In the article we describe causes and symptoms of 1/ Minimal Brain Dysfunction, the symptoms of 2/ the Syndrome of Contractures and Deformities, 3/ the etiology of the So-Called Idiopathic Scoliosis and present some problems of 4/ hips, knees and ankle joint. The article presents also the rules of prophylaxis and therapy for hips in children and in adults as well proper therapy of the So-Called Idiopathic Scoliosis.
{"title":"Minimal Brain Dysfunction, Syndrome of Contractures and Deformities, SoCalled Idiopathic Scoliosis, Problem of Hips and Knees-in 12 Points and 12 Figures","authors":"","doi":"10.33140/ijor.06.03.02","DOIUrl":"https://doi.org/10.33140/ijor.06.03.02","url":null,"abstract":"In the article we describe causes and symptoms of 1/ Minimal Brain Dysfunction, the symptoms of 2/ the Syndrome of Contractures and Deformities, 3/ the etiology of the So-Called Idiopathic Scoliosis and present some problems of 4/ hips, knees and ankle joint. The article presents also the rules of prophylaxis and therapy for hips in children and in adults as well proper therapy of the So-Called Idiopathic Scoliosis.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114938373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shoulder pain is a common complaint caused by various factors, including injury, overuse, or degenerative conditions [1,2]. One of the most frequent causes of shoulder pain is a rotator cuff injury, which can cause significant pain and weakness in the shoulder [1]
{"title":"The Evaluation and Treatment of Patients Referred for Rotator Cuff TearsOur Experience","authors":"M. ReuvenLexier, Sahil Patel, Short Communication","doi":"10.33140/ijor.06.03.01","DOIUrl":"https://doi.org/10.33140/ijor.06.03.01","url":null,"abstract":"Shoulder pain is a common complaint caused by various factors, including injury, overuse, or degenerative conditions [1,2]. One of the most frequent causes of shoulder pain is a rotator cuff injury, which can cause significant pain and weakness in the shoulder [1]","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"47 9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129662310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chondrosarcomas are the second most common cause of bone cancer and are removed surgically with wide margins. On recurrence, they are resistant to chemo and radiation therapy and new treatment options are critically required. This tumor type produces hyaline cartilage, a cartilage normally formed under hypoxic and acidic environment due to lack of vasculature in cartilage. Paradoxically, chondrosarcomas arise in the well vascularized, oxygen rich environment of the bone. Hypoxia and acidosis are two stressors where the cellular effects are typically reported separately even though cells experience combined effects of hypoxia and acidosis. Given the mechanistic links between hypoxia and acidosis we hypothesized that gene expression profiles will be differentially changed when chondrosarcoma cells were exposed to individual compared to combined stressors. We investigated expression of four genes expressed during cartilage and cartilage tumor formation in primary chondrocytes and two grade II chondrosarcoma cell lines, SW1353 and JJ012. Two genes, PTH1R and SOX9 are known to respond to hypoxia and acidosis separately. Two genes, IDH1 and IDH2, are mutated in chondrosarcoma cell lines JJ012 and SW1353 respectively. These mutations confer a condition of false hypoxia on the cells through stabilization of HIF-1α. The result is chondrosarcoma cells metabolize glycolytically through aerobic glycolysis. How the cells respond to hypoxia and acidosis is of considerable interest as metabolically the cells are molecularly predisposed to these conditions. Our gene expression data found that combined hypoxia and extracellular acidosis alter gene expression compared to either stressor alone. Cells showed gene specific responses to stressors that were cell type specific likely indicating influence on gene expression regulatory sequences. The importance of this work is highlighting that conditions under which cells are investigated is crucial and should be considered when measuring cell response to in vitro treatment exposures.
