Outcomes of corticosteroid injection and percutaneous release in treatment of trigger finger at tertiary hospital of Eastern Nepal.

Introduction: Trigger finger or stenosing tenosynovitis is a common cause of painful fingers and thumb that result in painful triggering, snapping or locking of fingers on flexion and extension of involved digit. Available treatment options for this condition are NSAID, splints, intralesional steroid injection, percutaneous release and open release of tendon sheath. Objectives: To study the clinical and functional outcomes and complications of corticosteroid injection and percutaneous release in management of trigger finger. Methodology: In this prospective study, sixty patients who presented with Grade 2 to Grade 3 trigger finger were placed into two groups. Group A(30 patients) were treated with intralesional steroid (40 mg of methylprednisolone) injection. Group B (30 patients) underwent percutaneous surgical release of affected tendon sheath. Both group of patients were treated in outpatient department. Patients of both groups were then asked to follow on scheduled time interval of two-week, six-week, three-months and six-months of period and their progress were recorded. Results: The baseline VAS score before intervention in group A (5.82) and group B (6.12) was statistically significant. In group B there was significant improvement of VAS score till 6 months of follow up. However, in group A there was significant improvement of VAS score by 3 months of follow-up, but by end of 6 months it again raised to 2.14. Yet it was far better than baseline VAS score. Conclusion: In our study both corticosteroid injection and percutaneous trigger finger release were found to be much effective in management of trigger finger.

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A comparative study of effectiveness of local injection of autologous platelet rich plasma and injection corticosteroid solution in treatment of plantar fasciitis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190801 ◽

2019 ◽

Vol 5 (2) ◽

pp. 335

Author(s):

Vithal Prakash Puri ◽

Anil Kumar Gaur

Keyword(s):

Plantar Fasciitis ◽

Platelet Rich Plasma ◽

Corticosteroid Injection ◽

Care Center ◽

Tertiary Care ◽

Vas Score ◽

Visual Analog Scales ◽

Group A ◽

Group B

Background: The heel pain is the most common problem worldwide and it was associated with plantar fasciitis (PF). The condition of treatment is very complex. Platelet-rich plasma (PRP) and injection of corticosteroids is the treatment of PF. This study was designed to access the effect of local PRP and local corticosteroid injection in PF patients.Methods: Sixty patients (between 29 to 60 years of age) with chronic PF were randomized prospectively in single tertiary care center in India. The study conducted from December 2013 to December 2015. All the patients were enrolled according to inclusion criteria and divided into two groups randomized. In group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Visual analog scales (VAS) were filled by all the included patients. The follow-up scheduled at one and six months after complete enrolment of patients.Results: Between both the groups the significantly different observed at one and six months follow-up from the baseline. At one month follow-up significantly improvement in mean VAS score were observed in group B (p<0.001). At six months follow-up significantly improvement in mean VAS score were observed in group A (p<0.001).Conclusions: The present study concluded from the significance difference between both the groups proved promising form of treatment in chronic PF patients. Both the treatment was safe and effective in relieving pain improving function at different time period.

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Comparative Study of Surgical Treatment of Chalazion

Faridpur Medical College Journal ◽

10.3329/fmcj.v9i2.25676 ◽

2015 ◽

Vol 9 (2) ◽

pp. 68-69

Author(s):

Khandaker Anowar Hossain ◽

Md Abdur Rashid ◽

AKM Rafiqul Islam

Keyword(s):

Inflammatory Lesion ◽

Skin Surface ◽

Meibomian Gland ◽

Medical College ◽

Large Size ◽

Intralesional Steroid ◽

Intralesional Steroid Injection ◽

Group A ◽

Group B

A chalazion is chronic lipogranulomatous inflammatory lesion caused by blockage of meibomian gland orifices & stagnation of sebaceous secretion. Common practices in treatment of chalazion are intralesional steroid injection, incision & curettage and excision of chalazion. Recurrence rate is high for incision & curettage in case of large chalazion. The aim of the study is to established that excision large chalazion give better result than incision & curettage. The study was carried out at Diabetic Association Medical College & Hospital, Faridpur and General Hospital, Fadidpur. A total 100 cases were selected for study. Technique of operation were incision & curettage through conjunctival surface and excision of chalazion through skin surface. In 50 % cases we performed incision & curettage both in small (size <5mm) and large (size >5mm) chalazion. In 50 % cases of large chalazion we performed excision of chalazion. The follow up period was 3 months to 6 months. In group -A with incision & curettage through conjunctival surface, in case of small chalazion 27 out of 30 patients were cured (90%). In case of large chalazion 14 out of 20 patients were cured (70%). In group B with excision of chalazion through skin surface, in case of large chalazion 49 out of 50 patients were cured (98%). So higher success rate after excision of large chalazion through skin surface.Faridpur Med. Coll. J. 2014;9(2): 68-69

