Comparative analysis of functional outcome between operative and conservative treatment for closed, displaced, intra- articular fractures of the Calcaneum, a randomized study

One hundred and eleven intra-articular fractures of the distal radius in young adults that were conservatively treated were studied. At two years, 80% of fractures were rated as excellent or good by the modified Green and O'Brien scoring system. The rate of re-displacement within casts was 28%. Sixty five per cent of re-displaced fractures were treated with surgical fixation. Those re-displaced fractures treated with repeated manipulation had only 33% excellent or good result. Moreover, their initial alignment could not be preserved. Axial compression (>2 mm) and dorsal angulation (>15°) were directly related to worse functional outcome and diminished range of motion.

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Patient-Reported Outcome Following Operative and Conservative Treatment of Calcaneal Fractures: A Retrospective Analysis of 79 Patients at Short- to Midterm Follow-Up

Frontiers in Surgery ◽

10.3389/fsurg.2021.620964 ◽

2021 ◽

Vol 8 ◽

Author(s):

Patrick Pflüger ◽

Michael Zyskowski ◽

Frederik Greve ◽

Chlodwig Kirchhoff ◽

Peter Biberthaler ◽

...

Keyword(s):

Conservative Treatment ◽

Functional Outcome ◽

Retrospective Analysis ◽

Patient Reported Outcome ◽

Calcaneal Fractures ◽

Severe Injuries ◽

Patient Reported ◽

The Mean ◽

Operative And Conservative Treatment

Background: Fractures of the calcaneus are severe injuries of the hindfoot, mostly resulting from high-energy axial loads, which still present enormous challenges to modern trauma surgery. Possible variables influencing the outcome are the type of fracture, age, and quality of fracture reduction. These might also be factors affecting the self-reported patient outcome, but large studies are still lacking. Therefore, the aim of this study was to analyze the patient-reported outcome of calcaneal fractures following operative and conservative treatment.Methods: All patients suffering from calcaneal fractures between 2002 and 2015 were enrolled in this retrospective analysis. The calcaneal fractures were classified according to Sanders and the AO classification system. For further analysis, two groups were formed: group I involved complex intra-articular fractures defined by the involvement of the posterior calcaneal facet, while group II consisted of extra-articular and process calcaneal fractures. Data were collected via the patient registry, radiographs, and a standardized questionnaire (Foot and Ankle Outcome Score, FAOS). For outcome analysis, non-parametric Mann–Whitney U-test was performed, and Spearman's rank correlation coefficient was calculated.Results: In total, the functional outcome of 79 patients with calcaneal fractures was analyzed. In group 1 (n = 43), the mean FAOS score was 65.5 ± 18.9. The surgically treated patients with a Sanders type II calcaneal fracture had a mean FAOS score of 72.9 ± 17.2, type III fractures had 65.6 ± 20.8, and type IV had 61.1 ± 19 (p = 0.15). The reoperation rate was 22%, most frequently caused by wound complications (10%). The mean follow-up time was 64.5 ± 44 months. The mean FAOS score of group 2 (n = 36) was 75.2 ± 18.4, and 83% of the patients (=30) were managed conservatively. Only one out of six operatively managed patients had a reoperation due to regular implant removal. The mean follow-up time was 31 ± 25.9 months.Conclusion: Intra-articular calcaneal fractures are severe injuries of the hindfoot leading to a fair to poor functional outcome in the majority of the patients. Complications regarding wound healing are the most common causes for revisional surgery. Extra-articular calcaneal fractures are a heterogenous entity commonly managed non-operatively. Overall, they show a better functional outcome in comparison to intra-articular calcaneal fractures.

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EXPERIENCE OF CONSERVATIVE TREATMENT OF INTERVERTEBRAL DISC HERNIAS WITH CARIFLEX GEL AND CREAM IN AMBULATORY CONDITIONS

JOURNAL OF NEUROLOGY AND NEUROSURGICAL RESEARCH ◽

10.26739/2181-0982-2020-3-1 ◽

2020 ◽

Vol 3 (1) ◽

pp. 6-8

Author(s):

Zufar ADAMBAEV ◽

◽

Ibodulla KILICHEV ◽

Tuygunoy XODJANOVA

Keyword(s):

Comparative Analysis ◽

Conservative Treatment ◽

Intervertebral Disc ◽

Range Of Motion ◽

Comparative Evaluation ◽

Intervertebral Discs ◽

Neurological Manifestations ◽

Complex Therapy

A complex therapy of patients with degenerative-dystrophic diseases of the spine with herniated intervertebral discs with neurological manifestations was carried out with the addition of phonophoresis Kariflex gel followed by segmental massage with Kariflex cream. The comparative evaluation of the method was carried out in 89 patients. Comparative analysis revealed the reliable efficiency of the method used. Against the background of the proposed therapy, there was a significant decrease in pain and muscle-tonic syndromes, an increase in the range of motion in the spine

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Faculty Opinions recommendation of Surgical procedures in the DANTE trial, a randomized study of lung cancer early detection with spiral computed tomography: comparative analysis in the screening and control arm.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717989850.793473038 ◽

2013 ◽

Author(s):

David Midthun

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Comparative Analysis ◽

Early Detection ◽

Surgical Procedures ◽

Randomized Study ◽

Spiral Computed Tomography ◽

Spiral Computed ◽

Cancer Early Detection ◽

And Control

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Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?