{"title":"Gene Expression Under Combined Hypoxia And Acidosis In Chondrosarcoma","authors":"","doi":"10.33140/ijor.06.02.04","DOIUrl":"https://doi.org/10.33140/ijor.06.02.04","url":null,"abstract":"Chondrosarcomas are the second most common cause of bone cancer and are removed surgically with wide margins. On recurrence, they are resistant to chemo and radiation therapy and new treatment options are critically required. This tumor type produces hyaline cartilage, a cartilage normally formed under hypoxic and acidic environment due to lack of vasculature in cartilage. Paradoxically, chondrosarcomas arise in the well vascularized, oxygen rich environment of the bone. Hypoxia and acidosis are two stressors where the cellular effects are typically reported separately even though cells experience combined effects of hypoxia and acidosis. Given the mechanistic links between hypoxia and acidosis we hypothesized that gene expression profiles will be differentially changed when chondrosarcoma cells were exposed to individual compared to combined stressors. We investigated expression of four genes expressed during cartilage and cartilage tumor formation in primary chondrocytes and two grade II chondrosarcoma cell lines, SW1353 and JJ012. Two genes, PTH1R and SOX9 are known to respond to hypoxia and acidosis separately. Two genes, IDH1 and IDH2, are mutated in chondrosarcoma cell lines JJ012 and SW1353 respectively. These mutations confer a condition of false hypoxia on the cells through stabilization of HIF-1α. The result is chondrosarcoma cells metabolize glycolytically through aerobic glycolysis. How the cells respond to hypoxia and acidosis is of considerable interest as metabolically the cells are molecularly predisposed to these conditions. Our gene expression data found that combined hypoxia and extracellular acidosis alter gene expression compared to either stressor alone. Cells showed gene specific responses to stressors that were cell type specific likely indicating influence on gene expression regulatory sequences. The importance of this work is highlighting that conditions under which cells are investigated is crucial and should be considered when measuring cell response to in vitro treatment exposures.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122253266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The human body is designed for upright standing and walking, with the lower extremities and axial skeleton supporting weight-bearing. Constant weight-bearing on joints not meant for this action can lead to various pathologies, as seen in wheelchair users. Handstand practitioners use their wrists as weight-bearing joints during activities, but little is known about wrist injuries in this population. This study aims to investigate the epidemiology of wrist pain among handstand practitioners, as no such data currently exists. Methods: The study is a cross-sectional online survey conducted among athletes who regularly practice handstands. Participants were asked to complete a three-part questionnaire regarding their workout regimen, training habits, and history of wrist pain. The inclusion criteria were athletes over 18 years old who practice handstands more than twice a month for at least 4 months. All data were collected using Google Forms, organized, and anonymized using Microsoft Excel, and analyzed using IBM SPSS 26.0. Descriptive statistics were calculated, and potential risk factors were tested using asymptotic t-tests and Fisher's tests. Differences were considered significant when p < 0.05. Results: This study surveyed 402 athletes who regularly practice handstands to investigate the prevalence of chronic wrist pain and potential risk factors. The participants had a mean age of 31.3 years, with most being male and having an average of 5 years of training experience. 56% of participants reported chronic wrist pain, and 14.4% reported a history of distal radial fracture. Yoga was the most practiced form, followed by Capoeira. No significant differences were found in demographic data between participants with and without chronic wrist pain, and no significant associations were found between chronic wrist pain prevalence and warm-up routines or protective aids. Discussion: The lower half of the body is meant to handle weight-bearing and impact, while transferring the load to upper extremities can lead to various pathologies. Athletes who perform handstands are particularly prone to chronic wrist pain, which affects over half of them. Warm-up sessions and protective instruments like wrist braces do not seem to prevent chronic wrist pain, and there are no significant differences in age or training volume between athletes with and without the condition. Further research is needed to understand the causes of chronic wrist pain in athletes, given the growing popularity of sports and activities that can cause this type of injury. Conclusion: Chronic wrist pain is prevalent in athletes practicing hand standing exercises. Protective instruments such as wrist braces do not significantly affect incidence, and age, training volume, and years of training do not play significant roles. Further research is needed to understand the underlying causes of chronic wrist pain in athletes, which may become a significant health burden due to the popular
