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Prognosis in Conservative Treated Fracture Clavicle 保守治疗锁骨骨折的预后
Pub Date : 2020-02-21 DOI: 10.33140/ijor.03.01.06
Introduction: Traditionally most of clavicular fracture can be treated conservally .Operative treatment is usuallyindicated for open injuries, lateral clavicular fracrure, fragments pressing the plueral cavity, neurovascular compromise,overlying skin. The main aim of this study was to determine the shoulder functional outcomes after clavicle fracturesin conservative treated patients.Method: Retrospective study of 261 patients of comservative treated clavicular fracture selected . Patient wereexamined after 3 months and 6 months according to below given test protocol and constant score was calculatedwith reference constant.Pain measured as 0-15 within ordinary shoulder activities within 24 hours. Activtites of dailyliving as 4 questions deal with everyday activities expect over last week (0---20points). Four different active and painfree movement of the arm are performed (0-20).Result: All the patient with fracture clavicle without associated other injuries were treated conservatively for 4-8weeks, and then constant score of both affected and nonaffected side were calculated and compared of both sidesafter 3 and 6 months as described in materials and methods. Difference between normal and abnormal side gradedas more than 30 pooor, 21-30 fair, 11-20 Good, less than 11 excellent.Conclusion: Conservative treated case of clavicular fracture is easy way to treat the cases in OPD bases but it leadto high rate of shortening and nonunion. In few case Operative should be done to restore the normal functional ofshoulder intregreity
传统上大多数锁骨骨折可以保守治疗,手术治疗通常适用于开放性损伤、锁骨外侧骨折、碎片压迫椎体腔、神经血管受损、皮肤覆盖。本研究的主要目的是确定锁骨骨折患者保守治疗后的肩关节功能结果。方法:选取保守治疗的锁骨骨折261例进行回顾性研究。病人wereexamined 3个月和6个月后根据得分低于给定的测试协议和常数是calculatedwith参考常数。疼痛测量0-15在普通肩活动在24小时内。Activtites dailyliving为4的问题处理日常活动预计在上周(0 - 20分)。进行四种不同的主动和无痛的手臂运动(0-20)。结果:所有未合并其他损伤的锁骨骨折患者均保守治疗4-8周,然后计算受累侧和未受累侧的恒定评分,并在3个月和6个月后按资料和方法进行比较。正常侧与异常侧评分差30分以上,一般21-30分,良好11-20分,优秀11分以下。结论:保守治疗锁骨骨折是一种简便易行的治疗方法,但其导致锁骨短缩和骨不愈合的发生率较高。在少数情况下,应通过手术恢复肩关节的正常功能
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引用次数: 0
The Effect of Abdominal and Spinal Muscles Fatigue in Spinal Postures 脊柱体位中腹、脊肌疲劳的影响
Pub Date : 2020-02-17 DOI: 10.33140/ijor.03.01.05
Background: A Pre/Post-Test Cohort investigating the effect of spinal and abdominal muscles fatigue on spinalcurvatures.Method and Results: The effect of spinal and abdominal muscle fatigue on pelvic tilt, trunk inclination and the lordoticangle, and on the rotation of the T6, L2 and L4 vertebras was investigated in 10 healthy individuals. Abdominal andspinal muscles fatigue had a significant effect (p <0.05) on pelvic tilt, trunk inclination and lordotic angle.Conclusion: Application of simple and quick fatigue tests resulted in changes in all static parameters (pelvic tilt,trunk inclination and lordotic angle) as measured by the DIERS system.
