scholarly journals Surgical Management of Chronic Tendoachilles Tear in Elderly Patients – A Case Series

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neetin P Mahajan ◽  
Pranay Kondewar ◽  
Prasanna Kumar G S ◽  
Ankit Marfatia
Keyword(s):  
Elderly Patients ◽  
Functional Outcome ◽  
Surgical Management ◽  
Soft Tissues ◽  
Case Series ◽  
Wound Complication ◽  
Treatment Method ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Selection Of

Introduction: Chronic tendoachilles (TA) tears are commonly missed injuries in elderly population with associated comorbidities and they usually occur as low-energy injuries. Appropriate surgical management helps in getting a better functional outcome in elderly patients. Case Series: We present a series of three cases of chronic TA tear in elderly patients managed surgically. Two patients had an insertional tear and they were managed with flexor hallucis longus (FHL) transfer and fixed with interference screw in the calcaneum. Another patient was managed with end-to-end suturing using fiber wire. All the patients are having good functional outcome without any wound complication or re rupture. Conclusion: Early diagnosis, meticulous repair, and handling of soft tissues and TA tear help in getting a better outcome in elderly patients. The final functional outcome depends on intraoperative stability of the repair, ankle physiotherapy, and wisely selection of the treatment method, which mainly depends on the location of the tear. Reconstruction with FHL tendon using interference screw in calcaneum helps to repair the insertional tears in elderly patients. Keywords: Tendoachilles tear, flexor hallucis longus graft, steroid, elderly patients.

scholarly journals An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

2017 ◽  
Vol 4 (1) ◽  
pp. 46
Author(s):  
Yeshwanth Subash ◽  
Lydia M. ◽  
Kamalakumar K. ◽  
Ilavarasan M. Dhamu
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Scoring System ◽  
Soft Tissues ◽  
Proximal Humerus ◽  
Articular Surface ◽  
Treatment Options ◽  
Early Mobilization ◽  
Functional Results ◽  
Non Union

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results</span><span lang="EN-IN">.</span></p>

Surgical Management of Esophageal Achalasia in Pediatrics: A Systematic Review

2019 ◽  
Vol 30 (01) ◽  
pp. 013-020
Author(s):  
Ayman Goneidy ◽  
James Cory-Wright ◽  
Limeng Zhu ◽  
Georgina Malakounides
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Surgical Management ◽  
Case Series ◽  
Esophageal Achalasia ◽  
Treatment Method ◽  
Diagnostic Methods ◽  
Success Rates ◽  
Esophageal Myotomy

Abstract Introduction There are no evidence-based guidelines on the surgical management of esophageal achalasia (OA) in children. This can be a challenging condition with significant physical and psychological morbidity. Our aim was to identify the most common management modalities and their outcomes. Materials and Methods A systematic review was performed through a literature search of health care databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming at identifying pediatric series discussing the diagnosis and management of OA. Duplicates, case series with < 9 patients, and follow-up of < 1 year were excluded. The included papers were analyzed for diagnostic methods, primary treatment method, complications, follow-up duration, outcome measures recorded, and outcome. Results Data from 33 papers for 742 children treated for OA was analyzed. Eleven mentioned multiple management modalities. In summary, 25 described Heller's esophagomyotomy (HM), 13 esophageal dilatation (EOD), and 6 peroral esophageal myotomy (POEM). Mean follow-up was 43.7 months (12–180). Outcome measures were heterogeneous. However, analysis of reported success showed a mean success of 78% for HM (p = 1.79 × 10–7), 44.9% for EOD (p = 0.24), and 99.3% for POEM (p = 0.001). Reported complications were 12.8% for HM, 5% for EOD, and 24.4% for POEM. Further interventions were required for 10.9% of HM, 62.3% of EOD, and 0.01% of POEM patient groups. Conclusion Methods of diagnosis and measures of successful outcomes were heterogeneous, limiting the strength of evidence. HM showed superior short-term success rates to EOD. POEM is a promising modality but requires investment in equipment and training. Information about sustainability of response and long-term outcomes is lacking.