{"title":"Chronic Wrist Pain Among Handstand Practitioners","authors":"","doi":"10.33140/ijor.06.02.02","DOIUrl":"https://doi.org/10.33140/ijor.06.02.02","url":null,"abstract":"Introduction: The human body is designed for upright standing and walking, with the lower extremities and axial skeleton supporting weight-bearing. Constant weight-bearing on joints not meant for this action can lead to various pathologies, as seen in wheelchair users. Handstand practitioners use their wrists as weight-bearing joints during activities, but little is known about wrist injuries in this population. This study aims to investigate the epidemiology of wrist pain among handstand practitioners, as no such data currently exists. Methods: The study is a cross-sectional online survey conducted among athletes who regularly practice handstands. Participants were asked to complete a three-part questionnaire regarding their workout regimen, training habits, and history of wrist pain. The inclusion criteria were athletes over 18 years old who practice handstands more than twice a month for at least 4 months. All data were collected using Google Forms, organized, and anonymized using Microsoft Excel, and analyzed using IBM SPSS 26.0. Descriptive statistics were calculated, and potential risk factors were tested using asymptotic t-tests and Fisher's tests. Differences were considered significant when p < 0.05. Results: This study surveyed 402 athletes who regularly practice handstands to investigate the prevalence of chronic wrist pain and potential risk factors. The participants had a mean age of 31.3 years, with most being male and having an average of 5 years of training experience. 56% of participants reported chronic wrist pain, and 14.4% reported a history of distal radial fracture. Yoga was the most practiced form, followed by Capoeira. No significant differences were found in demographic data between participants with and without chronic wrist pain, and no significant associations were found between chronic wrist pain prevalence and warm-up routines or protective aids. Discussion: The lower half of the body is meant to handle weight-bearing and impact, while transferring the load to upper extremities can lead to various pathologies. Athletes who perform handstands are particularly prone to chronic wrist pain, which affects over half of them. Warm-up sessions and protective instruments like wrist braces do not seem to prevent chronic wrist pain, and there are no significant differences in age or training volume between athletes with and without the condition. Further research is needed to understand the causes of chronic wrist pain in athletes, given the growing popularity of sports and activities that can cause this type of injury. Conclusion: Chronic wrist pain is prevalent in athletes practicing hand standing exercises. Protective instruments such as wrist braces do not significantly affect incidence, and age, training volume, and years of training do not play significant roles. Further research is needed to understand the underlying causes of chronic wrist pain in athletes, which may become a significant health burden due to the popular","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116608332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sickle cell anemia (SCA) is a hereditary hemoglobin disorder that results in sickling of the red cell, leading to chronic hemolytic anemia, vascular occlusion and progressive organ damage. Avascular necrosis (AVN) is a known and common complication in sickle cell anemia. There are very little studies addressing core decompression of femoral neck in children with SCA. Many studies are done for adult patients. We did core decompression (CD) of femoral neck in children with AVN due to sickle cell anemia .39 hips in 29 patients are done between 2008 to 2018. The patients age ranges between 4 to 14 years of age. AVN is classified according to Ficat radiological classifications. Stage 1, 2A, and 2B are operated. Stage 3 and 4 hips were operated if the other hip is stage 1 or 2. We found a significant improvement of the operated patients compared to non-operated patients. Patients were assessed in follow-up in form of pain, gait, activity and radiological grading. Core decompression is done using a percutaneous cannulated drilling that do not cross the growth plate of the head. Excellent results were found in 87%, good results in 9% and poor results in 4%. We recommend doing core decompression in all grades of AVN in sickle cell anemia children. Conclusion Core decompression in children with sickle cell anemia is a new surgical intervention. It is a simple surgical procedure that can be done by most of pediatric orthopedic surgeons. We found that core decompression is an effective method to stop and improve clinical and radiological stages of AVN of femoral head in children sickle cell anemia. We found out that core decompression in children has far much better outcome compared to adult’s core decompression.
