scholarly journals Evaluation of the clinical-radiographic results of patients undergoing arthroscopic metatarsal-phalangeal arthrodesis of the hallux

2021 ◽  
Vol 15 (3) ◽  
pp. 223-228
Author(s):  
Rogério de Andrade Gomes ◽  
Bruno Jannotti Pádua ◽  
Anderson Humberto Gomes ◽  
João Murilo Brandão Magalhães ◽  
Wagner Vieira da Fonseca ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Case Series ◽  
Pain Scale ◽  
Hallux Rigidus ◽  
Functional Score ◽  
Visual Analogue Pain Scale ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Advanced Stages ◽  
Low Incidence

Introduction: Hallux rigidus (HR) is a frequent pathological condition of the foot, responsible for marked functional impairment. Metatarsal-phalangeal arthrodesis is an excellent treatment alternative for advanced stages of the disease, usually performed as an open surgery. Forefoot arthroscopy had its greatest development in the last decade, with a progressive expansion of indications, yielding encouraging results. Objective: To present the clinical and radiographic results of patients undergoing arthroscopic metatarsal-phalangeal arthrodesis of the hallux, depicting the technique and reporting complications. Methods: This study involves a series of cases, we operated 9 patients (10 feet), all with advanced HR (grades 3 and 4 - Coughlin-Shurnas). The patients underwent an arthroscopic procedure through two dorsal portals, small joints instruments. We assessed the results using the AOFAS functional score and the visual analogue pain scale. The radiographic parameters we used to analyze were the metatarsal-phalangeal angulation in the anteroposterior (pre- and postoperative) and lateral (post-operative) views, and we measured the radius shortening. Conclusion: Arthroscopic metatarsal-phalangeal arthrodesis is an excellent treatment option in advanced stages of hallux rigidus, with minimal disruption and providing excellent results, in addition to a low incidence of complications. Level of Evidence IV; Therapeutic Studies; Case Series

scholarly journals PROSPECTIVE EVALUATION OF PERIARTICULAR HYALURONIC ACID INFILTRATION FOR THE TREATMENT OF LATERAL EPICONDYLITIS

2020 ◽  
Vol 28 (3) ◽  
pp. 107-110
Author(s):  
GUILHERME AUGUSTO STIRMA ◽  
DEGINALDO HOLANDA CHAVES ◽  
SIMONE TORTATO ◽  
PAULO SANTORO BELANGERO ◽  
PAULO HENRIQUE SCHMIDT LARA ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Visual Analogue Pain Scale ◽  
Performance Score ◽  
Level Of Evidence ◽  
Mayo Elbow Performance Score ◽  
Visual Analogue Pain ◽  
Mayo Elbow Score

ABSTRACT Objective: To prospectively, clinically and functionally follow-up patients previously diagnosed with lateral epicondylitis after periarticular application of hyaluronic acid and analyze the results. Methods: All patients were previously treated conservatively and had no clinical improvement. Data such as age, positivity for specific tests (Cozen and Mill), visual analogue pain scale (VAS) before and during dorsiflexion of the wrist with resistance, diagnosis time, Mayo Elbow Performance Score was collected. Patients were reevaluated 30 and 90 days after application. Results: The positivity rates for Cozen and Mill tests were identical, starting at 100%, dropping to 50% after one month, and ending at 41.7% after 3 months. The initial Mayo Elbow Score average was 61.3 points; 85.8 in the first month, remaining at 85 in the third month. VAS in active force situations had the initial average of 8.1; after one month it dropped to 3.8, and 3.6 after three months. At rest, the initial average was 5.9; after one month it decreased to 3 and ended at 2.1 in three months. Conclusion: Patients showed improvement in pain parameters, in the Mayo Elbow Performance Score standard, but with 25% of failure in satisfaction. Level of evidence IV, Case series.

