An excess of adipose tissue buildup restricted to the lumbar and thoracic areas of the spine is the cause of spinal epidural lipomatosis. The etiology of spinal epidural lipomatosis can be broadly categorized based on five often related risk factors: obesity, endogenous steroid hormonal disease, spine surgery, exogenous steroid use and idiopathic disease. However, the actual pathophysiology of the condition remains unclear. Neurological impairments, myelopathy, radiculopathy, neurogenic claudication, loss of sensation, difficulties voiding, lower extremity weakness and infrequently cauda equina syndrome might result from the progression of spinal epidural lipomatosis. Conservative treatment focuses on reducing symptoms that result from common risk factors and is primarily patient-specific. Open surgical procedures and minimally invasive surgery have shown to be effective if more advanced means of treatment are required. Here, we report an unusual case of idiopathic spinal epidural lipomatosis. Treatment will depend on the neurological status of the patient. We opted to manage the patient conservatively and closely monitor her on follow up visits.
{"title":"An Unusual Case of Idiopathic Spinal Epidural Lipomatosis","authors":"Pranab Jyoti Borah","doi":"10.46889/josr.2024.5104","DOIUrl":"https://doi.org/10.46889/josr.2024.5104","url":null,"abstract":"An excess of adipose tissue buildup restricted to the lumbar and thoracic areas of the spine is the cause of spinal epidural lipomatosis. The etiology of spinal epidural lipomatosis can be broadly categorized based on five often related risk factors: obesity, endogenous steroid hormonal disease, spine surgery, exogenous steroid use and idiopathic disease. However, the actual pathophysiology of the condition remains unclear. Neurological impairments, myelopathy, radiculopathy, neurogenic claudication, loss of sensation, difficulties voiding, lower extremity weakness and infrequently cauda equina syndrome might result from the progression of spinal epidural lipomatosis.\u0000\u0000Conservative treatment focuses on reducing symptoms that result from common risk factors and is primarily patient-specific. Open surgical procedures and minimally invasive surgery have shown to be effective if more advanced means of treatment are required. Here, we report an unusual case of idiopathic spinal epidural lipomatosis. Treatment will depend on the neurological status of the patient. We opted to manage the patient conservatively and closely monitor her on follow up visits.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139806254","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}
An excess of adipose tissue buildup restricted to the lumbar and thoracic areas of the spine is the cause of spinal epidural lipomatosis. The etiology of spinal epidural lipomatosis can be broadly categorized based on five often related risk factors: obesity, endogenous steroid hormonal disease, spine surgery, exogenous steroid use and idiopathic disease. However, the actual pathophysiology of the condition remains unclear. Neurological impairments, myelopathy, radiculopathy, neurogenic claudication, loss of sensation, difficulties voiding, lower extremity weakness and infrequently cauda equina syndrome might result from the progression of spinal epidural lipomatosis. Conservative treatment focuses on reducing symptoms that result from common risk factors and is primarily patient-specific. Open surgical procedures and minimally invasive surgery have shown to be effective if more advanced means of treatment are required. Here, we report an unusual case of idiopathic spinal epidural lipomatosis. Treatment will depend on the neurological status of the patient. We opted to manage the patient conservatively and closely monitor her on follow up visits.