{"title":"Core Decompression For Treatment of Avascular Necrosis of Femoral Head In Children With Sickle Cell Anemia","authors":"","doi":"10.33140/ijor.06.02.01","DOIUrl":"https://doi.org/10.33140/ijor.06.02.01","url":null,"abstract":"Sickle cell anemia (SCA) is a hereditary hemoglobin disorder that results in sickling of the red cell, leading to chronic hemolytic anemia, vascular occlusion and progressive organ damage. Avascular necrosis (AVN) is a known and common complication in sickle cell anemia. There are very little studies addressing core decompression of femoral neck in children with SCA. Many studies are done for adult patients. We did core decompression (CD) of femoral neck in children with AVN due to sickle cell anemia .39 hips in 29 patients are done between 2008 to 2018. The patients age ranges between 4 to 14 years of age. AVN is classified according to Ficat radiological classifications. Stage 1, 2A, and 2B are operated. Stage 3 and 4 hips were operated if the other hip is stage 1 or 2. We found a significant improvement of the operated patients compared to non-operated patients. Patients were assessed in follow-up in form of pain, gait, activity and radiological grading. Core decompression is done using a percutaneous cannulated drilling that do not cross the growth plate of the head. Excellent results were found in 87%, good results in 9% and poor results in 4%. We recommend doing core decompression in all grades of AVN in sickle cell anemia children. Conclusion Core decompression in children with sickle cell anemia is a new surgical intervention. It is a simple surgical procedure that can be done by most of pediatric orthopedic surgeons. We found that core decompression is an effective method to stop and improve clinical and radiological stages of AVN of femoral head in children sickle cell anemia. We found out that core decompression in children has far much better outcome compared to adult’s core decompression.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127453838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher J. Osgood, Maisoun Bani-Hani, Stephen J Beebe1, Michael W Stacey1, Christopher Osgood2
Nanodiamonds (ND) have attracted significant interest for their use in several biomedical applications. These applications can be very useful if the safety and compatibility of ND are proven. We assessed the effects of ND (100 nm, Carboxylated) on primary macrophages and a macrophage-like cell line and found that these particles are not toxic to these cells at lower concentrations but may interfere with cell functions and differentiation. Internalization of ND by these cells in a time- and dose-dependent manner was mostly via phagocytosis and clathrin-dependent endocytosis and localized to the cytoplasm but not into the nucleus. No significant induction of inflammatory cytokines or reduction in the ability of these cells to respond to lipopolysaccharides (LPS) was noted. However, the endocytic activity of these cells is significantly reduced. In addition, ND exposure reduced the ability of differentiating bone marrow cells to express macrophage surface markers. Measurement of the fluorescence and absorbance of ND-treated cells clearly showed the ability of these particles to produce a signal at different wavelengths. Therefore, it is important to consider interference of ND in different colorimetric and fluorometric assays when testing interactions or effects of ND on cells. Our findings suggest that ND are not cytotoxic to macrophages at the tested concentrations, but it can interfere with macrophage functions and differentiation and may interfere with assays’ result through the production of a signal at different wavelengths.
{"title":"Interactions of Carboxylated Nanodiamonds With Mouse Macrophages Cell Line and Primary Cells","authors":"Christopher J. Osgood, Maisoun Bani-Hani, Stephen J Beebe1, Michael W Stacey1, Christopher Osgood2","doi":"10.33140/ijor.06.01.05","DOIUrl":"https://doi.org/10.33140/ijor.06.01.05","url":null,"abstract":"Nanodiamonds (ND) have attracted significant interest for their use in several biomedical applications. These applications can be very useful if the safety and compatibility of ND are proven. We assessed the effects of ND (100 nm, Carboxylated) on primary macrophages and a macrophage-like cell line and found that these particles are not toxic to these cells at lower concentrations but may interfere with cell functions and differentiation. Internalization of ND by these cells in a time- and dose-dependent manner was mostly via phagocytosis and clathrin-dependent endocytosis and localized to the cytoplasm but not into the nucleus. No significant induction of inflammatory cytokines or reduction in the ability of these cells to respond to lipopolysaccharides (LPS) was noted. However, the endocytic activity of these cells is significantly reduced. In addition, ND exposure reduced the ability of differentiating bone marrow cells to express macrophage surface markers. Measurement of the fluorescence and absorbance of ND-treated cells clearly showed the ability of these particles to produce a signal at different wavelengths. Therefore, it is important to consider interference of ND in different colorimetric and fluorometric assays when testing interactions or effects of ND on cells. Our findings suggest that ND are not cytotoxic to macrophages at the tested concentrations, but it can interfere with macrophage functions and differentiation and may interfere with assays’ result through the production of a signal at different wavelengths.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132524535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this case presentation, it was aimed to treat a male patient aged 12 years and 1 month with Skeletal Class III anomaly characterized by maxillary retrognathia and achieve Skeletal Class I bite without the need for future orthognathic sur- gical procedures. In order to easily bypass the anterior crossbite of the patient, an intraoral clear plate to increase the occlusion was used. In order to rectify the maxillary retrognathia, a petit-type face mask was used for 8 weeks. With the application of the face mask, a successful treatment was achieved. Significant corrections were achieved in the skeletal, dental and soft tissue values of the patient.
