scholarly journals OUTCOME OF NON-SURGICAL TREATMENT OF MALLET FINGER

2020 ◽  
Vol 28 (4) ◽  
pp. 172-176
Author(s):  
Stephan Alejandro Dávalos Barrios ◽  
Arturo Felipe de Jesús Sosa Serrano ◽  
Jorge Alberto Gama Herrera ◽  
Maria Fernanda Ramírez Berumen ◽  
Jose Manuel Pérez Atanasio
Keyword(s):  
Relative Risk ◽  
Conservative Treatment ◽  
Case Series ◽  
Treatment Level ◽  
Mallet Finger ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
Analytical Research ◽  
Crawford Classification ◽  
Non Surgical Treatment

ABSTRACT Objective: To establish the association between initial and residual angulation of the distal interphalangeal joint (DIJ) in mallet finger treated conservatively. Methods: An observational, prospective, descriptive and analytical research developed with uncomplicated closed mallet finger patients between January and December 2017. A total of two measurements of the DIJ were done, at the initial trauma and 6 weeks after conservative treatment. All measurements were ranked according to the Crawford Classification and Relative Risk was measured. Results: In total, 43 patients were studied, in which 53.48% of outcomes obtained were excellent. The sample was divided in two groups; one with less than 30º of DIJ initial angulation, which had 28% of residual angulation. The second group with more than 30º presented 72.22% of residual angulation. The Relative Risk to present a residual angulation in patients that had 30º of DIJ initial angulation was 2.99 (CI 95%) with p = 0.0059. Conclusion: It is suggested that patients with an initial DIJ angulation more than 30º are more likely to present residual angulation with conservative treatment. Level of Evidence IV, Case series.

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

2019 ◽  
Vol 41 (2) ◽  
pp. 187-192
Author(s):  
Ricardo E. Colberg ◽  
Monte Ketchum ◽  
Avani Javer ◽  
Monika Drogosz ◽  
Melissa Gomez ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Case Series ◽  
Successful Outcome ◽  
Oral Steroid ◽  
Tarsal Tunnel ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

scholarly journals RESULTS OF TREATMENT OF PLICA SYNDROME OF THE KNEE

2021 ◽  
Vol 29 (2) ◽  
pp. 72-75
Author(s):  
GILBERTO LUIS CAMANHO ◽  
RICCARDO GOMES GOBBI ◽  
MARTA HALASZ DE ANDRADE
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Rehabilitation Program ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Results Of Treatment ◽  
Rehabilitation Period ◽  
Plica Syndrome ◽  
Synovial Fold ◽  
Non Surgical Treatment

ABSTRACT Objective: The synovial fold is an intra-articular structure found in more than 50% of the knees, which can cause symptoms similar to meniscal injuries. These symptoms are mostly related to hypertrophy of the synovial fold resulting from inadequate physical activity. Conservative treatment with readjustment of sports activity and muscle rebalancing solves most cases. Rare cases require surgical treatment, which is indicated due to the persistence of instability, blockage and pain. We present our experience in the treatment of this pathology. Methods: 58 patients (70 knees), with 62 knees treated conservatively and 8 treated surgically exclusively for the pathological synovial fold. Results: Description of the series and treatment results are reported. Conclusion: The non-surgical treatment of the pathological synovial fold of the knee provided good results within 60 days of rehabilitation program in almost 90% of the patients. Arthroscopic resection of the synovial fold is a surgery that has a longer and laborious rehabilitation period, despite good results in most cases. Level of Evidence IV, Case series.

Long-term Stack splint immobilization for closed tendinous Mallet Finger

2020 ◽  
Vol 52 (03) ◽  
pp. 170-175
Author(s):  
In Tae Hong ◽  
Eugene Baek ◽  
Cheungsoo Ha ◽  
Soo-Hong Han
Keyword(s):  
Treatment Protocol ◽  
Interphalangeal Joint ◽  
Flexion Angle ◽  
Full Time ◽  
Mallet Finger ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Crawford Classification

