scholarly journals PO 18122 - Treatment of Charcot arthropathy in the ankle joint

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 21S
Author(s):  
Milena Peloggia Cursino Fernandes ◽  
Noé De Marchi Neto ◽  
Ricardo Cardenuto Ferreira ◽  
Marco Tulio Costa ◽  
Jordanna Bergamasco ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Ankle Joint ◽  
Reconstructive Surgery ◽  
Joint Destruction ◽  
Charcot Arthropathy ◽  
Clinical Evaluations ◽  
Good Outcome ◽  
The Mean ◽  
The Stability ◽  
Acceptable Outcome

Introduction: Charcot arthropathy can lead to joint destruction and often causes ulcers at sites of bony prominences. In the ankle, it causes instability that limits gait and makes it difficult for patients to wear shoes or orthoses. This was a retrospective study describing cases of Charcot arthropathy of the ankle treated at our institution from 1997 to 2017. Methods: Over the study period, we treated 252 patients with Charcot arthropathy. Of these patients, 27 presented the disease exclusively in the ankle. The selected cases were unilateral; 17 of the patients were men, and the mean age was 55 years. Nine patients were treated conservatively, and 18 were treated surgically to stabilize the ankle (including the hindfoot, if necessary). During surgery, different fixation methods were used depending on the presence or absence of ulcer at the time of the intervention. At the end of the treatment, we assessed the patient’s ability to wear shoes or orthoses for walking, the stability of the ankle joint and, in surgical cases, union. We considered a good outcome when the patient was able to walk wearing shoes or orthoses, and the limb was stable; an acceptable outcome when the limb was unstable, but the patient adapted to orthoses; and a poor outcome when the patient was unable to walk, and the ankle was unstable or amputated. Results: Nine patients underwent conservative treatment using total contact casting at the initial phase of the disease, followed by orthosis after union. Of these patients, the outcome was poor for 5, good for 3 and acceptable for 1. Eighteen patients underwent reconstructive surgery; 12 patients had a good outcome; 2 patients underwent amputation, and 4 patients had unsuccessful surgeries. Conclusion: Charcot arthropathy of the ankle causes considerable instability. Conservative treatment of the disease fails to provide good outcomes, and the patients who underwent reconstructive surgery had the best functional and clinical evaluations.  

scholarly journals Endoprothesis of the Ankle Joint at Defeat by Tumours of Distal Part of Tibia

2011 ◽  
Vol 18 (4) ◽  
pp. 32-36
Author(s):  
V A Sokolovskiy ◽  
M D Aliev ◽  
Anatoliy Vladimirovich Sokolovskiy ◽  
P S Sergeev ◽  
V A Sokolovsky ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Ankle Joint ◽  
Functional Result ◽  
Tumor Resection ◽  
Distal Tibia ◽  
Reconstructive Operations ◽  
The Mean ◽  
Selection Of Patients ◽  
Selection Of

In a current of two years with 2008 for 2010, to six patients with primary malignant and aggressively benign bone tumors of the distal tibia executed six operations, in value of tumor resection with the subsequent reconstruction of defect by an ankle joint endoprosthesis. In group of patients there were five males and one female, with a mean age of 30 years. Among the treated patients 2 were with an osteosarcoma, 2 with Ewing's sarcoma and 2 with giant cell tumor. The mean duration of follow-up after the operation was 14,7 months (7 to 28). Reconstruction of the distal tibia defect was carried out using oncological modular endoprosthesis of the ankle joint. Common free of recurrence surviving during 2,4 years was 83%. Progressing of the primary disease is revealed in 50 % in the form of occurrence of the remote metastasis in lungs. A mean functional result assessed with the using of the MSTS system and consisted 75%. During the whole period of supervision no patient of six had complications such as periprosthesis infection, instability of a design of endoprosthesis or its fracture. At one patient with the diagnosis an osteosarcoma, through a floor of year after endoprosthesis, revealed a local recurrence during the spent of conservative treatment, in communication, with what amputation has been executed. For achievement of good clinical and functional result observance of indications to carrying out of reconstructive operations of area of an ankle joint, careful selection of patients taking into account effect on the spent conservative treatment is necessary.