Percutaneous Bunionette Correction: Retrospective Case Series

2020 ◽  
pp. 193864002093750
Author(s):  
Gustavo Nunes ◽  
Tiago Baumfeld ◽  
Caio Nery ◽  
Daniel Baumfeld ◽  
Paulo Carvalho ◽  
...  
Keyword(s):  
Case Series ◽  
Distal Region ◽  
Pain Scale ◽  
Invasive Technique ◽  
Visual Analogue Pain Scale ◽  
Retrospective Case ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
American Orthopaedic

Introduction. Bunionette is a deformity of the fifth metatarsal in which there is a painful lateral bony prominence of the distal region of this bone caused by various anatomical and biomechanical changes. The aim of this study is to report on a minimally invasive technique without the use of hardware to treat these deformities. Methods. This is a case series of 18 patients, 25 feet, who underwent bunionette percutaneous surgical treatment. All patients answered the American Orthopaedic Foot and Ankle Society (AOFAS) scale and the visual analogue pain scale (VAS) preoperatively and at the last follow-up. Standard radiological evaluation included measurement of intermetatarsal (4-5 IMA) and fifth toe metatarsophalangeal (5-MTTP) angles. Time to radiographic consolidation, complications, and satisfaction rate were also documented. Results. The average follow-up was 15.9 months, the AOFAS increased from 49.6 to 92.4 and the VAS decreased from 7.7 to 1.2. It was observed that average 5-MTTP decreased from 15° to 2.7° and that 4-5-IMA decreased from 9.1° to 3.3°. These outcomes showed a statistically significant difference ( P < .001). The most common observed complication was the formation of a hypertrophic bone callus in the third postoperative month in three operated feet (12%). One patient had algodystrophy, which improved after conservative treatment. There were no cases of infection, neuropraxis, or recurrences. Fifteen patients rated the result as excellent, 2 as good, and 2 as regular. Conclusion. Percutaneous osteotomy of the fifth metatarsal without the use of hardware is a safe, reproducible technique and presents good clinical and radiographic results for the treatment of bunionette. Levels of Evidence: Therapeutic studies, Level IV: Case series

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

scholarly journals Incidence and management of inguinodynia after inguinal plasty

2020 ◽  
Vol 8 (10) ◽  
pp. 3432
Author(s):  
Juan J. Granados-Romero ◽  
Jesus C. Ceballos-Villalva ◽  
Israel García-Olivo ◽  
Cruz Escobar Jonathan E. ◽  
María J. Corona-Torres ◽  
...  
Keyword(s):  
Hospital Costs ◽  
Laparoscopic Approach ◽  
Systematic Investigation ◽  
Pain Scale ◽  
Diagnostic Methods ◽  
Visual Analogue Pain Scale ◽  
Open Approach ◽  
Cross Sectional ◽  
Visual Analogue Pain ◽  
Quality Life

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

scholarly journals Buccal Mucosal Grafts for Urethroplasty: Comparison of Postoperative Oral and Perineal Morbidity

2009 ◽  
Vol 91 (2) ◽  
pp. 116-117 ◽  
Author(s):  
Khalid Abdel-Galil ◽  
Ian Eardley ◽  
Richard Loukota
Keyword(s):  
Donor Site ◽  
Pain Scale ◽  
Perineal Pain ◽  
Visual Analogue Pain Scale ◽  
Urethral Reconstruction ◽  
Visual Analogue Pain ◽  
Buccal Mucosa Graft ◽  
Buccal Mucosal Graft ◽  
Graft Harvest ◽  
Scale Scores

INTRODUCTION A prospective study of postoperative oral and perineal pain experienced by a group of patients undergoing buccal mucosal graft harvest for urethral reconstruction. PATIENTS AND METHODS A consecutive group of 24 male patients undergoing buccal mucosa graft harvest for urethral recon8truction of stricture disease was prospectively studied between June 2006 and December 2008. All patients were examined pre-operatively and entered into the study prospectively. After surgery, all patients were reviewed at 24 h and 48 h. On both occasions, they were asked to complete a proforma containing visual analogue pain scales for both the oral donor site as well as the perineum. RESULTS A statistically significant higher level of pain was experienced from the perineum than the oral donor site on both the first and second postoperative days. CONCLUSIONS Comparative analysis of visual analogue pain scale scores between oral donor site and perineum showed that patients experience significantly more pain from the latter postoperatively.