{"title":"Face Mask Protocol in An İndividual with Skeletal Class III in Malocclusion: A Case Report","authors":"","doi":"10.33140/ijor.06.01.03","DOIUrl":"https://doi.org/10.33140/ijor.06.01.03","url":null,"abstract":"In this case presentation, it was aimed to treat a male patient aged 12 years and 1 month with Skeletal Class III anomaly characterized by maxillary retrognathia and achieve Skeletal Class I bite without the need for future orthognathic sur- gical procedures. In order to easily bypass the anterior crossbite of the patient, an intraoral clear plate to increase the occlusion was used. In order to rectify the maxillary retrognathia, a petit-type face mask was used for 8 weeks. With the application of the face mask, a successful treatment was achieved. Significant corrections were achieved in the skeletal, dental and soft tissue values of the patient.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122510649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL) in geriatric population. Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture-healing. Purpose of the present prospective study was to evaluate the effect of teriparatide on the course of intertrochanteric fracture-healing. Methods: 40 patients of intertrochanteric fractures who underwent surgical intervention between October 2020 and September 2021 were enrolled in this prospective study and followed for minimum of six months. Group A included patients who received teriparatide along with calcium supplementation; patients in Group B received only calcium supplementation postoperatively. Demographics, time-to-union, VAS score, mortalities, and radiographic and functional outcomes between groups were compared. Results: A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 9.2 v/s 12 weeks, [P=0.00001]). Regard to Harris hip score [HHS], were significantly better in teriparatide-treated groups at 1 month (mean 79.16 v/s 69.76) [P=0.001]) and 6 month (mean84.1 v/s 75.6) [P=0.001]). Similar inter-group differences were noted when comparing the pain VAS scores at 1month (mean 2.4 v/s 2.9) [P= 0.005]}, 3month(mean 2.05 v/s 2.75) [P=0.001]} and 6 months(mean 0.0 v/s 0.35) [P=0.01])and also significant effectiveness regards to Parker and Palmer mobility score at 1month(mean 6 v/s 4.3 [P=0.001], 3 month (mean 6.9 v/s 5.3) [P=.001]}and 6 month(mean 8.7 v/s 6.8)[P=0.001]}and Pre BMD score (mean-2.3 v/s -3.2) [P=0.16]} and 3 month (mean -2.2 v/s -2.1) [P=0.46]} and at 6month (mean -1.11 v/s -1.4) [P=0.016]}. Conclusions: Teriparatide shows faster fracture healing and better functional outcome and decreases the pain in the intertrochanteric fracture patients. However, a randomized, large-scale cohort study is still necessary to determine the efficacy of teriparatide in intertrochanteric fractures.
