Study on Outcome of Complex Lower Limb Problems treated by Ring External Fixator and Evolvement of Practices toward its Acceptability

2017 ◽  
Vol 3 (2) ◽  
pp. 35-40
Author(s):  
Sandeep Shrivastava ◽  
Sohael M Khan ◽  
Romil Rathi ◽  
Gaurav Mundada ◽  
Pradeep K Singh ◽  
...  
Keyword(s):  
External Fixator ◽  
Lower Limb ◽  
Rural Population ◽  
Age Groups ◽  
Limb Lengthening ◽  
Lower Limbs ◽  
Ilizarov Method ◽  
Cross Sectional ◽  
Ilizarov Fixator ◽  
Ring External Fixator

ABSTRACT Introduction In the developing world, there is still lack of accessibility and availability of adequate health care. In rural population this further gets limited, due to meager immediate resource at disposition and lack of availability of transports to adequate set ups. This cross-sectional study is undertaken among our rural patients who had undergone this treatment to understand what difficulties they had faced during such treatments and their acceptability toward such treatment. This study was undertaken with the aim to find out the acceptability and adaptability among the rural population for Ilizarov ring fixators. Materials and methods The study consisted of 88 consecutive cases (91 lower limbs) of all age groups, who completed the treatment by Ilizarov methodology between July 2005 and July 2012. A retrospective analysis of the procedure was done through the medical records in terms of preoperative, intra­operative, and after the complete treatment. These were analyzed for limb lengthening in centimeters, correction of deformities, total wearing duration, and final outcome. Subsequently, these patients/parents were interviewed with a questionnaire to assess the self-accessibility (ease) toward self-care; self-distraction; self-adaptability–comfort during wearing time and the difficulties faced. Results Overall the functional outcome was excellent in 18, good in 50, fair in 8, and poor in 4. Out of 91 patients, 67 (73.6%) followed up and could be evaluated for adaptability toward Ilizarov fixator. Overall, 91.04% were satisfied with the treatment by Ilizarov fixator. In the remaining the main reason for not accepting the Ilizarov method was difficulty in commuting in the public transport, ugly and threatening looks of fixator with so many wires crossing the leg. Conclusion Ilizarov method is a very effective tool for manag­ing the complex lower limb problems, especially among the population with low resources. It will ensure delivery of a very low-cost solution offered to the needy patients, wherein otherwise due to multiplicity of problems, integral solution is difficult to achieve within their resources. How to cite this article Shrivastava S, Khan SM, Rathi R, Mundada G, Singh PK, Taywade S. Study on Outcome of Complex Lower Limb Problems treated by Ring External Fixator and Evolvement of Practices toward its Acceptability. J Med Sci 2017;3(2):35-40.

scholarly journals Biomechanical aspects of spinal sagittal balance in achondroplasia patients during Ilizarov limb lengthening

2018 ◽  
Vol 15 (4) ◽  
pp. 7-14
Author(s):  
O. G. Prudnikova ◽  
A. M. Aranovich ◽  
Yu. A. Mushtaeva ◽  
A. V. Gubin
Keyword(s):  
Lower Limb ◽  
Sagittal Balance ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Clinical Manifestations ◽  
Limb Lengthening ◽  
Neurological Status ◽  
Ilizarov Method ◽  
Sagittal Imbalance ◽  
Cross Sectional

To review specific features of spinal sagittal balance in achondroplasia patients at stages of lower limb lengthening using the Ilizarov method. Material and Methods. Cross-sectional clinical and radiological study was performed in 29 achondroplasia patients prior to lower limb lengthening and at lengthening stages using the Ilizarov method. Parameters of sagittal balance of the spine and pelvis were evaluated radiologically. Clinical evaluation included examination, and assessment of neurological status and pain level. Results. Clinical manifestations of sagittal imbalance included hypokyphosis of the thoracic spine in 44.8 % of cases and increased lumbar lordosis in 55.2 %. No neurological disorders were diagnosed in patients. Pain scores 2 to 4 were observed in 17.2 % ofcases. After staged lower limb lengthening by 19.8 ± 3.3 cm, it was revealed that the values of the thoracic kyphosis, lumbar lordosis and the angle of the sacrum tilt improved and approached those of healthy peers. Vertical sagittal alignment measurements correlated with those of thoracic kyphosis. Thoracic kyphosis showed a correlation with lumbar lordosis. Pelvic indices had a moderate correlation with lumbar lordosis. Conclusion. Biomechanically substantiated transosseous compression-distraction osteosynthesis by Ilizarov technique used for lower limb lengthening in achondroplasia patients improves spinal sagittal balance parameters.

