scholarly journals Functional Outcomes of Perilunate Dislocation Injuries Treated With Deep Friction Massage: One Year Follow-Up

2019 ◽  
Vol 4 (12) ◽  
Author(s):  
Anna Pantouvaki̽ ◽  
George Velivasakis ◽  
Grigorios Kastanis
Keyword(s):  
Functional Outcomes ◽  
Chronic Pain Management ◽  
Severe Injuries ◽  
Good Tolerance ◽  
Perilunate Dislocation ◽  
Rehabilitation Programs ◽  
Therapeutic Value ◽  
Therapeutic Protocols ◽  
One Year

Perilunate injuries are the most complex severe injuries occurring in the wrist and there is a lack of suggested therapeutic protocols in literature, concerning rehabilitation programs. Although Deep friction massage is a widely known technique in the field of tendinopathies, ligamentous injuries and chronic pain management, its therapeutic value has not yet been documented in treatment of wrist lesions. The purpose of this study is to suggest that the technique should be considered as a good therapeutic method with good tolerance in patients and good functional outcomes and should be included in management of perilunate injuries.

657 ROUTINE ESOPHAGRAMS FOLLOWING HIATUS HERNIA REPAIR MINIMISES REOPERATIVE MORBIDITY: A MULTICENTER COMPARATIVE COHORT STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
David Liu ◽  
Melissa Wee ◽  
James Grantham ◽  
Bee Ong ◽  
Stephanie Ng ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Functional Outcomes ◽  
Gastric Resection ◽  
Postoperative Morbidity ◽  
Early Complications ◽  
Esophageal Obstruction ◽  
Comparative Cohort Study ◽  
One Year

Abstract   Hiatus hernia repairs are common. Early complications such as re-herniation, esophageal obstruction and perforation, although infrequent, incur significant morbidity. Here, we determine whether routine postoperative esophagrams following hiatus hernia repair may expedite the surgical management of these complications, reduce reoperative morbidity, and improve functional outcomes. Methods Analysis of a prospectively-maintained database of 1829 hiatus hernia repairs undertaken in 14 hospitals from 1 January 2000 to 30 September 2020. 1571 (85.9%) patients underwent a postoperative esophagram which was reviewed. An early (<14 days) reoperation was performed in 44 (2.4%) patients. Results Compared to those without an esophagram, patients who received one prior to reoperation (n = 37) had a shorter time to diagnosis (2.4 vs. 3.9 days, p = 0.041) and treatment (2.4 vs. 4.3 days, p = 0.037) of their complications. This was associated with decreased open surgery (10.8% vs. 42.9%, p = 0.034), gastric resection (0.0% vs. 28.6%, p = 0.022), postoperative morbidity (13.5% vs. 85.7%, p < 0.001), ICU admission (16.2% vs. 85.7%, p < 0.001), and length-of-stay (7.3 vs. 18.3 days, p = 0.009). Furthermore, patients who underwent early reoperations for asymptomatic re-herniation had less complications and superior functional outcomes at one-year follow-up than those who needed surgery for symptomatic recurrences later on. Conclusion Postoperative esophagrams decreases the morbidity associated with early and late reoperations following hiatus hernia repair, and should be considered for routine use.

scholarly journals Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers

2020 ◽  
Author(s):  
Yi-Hsun Yu ◽  
Ying-Chao Chou ◽  
Yung-Heng Hsu ◽  
I-Jung Chen ◽  
Lien-Chung Wei
Keyword(s):  
Functional Outcomes ◽  
Injury Severity ◽  
Adjustment Disorder ◽  
Acetabular Fractures ◽  
Clinical Parameters ◽  
Severe Injuries ◽  
Severity Scores ◽  
Surgical Treatments ◽  
Major Diagnosis

Abstract Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.

scholarly journals Superior Capsular Reconstruction Patients Have High Rates of Return to Sports and Similar Functional Outcomes Compared to a Reverse Shoulder Arthroplasty Matched Cohort

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0027
Author(s):  
Brandon C. Cabarcas ◽  
Grant Hoerig Garcia ◽  
Joseph Liu ◽  
Gregory Louis Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Return To Work ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Postoperative Outcome ◽  
Rotator Cuff Tears ◽  
Return To Sports ◽  
Superior Capsular Reconstruction ◽  
One Year

