scholarly journals EPIDEMIOLOGY OF TRAUMATIC INJURIES OF THE UPPER LIMBS IN A UNIVERSITY HOSPITAL

2018 ◽  
Vol 26 (6) ◽  
pp. 370-373 ◽  
Author(s):  
Samuel Ribak ◽  
Elton João Nunes de Oliveira ◽  
Gustavo Pupo Rosolino ◽  
Pedro Orru Neto ◽  
Alexandre Tietzmann
Keyword(s):  
Case Series ◽  
University Hospital ◽  
Occupational Accidents ◽  
Upper Limbs ◽  
Level Of Evidence ◽  
Traumatic Injuries ◽  
Injured Area ◽  
Closed Fractures ◽  
A Prospective Study ◽  
Serious Injuries

ABSTRACT Objective: To evaluate the epidemiology of traumatic injuries of the upper limbs treated at a university hospital and identify the causes, types of injuries, and risk factors. Methods: A prospective study was performed with accidents resulting in trauma categorized into three groups: domestic, occupational, or transportation-related. A questionnaire containing information about the patient and the accident was administered. Lesion characteristics were evaluated according to the injured area, the type of injury, and the management strategy adopted for each case. Results: A total of 613 patients were evaluated. The most frequent accidents were domestic (66.6%), predominantly involving men (67.9%) with a mean age of 31 years. Wrist lesions prevailed in transportation-related (31.1%) and domestic (29.6%) accidents, and in accidents involving fingers at work (54.2%). Closed fractures were more frequent and conservative treatment was indicated most often. Serious injuries were associated with finger accidents (39.4%). There was a correlation between the level of education and the type of accident. Conclusion: Traumatic injuries of the upper limbs were more frequent in domestic accidents and in male patients. Closed fractures were the most common type of fracture and were usually treated conservatively. Serious injuries were more often related to finger trauma. Education level influenced domestic, transportation-related, and occupational accidents. Level of Evidence IV, Case Series.

scholarly journals Adolescent idiopathic scoliosis: surgical treatment and quality of life

2017 ◽  
Vol 25 (3) ◽  
pp. 85-89 ◽  
Author(s):  
Luciano Miller Reis Rodrigues ◽  
Alberto Ofenhejm Gotfryd ◽  
André Nunes Machado ◽  
Matheus Defino ◽  
Leonardo Yukio Jorge Asano
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Perioperative Complications ◽  
Case Series ◽  
Clinical Results ◽  
Spine Fusion ◽  
Level Of Evidence ◽  
Posterior Spine ◽  
A Prospective Study

ABSTRACT OBJECTIVES: The purpose of this study was to determine the influence of perioperative factors and their impact on clinical and functional outcomes in Brazilian patients with adolescent idiopathic scoliosis (AIS). METHODS: We performed a prospective study with 49 consecutive AIS patients who underwent spine fusion and had a minimum 2 year follow-up. Clinical and radiographic data were correlated to SRS-30 scores in order to predict postoperative results. RESULTS: There was a negative association between patient age at the time of surgery and back pain. We also observed higher scores in the "satisfaction" domain in patients who underwent surgery after 15 years of age (p < 0.05). The average SRS-30 "mental health" score was significantly higher in males than in females (p= 0.035). Patients treated with braces had worse results than those who did not use them (p= 0.005). CONCLUSIONS: Posterior spine fusion led to improvement of all domains of the SRS-30 questionnaire. Clinical results were influenced by age, sex and the use of braces prior to surgery. There was no correlation between curve correction and presence of perioperative complications. Level of Evidence IV, Case Series.

Tension Regulation at the Suture Lines for Repair of Neglected Achilles Tendon Laceration

2016 ◽  
Vol 38 (3) ◽  
pp. 304-309
Author(s):  
Elsayed Ibraheem Elsayed Massoud
Keyword(s):  
Achilles Tendon ◽  
Mechanical Loading ◽  
Case Series ◽  
Tendon Graft ◽  
Calf Circumference ◽  
Level Of Evidence ◽  
Normal Thickness ◽  
A Prospective Study ◽  
Tension Regulation ◽  
Tendon Laceration

