Combination of Reverse Shoulder Prosthesis, Elbow Prosthesis, and Polyetheretherketone: A Modified Total Humeral Replacement for Osteosarcoma Humerus Treatment

Total humeral replacement is a complex surgery that requires many challenges to overcome such as the weight of the implant material and the shoulder function due to extensive resection of the rotator cuff. Improvements in implants material that is lighter than usual can lead to higher surgery success rates. We present a patient who was diagnosed with osteosarcoma of the right humerus. The patient received 2 cycles of MAP chemotherapy (included: doxorubicin, cisplatin, and methotrexate) before surgery. He underwent radical resection of osteosarcoma and total humerus replacement with a modified total humeral material. The purpose of this improvement was to reduce the implant’s weight and to improve postoperative recovery. Six months after the surgery, the weight-bearing ability of the patient’s shoulder within a wide range of movement has restored; the shoulder, elbow, and hand can move in a controlled way. Despite the short postoperative follow-up time, the improvement in the modified technique has brought many positive results. Total humerus replacement, which combines the reverse shoulder prosthesis, elbow prosthesis, and polyetheretherketone, is an appropriate solution for patients with osteosarcoma of the humerus instead of custom-made humerus megaprosthesis.

Management of Non-Prosthetic Peri-Implant Fracture in a Case of Broken Intramedullary Locking Nail - A Rare Case Report and Review of Literature

A non-prosthetic peri-implant fracture (NPPIF) can be defined as a fracture in a bone with an existing non-prosthetic implant such as an extramedullary plate and screws or an intramedullary nail, NPPIFs are mostly reported together with peri-prosthetic fractures (PPFs) that occur around joint replacement implants, but they represent a separate clinical entity with different conceptual and practical considerations1. Our case is a 72-year male with a broken humerus intramedullary Nail in right upper limb who was managed with implant removal and bridge plating with locking plate. The favourable outcome in our case sheds a light in a grey region of non-prosthetic peri implant fractures of upper limbs where no definite management protocol is available. Our patient had very good outcome which was noted by 0/100 on dash scores and complete pain-free range of movement elbow and shoulder. Our case stands as a manifest for NPPIFs of humerus, which can be managed with similar protocol which was used in our case.

Interactive assistant tool for the evaluation of kinematic patterns and EMG signals in patients with a forearm injury

Subjective feelings feedbacks are commonly employed by a patient during forearm rehabilitation therapy without real-time data, leading to suboptimal recovery results in some patients. Technological innovations in the field of assisted rehabilitation have enabled the evolution of real-time monitoring systems. In this paper, interactive assistant development is presented as the interface to define the relationship between the kinematics patterns and the electromyographic signals during the forearm rehabilitation routine. Leap Motion (LM) and Shimmer3 EMG sensors read the routine behavior by following the movements that appear on the software. Real-time targets are programmed to lead the necessary forearm movements that the therapist sets to determine the recovery progress. The integration of software and hardware shows a dataset basis on interaction variables such as arm velocity, arm position, performance rate, and electrical muscle pulse. The results obtained from tests show that the system works effectively within a range of movement of 9 to 88 degrees in rotation about the axes, and velocities under 190 mm/s show stable movement representation on software. Finally, the outcomes ranges show an alternative tool to evaluate patients with a forearm injury.

A prospective analytical study on the effect of posterior femoral condylar offset on range of knee flexion in patients undergoing cruciate retaining total knee arthroplasty

