scholarly journals A modification of the Ponseti method for clubfoot management: a prospective comparative study

2021 ◽  
pp. 1-10
Author(s):  
Reda Ali Sheta ◽  
Mohamed El-Sayed ◽  
Hisham Abdel-Ghani ◽  
Sameh Saber ◽  
Amani Salah Eldin Mohammed ◽  
...  
Keyword(s):  
Treatment Method ◽  
Ponseti Method ◽  
Level Of Evidence ◽  
Home Based ◽  
Multicentre Cohort Study ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Multicentre Cohort

Purpose We aimed to compare our parent-based exercise programem’s efficacy with the foot abduction brace (FAB) Ponseti manipulation as a retention programme. Methods We conducted this prospective multicentre cohort study between August 2009 and November 2019. The included children were allocated into one of two groups according to the retention protocol. The Pirani and Laaveg-Ponseti scores were used to assess the feet clinically and functionally. Radiological assessment was performed using standing anteroposterior and lateral radiographs of the feet. We assessed the parents’ satisfaction and adherence to the retention method. SPSS version 25 was used for the statistical analysis. Results A total of 1265 feet in 973 children were included. Group A included 637 feet managed with FAB, while group B included 628 feet managed with our retention programme. All patients were followed up to the age of four years. At the final follow-up, Pirani scores in group A participants were excellent, good and poor in 515, 90, and 32 feet, respectivel, while in group B the scores were excellent, good and poor in 471, 110 and 44 feet, respectively. The mean total score of Laaveg-Ponseti was 87.81 (sd 19.82) in group A and 90.55 (sd 20.71) in group B (p = 0.02). Group B participants showed higher satisfaction with the treatment method (p = 0.011) and more adherence to the treatment (p = 0.013). Conclusion The deformity’s recurrence related to the brace’s non-compliance in the Ponseti method might be reduced by substituting the brace with our home-based daily stretching exercises. Level of Evidence II

scholarly journals Surgical Treatment Outcomes for Everted Bursal Flap of Delaminated Supraspinatus Tear

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199042
Author(s):  
Hyungsuk Kim ◽  
Chu Hwan Byun ◽  
Sung Bin Han ◽  
Hyun Seok Song
Keyword(s):  
Los Angeles ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Level Of Evidence ◽  
Supraspinatus Tear ◽  
Functional Scores ◽  
Group A ◽  
Vas Scores ◽  
Group B

Background: Although everted bursal flaps of delaminated tears have been reported, few studies have reported radiologic images, arthroscopic findings, and clinical results after repair. Purpose: To compare the repair outcomes of everted delaminated tears with those of classic delaminated supraspinatus tears. Study Design: Cohort study; Level of evidence, 3. Methods: Among 153 patients who underwent arthroscopic rotator cuff repair for a delaminated supraspinatus tear, everted bursal flap tears were observed in 24 patients upon arthroscopy (group A). Another 24 patients with classic delaminated supraspinatus tears, matched for age and sex, were selected for group B. Magnetic resonance imaging (MRI) and ultrasonography were performed preoperatively and postoperatively. Patients were evaluated using a visual analog scale (VAS) for pain as well as functional scores (American Shoulder and Elbow Surgeons [ASES] score, Constant score, and University of California Los Angeles shoulder score). Scores were compared preoperatively and at final follow-up (mean follow-up, 32 months). Results: Patients in both groups A and B reported improved VAS and functional scores at the final follow-up. In group A, preoperative VAS scores were higher and functional scores were poorer than in group B. Subacromial effusions with tendon swelling on preoperative MRI were more common in group A. During follow-up ultrasonography, group A patients exhibited persistent subacromial effusion. However, VAS scores at final follow-up were significantly better in group A (0.4 ± 0.7) than in group B (1.6 ± 1.4) ( P < .001), and ASES scores at final follow-up were better in group A (84.3 ± 4.3) than in group B (77.0 ± 10.2) ( P = .005). Conclusion: Everted bursal flap delaminated tears were associated with higher VAS scores and poorer functional scores preoperatively. Although subacromial effusions were experienced by group A during the early postoperative period, clinical outcomes at final follow-up were significantly better for everted delaminated tears compared with classic delaminated tears.

scholarly journals Comparison of prolene with parietex composite® mesh in laparoscopic intraperitoneal mesh hernioplasty for paraumbilical hernia.

2021 ◽  
Vol 29 (01) ◽  
pp. 13-18
Author(s):  
Ahsan Nasim ◽  
Pir Muneeb Rehman ◽  
Kamran Ali ◽  
Naila Jabbar
Keyword(s):  
Intestinal Obstruction ◽  
P Value ◽  
Composite Mesh ◽  
Paraumbilical Hernia ◽  
Laparoscopic Hernioplasty ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Mesh Hernioplasty

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty.