scholarly journals Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining

2020 ◽  
Vol 17 (7) ◽  
pp. 2566
Author(s):  
Madiha Ijaz ◽  
Sajid Rashid Ahmad ◽  
Muhammad M. Akram ◽  
Steven M. Thygerson ◽  
Falaq Ali Nadeem ◽  
...  
Keyword(s):  
Coal Mining ◽  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Underground Mines ◽  
Upper Limbs ◽  
Underground Coal Mining ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
R Programming

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers’ musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers’ musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

scholarly journals Lower limb amputations in Southern Finland 1984-1985

1988 ◽  
Vol 12 (1) ◽  
pp. 9-18 ◽  
Author(s):  
T. Pohjolainen ◽  
H. Alaranta
Keyword(s):  
Lower Limb ◽  
Age Groups ◽  
Lower Limbs ◽  
Amputation Rate ◽  
Common Site ◽  
Finnish Population ◽  
Elderly Age ◽  
Epidemiological Situation ◽  
Made In ◽  
Overall Mortality

To assess the current epidemiological situation concerning lower limb amputations in southern Finland the data on all amputations made in the catchment area of the Helsinki University Central Hospital were analysed for the period 1984-85. During the two-year period, 880 amputations of lower limbs were performed on 705 patients. The amputation rate was 32.5 per 100,000 inhabitants in 1984 and 28.1 in 1985. Patients requiring amputation were arteriosclerotics in 43.1 per cent, and diabetics in 40.7 per cent. Diabetics underwent amputation 3 years younger on average than the arteriosclerotics. The most common site of unilateral amputations was above-knee (42.0 per cent) followed by below-knee (27.7 per cent) and toe amputations (22.2 per cent). The level of amputation tended to become more proximal with increasing age of the patients. The overall mortality figure during three postoperative months was 27.0 per cent. Amputation incidence increased sharply with increasing age. On the base of predictions, the overall age structure of the Finnish population will shift upward causing an increase in the proportion of elderly age groups. A 50% increase in amputation rate is expected in Finland within the next 20-30 years.

scholarly journals Relationship Between Lower Limb Tightness and Practice Time Among Adolescent Baseball Players With Symptomatic Osgood-Schlatter Disease

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984797 ◽  
Author(s):  
Takuya Omodaka ◽  
Takashi Ohsawa ◽  
Tsuyoshi Tajika ◽  
Hiroyuki Shiozawa ◽  
Syogo Hashimoto ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Lower Limb ◽  
Cross Sectional Study ◽  
Tibial Tuberosity ◽  
Lower Limbs ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Baseball Players ◽  
Ankle Joints ◽  
Practice Time

Background: Osgood-Schlatter disease (OSD) is characterized by traction apophysitis of the tibial tuberosity. Few studies on symptomatic and asymptomatic OSD have correlated findings with clinical examination. Purpose: To investigate the relationship between lower limb tightness and practice time among adolescent baseball players with symptomatic OSD. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study participants were 402 male baseball players (N = 804 knees) with a mean ± SD age of 10.9 ± 1.5 years (range, 7-14 years). Participant age, height, body weight, body mass index, practice time per week, range of motion of the hip and ankle joints, heel-buttock distance (HBD), and straight-legged raise angle were evaluated. Tibial tuberosity development, as assessed with ultrasonography, was classified into 4 stages: cartilaginous, apophyseal, epiphyseal, and bony. Knees that were classified as apophyseal or epiphyseal were investigated. Participants were divided into 3 groups: non-OSD, asymptomatic OSD, and symptomatic OSD. Results: Of 400 knees in the apophyseal and epiphyseal stages, 23 knees had asymptomatic OSD, and 11 had symptomatic OSD. Players with symptomatic OSD practiced for significantly longer than the non-OSD group ( P = .001) and asymptomatic OSD group ( P = .001). Players with symptomatic OSD also had a larger HBD ( P = .006) and smaller range of motion regarding internal rotation of hip ( P = .023) and dorsiflexion of the ankle ( P = .013) than the non-OSD group. Conclusion: Players with symptomatic OSD had longer practice times than the non-OSD and asymptomatic OSD players. Symptomatic OSD was also associated with tightness of the lower limbs as assessed by the HBD and range of motion in the hip and ankle joints.