<p><strong>Background:</strong> Osteoarthritis (OA) of knee joint is a common problem in our society causing pain, deformity, oedema, malalignment and limitation of activity. Total knee arthroplasty (TKA) is the surgery done for treatment of this problem. The range of movement obtained after TKA is an important factor influencing success of surgery. Posterior femoral condylar offset (PCO) is one of the parameters influencing range of movement after surgery. The dearth of studies in Indian population and contradicting results in already conducted studies has been observed in assessing the effect of PCO on range of knee flexion in patients undergoing TKA. Hence this study is done to explore this correlation.</p><p><strong>Methods:</strong> A prospective analytical study on 36 patients (50 knees) who underwent cruciate retaining TKA at Department of Orthopaedics, Rajagiri Hospital, Aluva. PCO and posterior femoral condylar offset ratio (PCOR) were calculated radiologically before and after TKA. Range of flexion (ROF) and knee society scores (for functional outcome assessment) were recorded preoperatively and postoperatively (at 6 weeks and 3 months).</p><p><strong>Results:</strong> The study found a strong positive correlation between PCO difference and ROF difference (r=0.735). Strong positive correlation was also found between PCOR difference and ROF difference (r=0.777). Both these correlations were statistically significant (p&lt;0.05).</p><p><strong>Conclusions:</strong> The study enlightened us about the point that PCO is an important factor in attaining a good ROF after cruciate retaining TKA.</p>

Bilateral STT Arthrodesis in a Young Patient with Occult Proximal Row Coalition

Background Carpal coalitions have an incidence of 0.1 to 1% in Caucasians and up to 8 to 9% in African populations. They rarely cause clinical problems requiring investigation or treatment, but are commonly identified on imaging obtained for other indications. Case Description We report a case of a 35-year-old male with progressive degenerative change of incomplete coalitions of the scaphotrapeziotrapezoid joint (STT) in the presence of bilateral complete osseous lunate–triquetral coalitions (Minnaar type 4). He was successfully treated with staged bilateral arthrodesis with excellent symptom resolution and preservation of function. Literature Review In patients with isolated STT coalition six reports of surgery exist, two of which were for arthrodesis. This is the first described case of STT arthrodesis in a patient with coexistent lunate–triquetral coalition. Clinical Relevance The STT arthrodesis remains a safe and effective treatment for STT pain even in cases of occult carpal coalition. Functional range of movement was well preserved. Level of evidence This is a Level V study.

An effective, low-cost method to improve the movement velocity measurement of a smartphone app during the bench press exercise

Some studies have reported considerable errors in the movement velocity measurement when using the My Lift app. This study aimed to investigate whether these errors may be related to the use of a range of movement (ROM) statically measured prior to the movement (ROMMYLIFT) instead of ROM dynamically monitored. Ten young adults performed two repetitions of the bench press exercise on a Smith machine with loads that allowed two velocity conditions (above and below 0.6 m s−1). The exercises were monitored by the My Lift app, a magnet and a rotary encoder. After, 15 older adults performed the same exercise at different percentages of 1RM, monitored by the My Lift app and a magnet. The results revealed that ROM dynamically obtained by encoder (reference method) with the mean velocity above (0.497 ± 0.069 m) and below (0.450 ± 0.056 m) 0.6 m s−1 were quite different ( p < 0.05; large effect) from the ROMMYLIFT (0.385 ± 0.040 m). These errors provided highly biased and heteroscedastic mean velocity measurements (mean errors approximately 22%). The errors observed in adults were also observed in the older participants, except for loads equal to 85% of 1RM. The magnet method proved to be valid, presenting measurements very close to the encoder (mean errors approximately 1.7%; r > 0.99). In conclusion, the use of ROMMYLIFT is inadequate, as the higher the movement velocity, the higher the errors, both for young and older adults. Thus, to improve the measurement of the My Lift app, it is recommended that the magnet method be used in conjunction with the app to more accurately determine the ROM.

Sensitivity of cycling Motion Performance Indicators (MPIs) to incremented load and their relationship with performance in professional cyclists