Objectives: Superior capsular reconstruction (SCR) is a relatively new procedure to address irreparable rotator cuff tears and rotator cuff arthropathy. Biomechanical studies have produced favorable results on cadaveric models, but few studies have evaluated clinical outcomes, and none have addressed return to sport (RTS). The purpose of this study was to evaluate rates of RTS and functional outcomes after SCR compared to a reverse total shoulder arthroplasty (rTSA) matched cohort. Methods: A prospectively collected registry was queried retrospectively for consecutive patients who underwent SCR from 2015 to 2016. Inclusion criteria were ≥2 tendon irreparable rotator cuff tear by arthroscopic evaluation and minimum one-year follow up. All eligible SCR patients were matched by gender, age, handedness, and follow up time to patients that underwent rTSA with a similar preoperative diagnosis. All surgeries were performed by a single surgeon at one institution with consistent operative techniques. Patients were evaluated with the ASES questionnaire, VAS Pain Scale, as well as VR/SF-12 and VR6D. Patients were also administered a detailed outcomes survey regarding surgical history and return to sport and work activities. Results: Overall 75.0% of 32 eligible patients were available at follow up. Average age at surgery and follow up did not significantly differ between cohorts (p>0.500 both). Postoperative outcome scores for ASES, VAS, VR/SF-12, and VR6D did not differ (p>0.310 for all) between cohorts. Overall RTS rate was 77.8% for SCR and 87.5% for rTSA (p > 0.610). Average months to return to sports was significantly greater after SCR (7.3 ± 3.0) compared to rTSA (3.5 ± 2.2; p = 0.032). Patients in both cohorts participated in golf, weight-lifting, gym activity, basketball and cycling postoperatively. Direct RTS for these sports are displayed in Fig. 1. Return to work rate was 71.4% (10/14) SCR and 50.0% (4/8) rTSA (p = 0.326) at average 2.7 ± 2.8 and 1.9 ± 1.9 months, respectively (p = 0.591). Stratified by duty status, rates of return to work were sedentary (100% both SCR and rTSA), light (100% both SCR and rTSA), moderate (0% SCR and 66.67% rTSA), and heavy (0% both SCR and rTSA). Overall, 85.71% SCR patients and 90.0% rTSA patients were satisfied or very satisfied with their general postoperative outcome. Conclusion: At short-term follow-up, SCR patients had RTS rates comparable to rTSA patients with irreparable rotator cuff tears. However, time to RTS was more prolonged after SCR. Outcome scores did not significantly differ between the two cohorts, suggesting that SCR may achieve postoperative function and pain reduction similar to rTSA at one year. Return to work was also similar, although rates were not as high as return to sport. When stratified by duty status, return to more intense physical work demands was not consistent in either cohort. Despite this, over 85% of SCR and rTSA patients were satisfied postoperatively. The findings of this study demonstrate that SCR patients have high RTS levels, as well as similar functional outcomes and satisfaction compared to rTSA for irreparable rotator cuff tears. Clinicians can utilize this information for preoperative counseling, particularly with younger more athletic patients, considering SCR or rTSA for an irreparable rotator cuff tear.

Changes in Voice- and Swallowing-Related Symptoms After Thyroidectomy: One-Year Follow-Up Study

2018 ◽  
Vol 127 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Young Min Park ◽  
Kyung Ho Oh ◽  
Jae-Gu Cho ◽  
Seung-Kuk Baek ◽  
Soon-Young Kwon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Relief ◽  
Temporal Changes ◽  
Rehabilitation Programs ◽  
Significant Difference ◽  
One Year ◽  
Associated Risk Factors ◽  
Changes Over Time ◽  
Over Time

