scholarly journals Plaster, splint, brace, tape or functional mobilization after first-time patellar dislocation: what’s the evidence?

2019 ◽  
Vol 4 (3) ◽  
pp. 110-114 ◽  
Author(s):  
Daan Vermeulen ◽  
Mara Rosa van der Valk ◽  
Laurens Kaas
Keyword(s):  
Surgical Treatment ◽  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Treatment Options ◽  
Passive Restraint ◽  
New Research ◽  
First Time ◽  
Active Patients ◽  
Non Surgical Treatment

With an incidence of 5.8 per 100,000 per year, patellar dislocations are commonly seen in the emergency department. Surprisingly, there are only a few studies available that focus on the results of the different non-surgical treatment options after first-time patellar dislocation. The aim of this review is to provide an overview of the most recent and relevant studies on the rationales and results of the non-surgical treatment for first-time patellar dislocation. Patellar instability mainly affects young and active patients, with a peak incidence of 29 per 100 000 per year in adolescents. The medial patellofemoral ligament, a main passive restraint for lateral translation of the patella, is torn in lateral patellofemoral dislocations. Treatment of first-time patellar dislocation can be either conservative or surgical. There are two options in conservative management of first-time patellar dislocation: immobilization using a cylinder cast or removable splint, or, second, functional mobilization after applying a brace or patellar tape. The current available literature of conservative treatment after a first-time patellar dislocation is little and of low quality of evidence. Conclusions should be drawn with care, new research focussing on non-surgical treatment is therefore strongly needed. Cite this article: EFORT Open Rev 2019;4:110-114. DOI: 10.1302/2058-5241.4.180016

Dupuytren’s disease

2011 ◽  
Author(s):  
Peter Burge
Keyword(s):  
Surgical Treatment ◽  
Steroid Injection ◽  
Treatment Options ◽  
Genetic Component ◽  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Collagenase Injection ◽  
Operative Complications ◽  
Non Surgical Treatment

♦ Dupuytren’s disease is characterised by contracture of a finger resulting from thickening and shortening of the palmar fascia♦ A genetic component to the aetiology is apparent, smoking, alcohol and diabetes can increase the risk♦ The pathogenesis of Dupuytren’s disease remains elusive♦ Non-surgical treatment options include splintage, steroid injection and collagenase injection♦ Surgery cannot cure the disease but can straighten bent digits and minimize recurrence♦ Operative methods can be considered with regards to incision, management of the diseased fascia and closure techniques♦ Operative complications include injury of digital nerves and arteries

scholarly journals Osteopetrosis. Presentación de dos casos [Non-surgical management of osteopetrosis: two case reports an review of the literature]

2019 ◽  
Vol 84 (4) ◽  
pp. 386-392
Author(s):  
Juan Carlos Caruso ◽  
Juan Martín Patiño
Keyword(s):  
Surgical Treatment ◽  
Case Reports ◽  
Bone Dysplasia ◽  
Invasive Treatment ◽  
Non Invasive ◽  
History Of ◽  
Diaphyseal Fractures ◽  
Non Surgical Treatment ◽  
Delayed Consolidation

Las osteopetrosis (enfermedad de Albers-Schönberg) es un síndrome con cuatro tipos clásicos e instituye una displasia ósea secundaria a la falta de resorción de hueso por anormalidad de los osteoclastos, lo cual provoca un tejido óseo duro y quebradizo,propenso a fracturas difíciles de tratar quirúrgicamente. Se han publicado escasos artículos sobre el tema; por este motivo, decidimos presentar a dos pacientes con fracturas diafisarias de húmero con osteopetrosis, ambas tratadas en forma incruenta.Los objetivos son comunicar nuestra experiencia y el método de tratamiento de dicha afección y realizar una revisión bibliográfica acerca del tema. Creemos que el tratamiento de elección para las fracturas diafisarias de húmero en pacientes con osteopetrosises el incruento, ya que su tipo de tejido óseo dificulta la implementación de cualquier osteosíntesis. Además, la colocación de implantes puede provocar algunas complicaciones, como infecciones, retraso de la consolidación y seudoartrosis. La cirugía se reserva para ciertos casos, como en pacientes con riesgo de desarrollar deformidades incapacitantes, aquellos que han sufrido fracturas repetidas, con retraso de la consolidación, seudoartrosis, quienes no responden al tratamiento incruento o con unadeformidad previa.AbstractOsteopetrosis (also known as Albers-Schönberg disease) is a syndrome that includes four classic types and is characterized by bone dysplasia and lack of bone resorption due to abnormal osteoclastic activity and consequent development of brittle and hard bone that is prone to fractures that are difficult to treat surgically. Herein we present two cases of osteopetrosis with diaphyseal fractures of the humerus, both managed with non-surgical treatment. The objectives of our manuscript are to document our experience in the management of these cases and review the literature. The non-invasive treatment provides the best outcome for dyaphyseal fractures on the humerus in patients with osteopetrosis, given that the quality of the bone in these patients impairs the implementation of osteosynthesis. In addition, the placement of implants can lead to complications such as infections, delayed consolidation and pseudoarthrosis, among others. Surgical treatment should reserved for certain patients such as those with delayed consolidation, pseudoarthrosis, a history of repeated fractures, pre-existing deformity and those who are at risk for the development of disabling deformities or do not respond to non-surgical treatment.