There is a lack of research assessing Motion Performance Indicators (MPIs), which have been recently made commercially available. Therefore, this study explored: (1) the influence of incremented exercise on MPIs and; (2) the relationships between MPIs and cycling performance at different intensities during a graded exercise test (GXT) in professional cyclists. Thirty-six professional cyclists performed GXT until exhaustion with their own bikes attached to a cycle ergometer. MPIs were collected using a real-time motion capture system based on inertial measurement units at 100 Hz of sample rate. Data were extracted from intensities of the GXT when lactate thresholds (LT1, LT2) and peak power (POpeak) were determined. Results showed that only Pelvic Angle ( p < 0.01, d > 1.15) and Pelvic Rotation ( p < 0.01, d > 1.37) were sensitive to increases in exercise intensity (i.e. greater inclination and increased rotation at greater power). Multivariate liner regression analyses showed that a reduced range of movement (ROM) for the upper legs at sub-maximum intensities (LT1 and LT2) was associated with greater power production ( r2 > 0.21), whilst a reduced ROM for the right foot was associated with greater POpeak ( r2 = 0.20). In conclusion, changes in movement patterns were limited to a greater inclination and rotation of the pelvis at maximum power without changes in other MPIs throughout the GXT. Cyclists who produced greater power presented less ROM for their upper legs at LT1 and LT2 whilst at POpeak and greater power production was moderately associated with less ROM for the right foot. Coaches may be able to use MPI to analyze for excess ROM, particularly at higher exercise intensities, as this seems to increase inefficiencies and limit power production.

Penerapan Latihan ROM (RANGE OF MOTION) Terhadap Rentang Gerak Ekstremitas Pada Pasien Stroke

Stroke is a disease caused by an acute neurological deficit in blood vesseldisorders leading to the brain that occur suddenly and can cause physical disability or death.The common complain are mobility impairment or decreased range of movement of the extremities.This study aimed to increase the range of movement of the extremities by doing Range on Motion exercises in families who have a history of stroke.There are two post-stroke patients involved in this study and give the Range of Motion exercise.The method used is to measure the degree of joint range of motion before performing ROM exercises then ROM exercises ranging from flexion, extension, hyperextension, adduction, abduction, and so on then measure the degree of joint range of motion with a goniometer measuring instrument and the results are recorded on the observation sheet.Goniometer was used to measurement the range of movement of the extremities.Range of Motion was performed for 7 days, each movement of 10 seconds duration.The results show that the range of movement increased in both patients. Accordingly, the Range of Motion exercises proved can increase the range of movement of the extremities in stroke patients.Families are expected to doing the Range of Motion exercise independently at home.Keywords:Range of motion; Range of movement; Stroke. AbstrakStroke adalah penyakit yang disebabkan oleh defisit neurologis akut pada gangguan pembuluh darah menuju otak yang terjadi secara tiba-tiba dan dapat menyebabkan kecacatan fisik atau kematian.Keluhan yang sering dikeluhkan adalah gangguan mobilitas atau penurunan jangkauan gerak ekstremitas. Penelitian ini bertujuan untuk meningkatkan jangkauan gerak ekstremitas dengan melakukan latihan Range on Motion pada keluarga yang memiliki riwayat stroke.Ada dua pasien pasca stroke yang terlibat dalam penelitian ini dan memberikan latihan Range of Motion.Metode yang dilakukan mengukur derajat rentang gerak sendi sebelum dilakukan latihan ROM kemudian latihan ROM mulai dari gerakan fleksi, ekstensi, hiperekstensi, addukksi, abduksi, dan lain sebagainya kemudian mengukur kembali derajat rentang gerak sendi dengan alat ukur goniometer dan hasilnya catat dilembar observasi.Goniometer digunakan untuk mengukur jangkauan gerakan ekstremitas.ROM dilakukan selama 7 hari, setiap gerakan durasi 10 detik.Hasil penelitian menunjukkan bahwa rentang gerak meningkat pada kedua pasien. Dengan demikian, latihan Range of Motion terbukti dapat meningkatkan jangkauan gerak ekstremitas pada pasien stroke. Keluarga diharapkan melakukan latihan Range of Motion secara mandiri di rumah.Kata kunci:Range of motion; Rentang gerak; Stroke.

Study on the biparametrical transudations circuits with distributed parameters

This paper highlights the methods of resenting mode in the transudation with distributed parameters. The transient parameters of the power supply were analyzed. It was discovered that resonance is provided in a small range of movement of the moving component of the sensor in known turbofan engines, indicating that the known techniques of sustaining the resonance mode are flawed. Further study should focus on developing novel methods for preserving resonance mode over the entire range of change of the converted value, general principles of turbojet engine construction, and a complete examination of their resonant circuits, according to the findings.