{"title":"An Unusual Case of Idiopathic Spinal Epidural Lipomatosis","authors":"Pranab Jyoti Borah","doi":"10.46889/josr.2024.5104","DOIUrl":"https://doi.org/10.46889/josr.2024.5104","url":null,"abstract":"An excess of adipose tissue buildup restricted to the lumbar and thoracic areas of the spine is the cause of spinal epidural lipomatosis. The etiology of spinal epidural lipomatosis can be broadly categorized based on five often related risk factors: obesity, endogenous steroid hormonal disease, spine surgery, exogenous steroid use and idiopathic disease. However, the actual pathophysiology of the condition remains unclear. Neurological impairments, myelopathy, radiculopathy, neurogenic claudication, loss of sensation, difficulties voiding, lower extremity weakness and infrequently cauda equina syndrome might result from the progression of spinal epidural lipomatosis.\u0000\u0000Conservative treatment focuses on reducing symptoms that result from common risk factors and is primarily patient-specific. Open surgical procedures and minimally invasive surgery have shown to be effective if more advanced means of treatment are required. Here, we report an unusual case of idiopathic spinal epidural lipomatosis. Treatment will depend on the neurological status of the patient. We opted to manage the patient conservatively and closely monitor her on follow up visits.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139866110","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: According to recent research conducted internationally, the reported rate of falls among older adults varies from 4% to 35% and rises progressively with age. Aim of Study: assess relationship between nurses’ practices regarding fall prevention among elderly women and their personal characteristics. Research Design: An exploratory design; Setting: Outpatient clinics аt Beni-Suef University Hospital. Sample: a cross-sectional sample made up of one hundred nurses. Instrument: Independently administered; the questionnaire has two parts. (I): Personal attributes of nurses, (II): A checklist of nurses’ practices. Results: of the nurses in the study, about half (48.0%, 49% and 43%) were between the ages of 30-44, had five to fewer than ten years of experience and had received training in fall prevention and management, respectively. Less than two thirds of the studied nurses (61.0%) are competent in fall prevention total practices among elderly women patients. Conclusion: A highly statistically significant relation between total practices of the studied nurses in fall prevention among the elderly women during hospitalization and their educational qualification, years of experience and training was found. Recommendation: implement an educational program and guidelines related to fall prevention in elderly patients for in-services nurses.
{"title":"Relationship Between Nurses' Practices Regarding Fall Prevention among Elderly Women and Their personal Characteristics","authors":"Hassan He","doi":"10.46889/josr.2024.5103","DOIUrl":"https://doi.org/10.46889/josr.2024.5103","url":null,"abstract":"Background: According to recent research conducted internationally, the reported rate of falls among older adults varies from 4% to 35% and rises progressively with age.\u0000\u0000Aim of Study: assess relationship between nurses’ practices regarding fall prevention among elderly women and their personal characteristics.\u0000\u0000Research Design: An exploratory design; Setting: Outpatient clinics аt Beni-Suef University Hospital.\u0000\u0000Sample: a cross-sectional sample made up of one hundred nurses. Instrument: Independently administered; the questionnaire has two parts. (I): Personal attributes of nurses, (II): A checklist of nurses’ practices.\u0000\u0000Results: of the nurses in the study, about half (48.0%, 49% and 43%) were between the ages of 30-44, had five to fewer than ten years of experience and had received training in fall prevention and management, respectively. Less than two thirds of the studied nurses (61.0%) are competent in fall prevention total practices among elderly women patients.\u0000\u0000Conclusion: A highly statistically significant relation between total practices of the studied nurses in fall prevention among the elderly women during hospitalization and their educational qualification, years of experience and training was found.\u0000\u0000Recommendation: implement an educational program and guidelines related to fall prevention in elderly patients for in-services nurses.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"40 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139808684","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: According to recent research conducted internationally, the reported rate of falls among older adults varies from 4% to 35% and rises progressively with age. Aim of Study: assess relationship between nurses’ practices regarding fall prevention among elderly women and their personal characteristics. Research Design: An exploratory design; Setting: Outpatient clinics аt Beni-Suef University Hospital. Sample: a cross-sectional sample made up of one hundred nurses. Instrument: Independently administered; the questionnaire has two parts. (I): Personal attributes of nurses, (II): A checklist of nurses’ practices. Results: of the nurses in the study, about half (48.0%, 49% and 43%) were between the ages of 30-44, had five to fewer than ten years of experience and had received training in fall prevention and management, respectively. Less than two thirds of the studied nurses (61.0%) are competent in fall prevention total practices among elderly women patients. Conclusion: A highly statistically significant relation between total practices of the studied nurses in fall prevention among the elderly women during hospitalization and their educational qualification, years of experience and training was found. Recommendation: implement an educational program and guidelines related to fall prevention in elderly patients for in-services nurses.