International Orthopaedics ◽

10.1007/s00264-007-0355-4 ◽

2007 ◽

Vol 32 (4) ◽

pp. 505-509 ◽

Cited By ~ 20

Author(s):

Skand Kumar ◽

Subbaraju Penematsa ◽

Maziar Sadri ◽

Subodh C. Deshmukh

Keyword(s):

Functional Outcome ◽

Surrogate Markers ◽

Articular Fractures ◽

Radiological Results

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Abstract 3438: Intracranial Arterial Occlusion and Extent of Hypoattenuation on CT Angiography Source Images may Modify the Benefit of Thrombolysis

Stroke ◽

10.1161/str.43.suppl_1.a3438 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Imanuel Dzialowski ◽

Volker Puetz ◽

Jasmin Renger ◽

Andrei Khomenko ◽

Ulf Bodechtel ◽

...

Keyword(s):

Functional Outcome ◽

Ct Angiography ◽

Time Window ◽

Brain Infarction ◽

Randomized Study ◽

Arterial Occlusion ◽

Extended Time ◽

Anterior Circulation ◽

Nihss Score ◽

Mca Occlusion

Background: CT angiography source images (CTASI) improve diagnostic accuracy for ischemic brain infarction compared to non-contrast CT (NCCT). We studied whether CTASI alone or combined with the CTA occlusion status may improve patient selection for thrombolysis in an extended time window. Methods: We prospectively observed patients presenting with anterior circulation ischemic stroke within 12 hours from symptom onset and an NIHSS score ≥ 3. All patients underwent cranial NCCT and CTA. Patients were treated with intravenous and/or intra-arterial thrombolysis at the discretion of the treating stroke neurologist and neuroloradiologist. We determined intracranial occlusion status and applied the Alberta Stroke Program Early CT Score (ASPECTS) to CTASI. Primary clinical outcome measure was independent outcome at 3 months, defined as mRS scores 0-2. We calculated unadjusted risk ratios to assess the effect of thrombolysis on functional outcome in patients with: 1) minor ischemic changes on CTASI (CTASI-ASPECTS >5) and 2) patients with minor ischemic changes on CTASI and middle cerebral artery (MCA) occlusion. Results: We enrolled 102 patients with a mean age of 71 +/- 12 years, median onset-to-CTA time of 112,5 (range 37-898) min, a median NIHSS score of 9.5 (3-39), and a median CTASI-ASPECTS of 8. Sixty-two patients (61%) received any thrombolysis (56 IV, 5 IV/IA, 1 IA). MCA occlusion was present in 57 patients (56%), 80/101 (80%) assessable patients had a CTASI-ASPECTS >5 and 37/101 (37%) patients had a CTASI-ASPECTS >5 in the presence of a MCA occlusion. At 3 months, 52 (51%) patients had an independent functional outcome. When patients with CTA-SI ASPECTS > 5 received thrombolysis, 30/46 (65%) achieved an independent functional outcome, whereas 20/35 (57%) without thrombolysis were functionally independent (RR 1.1, CI 95 0.8-1.6). In patients with CTASI-ASPECTS > 5 and additional MCA-occlusion, 13/24 (54%) with thrombolysis and 3/13 (23%) without thrombolysis achieved an independent functional outcome (RR 2.3, CI 95 0.8-6.8). Conclusion: In our non-randomized study, the extent of CTASI hypoattenuation alone did not identify patients benefiting from thrombolysis. In the presence of an MCA-occlusion, however, CTASI might identify patients with benefit from thrombolysis in an extended time window.

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Comparative analysis of accommodative ability in children with hyperopia, anisometropia, amblyopia after femtolaser-assisted laser intrastromal keratomileusis

POINT OF VIEW EAST – WEST ◽

10.25276/2410-1257-2021-3-44-46 ◽

2021 ◽

pp. 44-46

Author(s):

I.L. Kulikova ◽

◽

K.A. Aleksandrova ◽

Keyword(s):

Comparative Analysis ◽

Treatment Group ◽

Conservative Treatment ◽

Key Words ◽

Treatment Results ◽

Accommodative Response

Purpose. Analysis of the accommodative ability in children with hyperopic anisometropia, amblyopia of operated amblyopic and paired leading eyes after femtolaser-assisted laser intrastromal keratomileusis (FS-LASIK). Material and methods. In the 1st group were 20 children with hyperopic anisometropia and amblyopia after FS-LASIK. In the 2nd were children receiving conservative treatment. Results. After 6 months, when analyzing the accommodation, the coefficient of the accommodative response (CAR) of amblyopic eye in the 1st group was 0.05±0.07 conv. units, in the 2nd group was -0.1±0.19 conv. units (рm-u=0.03). The microfluctuation coefficient (CMF) of the amblyopic eye was increased, but the CMF of the paired leading eye in children after FS-LASIK approached the norm and amounted to 58.4±5.4 µF / min. In the conservative treatment group CMF remained high and was 60.8±4.44 µF / min (рm-u= 0.08). The objective accommodative response of the amblyopic eye in the 1st group increased by -1.13±0.03 diopters, in the 2nd group – by -0.82±0.48 diopters (рm-u=0.05). Conclusion. FS-LASIK helps to improve the accommodative ability in children with hyperopia, anisometropia and amblyopia. Key words: accommodation, hyperopia, anisometropia, amblyopia, FS-LASIK.

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