{"title":"A Comparative Study to Evaluate the Role of Teriparatide in Post-Operative Intertrochanteric Fracture Healing","authors":"","doi":"10.33140/ijor.06.01.01","DOIUrl":"https://doi.org/10.33140/ijor.06.01.01","url":null,"abstract":"Background: Intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL) in geriatric population. Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture-healing. Purpose of the present prospective study was to evaluate the effect of teriparatide on the course of intertrochanteric fracture-healing. Methods: 40 patients of intertrochanteric fractures who underwent surgical intervention between October 2020 and September 2021 were enrolled in this prospective study and followed for minimum of six months. Group A included patients who received teriparatide along with calcium supplementation; patients in Group B received only calcium supplementation postoperatively. Demographics, time-to-union, VAS score, mortalities, and radiographic and functional outcomes between groups were compared. Results: A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 9.2 v/s 12 weeks, [P=0.00001]). Regard to Harris hip score [HHS], were significantly better in teriparatide-treated groups at 1 month (mean 79.16 v/s 69.76) [P=0.001]) and 6 month (mean84.1 v/s 75.6) [P=0.001]). Similar inter-group differences were noted when comparing the pain VAS scores at 1month (mean 2.4 v/s 2.9) [P= 0.005]}, 3month(mean 2.05 v/s 2.75) [P=0.001]} and 6 months(mean 0.0 v/s 0.35) [P=0.01])and also significant effectiveness regards to Parker and Palmer mobility score at 1month(mean 6 v/s 4.3 [P=0.001], 3 month (mean 6.9 v/s 5.3) [P=.001]}and 6 month(mean 8.7 v/s 6.8)[P=0.001]}and Pre BMD score (mean-2.3 v/s -3.2) [P=0.16]} and 3 month (mean -2.2 v/s -2.1) [P=0.46]} and at 6month (mean -1.11 v/s -1.4) [P=0.016]}. Conclusions: Teriparatide shows faster fracture healing and better functional outcome and decreases the pain in the intertrochanteric fracture patients. However, a randomized, large-scale cohort study is still necessary to determine the efficacy of teriparatide in intertrochanteric fractures.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126179455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Surgical sites infections (SSIs) in spine surgeries represent one of the commonest hospital-acquired infections. SSIs refers to infection of surgical wound within 30 days of surgery or one year of implant usage. SSIs portend a huge disease burden with devastating consequences to the patient and the hospital facility with attendant physical and psychological trauma to the patient and it is associated with increase rate of morbidity and mortality. Objective: The aim of this review is to identify factors that predispose a spine patient to SSIs and to highlight the current preventive and management concepts. Methods: We carried out a comprehensive review of literatures, using key words such as surgical site infections, spine surgery, predisposing factors, prevention, diagnosis, treatment, outcomes on search engines of Google Scholar, Scopus and PUBMED. Eligible articles for the review included full length published articles in English which we have access to contents. Results: Twenty-five full length articles were found eligible for the review. In spite of improvement in spine care and surgery, SSIs continue be a source of great concern to the patients, surgeons and healthcare system of any nation. Gram positive organisms are more common than gram negative organisms. The risk factors for SSIs include patient- and surgeon - related factors. Albeit, there is no universally accepted protocol for the prevention and treatment of SSIs in spine surgery. The incidence of SSIs is on the increase worldwide with associated high risk of morbidity, overall decrease in the quality of life and sometimes mortality. The economic burdens of the management of SSI is huge and stressful for every nation. Treating SSIs after spine surgery is daunting as the choice between removing the implants for proper bacteria clearance and the risk of causing spinal instability is a hard nut to crack. Conclusions: Despite the improved surgical technique, protocol on asepsis and role of prophylactic antibiotics in clean spine surgeries, there are still substantial increase in the rate of SSIs. Therefore, prevention is more profitable than the hope of proper treatment.