scholarly journals Assessment of balance, gait, lower limb strength and functionality in sarcopenic and non-sarcopenic elderlies

2020 ◽  
Vol 18 ◽  
pp. 1-7
Author(s):  
Alice Martins Magalhães ◽  
Daniella Macedo Cerceau ◽  
Kênia Kiefer Parreiras de Menezes ◽  
Gabriela Vieira Oliveira ◽  
Bárbara Batista Gomes
Keyword(s):  
Muscle Mass ◽  
Lower Limb ◽  
Gait Speed ◽  
Functional Performance ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Balance Test ◽  
Cross Sectional ◽  
Speed Test ◽  
Lower Limb Strength

Background: Sarcopenia is the involuntary loss of muscle mass predicted by aging and is associated with an increased likelihood ofunfavorable results, such as falls, mortality and functional disabilities. Objective: Evaluate balance, gait speed, lower limb strength andfunctionality in sarcopenic and non-sarcopenic elderly. Methods: Cross-sectional study, carried out with 68 subjects aged 60 years orover, residents of the community and possessing an independent gait. The assessment instruments were bioimpedance, balance test,four-meter gait speed test, chair support test and SPPB. Results: The prevalence of sarcopenia in the population of the present studywas 43.3%. In the group of non-sarcopenic subjects, a correlation was found between all the variables evaluated. In the group ofsarcopenic subjects, a correlation was found between lower limbs strength and gait speed. Conclusion: The skeletal muscle mass ofa sarcopenic elderly is related to their lower limb strength and gait speed, but it does not present a significant correlation with balanceand functional performance. Further studies are needed to clarify the behavior of balance, gait speed, lower limb strength and functionalperformance variables when compared to the decrease in muscle mass inherent in aging.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals A study of the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds

2019 ◽  
Vol 6 (3) ◽  
pp. 669
Author(s):  
Byomokesh Patro ◽  
Pankaj Surana ◽  
Kailash Chandra Mahapatra
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Working Environment ◽  
Lower Limbs ◽  
Control Group ◽  
Study Group

Background: Infection of a diabetic foot wound heralds a poor outcome, early diagnosis and treatments are important. The aim of the study was to study the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds.Methods: 50 patients with diabetic foot ulcer considered for the present study. Out of this 50 cases 25 are selected for external fixations (study group), after fulfilling the inclusion criteria and rest 25 cases are managed by posterior slab support. After reducing the infective load, the external fixator was applied as per application of external fixator procedure. The fixator is kept for 4 to 6 weeks. Daily dressings are done with advance dressing materials. Posterior slab group 25 patients are included having large, deep ulcers and unstable joints, to which posterior slabs were supported after proper and extensive debridement of wound under SA/LA.Results: DFU predominantly affects right lower limb than left lower limb. Both lower limbs affected in 4% cases. Because of different working environment males are more vulnerable to foot ulcerations. Out of 50 cases 48 (96%) of DFU are unilateral and 32 no of cases (64%) are predominantly occurs in right lower limb (Table 2). Out of 50 cases 38 no. of patient are males and 12 no. of patient are females. External fixator in exposed joint decreases the wounds in 52 days where as by posterior slab support 59 days. The mean surfaces are of the wound after therapy in study group is 75 cm2 and in control group it was 78 cm2.Conclusions: Large ulcers and exposed joints due to diabetic foot can be managed by external fixator for better prognosis than posterior slab method.

scholarly journals Diffusion Tensor Imaging of the Sciatic Nerve as a Surrogate Marker for Nerve Functionality of the Upper and Lower Limb in Patients With Diabetes and Prediabetes

2021 ◽  
Vol 15 ◽  
Author(s):  
Johann M. E. Jende ◽  
Zoltan Kender ◽  
Christoph Mooshage ◽  
Jan B. Groener ◽  
Lucia Alvarez-Ramos ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Lower Limb ◽  
Peroneal Nerve ◽  
Diffusion Tensor ◽  
Surrogate Marker ◽  
Nerve Damage ◽  
Lower Limbs ◽  
Magnetic Resonance Neurography ◽  
Cross Sectional ◽  
Patients With Diabetes