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Effect of microscopically assisted decompression with micro-hook scalpel in the surgical treatment of ossification of the posterior longitudinal ligament

Journal of International Medical Research ◽

10.1177/0300060519862464 ◽

2019 ◽

Vol 47 (10) ◽

pp. 5120-5129 ◽

Cited By ~ 2

Author(s):

Sheng Yang ◽

Jianmin Lu ◽

Dapeng Fu ◽

Depeng Shang ◽

Fei Zhou ◽

...

Keyword(s):

Recovery Rate ◽

Spinal Canal ◽

Japanese Orthopaedic Association ◽

Posterior Longitudinal Ligament ◽

Clinical Effects ◽

Posterior Surgery ◽

Vas Score ◽

Group A ◽

Group B

Objective This study was performed to investigate the effect of microscopically assisted decompression using a micro-hook scalpel on ossification of the posterior longitudinal ligament (OPLL). Methods Sixty-one patients with OPLL were divided into Group A (posterior surgery with laminectomy of the responsible segment and lateral mass screw fixation) and Group B (anterior cervical corpectomy with intervertebral titanium cage fusion). Neurological function was assessed by the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and recovery rate. The fixation status and the result of spinal canal decompression were radiographically assessed. Results In Groups A and B, the JOA score was significantly higher and the VAS score was significantly lower at 1 week postoperatively and at the final follow-up than during the preoperative period. The mean recovery rate in Group A and B was 59.92% ± 13.46% and 62.28% ± 14.00%, respectively. Postoperative radiographs showed good positioning and no damage to the internal fixation materials. The spinal canal was also fully decompressed. Conclusions Microscopically assisted decompression with a micro-hook scalpel in both anterior and posterior surgeries achieved good clinical effects in patients with OPLL.

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The Effect of Miniscalpel-Needle Versus Steroid Injection for Trigger Thumb Release

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408100961 ◽

2009 ◽

Vol 34 (4) ◽

pp. 522-525 ◽

Cited By ~ 23

Author(s):

M. CHAO ◽

S. WU ◽

T. YAN

Keyword(s):

Steroid Injection ◽

Trigger Thumb ◽

Visual Analogue Pain ◽

Pain Scales ◽

Percutaneous Release ◽

Group A ◽

Release Group ◽

Group B ◽

Lost To Follow Up

This study compared the result of percutaneous release using a miniscalpel-needle and steroid injection in 93 trigger thumbs in 83 patients. The patients were randomly assigned to either miniscalpel-needle percutaneous release (group A) or steroid injection (group B). Visual analogue pain scales and patients’ satisfaction were evaluated at baseline, 1 and 12 months. One patient in group A and two patients in group B were lost to follow-up. Forty-four of the 46 trigger thumbs in group A and 12 of 47 trigger thumbs in group B had satisfactory results at 12 months. No digital nerve injury occurred in either group. Percutaneous release with a miniscalpel-needle had a higher success rate than steroid injection.

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A second puncture and injection technique for treating osteoporotic vertebral compression fractures

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1498-x ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Zhaofei Zhang ◽

Feng Jiao ◽

He Huang ◽

Yonghui Feng ◽

Chunliang Xie ◽

...

Keyword(s):

Vertebral Fractures ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Injection Technique ◽

Vertebral Height ◽

Vas Score ◽

Injection Group ◽

Group A ◽

Group B

Abstract Objective To evaluate the clinical effect of the second puncture and injection technique during a percutaneous vertebroplasty (PVP) procedure. Methods Patients treated with a second puncture and injection (group A) or a single puncture and injection (group B) during PVP at our institution during 2010–2017 were reviewed. Vertebral height loss, visual analogue scale (VAS) score, Oswestry disability index (ODI), adjacent vertebral fractures, and cement leakage were compared between the groups. Results A total of 193 patients were enrolled (86 cases in group A, 107 cases in group B). The follow-up period was 15.64 (12–20) months. The loss of anterior (group A 0.01 ± 0.03; group B 0.14 ± 0.17) and middle (group A 0.13 ± 0.12; group B 0.16 ± 0.11) vertebral height in group B was significantly higher than that in group A (P < 0.05). The VAS score and ODI were also significantly higher in group B than in group A at the final follow-up; the VAS score and ODI in group B were 1.65 ± 0.70 and 14.50 ± 4.16, respectively, and those in group A were 1.00 ± 0.74 and 12.81 ± 4.02, respectively (P < 0.05). Three patients in group A and two in group B experienced adjacent vertebral fractures. Regarding mild, moderate, and severe cement leakage, there were 25 (29%), 5 (5%), and 0 cases, respectively, in group A and 28 (26%), 3 (2.8%), and 1 (0.009%) case, respectively, in group B (P > 0.05). Conclusions The second puncture and injection technique may effectively increase the dispersion of cement, thus preventing recompression of the cemented vertebral body, and it does not increase the risk of cement leakage or adjacent vertebral fracture.