背景:测试前/测试后队列研究脊柱和腹肌疲劳对脊柱弯曲的影响。方法与结果:观察10例健康人腰腹肌疲劳对骨盆倾斜、躯干倾斜、前椎弓背角及T6、L2、L4椎体旋转的影响。腹脊肌疲劳对骨盆倾斜、躯干倾斜和前凸角有显著影响(p <0.05)。结论:应用简单快速的疲劳试验可以改变DIERS系统测量的所有静态参数(骨盆倾斜、躯干倾斜和前凸角)。
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引用次数: 0
Hip Abductor Muscle Weakness after Antegrade Nailing of Femoral Fractures 股骨骨折顺行内钉治疗后髋外展肌无力
Pub Date : 2020-02-08 DOI: 10.33140/ijor.03.01.04
Nailing of femoral fractures is now considered as the standard line of management, although having many advantages,this technique carries some risks related to the technique, in this short review we will handle the issue of hip abductormuscle weakness after antegrade nailing of femoral fractures.
股骨骨折内钉治疗目前被认为是一种标准的治疗方法,尽管有很多优点,但这种技术也存在一些风险,在这篇简短的综述中,我们将处理股骨骨折顺行内钉治疗后髋外展肌无力的问题。
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引用次数: 0
A Retrospective Study of Claw Toe Repair Combining Partial Proximal Phalangectomy(PPP), Proximal Interphalangeal (PIP) Joint Interpositional Arthroplasty andKirschner Wire Fixation 爪趾修复联合部分近端指骨切除术(PPP)、近端指间关节置换术(PIP)和克氏针固定的回顾性研究
Pub Date : 2020-02-04 DOI: 10.33140/ijor.03.01.03
Background & Objective: Various operative methods have been used for the repair of claw toe deformities. We presenta review of a combination of three operative procedures performed for the correction of this deformity.Methods: A review was conducted examining 105 patient clinical records over a ten year period. Patients whoreceived either one or a combination of the following procedures: Partial Proximal Phalangectomy (PPP), ProximalInterphalangeal Joint (PIP) interpositional arthroplasty, and k-wire fixation were included.Results: Over a ten year span, a total of 86 PPP, 124 PIP and 29 k-wire fixations were performed on 96 patients. Ofthe 105 clinical cases reviewed, there were only 4 recurrences of claw toe deformity. Early complications includedk-wire backout/breakage, reversible avascular toe in the recovery room, and pin site infection.Conclusions: The combination of the three procedures presented, are an optimal operative treatment for the repairof claw toe deformity in various patients. Assessments can be made during surgery to determine if the proceduresshould be used solely or in combination based on the level of deformity. This customizable technique presented aminimal level of early complications and a low recurrence rate.
背景与目的:爪趾畸形的修复采用了多种手术方法。我们介绍了矫正这种畸形的三种手术方法的结合。方法:对10年间105例患者的临床资料进行回顾性分析。接受以下一种或多种手术的患者包括:部分近端指骨切除术(PPP),近端指骨间关节置换术(PIP)和k针固定。结果:在10年的时间里,96例患者共进行了86例PPP, 124例PIP和29例k线固定。在105例临床病例中,只有4例爪趾畸形复发。早期并发症包括金属丝回退/断裂,恢复室中可逆性无血管脚趾和针位感染。结论:三种术式相结合是修复各种患者爪趾畸形的最佳术式。可以在手术期间进行评估,以确定是否应根据畸形程度单独或联合使用这些手术。这种可定制的技术具有最低程度的早期并发症和低复发率。
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引用次数: 1
Skin Sensitivity to Pressure and Kneeling Ability Before and After TKA TKA前后皮肤对压力的敏感性和跪地能力
Pub Date : 2020-01-14 DOI: 10.33140/ijor.03.01.02
The kneeling ability and sensitivity to pain tested in 30 consecutive patients undergoing primary TKAs, Thirty (30)knees (16 right, 14 left). Kneeling difficulties following TKA were noticed in the majority of patients. Before surgery,the PPTs (Pain Pressure Thresholds) measures were lower in the patients who were unable to kneel compared tothose who were able to kneel. However, this difference was not significant at QT (Quadriceps Tendon) area (p=0.2)but significant in all other areas (P= < 0.05). At 6 months the values were changed but again the differences were notsignificant (p=> 0.05). There were notable gender differences in the kneeling ability before and after TKA.