{"title":"Relationship Between Nurses' Practices Regarding Fall Prevention among Elderly Women and Their personal Characteristics","authors":"Hassan He","doi":"10.46889/josr.2024.5103","DOIUrl":"https://doi.org/10.46889/josr.2024.5103","url":null,"abstract":"Background: According to recent research conducted internationally, the reported rate of falls among older adults varies from 4% to 35% and rises progressively with age.\u0000\u0000Aim of Study: assess relationship between nurses’ practices regarding fall prevention among elderly women and their personal characteristics.\u0000\u0000Research Design: An exploratory design; Setting: Outpatient clinics аt Beni-Suef University Hospital.\u0000\u0000Sample: a cross-sectional sample made up of one hundred nurses. Instrument: Independently administered; the questionnaire has two parts. (I): Personal attributes of nurses, (II): A checklist of nurses’ practices.\u0000\u0000Results: of the nurses in the study, about half (48.0%, 49% and 43%) were between the ages of 30-44, had five to fewer than ten years of experience and had received training in fall prevention and management, respectively. Less than two thirds of the studied nurses (61.0%) are competent in fall prevention total practices among elderly women patients.\u0000\u0000Conclusion: A highly statistically significant relation between total practices of the studied nurses in fall prevention among the elderly women during hospitalization and their educational qualification, years of experience and training was found.\u0000\u0000Recommendation: implement an educational program and guidelines related to fall prevention in elderly patients for in-services nurses.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"61 7-8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139868381","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}
The treatment of complex intra-articular fractures of the middle phalanx is a difficult task for the hand surgeon. A 61-year-old male presented with complex intra-articular middle phalanx fracture of the ring finger which was treated with the aid of the Ilizarov mini-apparatus. The proposed use of the Ilizarov mini-apparatus has some advantages. The degree of traction is easy to dose and control. Parts of apparatus and K-wires do not cover the image of the proximal interphalangeal joint on radiographs. The Ilizarov mini-apparatus is quite stable.
对于手外科医生来说，治疗复杂的关节内中指骨骨折是一项艰巨的任务。一名 61 岁的男性无名指中指骨关节内复杂骨折患者借助 Ilizarov 迷你器械进行了治疗。建议使用伊利扎洛夫微型器械有一些优点。牵引的程度易于剂量和控制。仪器的部件和 K 线不会遮挡近端指间关节在 X 光片上的图像。伊利扎洛夫迷你器械相当稳定。
{"title":"Pilon Fracture of the Middle Phalanx: Treatment Using Mini-Ilizarov Apparatus","authors":"Alexander S Zolotov","doi":"10.46889/josr.2024.5102","DOIUrl":"https://doi.org/10.46889/josr.2024.5102","url":null,"abstract":"The treatment of complex intra-articular fractures of the middle phalanx is a difficult task for the hand surgeon. A 61-year-old male presented with complex intra-articular middle phalanx fracture of the ring finger which was treated with the aid of the Ilizarov mini-apparatus. The proposed use of the Ilizarov mini-apparatus has some advantages. The degree of traction is easy to dose and control. Parts of apparatus and K-wires do not cover the image of the proximal interphalangeal joint on radiographs. The Ilizarov mini-apparatus is quite stable.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139591790","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}
Results: more than а half of the studied nurses (59.1%) report that they know Morse tool, 86.6% mention that the most ones at risk of falling are those they have a weakness of the lower extremities, 89.0% mention that the medications associated with falls and the harmful effects those are Antihypertensive medications, 73.6% mention that; loss of balance is the main factor that contribute to falls among the elderly, 88.8% report that they provide adequate lighting for safe walking as a safety precautions and basic nursing practice for fall prevention among old women. Conclusion: Figure (1) Most of the studied nurses have knowledge regarding whom are at risk of falling, medications associated with falls and the harmful effects, complications resulting from falls for the elderly, factors that contribute to falls among the elderly and information/instructions should be given to the patient to avoid falling. Recommendation: Further study should be conducted for identifying and understanding the combination of factors that produce successful unit-level fall prevention strategies.
