scholarly journals First experience of arthroscopic treatment of patients with false joint of the middle third scaphoid bone of the hand

2019 ◽  
Vol 26 (3) ◽  
pp. 14-20
Author(s):  
I. O Golubev ◽  
I. A Kutepov ◽  
G. G Baliura ◽  
M. V Merkulov ◽  
O. M Bushuev ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Bone Fractures ◽  
Wrist Joint ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Scaphoid Bone ◽  
Non Union ◽  
Active Flexion

Introduction. Fractures of the scaphoid bone are the most frequent - among wrist bone fractures and in 10-15% of cases they end with the development of a false joint. The pain is a restriction of movements in the wrist joint, a decrease in the strength of the hand, significantly limiting the working capacity of patients, as a rule, of young and middle age. In recent years, arthroscopic techniques have been widely used to treat non-union scaphoid in the middle third of the rook. Experience in the treatment of false joints of the scaphoid with the use of arthroscopic techniques in the N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics is presented in this review. Aim of Study: studying the effectiveness of arthroscopy during the healing of the non-union of the scaphoid bone. Material and methods. In the department of microsurgery and hand injuries. N.N. Priorova Ministry of Health of the Russian Federation from 2015 to 2018. 28 patients were treated with non-union scaphoid bone localized in the middle third of the bone’s body. The clinical examination included: measurement of movements in the wrist joint, the strength of the fist grasp; assessment of pain syndrome on a visual analogue scale (VAS), data from the DASH questionnaire; X-ray of the carpal joint in three projections (straight, lateral, ¾), computed tomography. Results. Consolidation of the non-union scaphoid was achieved in 24 (86%) patients within 8 weeks after surgery. Consolidation did not occur in 4 (14%) patients. Long-term results 6 months after surgery were followed up in 15 patients. The range of motion in the wrist joint was an extension of 68° (from 45° to 90°), the volume of active flexion of the hand, respectively, 66° (from 55° to 90°). Pain syndrome on a visual analogue scale (VAS) 1.5 points (from 1 to 3 points). Fist grasp strength 6 months after surgery was 41 kg (from 25 to 57 kg). DASH scale after surgery 10.5 points (from 5.5 to 16.3 points). Conclusion. Arthroscopic resection of the pseudarthrosis of the middle third of the bone with the plastic of the crushed spongy bone autograft from the ileal wing allows for consolidation of the scaphoid bone within 8 weeks. The first experience testifies to the effectiveness of this method and the need for further research in this direction, the analysis of long-term results.

scholarly journals Olfaction after endoscopic sinus surgery: long-term results

2012 ◽  
Vol 50 (2) ◽  
pp. 178-184
Author(s):  
H.R. Briner ◽  
N. Jones ◽  
D. Simmen
Keyword(s):  
Visual Analogue Scale ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Analogue Scale ◽  
Quantitative Measurement ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Long Term Results ◽  
Interventional Study

Loss of olfactory function is one of the main symptoms in patients with chronic rhinosinusitis. This prospective, non-randomized interventional study reports five years results of olfaction of patients with chronic rhinosinusitis who underwent endoscopic sinus surgery in conjunction with topical medical treatment. Forty-five patients with chronic rhinosinusitis who underwent endoscopic sinus surgery were evaluated preoperatively, after three months and 34 (76%) of them after five years. Olfactory function was assessed by a subjective visual analogue scale, by a screening test of olfaction with Smell Diskettes and by measuring the N-Butanol threshold. Patient`s subjective sense of olfaction using a visual analogue scale was improved in 79% at 5 years. Objective measurements by Smell Diskettes improved in 53% at 5 years whilst the quantitative measurement by the N-Butanol threshold improved in 85% at 5 years. The high percentage of patients with improvement of olfaction five years after surgery indicates that endoscopic sinus surgery in conjunction with continued topical treatment leads to a long term improvement of the sense of smell. However, it was found that - measured by the sensitive N-Butanol threshold - up to 9% had no improvement and 6% had deterioration in their olfaction at 5 years after endoscopic sinus surgery. This fact has to be considered in the preoperative counselling of patients.

scholarly journals Transdermal electroneurostimulation in patients with diabetic neuropathy