Implant Design and Effects on Patellofemoral Crepitus

2017 ◽  
Vol 30 (09) ◽  
pp. 863-871 ◽  
Author(s):  
David McNabb ◽  
Jason Jennings ◽  
Brian Daines ◽  
Peter Laz ◽  
Raymond Kim ◽  
...  
Keyword(s):  
Mobile Bearing ◽  
Implant Design ◽  
Fixed Bearing ◽  
Posterior Stabilized ◽  
Level Of Evidence ◽  
Component Design ◽  
Group A ◽  
Total Knee ◽  
Group B

Background Patellofemoral crepitus is a known complication of posterior stabilized (PS) total knee arthroplasty (TKA). This study compared the incidence of patellofemoral crepitus between two femoral components designs. Materials and Methods Between January 2005 and August 2010, 1,120 patients with complete 2-year follow-up had a PS TKA with two different prosthetic designs (group A, 553 patients; group B, 567 patients). Records were reviewed to identify the incidence of total, symptomatic, and operative patellofemoral crepitus. Results No statistical differences were observed in the incidence of total patellofemoral crepitus (group A 14.1%, group B 14.5%; p = 0.932) or symptomatic patellofemoral crepitus (group A 5.6%, group B 4.2%; p = 0.334). The incidence of operative crepitus was greater in group A (3.3%) than in group B (1.3%; p = 0.026). Analysis of mobile versus fixed bearing designs showed a higher incidence of total patellofemoral crepitus in mobile bearing TKA (16.04 vs. 4.93%; p = 0.006) within group B only. Conclusion Femoral component design with a smoother intercondylar box transition zone resulted in a lower incidence of operative patellofemoral crepitus. No statistical differences were noted regarding the incidence of total and symptomatic patellofemoral crepitus. Mobile bearing TKA exhibited greater total crepitus within group B. Level of Evidence Level III.

scholarly journals Isolated arthroscopic treatment of intra-articular pathologies in mild hip dysplasia: a short-term case control study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Enrico Tassinari ◽  
Federica Mariotti ◽  
Francesco Castagnini ◽  
Stefano Lucchini ◽  
Francesco Perdisa ◽  
...  
Keyword(s):  
Labral Repair ◽  
Control Group ◽  
Level Of Evidence ◽  
Capsular Plication ◽  
Small Series ◽  
Center Edge ◽  
Group A ◽  
Group B ◽  
Lateral Center Edge Angle

Abstract Purpose The aim is to compare the results of isolated hip arthroscopy in patients with borderline dysplasia with Lateral center edge angle (LCEA) between 18° and 25° with a control group of patients with normal LCEA (> 25°). Methods Fifty hip arthroscopies performed in 45 patients were retrospectively evaluated. Exclusion criteria were: age > 40, hip arthritis > grade 2 according to Tonnis classification, femoral head avascular necrosis, pediatric’s orthopaedics conditions and true dysplasia with LCEA < 18°.Two groups were identified: group A with 15 hips with LCEA between 25° and 18° and Group control B made of 35 hips with LCEA > 25°. Results The groups were homogeneous for demography and pre-operative WOMAC and HOOS. Osteoplasty for CAM were performed in 100% of patients in both groups, only in 12 hips (34.4%) in group B we had both femoral and acetabular osteoplasty. Labral repair was performed in 86% of patients in group A, in 60% of patients in group B, capsular plication in 93% of group A, in 5% of case of group B. WOMAC and HOOS statically significant improved in both groups at final follow-up (24 months). No cases in both groups required conversion to total hip arthroplasty. Clinical outcomes of study group were comparable to the control group. Conclusion Even if the present small series is not conclusive, we suggest isolated arthroscopic management of patients with FAI and LCEA between 18° and 25°, but capsular plication and careful labral management are strongly recommended. Level of evidence Level IV.

scholarly journals A study to evaluate and compare the outcomes of endoscope versus microscope assisted myringoplasty

2021 ◽  
Vol 7 (6) ◽  
pp. 988
Author(s):  
K. Sharath Babu ◽  
R. Shankar
Keyword(s):  
Sinus Tympani ◽  
Graft Take ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Prospective Comparative Study ◽  
The Difference ◽  
One Year ◽  
Group B