Abstract Background Closed tendinous mallet finger can be treated non-operatively by extension splinting of the distal interphalangeal joint (DIPJ) for 6 to 8 weeks. However, method of conservative treatment in detail differs among various reports, especially in type of orthosis, duration of full-time immobilization and additional night orthotic wear after full-time immobilization. In our institution, full-time Stack splint is applied with distal interphalangeal joint (DIPJ) in extension for 12 weeks and night orthosis is worn for 4 weeks. Purpose The purpose of this study was to evaluate clinical and functional outcomes of tendinous mallet finger using our treatment protocol. Patients and Methods Between March 2007 and December 2017, patients with tendinous mallet finger who were managed conservatively according to our treatment protocol were retrospectively reviewed. A total of 100 patients (101 cases) were enrolled, including 77 males and 23 females. Extension lag was measured before, soon after treatment, and at the final follow-up. Flexion angle of DIP joint was measured at the final follow-up. Patients were clinically evaluated based on the Crawford classification scale and Abouna & Brown criteria. Results The mean age of patients was 40 years and the mean follow-up was 48 months. The mean extension lag was 28.3 degrees initially and 2.6 degrees at the final follow-up. (p-value < 0.001) Flexion angle at the final follow-up was 68.3 degrees. Based on the Crawford classification scale, 56 % of patients had excellent results, and 25 % of patients had good results. According to Abouna & Brown criteria, 78 % of patients had success results and 7.5 % of patients had improved results. Conclusions Wearing orthosis for up to 16 weeks (12 weeks full time and 4 weeks night orthosis) in the treatment of tendinous mallet finger injuries can achieve satisfying result.

scholarly journals Who Needs Surgical Stabilization for Pyogenic Spondylodiscitis? Retrospective Analysis of Non-Surgically Treated Patients

2021 ◽  
pp. 219256822110394
Author(s):  
Ronen Blecher ◽  
Sven Frieler ◽  
Bilal Qutteineh ◽  
Clifford A. Pierre ◽  
Emre Yilmaz ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
De Novo ◽  
Vertebral Osteomyelitis ◽  
Case Series ◽  
Spinal Instability ◽  
Radiographic Outcome ◽  
Retrospective Case ◽  
Posterior Element ◽  
Non Surgical Treatment

Study Design: Retrospective case series analysis. Objective: To identify relevant clinical and radiographic markers for patients presenting with infectious spondylo-discitis associated with spinal instability directly related to the infectious process. Methods: We evaluated patients presenting with de-novo intervertebral discitis or vertebral osteomyelitis /discitis (VOD) who initiated non-surgical treatment. Patients who failed conservative treatment and required stabilization surgery within 90 days were defined as “ failed treatment group” (FTG). Patients who experienced an uneventful course served as controls and were labeled as “ nonsurgical group” (NSG). A wide array of baseline clinical and radiographic parameters was retrieved and compared between 2 groups. Results: Overall 35 patients had initiated non-surgical treatment for VOD. 25 patients had an uneventful course (NSG), while 10 patients failed conservative treatment (“FTG”) within 90 days. Factors found to be associated with poorer outcome were intra-venous drug abuse (IVDA) as well as the presence of fever upon initial presentation. Radiographically, involvement of the same-level facets and the extent of caudal and rostral VB involvement in both MRI and CT were found to be significantly associated with poorer clinical and radiographic outcome. Conclusions: We show that clinical factors such as IVDA status and fever as well as the extent of osseous and posterior element involvement may prove to be helpful in favoring surgical treatment early on in the management of spinal infections.

scholarly journals DOUBLE FEMORAL OSTEOTOMY FOR THE TREATMENT OF SEVERE SEQUELAE OF THE IMMATURE HIP

2020 ◽  
Vol 28 (6) ◽  
pp. 287-290
Author(s):  
MARIANA DEMÉTRIO DE SOUSA PONTES ◽  
PAULO HENRIQUE BORTOLIN ◽  
JOSÉ BATISTA VOLPON
Keyword(s):  
Lower Limb ◽  
Therapeutic Option ◽  
Slipped Capital Femoral Epiphysis ◽  
Case Series ◽  
Gluteus Medius ◽  
Developmental Dysplasia ◽  
Femoral Osteotomy ◽  
Treatment Level ◽  
Level Of Evidence ◽  
Pelvic Support