{"title":"Study on Nurses' Knowledge about Fall Prevention among Elderly Women","authors":"Hanan Elzeblawy Hassan","doi":"10.46889/josr.2024.5101","DOIUrl":"https://doi.org/10.46889/josr.2024.5101","url":null,"abstract":"Results: more than а half of the studied nurses (59.1%) report that they know Morse tool, 86.6% mention that the most ones at risk of falling are those they have a weakness of the lower extremities, 89.0% mention that the medications associated with falls and the harmful effects those are Antihypertensive medications, 73.6% mention that; loss of balance is the main factor that contribute to falls among the elderly, 88.8% report that they provide adequate lighting for safe walking as a safety precautions and basic nursing practice for fall prevention among old women. Conclusion: Figure (1) Most of the studied nurses have knowledge regarding whom are at risk of falling, medications associated with falls and the harmful effects, complications resulting from falls for the elderly, factors that contribute to falls among the elderly and information/instructions should be given to the patient to avoid falling. Recommendation: Further study should be conducted for identifying and understanding the combination of factors that produce successful unit-level fall prevention strategies.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"5 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139592862","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: It is hypothesized that elderly patients with type II mellitus are at a higher risk for delayed union of distal radius fracture and this risk is specific to patients with comorbidity of diabetes mellitus. The purpose of this study is to compare the fracture healing time duration in elderly, diabetic distal radius fracture with those of non-diabetic control group. Material and methods: Elderly distal radius fracture with type II diabetes mellitus in 22 patients were retrospectively reviewed. Patients were individually matched to controls, who were treated by the author from the same institute with respect to age, gender, fracture type Radiographs were reviewed to determine fracture healing Univariate and multivariate regression were used to identify factors associated with time to radiographic fracture union. Results: In 4 (18.2%) of diabetic group A and 20 (90.9%) non diabetic group B patients exhibited a radiologically visible callus formation at 4 weeks. While no callus formation was visible in 18 (81.8%), 2 (9.1%) accordingly. The mean average time to fracture of 66 ± 19 days was visualized in group A of type II diabetes mellitus patients versus 46 ± 12 days in group B, non-diabetic control group (P > 0.001). Linear regression analysis revealed that group A patients were associated with longer time for fracture healing (P = 0.02). The age (P = 0.29), sex (P = 0.31) was not associated with increased fracture healing time duration. No differences were detected between both the groups A and B in terms of treatment approach (P = 0.61). Conclusion: The fracture healing time duration in elderly diabetic distal radius fracture group was categorically prolonged than non-diabetic control group.
导言：据推测，患有 II 型糖尿病的老年患者桡骨远端骨折延迟愈合的风险较高，而且这种风险是糖尿病合并症患者所特有的。本研究旨在比较老年糖尿病桡骨远端骨折患者与非糖尿病对照组的骨折愈合时间。 材料和方法对 22 例老年桡骨远端骨折伴 II 型糖尿病患者进行回顾性研究。在年龄、性别、骨折类型方面，将患者与由作者在同一研究所治疗的对照组进行单独配对，并复查X光片以确定骨折愈合情况。 结果糖尿病 A 组中有 4 名患者（18.2%）和非糖尿病 B 组中有 20 名患者（90.9%）在 4 周后出现了影像学可见的胼胝形成。而 18 名（81.8%）和 2 名（9.1%）患者未见胼胝形成。A 组 II 型糖尿病患者平均骨折时间为 66 ± 19 天，而 B 组（非糖尿病对照组）为 46 ± 12 天（P > 0.001）。 线性回归分析显示，A 组患者的骨折愈合时间更长（P = 0.02）。年龄（P = 0.29）和性别（P = 0.31）与骨折愈合时间的延长无关。A 组和 B 组在治疗方法上没有差异（P = 0.61）。 结论与非糖尿病对照组相比，老年糖尿病桡骨远端骨折组的骨折愈合时间明显延长。
{"title":"Fracture Healing in Elderly Distal Radius Fracture with Type II Diabetes Mellitus","authors":"Raghavendra S Kulkarni","doi":"10.46889/josr.2023.4312","DOIUrl":"https://doi.org/10.46889/josr.2023.4312","url":null,"abstract":"Introduction: It is hypothesized that elderly patients with type II mellitus are at a higher risk for delayed union of distal radius fracture and this risk is specific to patients with comorbidity of diabetes mellitus. The purpose of this study is to compare the fracture healing time duration in elderly, diabetic distal radius fracture with those of non-diabetic control group. Material and methods: Elderly distal radius fracture with type II diabetes mellitus in 22 patients were retrospectively reviewed. Patients were individually matched to controls, who were treated by the author from the same institute with respect to age, gender, fracture type Radiographs were reviewed to determine fracture healing Univariate and multivariate regression were used to identify factors associated with time to radiographic fracture union. Results: In 4 (18.2%) of diabetic group A and 20 (90.9%) non diabetic group B patients exhibited a radiologically visible callus formation at 4 weeks. While no callus formation was visible in 18 (81.8%), 2 (9.1%) accordingly. The mean average time to fracture of 66 ± 19 days was visualized in group A of type II diabetes mellitus patients versus 46 ± 12 days in group B, non-diabetic control group (P > 0.001). Linear regression analysis revealed that group A patients were associated with longer time for fracture healing (P = 0.02). The age (P = 0.29), sex (P = 0.31) was not associated with increased fracture healing time duration. No differences were detected between both the groups A and B in terms of treatment approach (P = 0.61). Conclusion: The fracture healing time duration in elderly diabetic distal radius fracture group was categorically prolonged than non-diabetic control group.