{"title":"Management of Surgical Site Infections in Spine Surgery: A Current Concept Review","authors":"","doi":"10.33140/ijor.06.01.02","DOIUrl":"https://doi.org/10.33140/ijor.06.01.02","url":null,"abstract":"Background: Surgical sites infections (SSIs) in spine surgeries represent one of the commonest hospital-acquired infections. SSIs refers to infection of surgical wound within 30 days of surgery or one year of implant usage. SSIs portend a huge disease burden with devastating consequences to the patient and the hospital facility with attendant physical and psychological trauma to the patient and it is associated with increase rate of morbidity and mortality. Objective: The aim of this review is to identify factors that predispose a spine patient to SSIs and to highlight the current preventive and management concepts. Methods: We carried out a comprehensive review of literatures, using key words such as surgical site infections, spine surgery, predisposing factors, prevention, diagnosis, treatment, outcomes on search engines of Google Scholar, Scopus and PUBMED. Eligible articles for the review included full length published articles in English which we have access to contents. Results: Twenty-five full length articles were found eligible for the review. In spite of improvement in spine care and surgery, SSIs continue be a source of great concern to the patients, surgeons and healthcare system of any nation. Gram positive organisms are more common than gram negative organisms. The risk factors for SSIs include patient- and surgeon - related factors. Albeit, there is no universally accepted protocol for the prevention and treatment of SSIs in spine surgery. The incidence of SSIs is on the increase worldwide with associated high risk of morbidity, overall decrease in the quality of life and sometimes mortality. The economic burdens of the management of SSI is huge and stressful for every nation. Treating SSIs after spine surgery is daunting as the choice between removing the implants for proper bacteria clearance and the risk of causing spinal instability is a hard nut to crack. Conclusions: Despite the improved surgical technique, protocol on asepsis and role of prophylactic antibiotics in clean spine surgeries, there are still substantial increase in the rate of SSIs. Therefore, prevention is more profitable than the hope of proper treatment.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128478477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Fractures of the distal femur are complex injuries that pose a challenge to orthopaedic surgeon. Significant advances have been made in treatment of these fractures. Out of various options for surgical treatment, retrograde intramedullary nailing has several benefits compared to other methods of fixation. Amongst the routinely available IMSC nails which have a specific design, we used an indigenous IMSC nail with unique design. Materials And Methodology We conducted a retrospective study among 40 patients with distal femur fractures treated with this indigenous IMSC nail in our institute from May 2019 to October 2021. The patients were followed up in outpatient department till June 2022. Data was retrieved from case record forms and hospital information computer software. The study was conducted after obtaining permission from institutional review board. Results All the patients in our study were assessed using knee society score and functional knee score. Average knee society score at final follow up was 88.75/100 and average functional knee score at final follow up was 86.50/100 which showed excellent results. The results were better for extra-articular fractures. Average operative time, blood loss, time for radiological union and rate of complications were considerably less. Discussion Retrograde intramedullary nailing has been developed in order to address previous problems associated with distal femur fracture fixation. It has several advantages over plate fixation. Indigenous IMSC nail used in our study has added benefits over the routine IMSC nail due to its structure, number of screw holes in the distal part of nail, alignment of screw holes inside nail and unique thread design of the screws. Thus, it provides multi-planar fixation of fracture rather than in only one plane as achieved by routine IMSC nail giving excellent rotational stability to bone-implant construct.
{"title":"Outcomes of Distal Femur Fractures Treated with Retrograde Indigenous Intramedullary Supracondylar (IMSC) Nailing","authors":"","doi":"10.33140/ijor.05.04.01","DOIUrl":"https://doi.org/10.33140/ijor.05.04.01","url":null,"abstract":"Introduction Fractures of the distal femur are complex injuries that pose a challenge to orthopaedic surgeon. Significant advances have been made in treatment of these fractures. Out of various options for surgical treatment, retrograde intramedullary nailing has several benefits compared to other methods of fixation. Amongst the routinely available IMSC nails which have a specific design, we used an indigenous IMSC nail with unique design. Materials And Methodology We conducted a retrospective study among 40 patients with distal femur fractures treated with this indigenous IMSC nail in our institute from May 2019 to October 2021. The patients were followed up in outpatient department till June 2022. Data was retrieved from case record forms and hospital information computer software. The study was conducted after obtaining permission from institutional review board. Results All the patients in our study were assessed using knee society score and functional knee score. Average knee society score at final follow up was 88.75/100 and average functional knee score at final follow up was 86.50/100 which showed excellent results. The results were better for extra-articular fractures. Average operative time, blood loss, time for radiological union and rate of complications were considerably less. Discussion Retrograde intramedullary nailing has been developed in order to address previous problems associated with distal femur fracture fixation. It has several advantages over plate fixation. Indigenous IMSC nail used in our study has added benefits over the routine IMSC nail due to its structure, number of screw holes in the distal part of nail, alignment of screw holes inside nail and unique thread design of the screws. Thus, it provides multi-planar fixation of fracture rather than in only one plane as achieved by routine IMSC nail giving excellent rotational stability to bone-implant construct.","PeriodicalId":192630,"journal":{"name":"International Journal of Orthopaedics Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130034300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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