Background: Operative intervention is the preferred option for management of the neglected laceration of the Achilles tendon. However, the commonly used techniques rarely follow the principles of the regenerative medicine for the restoration of the lost tissue. This study postulated that incorporation of the autogenous tendon graft would properly progress when the interplay between mechanical loading and healing phases was correctly applied. Methods: A prospective study included 15 patients who were treated for neglected Achilles tendon laceration using the technique of lengthening of the proximal tendon stump. An absorbable reinforcement suture was used for control of the mechanical environment at the suture lines. Results: By an average 5 years of the prospective follow-up, all the repaired tendons had restored continuity and length. The calf circumference equalized to the uninjured side in 12 patients. However, 3 patients had calf atrophy but they improved compared to the preoperative measurements. Sonogram confirmed the restoration of the normal thickness and the gliding characteristics of the repaired tendon. Conclusion: The technique restored continuity and tension of the repaired tendon, preserved the calf circumference, and prevented peritendinous adhesions. The absorbable reinforcement suture spontaneously allowed for the mechanical loading of the grafted tendon. Level of Evidence: Level IV, case series.

scholarly journals Epidemiological study of ankle fractures

2021 ◽  
Vol 15 (2) ◽  
pp. 120-123
Author(s):  
Jorge Mizusaki ◽  
Sérgio Damião Santos Prata ◽  
Marco Rizzo ◽  
Luiz Augusto Sampaio Gonzaga Filho ◽  
Leandro Carneiro
Keyword(s):  
Epidemiological Study ◽  
Case Series ◽  
Mixed Race ◽  
Ankle Fractures ◽  
Level Of Evidence ◽  
Working Age ◽  
Closed Fractures ◽  
The Right ◽  
Epidemiological Characteristics ◽  
Detailed Questionnaire

Objective: To evaluate the epidemiological characteristics of patients with fractures in the ankle region. Methods: This prospective, observational, descriptive, and epidemiological study included ankle fractures treated at our service from March 1, 2017 to March 1, 2018. Data were obtained from 150 patients through a detailed questionnaire. Results: The sample, which included 61.33% men, aged mainly between 20 to 30 years; 46.68% were of mixed race, and 41.33% had only completed elementary school. A total of 33.66% of the ankle fractures occurred in the afternoon. According to the Weber classification system, 46.66% were type B fractures.Conclusion: Ankle fractures were more common in men of working age, and were mostly closed fractures in the right lower limb. Level of Evidence IV; Prognostic Studies; Case Series.

Mini TightRope Suspension Allows for Accelerated Rehabilitation following Ligament Reconstruction Interposition Arthroplasty of the Basal Joint of the Thumb

2021 ◽  
Author(s):  
Rasmus Wejnold Jørgensen ◽  
Kiran Annette Anderson ◽  
Claus Hjorth Jensen
Keyword(s):  
Ligament Reconstruction ◽  
Case Series ◽  
Early Mobilization ◽  
Level Of Evidence ◽  
Suture Button ◽  
Usual Procedure ◽  
Trapeziometacarpal Osteoarthritis ◽  
Increased Risk ◽  
Patient Reported ◽  
A Prospective Study

Abstract Introduction Surgical treatment of thumb trapeziometacarpal osteoarthritis usually involves 4 to 8 weeks of postoperative casting and splinting followed by varying mobilization protocols. Suspension arthroplasty has been described as an alternative to allow earlier range of motion exercises. The purpose of this study was to compare patient-reported outcomes (PRO) when adding a two-string suture-button suspension arthroplasty (Mini TightRope, MTR) to our usual procedure of ligament reconstruction and tendon interposition (LRTI), allowing early mobilization. Can we allow early mobilization using this technique without jeopardizing the PRO results at the 1 year follow-up and without an increased risk of complication? Materials and Methods A prospective study using the MTR system (Arthrex) as a suture-button suspensionplasty was conducted. Twelve patients (MTR group) and 36 historical patients (LRTI alone) were included. Results At 12 months, the median value for quick disabilities of the arm, shoulder, and hand was 11.3 (range, 0–43.2) in the MTR group and 13.6 (range, 0–88.6) in the LRTI group, resulting in similar improvements, p = 0.46. One in twelve patients in the MTR group was dissatisfied and 9 in 36 in the LRTI group were dissatisfied, p = 0.41. No complications were observed during the first year. Conclusion Supplemental suture-button suspensionplasty can be utilized for high demand patients and patients who want to reduce immobilization time without major complications and with similar PRO as LRTI at 6 and 12 months. Level of evidence Four case series

Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy of the Lesser Toes: Clinical, Radiologic, and Pedobarographic Outcomes

2021 ◽  
pp. 107110072110348
Author(s):  
Elena Neunteufel ◽  
Sabine Krenn ◽  
Michel Chraim ◽  
Pascal Amann ◽  
Fabian Greiner ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Case Series ◽  
Level Of Evidence ◽  
Foot Function ◽  
Prospective Case Series ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Postoperative Improvement ◽  
Mtp Joints ◽  
Plantar Area

Background: The minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) is a percutaneous operative technique with the aim to relieve the symptoms of metatarsalgia. To our knowledge, no previous research has analyzed both pre- and postoperative pedobarographic data including the changes in plantar pressure. Methods: Thirty patients (31 feet) were operated on with a DMMO and included in a prospective study. Clinical, radiologic, and pedobarographic outcomes were evaluated in comparison with the preoperative parameters. The American Orthopaedic Foot & Ankle Society (AOFAS) forefoot score, the Foot Function Index (FFI), the Foot and Ankle Outcome Score (FAOS), and a visual analog scale (VAS) for pain were used in order to assess clinical parameters. Radiographs were taken to compare metatarsal lengths. The pedobarographic analysis served to determine plantar peak pressure (PPP) beneath the metatarsophalangeal (MTP) joints. Results: All scores indicated a significant mean pre- to postoperative improvement (AOFAS = 31.9 points, FAOS = 16.3%, FFI = 24.3%, VAS pain = 4.1 points, VAS general limitation = 3.3 points) ( P < .05). PPP was substantially reduced in the relevant area (M6 [plantar area beneath the second and third MTP joint] had a mean pre to post PPP = 14.15 N/cm2) and concurrently higher in the lateral and medial MTP joint areas (M5 mean pre to post = +14.37, M7 pre to post = +7.11). Our mean metatarsal shortening was 6.6 mm. However, our findings do not demonstrate a significant correlation between metatarsal length relationships and the prevalence of metatarsalgia. Conclusion: Our results demonstrate a significant improvement in clinical scores and PPP. A statistically significant relation between metatarsal length and the prevalence of metatarsalgia was not found in this prospective case series Level of Evidence: Level IV, case series.

scholarly journals TRANSFER OF NERVE BRANCHES OF THE FLEXOR CARPI RADIALIS TO THE POSTERIOR INTEROSSEOUS NERVE

2018 ◽  
Vol 26 (4) ◽  
pp. 222-226
Author(s):  
Edie Benedito Caetano ◽  
Luiz Angelo Vieira ◽  
Rodrigo Guerra Sabongi ◽  
Luca Martinez Correio ◽  
Kelson Koiti Ogata ◽  
...  
Keyword(s):  
Case Series ◽  
Anatomical Variations ◽  
Common Trunk ◽  
Posterior Interosseous Nerve ◽  
Upper Limbs ◽  
Level Of Evidence ◽  
Nerve Branch ◽  
Flexor Carpi Radialis ◽  
Supinator Muscle ◽  
Flexor Carpi Radialis Muscle

ABSTRACT Objective: The objective of this paper was to study the anatomical variations of the flexor carpi radialis muscle (FCR) and determine in cadaver limbs whether the FCR nervous branch can be connected to the posterior interosseous nerve (PIN) without tension and how close to the target muscles the transfer can be performed. Method: Thirty cadaveric upper limbs were dissected. Results: The FCR received exclusive innervation of the median nerve, distally to the intercondylar line of the humerus. In 5 limbs, an isolated branch was found and in 25, a common trunk with other nervous branches occurred. We investigated whether the branch for the FCR was long enough to be transferred to the PIN. The diameter of the nerve branch for the FCR corresponded on average to 50% of the PIN. Conclusion: In 12 limbs, the branch destined to the FCR could be connected to the PIN, distally to the nerve branches to the supinator muscle even during the movements of the forearm and the elbow. In 18 specimens, it was necessary to mobilize the PIN for this innervation. Level of Evidence IV, Case Series.