<p class="abstract"><strong>Background:</strong> In microscope assisted middle ear procedures surgeons can only observe the parts of the tympanic cavity, the hidden areas, such as the facial recess and sinus tympani, would not be visualised which needs to be exposed for performing tympanoplasty. The aim of the study was to compare the outcomes of microscope versus endoscope assisted myringoplasties in terms of duration of the procedure, graft take up, improvement in hearing and incidence of any complications.</p><p class="abstract"><strong>Methods:</strong> A prospective comparative study was conducted for a period of one year. A total of 72 patients with CSOM were randomised into two groups of 36 each. Group A patients (n=36) underwent traditional myringoplasty under a microscope and group B patients (n=36) endoscopic assisted myringoplasty was performed. Post-operatively all the patients were followed up for a period of one year. During the follow-up period patients were assessed for the graft take up, hearing improvement, incidence of complications and recurrence rate between the two groups.</p><p class="abstract"><strong>Results:</strong> Successful graft uptake was observed in 88.8% among patients underwent microscope assisted myringoplasty and it was 94.4% in endoscopic assisted myringoplasty. The mean duration of surgery was 123 mins in microscopic assisted group compared to 92 mins in endoscopic assisted group and the difference was found to be statistically significant. Similarly, the cosmetic results and the post-operative pain were more favorable for endoscopic assisted group than microscopic assisted group and the difference was found to be statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Enoscopic assisted procedure could be considered as a better alternative for microscopic assisted myringoplasty.</p>

scholarly journals Are there any differences between the shoulder-arm sling and figure-of-eight bandage in the conservative treatment of paediatric clavicle fractures?

2021 ◽  
pp. 1-6
Author(s):  
Ali Sisman ◽  
Caner Poyraz ◽  
Ali Can Cicek ◽  
Suleyman Kor ◽  
Emre Cullu
Keyword(s):  
Muscle Strength ◽  
Conservative Treatment ◽  
Age Group ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Paediatric Age ◽  
Group A ◽  
Clavicle Fractures ◽  
Group B

Purpose Clavicle fractures are treated conservatively in the paediatric age group, except in rare types of fractures. We investigated whether there was a difference between using shoulder-arm sling and figure-of-eight bandage in this age group. Methods This study was designed as a retrospective study. In all, 41 children among 53 who underwent conservative treatment with a shoulder-arm sling or figure-of-eight bandage between 2014 and 2019 were included in the study and divided into two groups. Treatment results were compared clinically with respect to pain intensity, muscle strength and radiological examinations. Results Group A comprised 20 children with a figure-of-eight bandage and group B comprised 21 children with shoulder sling. According to the Robinson classification, ten fractures were displaced in group A and 12 in group B (p = 0.647). The mean time until the first appointment after the index visit that started the management course was 25.5 days (21 to 31) in group A and 24 days (20 to 30) in group B (p = 0.129). Fracture healing was observed in all patients at the first follow-up and the treatment was discontinued. There was no difference between the groups in the muscle strength examination and shoulder joint range of movement examination at the first-year follow-up (p = 1.00). Conclusion In the paediatric age group, there was no significant difference between shoulder-arm sling and figure-of-eight bandage in the conservative treatment of clavicle fractures. Since the shoulder-arm sling is more suitable for treatment, it may be the primary preference. Level of Evidence Level III (retrospective comparative study)

scholarly journals Foot abduction brace noncompliance in children with idiopathic clubfoot: how the deep squatting posture might help

2020 ◽  
Vol 8 (3) ◽  
pp. 241-248
Author(s):  
Pipattra Sailohit ◽  
Noppachart Limpaphayom
Keyword(s):  
Exercise Group ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Routine Practice ◽  
Group A ◽  
Metatarsus Adductus ◽  
Noncompliance Rate ◽  
Group B ◽  
Recent Evaluation

Background. Compliance with the foot abduction brace (FAB) is essential for idiopathic clubfoot (ICF) managed by the Ponseti method. The deep squatting posture (DSP) was correlated with favorable outcomes in ICF. Aim. The aims of the study were to identify the noncompliance rate with the FAB, and assess how the routine practice of ankle stretching and Asian-style DSP affected the ICF correction during the Ponseti method. Materials and methods. Of 42 children with ICF, 63 ICF underwent the Ponseti method at an average age of 8.7 12.6 weeks using an average of 5.4 1.7 casts followed by FAB wear. The children practiced the DSP exercise as an adjunct to the FAB protocol. Children noncompliant with the FAB protocol but compliant with the DSP exercise (group A) were compared with children noncompliant with both FAB protocol and DSP exercise (group B). Results. At an average follow-up of 3.5 1.4 years, 8 of 42 children compliant with the FAB protocol. The FAB protocol deviation was documented at an average of 10.3 4.8 months. Children who did not adhere to the practice of the DSP exercise had a higher recurrent rate of any ICF deformity (OR 7.82, 95% CI 1.3553.79, p = 0.003). Of the 34 children (48 feet) noncompliant with FAB, the children in group A (39 feet) had lower recurrence rate (p = 0.02), a better Dimeglio grade (p = 0.005), and a better Pirani score (p 0.001) at the most recent evaluation than children in group B (nine feet). However, recurrent metatarsus adductus was more prevalent in group A. Conclusion. The DSP exercise should be advocated as a supplemental modality but cannot substitute the regular use of FAB.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

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