ABSTRACT Objective: To evaluate the results of double femoral osteotomy for the treatment of severe sequelae of the hip. Methods: Immature patients with anatomical loss of the hip were treated with pelvic support osteotomy in the distal femur to correct lower limb shortening, they were evaluated clinically and radiographically. Results: Eleven cases (eleven hips) were assessed with verage follow-up of three years. The mean age of the patients was 14.7 years. Seven patients had sequela of infectious arthritis; three had sequela of developmental dysplasia of the hip and one patient had a sequela of slipped capital femoral epiphysis. Preoperatively, the gluteus medius was insufficient in all patients, and it became negative in ten of them. The average of lower limb shortening was 5 cm (2.5 to 7 cm) and reduced shortening was 1.9 cm (0 to 4 cm). According to Paley Classification, 72.7% of complications were considered problems, 90.9% were considered obstacles and 27.2% complications, among which the limitation of the knee flexion was the most frequent. Conclusion: The technique yielded good results, considering the severity of the sequela and the absence of a better therapeutic option. No important sequela was associated with the treatment. Level of Evidence IV, Case series.

scholarly journals COMPLICATIONS AND MIDTERM OUTCOMES OF HEMIARTHROPLASTY IN HEMODIALYSIS PATIENTS

2017 ◽  
Vol 25 (5) ◽  
pp. 220-223 ◽  
Author(s):  
AHMET SALDUZ ◽  
GÖKHAN POLAT ◽  
TURGUT AKGÜL ◽  
OMER NACI ERGIN ◽  
KORAY ŞAHIN ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Case Series ◽  
Functional Results ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Bleeding Complications ◽  
Harris Hip Score ◽  
Treatment Level ◽  
Complication Rates ◽  
Level Of Evidence

ABSTRACT Objective: The aim of this study was to evaluate the functional results, complications, and morbidity and mortality rates in patients with end-stage chronic renal failure (ESCRF) with collum femoris fractures who were treated with hemiarthroplasty. Methods: From 2005 to 2013, patients with ESCRF admitted to our hospital with collum femoris fracture and treated with hemiarthroplasty were retrospectively evaluated, and 44 hips in 42 patients were included in the study. Duration of hospital stay, bleeding, complications, morbidity and mortality were recorded for each patient. At the last control evaluation, patients were assessed via pelvis x-ray and functional status according to Harris Hip Score (HHS). Results: Patients required a mean 2.7 units of erythrocyte suspension. Mean hospital stay was 19.74 days. The most common complication was bleeding. The complication rate was 38.1%; mortality rate at first-year follow-up was 42.8%, and mean HHS was 74.5. Conclusion: Collum femoris fractures are more common in ESCRF patients due to metabolic bone disease, and these patients had many comorbidities which may exacerbate high complication and mortality rates. Orthopedic surgeons should consider these higher complication rates and inform patients about the consequences of this treatment. Level of Evidence IV, Case Series.

scholarly journals MID-LONG TERM RESULTS OF MANIPULATION AND ARTHROSCOPIC RELEASE IN FROZEN SHOULDER

2017 ◽  
Vol 25 (6) ◽  
pp. 270-274 ◽  
Author(s):  
HALUK CELIK ◽  
MUSTAFA FAIK SECKIN ◽  
MEHMET AKIF AKCAL ◽  
ADNAN KARA ◽  
BEKIR ERAY KILINC ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Case Series ◽  
Long Term Results ◽  
Treatment Level ◽  
Capsular Release ◽  
Arthroscopic Release ◽  
Arthroscopic Capsular Release

ABSTRACT Objective: Surgical treatment options should be discussed in cases of frozen shoulder, which is usually treated in a conservative manner. In this study, we evaluated the efficacy of manipulation and arthroscopic release in cases of frozen shoulder which resisted conservative treatment. Methods: A total of 32 patients who underwent manipulation and arthroscopic capsular release in 34 shoulders were included in the study. The average follow-up period was 49.5 months (range: 24-90 months). No reason for onset could be found in 8 (25%) patients, who were classified as primary frozen shoulder; twenty-four (75%) patients were classified as secondary frozen shoulder due to underlying pathologies. The average pre-operative complaint period was 11 months (range: 3-24 months). After arthroscopic examination, manipulation was performed first, followed by arthroscopic capsular release. The range of motion in both shoulders was compared before the procedure and in the last follow-up visit. Constant and Oxford classifications were used to assess functional results, and the results were assessed statistically. Results: Patient values for passive elevation, abduction, adduction-external rotation, abduction-external rotation, and abduction-internal rotation increased in a statistically significant manner between the preoperative assessment and follow-up evaluation (p<0.01). The average change of 47.97±21.03 units observed in the patients’ values obtained in the control measurements against the pre-op Constant scores was determined to be statistically significant (p<0.01). According to the Oxford classification, 29 shoulders were sufficient. Conclusion: Successful results can be obtained with arthroscopic release performed after manipulation in patients with frozen shoulder resistant to conservative treatment. Level of Evidence IV, Case Series.