Utilisation of an 810 nm diode laser for surgical management of oral soft tissues related to orthodontic treatment: A case series

2021 ◽  
pp. 146531252110392
Author(s):  
Snehal Dalvi ◽  
Saurabh Lingala ◽  
Namrata Khetal ◽  
Stefano Benedicenti ◽  
Reem Hanna
Keyword(s):  
Diode Laser ◽  
Surgical Management ◽  
Orthodontic Treatment ◽  
Soft Tissues ◽  
Continuous Wave ◽  
Average Power ◽  
Fibre Diameter ◽  
Case Series ◽  
Spot Size ◽  
Emission Mode

The present case series demonstrates the efficacy of an 810 nm diode laser for the surgical management of oral soft tissues related to orthodontic treatment. Three orthodontic patients aged 16–23 years underwent operculectomy, ablation of soft-tissue overgrowth over orthodontic appliance and gingivectomy along with gingival recontouring procedures, respectively, using the 810 nm diode laser. In each case, an initiated laser fibre tip was utilised to ablate the tissue at the treatment site by making a light contact with the tissue (average power output = 1–1.6 W, continuous wave emission mode, fibre diameter = 400 µm, spot size = 0.0013 cm2, energy density = 124.9–199.9 J/cm2, irradiance = 796–1273 W/cm2, total energy dose = 300–480 J). The maximum total length of treatment was 300 s (5 min). None of the patients reported any instantaneous or delayed postoperative complications over six months. Utilisation of the 810 nm diode laser for surgical management of oral soft tissues related to orthodontic treatments can be considered safe, effective and justifiable over the conventional scalpel technique; however, it must be performed by trained and experienced clinicians only.

Case-series analysis of intracranial saccular aneurysms treatment

2015 ◽  
Vol 22 (3) ◽  
pp. 142-149
Author(s):  
Gytis Šustickas ◽  
Dainius Rinkevičius ◽  
Jurgita Ušinskienė ◽  
Simona Rūta Letautienė ◽  
Audrius Širvinskas
Keyword(s):  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Case Series ◽  
Treatment Method ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Unruptured Aneurysms ◽  
Aneurysm Embolization ◽  
Radical Method ◽  
Selection Of

Nowadays, selection of the best treatment method for intracranial aneurysms is one of the most discussed topics. We report our operative and coiling experience of 128 cases  –  series with 106 ruptured and 22 unruptured aneurysms. The aim of the research was to identify the factors influencing the optimal radical method for treatment of intracranial aneurysms and to compare the neurosurgical and neuroradiological activity of our hospital with that of other regions of the world. Of 128 aneurysms the clipped group was 94 patients (mean age ± SD: 52.21 ± 13.34 years, 73.4%) while 34 patients underwent aneurysm embolization (mean age ± SD: 61.59 ± 13.34 years, 36.6%). Most of the aneurysms were located at the anterior communicating artery (n = 36, 28.13%), the middle cerebral artery (n = 34, 26.56%) and the internal carotid artery (n  =  20, 15.63%). Comorbidity, neurology status at admission, clinical outcomes, operative complications, aneurysm localization, size and condition were analysed. According to our experience, surgical clipping of aneurysms is more efficient and safe for patients with no or mild comorbidity, with less severe neurological symptoms, ruptured aneurysms, and anterior cerebral circulation aneurysms.

Percutaneous Sacroplasty for Sacral Insufficiency Fractures: Case Series and Review of Presentation, Diagnosis, and Treatment

2019 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Andrew C. Clark ◽  
Devang Butani
Keyword(s):  
Low Back Pain ◽  
Elderly Population ◽  
Case Series ◽  
The Elderly ◽  
Treatment Method ◽  
Open Reduction Internal Fixation ◽  
Low Back ◽  
Insufficiency Fractures ◽  
Invasive Treatment ◽  
Sacral Insufficiency Fractures

Sacral insufficiency fractures (SIFs) are a cause of debilitating low back pain that is often difficult to diagnosis and manage. The diagnosis of SIF is often delayed due to inaccurately attributing symptoms to spondylosis, which is a commonly present in the elderly population where SIFs are most prevalent. Historically, treatment consisted of medical management and open reduction internal fixation reserved for severe cases. However, percutaneous sacroplasty has emerged as a minimally invasive treatment option which provides early pain relief without significant complications. The objective of this article is to raise awareness of SIFs and percutaneous sacroplasty as an effective and safe treatment method.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

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