clinical and radiological results
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H-INDEX

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2021 ◽  
pp. 175319342110636
Author(s):  
Delphine Lambrecht ◽  
Wim Vanhove ◽  
Nadine Hollevoet

We report the results of the treatment of disorders of the distal radioulnar joint with the semi-constrained Aptis prosthesis. Nineteen patients were assessed at a mean follow-up of 7 years. All patients had been operated on previously at the wrist, forearm or elbow. The Disabilities of Arm, Shoulder and Hand score had a mean value of 40, the Patient-Rated Wrist Evaluation score had a mean of 49 and the visual analogue scale for pain had a mean of 3.9. The mean ranges of pronation, supination, wrist flexion and wrist extension were 78°, 76°, 60° and 51°, respectively. The mean grip strength was 23 kg. Complications were noted in ten patients. Eighteen patients would undergo the operation again. The 10-year cumulative survival rate was 84%. The Aptis prosthesis may be a solution to treat patients in whom previous surgery at the distal radioulnar joint has failed. Level of evidence: IV


2021 ◽  
Vol 24 (4) ◽  
pp. 202-208
Author(s):  
Min Su Joo ◽  
Hoi Young Kwon ◽  
Jeong Woo Kim

Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH).Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes.Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (P=0.021, P=0.019), the rest of those and ROM showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (P=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (P=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson’s coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and –0.63 (P=0.027 and P=0.032), respectively.Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.


2021 ◽  
Vol 12 (11) ◽  
pp. 867-876
Author(s):  
Ahmet Uğur Turhan ◽  
Sezgin Açıl ◽  
Orkun Gül ◽  
Kerim Öner ◽  
Ahmet Emin Okutan ◽  
...  

2021 ◽  
Vol 10 (22) ◽  
pp. 5288
Author(s):  
David González-Martín ◽  
Sergio González-Casamayor ◽  
Mario Herrera-Pérez ◽  
Ayron Guerra-Ferraz ◽  
Jorge Ojeda-Jiménez ◽  
...  

Although stem revision is recommended for Vancouver B2 periprosthetic hip fractures (PPHFs), there has recently been a debate whether, under certain conditions, they could be treated by osteosynthesis alone. This study aimed to describe the medium-term clinical and radiological results of several patients with V-B2 fractures treated via osteosynthesis. A retrospective study of patients with V-B2 PPHF treated by osteosynthesis without stem revision, operated on between 2009 and 2019, was performed. The type of arthroplasty, type of stem, ASA, Charlson Comorbidity Index (CCI), medical and implant complications, reoperation rate, first-year mortality, radiological results (consolidation time), and functional results were analyzed. Thirty-nine patients were included. Their average age was 78.82 years. Most of the patients presented ASA ≥ 3 (35/39) and CCI ≥ 5 (32/39). Radiological consolidation was achieved in 93.5% of patients, with an average consolidation time of 92.93 days. The average Parker test score before admission was 5.84 while the current one was 4.92 (5.16 years follow-up). Osteosynthesis without stem revision is a valid surgical alternative in certain types of patients with V-B2 PPHF, depending on previous mobility, fracture pattern (anatomical reconstruction possible), anesthetic risk, comorbidities, and previous hip pain.


Medicine ◽  
2021 ◽  
Vol 100 (44) ◽  
pp. e27670
Author(s):  
Mateusz Bielecki ◽  
Przemysław Kunert ◽  
Artur Balasa ◽  
Sławomir Kujawski ◽  
Andrzej Marchel

2021 ◽  
Vol 12 (6) ◽  
pp. 5-7
Author(s):  
Ricardo Marta ◽  
◽  
Joana Costa ◽  
João Costa ◽  
João Moura ◽  
...  

Pediatric fractures of the tibial eminence are relatively rare, equivalent to the anterior cruciate ligament rupture in the adult. Severely displaced tibial eminence fractures should be treated surgically. Arthroscopy is preferred as it allows for accurate diagnosis and treatment of associated lesions and reduction and fixation of all types of tibial spine fractures while reducing the morbidity associated with open techniques. We report the clinical and radiological results of two cases with displaced tibial eminence fractures, submitted to surgical treatment and the arthroscopic technique of internal fixation with absorbable suture. After a follow-up of 18 months both patients had great improvement. Radiographic exams confirm complete fracture healing at 6 weeks of follow-up. The International Knee Documentation Committee subjective score were excellent (96 and 98 points) and the range of motion of the injured knees were also similar to the no-injured knees. This arthroscopic technique is simple, reproducible and very useful in dealing with these fractures, allowing to obtain excellent functional results.