Objective: We analyzed the changes in voice- and swallowing-related symptoms that occurred over time in patients who underwent thyroidectomy and identified any associated risk factors. Methods: One hundred and three patients who underwent thyroidectomy were enrolled. Results: The mean thyroidectomy voice-related questionnaire (TVQ) score before surgery was 12.41 ± 12.19; it significantly increased to 28.24 ± 18.01 ( P < .001) 1 month postoperatively, decreased to 24.02 ± 17.30 ( P = .014) and 20.66 ± 15.29 ( P = .023) 3 and 6 months postoperatively, respectively. It was continuously decreased to 18.83 ± 14.63 twelve months postoperatively. The temporal changes in TVQ scores between patients who underwent total thyroidectomy or lobectomy were significantly different. There was a statistically significant difference in the temporal changes in TVQ according to whether neck dissection was performed. The temporal changes in TVQ in patients with and without extrathyroidal extension were significantly different. Conclusions: Voice- and swallowing-related discomfort in patients who received thyroidectomy showed dynamic changes over time. There was a significant difference in the degree of change according to clinicopathological factors. Patients with these risk factors may benefit from appropriate patient education and various rehabilitation programs for symptom relief.

Can Addition of GM-CSF in Adult Haplo-Identical Transplant Who Cannot Benefit from NK Alloreactivity Improve the Relapse Rate of Advanced Leukemia: A 3 Step Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4975-4975
Author(s):  
Philippe Lewalle ◽  
Alain Delforge ◽  
Berengere Nowak ◽  
Virginie Misplon ◽  
Laurence Lagneaux ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Good Tolerance ◽  
Gm Csf ◽  
Poor Risk ◽  
Advanced Stages ◽  
One Year ◽  
Time To Relapse ◽  
The Impact ◽  
Related Mortality

Abstract Haplo-identical transplant is now established as a procedure of choice for patients who lack a compatible donor. It might even be the best choice for AML, provided there is a GvH NK alloreactivity. However, patients are still referred too late, heavily pre-treated, at very advanced stages. We initiated a three-step phase I study trying improve transplant related mortality, relapse rate and immunity: (1): G-CSF + DLI, (2): GM-CSF + DLI, (3): patient and disease adapted strategy. Thirty-four consecutive leukemia patients, aged 18–55, were investigated (20 very poor risk, 11 poor risk and 3 better risk). GvH type NK alloreactivity was chosen when possible (19/34) and balanced across the 3 groups. In the first 9 patients, G-CSF was used pot-transplant and prophylactic DLI were given at month 1, 2 and 3. The use of G-CSF and 1 to 3 DLI (104 CD3/kg) was found safe. It resulted in faster CD4 recovery and a low rate of infections. However, it was insufficient to induce a protective GVL effect. In the next 12 patients, GM-CSF was used plus 1 DLI (104 CD3/kg) at day 30 unless aGVHD (3 pts). The comparison between the 2 first groups can be summarized as follows: G-CSF + DLI: TRM at day 100: 0, RR: 6/9, severe aGVHD:0. GM-CSF + 1 DLI group: RR: 1/12, TRM at day 100: 3, aGVHD grade 2 or more: 9/12; price to pay: GVHD resulting in 5 deaths in total. Median time to relapse in the 21 first patients was 6 months (range 4 to 9). Step 3 (14 patients) consists of a patient adapted strategy: no more aspecific DLI (selected anti-CMV and aspergillus DLI planned in all patients); in myeloid disorders with NK alloreactivity: no GF. In the other cases, GM-CSF (at a reduced total dose of 500 mcg) is given from day 5 to day 9. The follow-up of these 14 patients, although promising (2 relapses), is currently short (median 5 months), compared to the median of relapse in the 2 first groups (6 months) but will be updated for the meeting (10 months and 17 patients). Overall, TRM at day 100 is 3/29, reflecting the good tolerance of the conditioning in a heavily pre-treated population (median age : 43). Overall NR-mortality at one year is 8/26, but was greater in the GM-CSF + DLI group, reflecting the impact of severe aGVHD. In the current group, its is 2/14 at 3 months. We conclude that the third strategy might improve the outcome and the relapse rate without exposing patients to unnecessary severe GVHD.

scholarly journals Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

2019 ◽  
Vol 08 (06) ◽  
pp. 508-512
Author(s):  
Hui-Kuang Huang ◽  
Tung-Yeh Tsai ◽  
Jung-Pan Wang
Keyword(s):  
Functional Outcomes ◽  
Screw Fixation ◽  
Case Series ◽  
Compression Screw ◽  
Perilunate Dislocation ◽  
Motorcycle Accident ◽  
Lunotriquetral Ligament ◽  
The Stability ◽  
Radiographic Result