在30例连续接受原发性tka的患者中,30(30)个膝关节(16个右膝,14个左膝)进行了跪下能力和对疼痛的敏感性测试。大多数患者在TKA后出现跪地困难。在手术前,无法下跪的患者的疼痛压力阈值(PPTs)比能够下跪的患者低。然而,这种差异在QT(股四头肌肌腱)区域无统计学意义(p=0.2),但在其他区域均有统计学意义(p= < 0.05)。6个月时,数值有所改变,但差异无统计学意义(p=> 0.05)。在膝关节置换术前后,跪下能力有显著的性别差异。
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引用次数: 0
Main Implications of Early Surgical Treatment of Elderly Hip Fractures and TheirInfluence on Mortality 老年髋部骨折早期手术治疗的主要意义及其对死亡率的影响
Pub Date : 2020-01-04 DOI: 10.33140/ijor.03.01.01
Aim: The present literature review aimed to investigate the main indications and implications of early surgical treatment ofhip fractures (proximal femur) and their influence on mortality in the elderly.Introduction: In Brazil estimates show that about 100,000 hip fractures occur annually in the elderly, being a major publichealth problem. When examining mortality, it is observed that the average mortality after one year of fracture is about 30%.Studies show that the surgical approach is the key element in its treatment, and in general the surgical approach time shouldoccur as soon as possible, preferably within 24 to 48 hours of admission. Such interval allows clinical stabilization of thepatient, and the time of surgical approach may affect the patient's evolution, delay surgical treatment resulting in delayedmobilization and thus affect the patient's functional recovery. On the other hand, failure of clinical stabilization before surgerymay increase the risk of perioperative complications.Methodology: Due to the implications involved in the surgical treatment of proximal femur fractures in the elderly, both periand postoperatively, an investigation in the literature produced in the last 10 years using SCIELO, PUBMED, and COCHRANEas databases. They were selected produced in English or Portuguese. Advanced research was performed using the followingdescriptors in English: proximal femur fracture, surgery, elderly, Brazil, hospital, trauma and mortality. About 280 articleswere found. A title reading was performed, followed by a summary and 20 articles pertinent to the theme of this systematicreview were selected at the end.Results and Discussion: The present literature review showed that many studies showed that the lack of immediate surgicaltreatment of the proximal femur fracture resulted in an increase in the mortality rate of about 10% and a complication rate ofabout 23% in 30% days. Complications due to late surgical treatment included urinary tract infection, pneumonia, thrombosis,as well as other cardiorespiratory problems, and other comorbidities.Conclusion: This review concludes from the studies analyzed that surgical treatment should be performed on the patient nolater than 48 hours after hip fracture or soon after the patient's clinical stabilization, and the mortality rate found after 30days of surgery. Surgical treatment of proximal femur fracture was about 10% in the elderly. In addition, complications arepresent in about 23% of postoperative patients, which implies increased health costs involved in rehabilitation, postoperativecomplications and readmissions.