2021 ◽  
Vol 20 (2) ◽  
pp. 119-124
Author(s):  
Mustafa Kh. Al-Zamil ◽  
Natalia G. Kulikova
Keyword(s):  
Neuropathic Pain ◽  
Drug Therapy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Pain Syndrome ◽  
Diabetic Polyneuropathy ◽  
Control Group ◽  
Diabetic Neuropathic Pain ◽  
Neuropathic Pain Syndrome

BACKGROUND: The dynamics of pain syndrome determined using various algic tests in the treatment of patients with diabetic neuropathic pain syndrome using tansdermal electroneurostimulation has been little studied. AIMS: To study the dynamics of projection zones of neuropathic pain syndrome in patients with diabetic polyneuropathy while using TENS. MATERIAL AND METHODS: 75 patients with diabetic polyneuropathy were examined. The control group (n=25; 33.3%) received a course of standard pharmacotherapy. The main group consisted of 2 groups. The first group (n=25; 33.3%) underwent a course of high-frequency low-amplitude (HL TENS) transdermal electroneurostimulation, and the second group (n=25; 33.3%) underwent a course of low-frequency high-amplitude (LH TENS) therapy. Pain syndrome was determined using a visual analogue scale (VAS) and a body diagram before, after treatment and in the long-term period. RESULTS: Using a visual analogue scale (VAS), the dynamics of pain syndrome after the use of LF TENS was lower than after the use of HFTENS by an average of 35% (p 0.05). The data obtained indicate that the regression of pain syndrome after physiotherapeutic treatment of TENS in patients from the main comparison groups exceeds similar indicators in patients from the control group by an average of 63% (p 0.05) both immediately after the course of exposure and in the distant the observation period by 23%. Against the background of TENS, the area of pain syndrome according to the body pattern significantly decreased by 53% after treatment (p 0.05) and by 65.6% in the long-term period (p 0.05), compared with a decrease in the area of pain syndrome in the control group. CONCLUSION: There were revealed significant differences between the quantitative and projection forms of pain measurement. The use of TENS enhances the analgesic effect of drug therapy in the treatment of diabetic neuropathic pain syndrome by 1.37 times while maintaining this effect without negative dynamics for 2 months after the end of the course of non-drug therapy. The developed technique for assessing pain syndrome using a body diagram in combination with a visual analogue scale (VAS) in patients with diabetic polyneuropathy provides a more reliable assessment of pain syndrome.

scholarly journals Long-term Prednisolone in Post-stroke Complex Regional Pain Syndrome

2016 ◽  
Vol 8;19 (8;11) ◽  
pp. 565-574
Author(s):  
Jayantee Kalita
Keyword(s):  
Visual Analogue Scale ◽  
Complex Regional Pain Syndrome ◽  
Analogue Scale ◽  
Low Dose ◽  
Pain Syndrome ◽  
High Dose ◽  
Post Stroke ◽  
Group I ◽  
Group Ii

Background: There is no study on the long-term use of prednisolone in post-stroke complex regional pain syndrome-1 (CRPS1). Objective: To evaluate the efficacy and safety of long-term low dose prednisolone in post-stroke CRPS-I. Study Design: Open-labeled randomized controlled trial. Setting: Tertiary care teaching institute. Methods: Seventy-seven out of 396 (19.4%) patients with stroke had CRPS-1 and 58 met the inclusion criteria. Their clinical details and CRPS, Visual Analogue Scale (VAS), modified Rankin Scale (mRS), and Barthel Index (BI) scores were noted. The patients were prescribed 40 mg prednisolone for 2 weeks followed by tapering in the next 2 weeks. Patients who responded were randomly assigned prednisolone 10 mg daily (group I) or no prednisolone (group II). They were followed up for the first and second month of randomization and their CRPS, VAS, mRS, and BI scores were noted. The primary outcome was improvement in CRPS score and secondary outcomes were VAS, mRS, BI scores, and severe adverse events (SAE). Results: Fifty-six of fifty-eight (96.5%) patients responded to the initial high dose prednisolone and 26 each were assigned group I and group II treatment. Group I patients had further improvement in CRPS score. Fifty percent of patients in group II had deterioration at one month and needed reinstitution of prednisolone; following which 77% of them improved in the next month. The improvement in CRPS score paralleled the VAS score but not mRS and BI scores in the first and second months in group I compared to group II. There was no SAE necessitating withdrawal of prednisolone. Limitation: The design of the study is not double blind. Conclusion: In post-stroke CRPS-I, continuation of low dose prednisolone for 2 months is safe and effective. Key words: Shoulder hand syndrome, CRPS, corticosteroid, prednisolone, stroke, Visual Analogue Scale