scholarly journals Systematic treatment of charcot arthropathy of the midfoot

2018 ◽  
Vol 12 (4) ◽  
pp. 324-31
Author(s):  
Milena Peloggia Cursino Fernandes ◽  
Marco Túlio Costa ◽  
Ricardo Cardenuto Ferreira
Keyword(s):  
Conservative Treatment ◽  
Treatment Protocol ◽  
Type Ii ◽  
Charcot Arthropathy ◽  
Systematic Treatment ◽  
Level Of Evidence ◽  
Satisfactory Outcome ◽  
The Mean ◽  
Lost To Follow Up

Objective: The objective of this study was to evaluate the efficacy of the systematic protocol developed in our institution for the treatment of Charcot arthropathy (CA) of the midfoot, specifically for cases anatomically classified as Brodsky type II. Methods: Sixty patients with type II CA were treated in the period between 1997 and 2017 following a systematic protocol adopted at our institution. Two patients (3%) were lost to follow-up, leaving a total of 58 patients with 64 feet (six had bilateral involvement). The mean follow-up time was 31 months (range 12 to 150), and the mean age was 55 years (range 27 to 73). Conservative treatment was indicated in 41/64 of the extremities (64%), and surgical treatment was indicated in 23/64 of the extremities (36%). We considered the result as satisfactory when the patient was able to walk independently, placing full body weight on the foot. The result was considered unsatisfactory when the affected extremity presented clear instability and was deformed to the point that it was not possible to fit it in a stabilizing orthosis or for the patient to place their weight on the foot during walking as well as when it was necessary to perform an amputation. Results: We obtained a satisfactory outcome in 54/60 patients (90%) and in 58/64 feet (91%). In 19/23 of the operated feet (83%) and 39/41 of the conservatively treated feet (95%), the result was  atisfactory. Conclusion: The systematic treatment protocol developed at our institution allows achievement of a favorable prognosis regarding the clinicalfunctional outcome of type II CA, with conservative treatment being sufficient in most cases. Level of Evidence IV; Prognostic Study; Retrospective study.

Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

2020 ◽  
Author(s):  
Valentin Rausch ◽  
Sina Neugebauer ◽  
Tim Leschinger ◽  
Lars Müller ◽  
Kilian Wegmann ◽  
...  
Keyword(s):  
Fragment Size ◽  
Coronoid Process ◽  
Annular Ligament ◽  
Concomitant Injuries ◽  
Proximal Ulna ◽  
Sigmoid Notch ◽  
Coronoid Fractures ◽  
The Mean ◽  
The Stability ◽  
Arthritic Changes

Abstract Introduction This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch. Material and Methods Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured. Results Seventy-two patients (mean age: 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm. Conclusion Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.

Instant 99mTc-Labelled Glucoheptonate Kit for Kidney Imaging

1983 ◽  
Vol 22 (05) ◽  
pp. 246-250 ◽  
Author(s):  
M. Al-Hilli ◽  
H. M. A. Karim ◽  
M. H. S. Al-Hissoni ◽  
M. N. Jassim ◽  
N. H. Agha
Keyword(s):  
Sodium Hydroxide Solution ◽  
Normal Subjects ◽  
Organ Distribution ◽  
Stable Complex ◽  
Scintillation Camera ◽  
Ph Adjustment ◽  
The Mean ◽  
The Stability ◽  
Kidney Imaging ◽  
Mean Concentration

Gelchromatography column scanning has been used to study the fractions of reduced hydrolyzed 99mTc, 99mTc-pertechnetate and 99mTc-chelate in a 99mTc-glucoheptonate (GH) preparation. A stable high labelling yield of 99mTc-GH complex in the radiopharmaceutical has been obtained with a concentration of 40-50 mg of glucoheptonic acid-calcium salt and not less than 0.45 mg of SnCl2 2 H2O at an optimal pH between 6.5 and 7.0. The stability of the complex has been found significantly affected when sodium hydroxide solution was used for the pH adjustment. However, an alternative procedure for final pH adjustment of the preparation has been investigated providing a stable complex for the usual period of time prior to the injection. The organ distribution and the blood clearance data of 99mTc-GH in rabbits were relatively similar to those reported earlier. The mean concentration of the radiopharmaceutical in both kidneys has been studied in normal subjects for one hour with a scintillation camera and the results were satisfactory.