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The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

10.21203/rs.3.rs-27528/v2 ◽

2020 ◽

Author(s):

Lei Tan ◽

Bingtao Wen ◽

Zhaoqing Guo ◽

Zhongqiang Chen

Keyword(s):

Bone Cement ◽

Vertebral Body ◽

Kyphotic Angle ◽

Vas Score ◽

Angle Change ◽

Significant Difference ◽

Cement Distribution ◽

Group A ◽

Group B

Abstract Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 hours post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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Analysis of Clinical Results of Three Different Routes of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Lumbar Herniated Disk

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i2.86 ◽

2018 ◽

Vol 1 (2) ◽

pp. 8

Author(s):

Farid Yudoyono ◽

Rully Hanafi Dalan

Keyword(s):

Analogue Scale ◽

Clinical Results ◽

Lumbar Discectomy ◽

Excellent Outcome ◽

Vas Score ◽

Group A ◽

Herniated Disk ◽

The Mean ◽

Group B

Objective: Percutaneous endoscopic transforaminal lumbar discectomy (PETLD) can be performed by using foraminal, intervertebral, and suprapedicular routes. The aim of this study was to assess clinical results of three different routes of PETLD.Methods: One hundred and eleven patients who underwent PETLD between January 2016 and October 2016 were included in this study. PETLD was performed using the foraminal (group A), intervertebral (group B), and suprapedicular (group C) routes in 32, 46, and 33 patients, respectively. Outcomes were evaluated using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and MacNab criteria.Results: Seventy-one men and 40 were women (mean age 53.33 ± 14.12 years). The mean follow-up period was 6.44 ± 3.26 months. The preoperative VAS score decreased significantly (P < 0.01) in all 3 groups, but the postoperative VAS score was higher for the foraminal route than the intervertebral (P<0.001) and suprapedicular routes (P< 0.001). Excellent outcome grade according to MacNab criteria was less in foraminal route (18.7%) than in intervertebral (52.2%) and suprapedicular (56.7%) routes. ODI improved significantly (P< 0.01) in all 3 groups.Conclusion: All 3 routes of PETLD resulted in good to excellent clinical results. Nevertheless, the postoperative VAS score was higher for the foraminal route than the intervertebral and suprapedicular routes, probably because of the neurologic characteristics of the disk location. The surgeon should consider this problem to alleviate pain postoperatively and to better counsel the patient before surgery.

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Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35151 ◽

2020 ◽

Vol 18 (1) ◽

pp. 15-17

Author(s):

Gopal Sagar DC

Keyword(s):

Pain Score ◽

Steroid Injection ◽

Tennis Elbow ◽

Corticosteroid Injection ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Significant Difference ◽

Group A ◽

Group B

Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.

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Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20183683 ◽

2018 ◽

Vol 4 (5) ◽

pp. 790

Author(s):

Divya Anil Kumar ◽

Harsha Kumar Koramutla

Keyword(s):

Plantar Fasciitis ◽

Platelet Rich Plasma ◽

Vas Score ◽

Plasma Injection ◽

Intralesional Corticosteroid ◽

Group A ◽

Autologous Platelet Rich Plasma ◽

Group B ◽

Autologous Platelet

Background: Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.Methods: Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.Results: A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.Conclusions: To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.

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Absorbable suture material in carotid surgery

VASA ◽

10.1024/0301-1526/a000468 ◽

2015 ◽

Vol 44 (6) ◽

pp. 451-457 ◽

Cited By ~ 4

Author(s):

Vincenzo Gasbarro ◽

Luca Traina ◽

Francesco Mascoli ◽

Vincenzo Coscia ◽

Gianluca Buffone ◽

...

Keyword(s):

Suture Material ◽

Absorbable Suture ◽

Paediatric Surgery ◽

Carotid Surgery ◽

Suture Materials ◽

Absorbable Suture Material ◽

Absorbable Sutures ◽

Group A ◽

Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

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