目的:本文献综述旨在探讨早期手术治疗老年髋部骨折(股骨近端)的主要适应症和意义及其对死亡率的影响。引言:据估计,巴西每年约有10万例老年人髋部骨折,这是一个重大的公共卫生问题。在检查死亡率时,观察到骨折一年后的平均死亡率约为30%。研究表明,手术入路是其治疗的关键因素,一般情况下手术入路时间应尽快确定,最好在入院后24 - 48小时内。这样的时间间隔使得患者的临床稳定,手术入路的时间可能会影响患者的发展,延迟手术治疗导致活动延迟,从而影响患者的功能恢复。另一方面,术前临床稳定的失败可能会增加围手术期并发症的风险。方法学:考虑到老年人股骨近端骨折手术治疗的影响,包括围手术期和术后,对近10年来SCIELO、PUBMED和COCHRANEas数据库的文献进行了调查。他们被挑选出来用英语或葡萄牙语制作。高级研究使用以下英文描述符进行:股骨近端骨折,手术,老年人,巴西,医院,创伤和死亡率。大约有280件物品被发现。首先进行标题阅读,然后进行总结,最后选出与本次系统综述主题相关的20篇文章。结果与讨论:目前的文献综述显示,许多研究表明,股骨近端骨折不立即手术治疗导致30%天内死亡率增加约10%,并发症发生率增加约23%。手术治疗后期引起的并发症包括尿路感染、肺炎、血栓形成以及其他心肺问题和其他合并症。结论:本综述从分析的研究中得出结论:髋部骨折后48小时内或患者临床稳定后不久应进行手术治疗,并在手术后30天内发现死亡率。老年人股骨近端骨折手术治疗约占10%。此外,约23%的术后患者出现并发症,这意味着康复、术后并发症和再入院的医疗费用增加。
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引用次数: 0
Tarsal Navicular Osteonecrosis in Children 儿童跗骨舟骨骨坏死
Pub Date : 2019-12-24 DOI: 10.33140/ijor.02.01.06
Osteonecrosis (avascular, aseptic or ischemic bone necrosis) of the tarsal navicular in children may develop either spontaneously (primary, idiopathic, atraumatic or non-traumatic) or secondary to trauma (post-traumatic) and osteochondrosis. In both groups, of primary and secondary osteonecrosis, the clinical findings as well as the radiographic abnormalities are self-limited and usually resolve spontaneously irrespective of weight-bearing and immobilization treatment modalities. Köhler’s disease has been defined either as atraumatic navicular osteonecrosis or as an osteochondrosis process, based on the similar radiographic appearance of increased sclerosis and flattening detected in both asymptomatic and symptomatic children. Post-traumatic tarsal navicular osteonecrosis in children may follow microtrauma or overuse injuries, stress fractures, acute fractures, osteochondritis dissecans and severe foot injuries. This editorial aims to present the primary and secondary causes of osteonecrosis of the tarsal navicular in children and to describe the difficulties of the clinical and radiological evaluation in order to define an accurate diagnosis.
儿童跗骨舟骨骨坏死(无血管性、无菌性或缺血性骨坏死)可能自发发生(原发性、特发性、非创伤性或非创伤性),也可能继发于创伤(创伤后)和骨软骨病。在原发性和继发性骨坏死的两组中,临床表现和影像学异常都是自限性的,通常自发消退,与负重和固定治疗方式无关。基于在无症状和有症状的儿童中检测到的类似的硬化和变平的x线表现,Köhler的疾病被定义为非外伤性舟骨坏死或骨软骨硬化过程。儿童创伤后跗舟骨坏死可继发于微创伤或过度使用性损伤、应力性骨折、急性骨折、剥离性骨软骨炎和严重的足部损伤。这篇社论旨在介绍儿童跗骨舟骨坏死的主要和次要原因,并描述临床和影像学评估的困难,以便确定准确的诊断。
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引用次数: 3
In Vivo Therapeutic Effect of a Novel Thiolated Chitosan/Modified CalciumCarbonate Composite Microspheres Scaffold for Bone Repair 新型硫代壳聚糖/改性碳酸钙复合微球骨修复支架的体内治疗效果
Pub Date : 2019-12-21 DOI: 10.33140/ijor.02.01.05
In this study, thiolated chitosan (CS-TBA) and modified calcium carbonate microspheres (CCM), were used tofabricate composite scaffolds, and their physical and performances were compared and evaluated in vitro and invivo. Specimen of the following was prepared as 5 mm diameter, 1 mm thick discs; CS-TBA/CCM group and a controlgroup (blank group). A scanning electron microscope study was conducted. Graft materials were implanted in a 5mm diameter in the calvarial bone. Rats were sacrificed after four and eight weeks for micro-CT and histologicalstaining, and the findings obtained were used to calculate the bone mineral density (BMD), bone volume/total bonevolume (BV/TV), and trabecular number (TB.N). It was found that these three values were significantly higher in theCS-TBA/CCM group than in the control group (p<0.05). This study demonstrated an excellent potential of CS-TBA/CCM scaffold as a bone graft substitute.