scholarly journals The force effects of two types of polyethylene terephthalate glyc-olmodified clear aligners immersed in artificial saliva

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Biao Xiang ◽  
Xingxing Wang ◽  
Gang Wu ◽  
Yichen Xu ◽  
Menghan Wang ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Polyethylene Terephthalate ◽  
Artificial Saliva ◽  
Orthodontic Force ◽  
The Mean ◽  
The Stability ◽  
Scanning Electron

AbstractNumerous factors can influence the force exerted by clear aligners on teeth. This study aimed to investigate the stability of the force delivered by two different material appliances. 90 clear aligners with 2 materials and three different activations were designed and fabricated. Then, a device was employed to measure the force generated by the two types of PET-G material appliances immersed in artificial saliva for 0, 3, 7, 10, 14 days. Scanning electron microscopy was applied to observe the morphologic alterations on the aligner surfaces, respectively. The forces generated by different activation appliance exhibited differently, 0.0 mm < 0.1 mm < 0.2 mm. In addition, increasing the immersion times and the orthodontic force also decreased, but the forces decreased differently. Compared with the forces of conventional PETG appliances with 0.20 mm activation, the modified PETG appliances with the same activation exhibited significantly higher mean force. When comparing the mean force for modified PETG appliances after 10 and 14 days with conventional PETG appliances, the delivery forces exhibited significant differences (P < 0.05). The force delivered by both materials decreased obviously following artificial saliva immersion, and the force generated by modified aligners exhibited better stability than conventional aligners.

Stability as a constraint in sagittal plane human force exertion modeling

1998 ◽  
Vol 1 (1) ◽  
pp. 23-39
Author(s):  
Carter J. Kerk ◽  
Don B. Chaffin ◽  
W. Monroe Keyserling
Keyword(s):  
Muscle Strength ◽  
Ankle Joint ◽  
Coefficient Of Friction ◽  
Sagittal Plane ◽  
Biomechanical Model ◽  
Whole Body ◽  
The Stability ◽  
Joint Center ◽  
Static Conditions ◽  
Stability Limits

The stability constraints of a two-dimensional static human force exertion capability model (2DHFEC) were evaluated with subjects of varying anthropometry and strength capabilities performing manual exertions. The biomechanical model comprehensively estimated human force exertion capability under sagittally symmetric static conditions using constraints from three classes: stability, joint muscle strength, and coefficient of friction. Experimental results showed the concept of stability must be considered with joint muscle strength capability and coefficient of friction in predicting hand force exertion capability. Information was gained concerning foot modeling parameters as they affect whole-body stability. Findings indicated that stability limits should be placed approximately 37 % the ankle joint center to the posterior-most point of the foot and 130 % the distance from the ankle joint center to the maximal medial protuberance (the ball of the foot). 2DHFEC provided improvements over existing models, especially where horizontal push/pull forces create balance concerns.

Cement Arthroplasty for Ankle Joint Destruction

2014 ◽  
Vol 96 (17) ◽  
pp. 1468-1475 ◽  
Author(s):  
Ho-Seong Lee ◽  
Ji-Yong Ahn ◽  
Jong-Seok Lee ◽  
Jun-Young Lee ◽  
Jae-Jung Jeong ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Joint Destruction ◽  
Cement Arthroplasty

scholarly journals The Mean Stability Criteria in terms of Two Measures for Stochastic Differential Equations with Coefficient’s Uncertainty

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Rui Zhang ◽  
Yinjing Guo ◽  
Xiangrong Wang ◽  
Xueqing Zhang
Keyword(s):  
Optimal Control ◽  
Differential Equations ◽  
Stochastic Differential Equations ◽  
Stochastic Stability ◽  
Stochastic Systems ◽  
Stability Criteria ◽  
Two Measures ◽  
The Mean ◽  
The Stability

This paper extends the stochastic stability criteria of two measures to the mean stability and proves the stability criteria for a kind of stochastic Itô’s systems. Moreover, by applying optimal control approaches, the mean stability criteria in terms of two measures are also obtained for the stochastic systems with coefficient’s uncertainty.

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