Relationship of Plantar Fascia Thickness and Preoperative Pain, Function, and Quality of Life in Recalcitrant Plantar Fasciitis

2018 ◽  
Vol 39 (8) ◽  
pp. 930-934 ◽  
Author(s):  
Carlo Gamba ◽  
Aleix Sala-Pujals ◽  
Daniel Perez-Prieto ◽  
Jesus Ares-Vidal ◽  
Alberto Solano-Lopez ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Health Perception ◽  
Functional Score ◽  
Preoperative Pain ◽  
Level Of Evidence ◽  
Sf 36 ◽  
American Orthopaedic ◽  
Relationship Of

Background: The measurement of plantar fascia thickness has been advocated as a diagnostic and prognostic instrument in patients with plantar fasciitis, but there are no data relative to it in recalcitrant plantar fasciitis. The aim of the study is to evaluate the correlation between plantar fascia thickness and pain, functional score, and health perception in patients with this condition. Methods: Thirty-eight feet were studied with ultrasound and magnetic resonance imaging to measure plantar fascia thickness. The visual analogue scale (VAS), American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), and SF-36 were then recorded for each patient. The relationship between the fascia and these scores was analyzed to evaluate the correlation of thickness with pain, functional level, and health perception of patients. Results: In patients with recalcitrant plantar fasciitis, plantar fascia thickness did not correlate with pain (VAS), AOFAS, or any item of the SF-36. Conclusion: The thickness of the plantar fascia in patients with recalcitrant plantar fasciitis did not correlate with its clinical impact, and thus, we believe it should not be used in treatment planning. Level of Evidence: Level IV, case series.

scholarly journals Transcutaneous Electrical Stimulation and Postoperative Total Knee Arthroplasty Pain

1998 ◽  
Vol 3 (2) ◽  
pp. 101-104
Author(s):  
Mohamed N Mahomed ◽  
Gianni L Maistrelli ◽  
Ayoob Mossanen ◽  
Derek Glazier
Keyword(s):  
Electrical Stimulation ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Pain Scale ◽  
Control Group ◽  
Visual Analogue Pain Scale ◽  
Transcutaneous Electrical Stimulation ◽  
Visual Analogue Pain ◽  
Total Knee ◽  
Analgesic Use

OBJECTIVE: To determine the efficacy of the Synaptic 2000 in reducing total knee replacement postoperative pain in a prospective randomized controlled trial.DESIGN: Patients were prospectively randomly assigned to two groups, one receiving seven days of transcutaneous electrical stimulation (TES) therapy in addition to standard postoperative care, and the other receiving standard postoperative care. Both groups received postoperative patient-controlled analgesia and were switched to oral opiates.SETTING: Patients were treated at a university teaching hospital for elective primary unilateral total knee replacement.PATIENTS: All patients consented to enter the study. All had primary osteoarthritis. Fifteen patients were entered into each arm of the study, and all patients completed the study. The mean age of patients was 64 years for treatment and 71 years for controls.OUTCOME MEASURES: Outcome measures were analgesic consumption, return of knee range of motion and score on a visual analogue pain scale.RESULTS: No significant differences were noted in postoperative analgesic use, knee range of motion, length of stay or visual analogue pain scale score. Mean total analgesic use of morphine was 148 mg in the TES group and 108 mg in the control group. The TES group mean knee range of motion on postoperative day 7 was 75.3°; it was 73.6° in the control group. Group mean length of stay was 9.5 days in the TES group and 8.3 days in the control group.

Epidural Morphine plus Bupivacaine for Relief of Postoperative Pain following Harrington Rod Insertion for Correction of Idiopathic Scoliosis

1995 ◽  
Vol 23 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Y Adu-Gyamfi
Keyword(s):  
Side Effects ◽  
Idiopathic Scoliosis ◽  
Pain Score ◽  
Epidural Catheter ◽  
Epidural Morphine ◽  
Pain Scale ◽  
Injection Pain ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Harrington Rod