Abstract Background Reverse perilunate injuries are rare. Contrary to perilunate injuries, the violent force would start from the lunotriquetral ligament, go reversely toward the radial side, and cause the reverse or ulnar-sided perilunate dislocation. Case Description We describe a 31-year-old man with a reverse perilunate dislocation, who presented to our institution 3 weeks after a motorcycle accident. The patient was successfully treated with the reduction and association of the lunate and triquetrum (RALT) procedure by using closed maneuver and percutaneous headless compression screw fixation. The patient can obtain a good radiographic result and satisfactory function at the 30-month follow-up. Literature Review Many case series were reported concerning the perilunate injuries. However, few cases of reverse perilunate dislocation have been reported in the literature. No cases of reverse perilunate dislocation treated 3 weeks after the injury with the RALT procedure have been reported. Clinical Relevance In this case, we found that the dislocation could still be reduced with the closed maneuver. With the RALT procedure, the carpal alignment can be maintained and the stability can be regained. Also, the functional outcomes are good.

scholarly journals Basic self-disturbance in subjects at clinical high risk for psychosis: relationship with clinical and functional outcomes at one year follow-up

2021 ◽  
pp. 113942
Author(s):  
Tor Gunnar Værnes ◽  
Jan Ivar Røssberg ◽  
Ingrid Melle ◽  
Barnaby Nelson ◽  
Kristin Lie Romm ◽  
...  
Keyword(s):  
High Risk ◽  
Functional Outcomes ◽  
Clinical High Risk ◽  
One Year

scholarly journals Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers

2020 ◽  
Author(s):  
Yi-Hsun Yu ◽  
Ying-Chao Chou ◽  
Yung-Heng Hsu ◽  
I-Jung Chen ◽  
Lien-Chung Wei
Keyword(s):  
Functional Outcomes ◽  
Injury Severity ◽  
Adjustment Disorder ◽  
Acetabular Fractures ◽  
Clinical Parameters ◽  
Severe Injuries ◽  
Severity Scores ◽  
Surgical Treatments ◽  
Major Diagnosis

Abstract Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.

scholarly journals MORTALITY AND FUNCTION AFTER SURGICALLY-TREATED HIP FRACTURE IN ADULTS YOUNGER THAN AGE 60

2017 ◽  
Vol 25 (4) ◽  
pp. 129-131 ◽  
Author(s):  
Babak Pourabbas ◽  
Mohammad Jafar Emami ◽  
Amir Reza Vosoughi ◽  
Hamideh Mahdaviazad ◽  
Zeinab Kargarshouroki
Keyword(s):  
Young Adults ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Functional Outcomes ◽  
Pain Severity ◽  
Walking Aids ◽  
One Year ◽  
The One

ABSTRACT Objective: Hip fractures in young adults can cause poor functional capacity throughout life because of several complications. The purpose of this study was to prospectively evaluate 1-year mortality and functional outcomes for patients aged 60 years or younger with hip fracture . Methods: We prospectively obtained data for all consecutive patients aged 60 or younger with any type of hip fracture who were treated operatively between 2008 and 2014. After one year, patient outcomes were evaluated according to changes in pain severity, functional status (modified Barthel index), and mortality rate . Results: Of the total of 201 patients, 132 (65.7%) were men (mean age: 41.8 years) and 69 (34.3%) were women (mean age: 50.2 years) (p<0.001). Reduced pain severity was reported in 91.5% of the patients. The mean modified Barthel index was 22.3 in men and 18.6 in women (p<0.001). At the one-year follow-up, 39 cases (19.4%) were dependent on walking aids while only 17 patients (8.5%) used walking aids preoperatively (p<0.001). Seven patients (4 men and 3 women) died during the one-year follow-up period; 2 died in the hospital after surgery . Conclusion: Hip fractures in young adults have a low mortality rate, reduction in pain severity, and acceptable functional outcomes one year after surgery. Level of Evidence II, Prospective Comparative Study.

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