case Report ◽  
Surgical Planning ◽  
Level Of Evidence ◽  
Medial Plantar Nerve ◽  
Plantar Surface ◽  
Patient Level ◽  
Red Flag ◽  
Plantar Region ◽  
Second Toe ◽  
Multiple Schwannomas

We report the case of a 60-year-old woman with a schwannoma of the medial plantar nerve. She presented with the complaint of pain for about 2 years and a painful lesion in the medial plantar region of the left forefoot and on the second toe. Physical examination showed well-defined, firm tumor masses painful to palpation on the medial and plantar surface of the left forefoot and second toe. We surgically explored the area and excised 3 lesions, resulting in complete pain relief and no aesthetic complaints. Schwannomas of the medial plantar nerve are rare tumors, with only a few reports of cases extending to the forefoot. The finding of multiple schwannomas may be a red flag for the possible existence of local, painful, nerve lesions despite a negative Tinel sign. Appropriate surgical planning contributed to our successful intervention, without aesthetic, painful, or functional sequelae for the patient. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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