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

SCAPHOID BONE BRUISING – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NON-UNION OF THE SCAPHOID

2007 ◽  
Vol 32 (3) ◽  
pp. 337-340 ◽  
Author(s):  
N. LA HEI ◽  
I. MCFADYEN ◽  
M. BROCK ◽  
J. FIELD
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Classification System ◽  
Complete Resolution ◽  
Scaphoid Bone ◽  
Bone Bruise ◽  
Radiological Findings ◽  
Non Union ◽  
Bone Bruising

The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a ‘bone bruise’. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a scaphoid bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.

scholarly journals Comparative analysis of different methods of anesthesia in patients with acute pancreatitis using pain scales

2016 ◽  
Vol 97 (2) ◽  
pp. 217-221
Author(s):  
V N Shilenok ◽  
E V Nikitina
Keyword(s):  
Acute Pancreatitis ◽  
Comparative Analysis ◽  
Visual Analogue Scale ◽  
Pain Intensity ◽  
Epidural Anesthesia ◽  
Analogue Scale ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.

Long-Term Results after Silicone Prosthesis Replacement of the Proximal Pole of the Scaphoid Bone in Advanced Scaphoid Nonunion

2002 ◽  
Vol 27 (5) ◽  
pp. 417-423 ◽  
Author(s):  
P. HAUSSMANN
Keyword(s):  
Scaphoid Fracture ◽  
Long Term Results ◽  
Partial Replacement ◽  
Scaphoid Bone ◽  
Proximal Fragment ◽  
Carpal Collapse ◽  
X Ray ◽  
Silicone Prosthesis ◽  
Prosthesis Replacement

The treatment of scaphoid fracture nonunion with a small proximal fragment with disturbed circulation and radioscaphoid arthrosis is difficult, and the result is often unsatisfactory. For this reason, in 1981 the replacement of the proximal fragment by a silicone lunate prosthesis was recommended for such cases. From 1980 to 1984, 11 patients (all male, average age 42 [range, 25–59] years) with the conditions described above were treated by silicone prosthesis partial replacement of the scaphoid. In one patient, the prosthesis had to be removed due to dislocation, and in another patient an arthrodesis of the wrist had to be carried out after 5 years due to increasing pain. All nine remaining patients were followed up after an average of 14 (range, 12–16) years, and were clinically and radiologically re-examined and assessed using the evaluation scheme proposed by Martini (1999) . The overall results were satisfactory. Specifically, the outcome was good in one case, satisfactory in six cases, and poor in two cases. Concerning the individual criteria, the best scores were observed in “subjective overall assessment” and in “work and sports”, whilst the worst were found in “movement” and “X-ray”. For all patients, X-ray examination revealed both postoperative arthrosis and extensive multiple cystoid osteolysis, presumably due to silicone synovitis. Nevertheless, most patients were free of symptoms. None of the patients felt that further treatment was necessary. Silicone prosthesis partial replacement of the scaphoid leads to long-term reduction in pain and adequate hand function. However, it is not capable of preventing carpal collapse and carpal arthrosis. Furthermore, since in several cases a progressive silicone synovitis developed, the method was rightly abandone d after 1984.

Long-term results of treatment of closed bone fractures in children

1980 ◽  
Vol 61 (5) ◽  
pp. 57-58
Author(s):  
D. N. Shamsutdinov
Keyword(s):  
Bone Fractures ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Results Of Treatment ◽  
Fractures In Children ◽  
Closed Fractures

We studied the long-term outcomes of the treatment of closed fractures in the period from 1 to 10 years after the injury in IZ children (boys - 78, girls - 35; age: up to 3 years - 9, from 4 to 7 years - 26, from 8 to 14 years - 68 , from -15 to 16 years-10).

Sign in / Sign up

Export Citation Format

Share Document