Does the Modified Harris Hip Score Reflect Patient Satisfaction After Hip Arthroscopy?

2012 ◽  
Vol 40 (11) ◽  
pp. 2557-2560 ◽  
Author(s):  
Alessandro Aprato ◽  
Narlaka Jayasekera ◽  
Richard N. Villar
Keyword(s):  
Patient Satisfaction ◽  
Predictive Value ◽  
Hip Arthroscopy ◽  
Case Series ◽  
Harris Hip Score ◽  
Current Standard ◽  
Level Of Evidence ◽  
Negative Results ◽  
Modified Harris Hip Score ◽  
A Prospective Study

Background: No published studies have explored the relationship between commonly reported clinical outcomes and patient satisfaction after hip arthroscopy. Purpose: To compare the modified Harris Hip Score (mHHS) with patient satisfaction in a prospective study over a 2-year period. Study Design: Case series; Level of evidence, 4. Methods: We reviewed our institutional database for prospectively collected mHHS and patient satisfaction data from 697 patients. Patients were evaluated preoperatively and at 1 and 2 years after surgery. Results: The mHHS correlated with patient satisfaction at 1 year ( P < .001, Pearson R = 0.451) and at 2 years ( P < .001, Pearson R = .454). Considering scores from excellent to good as positive results and from fair to poor as negative results, sensitivity was 73% at 1 year and 77% at 2 years. Respectively, the specificity was 64% and 73%, positive predictive value 86% and 91%, negative predictive value 45% and 46%, and accuracy 71% and 76%. At 1- and 2-year follow-up, a respective 55% and 54% of patients with fair to poor mHHS were satisfied with the outcome of hip arthroscopy. In contrast, for those patients with an excellent to good mHHS at 1 and 2 years after surgery, 14% and 9%, respectively, were dissatisfied with their outcome. Conclusion: Our results show a correlation between patient satisfaction and the mHHS but also demonstrate a limitation of the mHHS as an outcome measure in the prediction of patient satisfaction. Further investigation is required to assess factors beyond current standard orthopaedic clinical outcome measures that may influence patient satisfaction after hip arthroscopy.

scholarly journals Tendoscopy in stage I posterior tibial tendon dysfunction

2020 ◽  
Vol 14 (1) ◽  
pp. 9-13
Author(s):  
Gabriel Khazen ◽  
Cesar Khazen
Keyword(s):  
Soft Tissues ◽  
Case Series ◽  
Tendon Injury ◽  
Stage I ◽  
Stage Ii ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Level Of Evidence ◽  
Injured Area ◽  
Therapeutic Study

Objective: To evaluate the progression of patients with this pathology treated by tendoscopy and with a minimum 8-year follow-up. Methods: This is a retrospective study of patients operated on between 2008 and 2011. During that period, 11 patients with this pathology aged between 28 and 56 years (average 37 years) underwent surgery. The patients were assessed subjectively using the VAS scale and the AOFAS scale was used as the objective method. Results: Nine of the 11 operated patients could be evaluated. Tendon injury was evident in three patients during the tendoscopy and open repair was indicated. Seven patients improved their symptoms according to the VAS and did not progress to stage II. Two patients progressed to stage II and underwent hindfoot reconstruction: one with tendon injury and the other without. The AOFAS scale improved on average from 64 to 96 in the patients who did not progress to stage II. Conclusion: Tendoscopic synovectomy of the PTT is an effective surgical procedure to treat patients with stage I PTTD. It has the advantages of less pain and fewer complications of the soft tissues. If a tendon injury is encountered during the tendoscopy, it must be repaired through a 3 to 4cm incision above the injured area of the tendon. Level of Evidence IV; Therapeutic Study; Case Series.

The role of blood inflammatory markers in the diagnosis of appendicitis in children: a prospective study from a University Hospital in Greece

2020 ◽  
Vol 178 (11) ◽  
Author(s):  
George Sakellaris ◽  
Dimitra Dimopoulou ◽  
Maria Niniraki ◽  
Anastasia Dimopoulou ◽  
Athanasios Alegakis ◽  
...  
Keyword(s):  
Prospective Study ◽  
Inflammatory Markers ◽  
University Hospital ◽  
A Prospective Study

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

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