Author(s):  
Vijendra Yadav ◽  
Parvez Ahmad Ganie ◽  
Rajendra Pranav Prasad ◽  
Madhan Jeyaraman

<p class="abstract"><strong>Background: </strong>Inter-condylar fractures of the distal humerus are uncommon injuries and present the most difficult challenge among fractures of the lower end of the humerus. The principle involves anatomical reduction and fixation with stabilization of extra-osseous implants. The functional outcome has been greatly influenced by the early graduated rehabilitative exercise. We aimed to evaluate the functional outcome of inter-condylar fractures of the distal humerus in adults using bi-columnar plating through a trans-olecranon approach.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 40 adult patients with inter-condylar fracture of the distal humerus were managed with bi-columnar plating through a trans-olecranon approach and were followed up for 12 months. The functional outcome was analysed by Mayo’s Elbow Performance Score (MEPS) at the end of 12 months follow up.</p><p class="abstract"><strong>Results: </strong>The average age of study participants were 50.8 years. A total of 24 cases were due to RTA and 16 cases were due to direct falls. Out of 40 cases, 6 (15%) were of B1 type, 2 (5%) were of type B2, 12 (30%) were of C1, 10 (25%) of C2, and 10 (25%) were of the type of C3 according to AO classification. According to MEPS at the end of the 12th-month follow-up, excellent results were seen in 24 (60%), good in 8 (20%), fair in 6 (15%), and poor results in 2 (5%) cases.</p><p class="abstract"><strong>Conclusions: </strong>Anatomically, bi-columnar plating for distal humerus is useful in providing stable fixation for complex distal articular fractured by trans-olecranon approach and facilitating early postoperative rehabilitation. Clinical and radiological results showed a good healing rate with a good range of motion.  </p>


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Linbo Peng ◽  
Jun Ma ◽  
Yi Zeng ◽  
Yuangang Wu ◽  
Haibo Si ◽  
...  

Abstract Background Although the high offset Tri-Lock bone preservation stem (BPS) was used widely, few studies explored the clinical and radiological results. The purpose of this study was to determine the clinical and radiological results of high offset Tri-Lock BPS in unilateral primary total hip arthroplasty (THA) at a minimum follow-up of 3 years. Methods 55 patients who underwent cementless THA with high offset Tri-lock BPS from 2017 to 2018 were followed for a minimum follow-up of 3 years. Patients were assessed clinically for complications, Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Hip Score (OHS). Femoral offset (FO), acetabular offset (AO), hip offset (HO), HO difference, and leg length discrepancy (LLD) were measured on the anteroposterior (AP) pelvic radiograph. Standard pelvic AP and lateral radiographs were used to evaluate for evidence of bone ingrowth, stem subsidence, stem alignment, radiolucent line around the stem, osteolysis, loosening, ectopic ossification, and femoral stress shielding. Results No patients reported complications during hospitalization nor the follow-up period. At a mean follow-up of 42.5 months, the mean HHS, WOMAC, and OHS scores showed a significant improvement from preoperative to the latest follow-up. No patients reported thigh pain. No revision nor sign of radiographic loosening had been detected. The high offset Tri-Lock BPS significantly improved the FO and HO postoperatively. HO difference and LLD were balanced postoperatively. No sign of stem subsidence, radiolucent line, osteolysis, loosening, ectopic ossification, nor severe stress shielding (more than grade 3–4) were observed at the latest follow-up. Conclusion The high offset Tri-Lock BPS demonstrated excellent clinical and radiographic outcomes at a minimum follow-up of 3 years. HO difference and LLD between legs decreased significantly and achieved balance postoperatively. Long-term follow-up is required for a definitive conclusion.


2021 ◽  
Vol 6 (10) ◽  

Fascioscapulohumeral muscular dystrophy is an uncommon hereditary myopathy which affects mainly the muscle of the face and upper limb girdle. We present a rare case with dropped head syndrome as the prominent manifestation of that disease and successfully treated by surgical management. It was a 25-year-old male patient with the chief complaint of neck pain and inability to maintain his horizontal gaze for long periods and as a result he had to quit his job as a shipper. His mother also had signs and symptoms of fascioscapulohumeral muscle dystrophy. Conservative treatment consisting of physical therapy and hard collar was the first attempt in order to reduce the neck pain and had limited result. We then performed a posterior cervical surgery including C2 to T2 instrumentation and kyphotic correction for the patient. The ten-month postop clinical and radiological results were satisfactory and the patient could return to his previous job. Dropped head syndrome with failed conservative treatment can be surgically treated after considering all clinical and radiographic factors.


2021 ◽  
Vol 87 (3) ◽  
pp. 419-426
Author(s):  
Mohamed S. Kassem ◽  
Mostafa A. Elsayed

This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirty patients (66.7%) needed autogenous acetabular bone grafting. There has been a statistically significant improvement from a preoperative mean Oxford hip score of 16 to a postoperative mean score of 39.8 (p < 0.001). At the end of follow up, two cases had revision for cup loosening. The complications included one case of transient sciatic nerve palsy, and two cases of heterotopic ossification. Currently, total hip replacement remains the best option for end stage post traumatic arthritis. There are technical challenges associated with this replacement surgery which the surgeon should be aware of.


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