本研究采用巯基壳聚糖(CS-TBA)和改性碳酸钙微球(CCM)制备复合支架,并对其体外和体内的物理性能进行了比较和评价。以下标本制备为直径为5mm,厚度为1mm的椎间盘;CS-TBA/CCM组和对照组(空白组)。采用扫描电镜观察。植骨材料以5mm直径植入颅骨。4周和8周后处死大鼠,进行显微ct和组织学染色,计算骨密度(BMD)、骨体积/总骨体积(BV/TV)和骨小梁数(TB.N)。结果发现,cs - tba /CCM组这三项指标均显著高于对照组(p<0.05)。本研究证明了CS-TBA/CCM支架作为骨移植替代品的良好潜力。
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引用次数: 0
Biomechanical Etiology of the So-Called Idiopathic Scoliosis, Connection with“Syndrome of Contractures and Deformities”, Role of Gait and Standing ‘At Ease’On the Right Leg in the Development of Spine Deformity, New Treatment, CausalProphylactics 所谓特发性脊柱侧凸的生物力学病因学,与“挛缩和畸形综合征”的联系,步态和右腿“轻松”站立在脊柱畸形发展中的作用,新治疗方法,因果预防
Pub Date : 2019-11-21 DOI: 10.33140/ijor.02.01.04
In years 1984 – 1995 were gathered first information about the biomechanical etiology of the so-called idiopathicscoliosis. In years 1995 – 2007 were found all importance of knowledge about etiology, new classification, and newtherapy. The development of scoliosis is connected with “asymmetry of movement” of the hips and this is the part ofasymmetries described by Professor Hans Mau as “Seven Contracture Syndrome” (German Siebenersyndrom). Nextscoliosis develop because of “permanent standing ‘at ease’ on the right leg” and during “gait”, when blocked momentof the right hip, as compensatory movement, is transmitted to pelvis and the spine-making / acting the spine deformity.
在1984 - 1995年间,首次收集了关于所谓的特发性脊柱侧凸的生物力学病因的信息。1995 - 2007年发现病因学、新分类和新疗法知识的重要性。脊柱侧凸的发展与髋关节的“运动不对称”有关,Hans Mau教授将这部分不对称描述为“七挛缩综合征”(德语siebener综合征)。下一次脊柱侧弯的发生是由于“右腿永久地‘自在地’站立”和“步态”时,当右髋关节的阻塞力矩作为代偿运动传递到骨盆和脊柱时,造成/导致脊柱畸形。
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引用次数: 4
Case Report of a Medial Femoral Condyle Fracture in a Unicompartmental OxfordKnee Replacement Surgery 单室牛津膝关节置换术中股骨内侧髁骨折1例报告
Pub Date : 2019-08-28 DOI: 10.33140/ijor.02.01.03
Introduction: The unicompartmental Oxford prosthesis has been used as a goodalternative for medial unicompartmentalosteoarthritis because it is associated with earlyrehabilitation and a low rate of intraoperative complications. Thiscase describes a rarecomplication during the procedure.Case Presentation: We present an intraoperative fracture of the medial condyle in a 70-year-old woman that wastreated with 6.5 mm cannulated screws with a compressiontechnique. The patient remained in a non-weight bearingprotocol for 6 weeks andreached a full range of mobility at 3 months. Complete radiological consolidation andagood functional outcome were observed.Conclusion: Intraoperative fractures benefit from a stable osteosynthesis that allows freerange of mobility and doesnot delay postoperative rehabilitation.
单室Oxford假体被认为是治疗内侧单室骨关节炎的一种很好的替代方法,因为它具有早期康复和术中并发症发生率低的特点。本病例描述了手术过程中一个罕见的并发症。病例介绍:我们报告一例70岁女性术中内侧髁骨折,采用6.5 mm空心螺钉加压技术治疗。患者在非负重方案中保持6周,并在3个月时达到全范围活动。观察到完全的放射学巩固和良好的功能预后。结论:术中骨折受益于稳定的植骨术,允许活动范围自由,且不会延迟术后康复。
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引用次数: 0
期刊
International Journal of Orthopaedics Research
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