scholarly journals Outcomes of plantar fasciotomy to treat plantar fasciitis

2019 ◽  
Vol 13 (1) ◽  
pp. 42-48
Author(s):  
Rodrigo Guimarães Huyer ◽  
Cíntia Kelly Bittar ◽  
Carlos Daniel Candido de Castro Filho ◽  
Carlos Augusto Mattos ◽  
Mário Sérgio Paulillo De Cillo ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Treatment Level ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Patient Health ◽  
Plantar Fasciotomy

Objective: This study sought to evaluate the effectiveness of a surgery (plantar fasciotomy) to treat plantar fasciitis using the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire. Methods: Patients were retrospectively identified using their postoperative orthopedic (medical) records after receiving medial plantar fasciotomy for plantar fasciitis between 1997 and 2009. Results: A significant difference was observed between the pre- and postoperative AOFAS score; this result indicates that patient health improved after the fasciotomy to treat plantar fasciitis. Conclusions: A strength of this study was its long follow-up time of patients undergoing plantar fasciotomy to treat plantar fasciitis. This surgery is indicated for patients with chronic plantar fasciitis after 6 months without response to conservative treatment. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Endovascular treatment of unique colonic arteriovenous malformation with dual supply from superior and inferior mesenteric arteries

2021 ◽  
Vol 5 ◽  
pp. 7
Author(s):  
Lucas Richards ◽  
Aaron Rohr ◽  
Adam Alli ◽  
Steven Lemons
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Arteriovenous Malformations ◽  
Inferior Mesenteric Artery ◽  
Case Series ◽  
Mesenteric Arteries ◽  
Treatment Level ◽  
Level Of Evidence ◽  
Hepatic Venous Congestion ◽  
Endovascular Approach

Colonic arteriovenous malformations (AVMs) are well recognized in the literature and commonly manifest as colitis, abdominal pain, and rare cases have been reported of liver congestion. Dual-supply superior artery/ inferior mesenteric artery (SMA/IMA) colonic AVMs have never been reported and only one case of treating portal hypertension due to an AVM with an endovascular approach has been reported. We present a case of dual-supply SMA/IMA colonic AVM manifesting as hepatic venous congestion and demonstrate an endovascular approach to treatment. Level of evidence: Level 4, case series.

scholarly journals Conservative treatment of intra-articular calcaneal fracture

2019 ◽  
Vol 13 (3) ◽  
pp. 198-204
Author(s):  
Igor Freitas de Lucena ◽  
Marco Túlio Costa
Keyword(s):  
Conservative Treatment ◽  
Functional Outcomes ◽  
Bone Fractures ◽  
Outpatient Visit ◽  
Case Series ◽  
Calcaneal Fracture ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Declination Angle

Objective: To evaluate patients who received conservative treatment for a displaced intra-articular calcaneal fracture and to correlate the clinical-functional outcomes with the calcaneus shape measured using radiographs at the last outpatient visit. Methods: A retrospective study was performed with patients who suffered calcaneal bone fractures and were treated nonsurgically between 2006 and 2016. Radiographic (Böhler’s and Gissane’s angles, calcaneal width, talar declination angle, and calcaneal pitch) and clinical-functional parameters (American Orthopedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) pain scores and personal satisfaction) were evaluated. Results: We found no relationship between the measured angles and the clinical-functional outcomes. Conclusion: Despite the small number of cases evaluated in this study, the clinical-functional ankle and hindfoot AOFAS scale score was considered satisfactory in most cases. We found no relationship between the calcaneus shape measured using radiographic parameters and the clinical-functional outcome. Level of Evidence IV; Therapeutic Studies; Case Series

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