The aim of this study was to assess the efficacy of epidural morphine plus bupivacaine for post-operative pain control following Harrington rod insertion. In 22 scoliotic patients, studied prospectively, the epidural catheter was positioned under direct vision, intra-operatively before wound closure. Post-operatively, the patients received 2 mg morphine in 4 ml of 0.25% bupivacaine through the epidural catheter whenever they complained of pain. The pain score was assessed before and after every injection, using the Visual Analogue Pain Scale, and side-effects were monitored. All patients had adequate pain relief following analgesic administration. The mean (± SD) pre-injection pain score decreased from 2.5 ± 0.15 on the first post-operative day to 0.7 ± 0.2 by the fourth day. The side-effects, including nausea, vomiting and pruritus, were minimal. It is concluded that morphine, in 0.25% bupivacaine administered through an intra-operatively placed epidural catheter, provides a safe and effective post-operative analgesia in patients undergoing Harrington rod insertion for idiopathic scoliosis.

scholarly journals EndoTech® minimally invasive trigger thumb release

2021 ◽  
Vol 3 (2) ◽  
pp. 157-160
Author(s):  
Michael J Fitzmaurice
Keyword(s):  
Minimally Invasive ◽  
Pain Scale ◽  
Minimally Invasive Technique ◽  
Endoscopic Technique ◽  
Invasive Technique ◽  
Visual Analogue Pain Scale ◽  
Trigger Thumb ◽  
Visual Analogue Pain ◽  
Minimal Incision

We describe a novel minimally invasive technique for the treatment of trigger thumb. 37 patients with a total of 41 thumbs were included in the study. A visual analogue pain scale was used before surgery and also at 2 week and 6 month follow up visits. The pain was significantly improved from a pre op of 7.92 (+/- 1.6) to .65 (+/- .8) at the 2 week follow up and finally .29 (+/- 1.8) at the 6 month follow up. All of the patients had relief of triggering and only 1 patient required any therapy. This endoscopic technique for trigger thumb allows the surgeon to perform a trigger release with a minimal incision and provides excellent relief without any complications.

scholarly journals Effect of unicornuate uterus on women's reproductive health

2019 ◽  
Keyword(s):  
Quality Of Life ◽  
Reproductive Health ◽  
Clinical Symptoms ◽  
Normal Karyotype ◽  
Pain Scale ◽  
Control Group ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Unicornuate Uterus

Objectives. The effect of the unicornuate uterus on the reproductive health and quality of life of woman has been analyzed. Materials and methods. The study included 26 patients with unicornuate uterus aged 25 to 42 years and 20 women without gynecological pathology. Diagnosis of uterine abnomalies was based on patient complaints, medical history and life history, as well as clinical and laboratory and instrumental examinations. The severity of dysmenorrhea was determined using a visual analogue pain scale, women's quality of life was assessed using a short SF-12 health questionnaire. Results. The average age of the surveyed women was 30.2 ± 3.9 years. All patients with unicornuete uterus by subclasses were distributed as follows: subclass U4a (unicornuate uterus with rudimentary cavity) – 69.2% of patients, subclass U4b (unicornuate uterus without rudimentary cavity in the contralateral horn or with its aplasia) – 30.8%. In all patients was confirmed normal karyotype – 46XX. The combination of a unicornuate uterus with a defect of the urinary system (aplasia, doubling, or kidney dystopia) occurred in 23.1% of women. It has been found that in women with unicornuate uterus, clinical symptoms in 76.9% of cases are accompanied by dysmenorrhea. The unicornuate uterus in 69.2% of cases causes negative reproductive outcomes, among which 26.9% – early spontaneous abortions, 11.5% – ectopic pregnancy. In 46.2% of cases the unicornuate uterus is combined with other gynecological pathology, whereby the incidence of concomitant gynecologic pathology is significantly more frequent in U4a patients than in the U4b subclass (˂0.01). The severity of dysmenorrhea in the main group was 5.8 ± 1.8 points (the difference was significant compared with the control group, p = 0.0032). Conclusions. Due to the low physical subunit, the unicornuate uterus significantly impairs the quality of life of women, which was significantly lower in the group of patients with unicornuate uterus compared to the control group (total SF-12 score: 85.4 ± 11.2 vs. 95.8 ± 12.1; p = 0.002).

Sign in / Sign up

Export Citation Format

Share Document