BackgroundNerve damage in diabetic neuropathy (DN) is assumed to begin in the distal legs with a subsequent progression to hands and arms at later stages. In contrast, recent studies have found that lower limb nerve lesions in DN predominate at the proximal sciatic nerve and that, in the upper limb, nerve functions can be impaired at early stages of DN.Materials and MethodsIn this prospective, single-center cross-sectional study, participants underwent diffusion-weighted 3 Tesla magnetic resonance neurography in order to calculate the sciatic nerve’s fractional anisotropy (FA), a surrogate parameter for structural nerve integrity. Results were correlated with clinical and electrophysiological assessments of the lower limb and an examination of hand function derived from the Purdue Pegboard Test.ResultsOverall, 71 patients with diabetes, 11 patients with prediabetes and 25 age-matched control subjects took part in this study. In patients with diabetes, the sciatic nerve’s FA showed positive correlations with tibial and peroneal nerve conduction velocities (r = 0.62; p < 0.001 and r = 0.56; p < 0.001, respectively), and tibial and peroneal nerve compound motor action potentials (r = 0.62; p < 0.001 and r = 0.63; p < 0.001, respectively). Moreover, the sciatic nerve’s FA was correlated with the Pegboard Test results in patients with diabetes (r = 0.52; p < 0.001), prediabetes (r = 0.76; p < 0.001) and in controls (r = 0.79; p = 0.007).ConclusionThis study is the first to show that the sciatic nerve’s FA is a surrogate marker for functional and electrophysiological parameters of both upper and lower limbs in patients with diabetes and prediabetes, suggesting that nerve damage in these patients is not restricted to the level of the symptomatic limbs but rather affects the entire peripheral nervous system.

scholarly journals Roles of drinking and diet in the U-shaped relationship between smoking and BMI in middle-aged and elderly Chinese rural adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Da Pan ◽  
Shaokang Wang ◽  
Ming Su ◽  
Jie Wei ◽  
Kai Wang ◽  
...  
Keyword(s):  
Rural Population ◽  
Age Groups ◽  
Normal Weight ◽  
Dietary Factors ◽  
Middle Aged ◽  
Cross Sectional ◽  
Elderly Chinese ◽  
The Relationship ◽  
Overweight Or Obesity ◽  
Rural Adults

Abstract The study aimed to investigate the relationship between smoking and BMI, from the perspective of the roles of alcohol drinking and dietary factors in a rural population. We analysed cross-sectional data from 10,837 middle-aged and elderly Chinese rural adults who completed a questionnaire that included questions on demographic characteristics, dietary intake, and detailed smoking and drinking status. Results showed that current smokers had lower BMI and consumed foods less frequently (except coriander, onion, garlic, hawthorn and fermented bean curd) than non-smokers. The relationship between smoking amount and the risk of overweight or obesity was U-shaped, and the trends were also similar by stratum of baseline age groups (all p for interaction < 0.001). Heavy smokers tended to have drinking habits, which was associated with increased BMI (all p for trend < 0.001). Additionally, despite the lower risk of overweight or obesity for current smokers, normal weight individuals were found to have the minimum smoking amount. In conclusion, smoking may cause suppression of appetite but smokers tend to have other unhealthy habits relating to increased BMI. Dietary factors and alcohol use play important roles in the U-shaped relationship between smoking behaviours and BMI in the middle-aged and elderly Chinese rural population.

Atendimento às vítimas de acidentes de trânsito pelo serviço pré-hospitalar: estudo transversal

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Érika Mitiyo Watanabe ◽  
José Carlos Dalmas ◽  
Maria Regiane Trincaus ◽  
Elma Mathias Dessunti ◽  
Eleine Aparecida Penha Martins
Keyword(s):  
Traffic Accident ◽  
Traffic Accidents ◽  
Emergency Service ◽  
Age Groups ◽  
Lower Limbs ◽  
Statistical Association ◽  
Cross Sectional ◽  
Automobile Accidents ◽  
Closed Fractures ◽  
South Of Brazil

Aim: to evaluate the profile of traffic accident assistance performed by the Mobile Emergency Service (Serviço de Atendimento Móvel de Urgência – SAMU) of a city in the South of Brazil. Method: a cross-sectional, retrospective and quantitative study, developed with data from 342 victims of traffic accidents attended by SAMU in 2015, statistically analyzed. Results: among the victims, men prevailed (71.3%); ages ranged from 15 to 44 years (65.7%); and who were involved in automobile accidents with motorcycles (29.2%). The most frequent lesions were bruises (48.2%) and short-bruises (33.0%); and those involving multiple body sites (50.6%) and lower and upper limbs (85.1%). Advanced support accounted for 75.1% of incidents. Conclusion: it was found a statistical association between the mechanisms of accident with age groups, with open and closed fractures and lesions in the upper and lower limbs.

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