scholarly journals Case Report: Abomasum Impaction in Beef Cattle Due to High Intake of Distillers' Grain and Treatment Options in Southwest China

2021 ◽  
Vol 8 ◽  
Author(s):  
Kang Yong ◽  
Zhengzhong Luo ◽  
Qinwen Yang ◽  
Chuanshi Zhang ◽  
Qianlan Zhou ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Beef Cattle ◽  
Southern China ◽  
Treatment Options ◽  
Treatment Success ◽  
Solid Content ◽  
High Intake ◽  
Surgical Options ◽  
Distillers Grain ◽  
Non Surgical Treatment

In Southern China, distillers' grain is the main feed ingredient for small beef cattle farms. High intake of distillers' grain may lead to abomasum impaction, a disorder caused by the accumulation of solid content within the organ. For treatment, there are non-surgical and surgical options. In this study, we aimed to describe the clinical presentation, diagnosis, and treatment of beef cattle with abomasum impaction due to high intake of distillers' grain. Forty-nine Simmental beef cattle from 13 farms in Chongqing, China, were diagnosed with abomasum impaction. Animals were male, aged ≤2 years, and weighed between 200 and 350 kg. In this retrospective study, information on distillers' grain intake and clinical data were collected for 49 beef cattle diagnosed with abomasum impaction. The animals were treated between 2011 and 2019 with either non-surgical therapy or surgery. Animals diagnosed with mild abomasum impaction (n = 14) fully recovered after non-surgical treatment. Among moderate cases (n = 19), 12 cattle recovered after non-surgical treatment (63%), while the remaining seven did not respond well and underwent surgery. Three of those animals were subsequently cured (3/7). Among the severe cases (n = 16), four cattle were cured after non-surgical treatment (25%) (4/16). Of the remaining 12 cattle, six were slaughtered, and six died after surgery. Non-surgical treatment is efficient for mild abomasum impaction caused by a high intake of distillers' grain and may be considered for both moderate and severe cases. However, the treatment success rate for more severe cases decreases as the disease severity worsens.

scholarly journals Assessing the Quality of Life Among Pediatric Population After Surgery for Recurrent Patellar Dislocation: a Prospective Cohort Study

2021 ◽  
Author(s):  
Alexandru Herdea ◽  
Charkaoui Adham ◽  
Alexandra Toma ◽  
Mihai-Codrut Dragomirescu ◽  
Vlad Pencea ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Pediatric Population ◽  
Patellofemoral Instability ◽  
Reconstruction Technique ◽  
Medial Patellofemoral Ligament Reconstruction

Abstract Patellofemoral instability is a common cause of knee pathology that is affecting the quality of life among pediatric population. Methods: We performed a prospective cohort study, including patients that underwent surgical management by using the Lateral Release and Medial Imbrication approach (LRMI) or Medial Patellofemoral Ligament Reconstruction (MPFL-R). The purpose of this study was the assessment of the quality of life among pediatric population that underwent surgery for patellar dislocation. The quality of life was evaluated before and after surgery using the Pediatric International Knee Documentation Committee form (Pedi-IKDC). The postoperative scar was evaluated using The Stony Brook Scar Evaluation Scale. 108 patients were selected and grouped according to the type of procedure. Results: before surgery, the calculated Pedi-IKDC scores were similar between the two groups of patients. We identified substantial improvement in the postoperative score after surgery and the Medial Patellofemoral Ligament Reconstruction technique showed better results. The difference regarding the Pedi-IKDC score between the two groups was significant, in favor of the Medial Patellofemoral Ligament Reconstruction. By using the Stony Brook Scar Evaluation Scale, an important difference emerged between the two groups of patients in favor of the Medial Patellofemoral Ligament Reconstruction technique, revealing that it is a minimally invasive approach, improves recovery, reduces postoperative stay and increases the patients quality of life.Conclusions: This study provides further evidence based results that support the recommendations regarding the Medial Patellofemoral Ligament Reconstruction technique as the gold standard for the patellofemoral instability.Trial registration: The Ethics Committee of „Grigore Alexandrescu” Children’s Emergency Clinical Hospital of Bucharest approved this study on 1st of March 2013. The project code is 7/01.03.2013. An informed parental consent was obtained for every participant.

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