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"112 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139134492","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}
Aim: In this study, we aim to compare the adverse effects and oncological outcomes of patients with high-grade extremity soft tissue sarcoma receiving neoadjuvant or adjuvant RT. Methods: From 2008 to 2022, Sixty-four patients underwent limb-preserving surgery in our institute for localized high-grade extremity soft tissue sarcoma were included. Thirty-nine patients received adjuvant radiotherapy while twenty-five patients received neoadjuvant RT before surgery if the soft tissue sarcomas were close to the neurovascular bundles, bones or histological types of myxoid liposarcoma or rhabdomyosarcoma. Primary outcomes were acute RT-related skin adverse reactions and significant side effects comprising postoperative wound complications, pathological fractures and RT-induced sarcoma. Secondary outcomes included surgical margin quality, Local-Recurrence (LR)-free survival, metastasis-free survival and overall survivorship. Results and Discussion: Patients in the neoadjuvant RT group had significantly fewer acute RT-induced adverse skin reactions than the adjuvant RT group (p=0.044, Table 2). None in the neoadjuvant RT group suffered severe acute skin reaction (RTOG grade 3-4). Wound infection (n=2) and pathological fracture (n=1) were rare in both adjuvant and neoadjuvant RT groups (P=0.640 & 1.000 respectively). Survival curves for local-recurrence-free survival, metastasis-free survival and overall survivorship of both neoadjuvant and adjuvant groups were analyzed via Kaplan-Meier Curve. All results are statistically insignificant, with p=0.835, 0.948 and 0.540, respectively. Presence of metastasis was the only statistically significant predictor of the overall survival-adjusted hazard ratio of 8.7 (95%CI 2.7-28), p<0.001. Conclusion: Patients with neoadjuvant RT had lower cumulative radiation doses and fewer acute adverse skin reactions. There was no increased risk of postoperative wound complication compared to adjuvant RT. The LR-free survival, metastasis-free survival and overall survival were comparable in both groups. Our results suggested that postponing surgery to eight weeks after neoadjuvant RT and primary wound closure were associated with fewer wound complications, but further studies were warranted.
{"title":"Neoadjuvant Radiotherapy Is Associated with Fewer Acute Adverse Skin Reactions Without Increased Risk of Postoperative Wound Complications in High-Grade Extremity Soft Tissue Sarcoma - A Retrospective Comparative Study with A Mean Follow-Up of 7 Years","authors":"Hiu Woo Lau","doi":"10.46889/josr.2023.4311","DOIUrl":"https://doi.org/10.46889/josr.2023.4311","url":null,"abstract":"Aim: In this study, we aim to compare the adverse effects and oncological outcomes of patients with high-grade extremity soft tissue sarcoma receiving neoadjuvant or adjuvant RT. Methods: From 2008 to 2022, Sixty-four patients underwent limb-preserving surgery in our institute for localized high-grade extremity soft tissue sarcoma were included. Thirty-nine patients received adjuvant radiotherapy while twenty-five patients received neoadjuvant RT before surgery if the soft tissue sarcomas were close to the neurovascular bundles, bones or histological types of myxoid liposarcoma or rhabdomyosarcoma. Primary outcomes were acute RT-related skin adverse reactions and significant side effects comprising postoperative wound complications, pathological fractures and RT-induced sarcoma. Secondary outcomes included surgical margin quality, Local-Recurrence (LR)-free survival, metastasis-free survival and overall survivorship. Results and Discussion: Patients in the neoadjuvant RT group had significantly fewer acute RT-induced adverse skin reactions than the adjuvant RT group (p=0.044, Table 2). None in the neoadjuvant RT group suffered severe acute skin reaction (RTOG grade 3-4). Wound infection (n=2) and pathological fracture (n=1) were rare in both adjuvant and neoadjuvant RT groups (P=0.640 & 1.000 respectively). Survival curves for local-recurrence-free survival, metastasis-free survival and overall survivorship of both neoadjuvant and adjuvant groups were analyzed via Kaplan-Meier Curve. All results are statistically insignificant, with p=0.835, 0.948 and 0.540, respectively. Presence of metastasis was the only statistically significant predictor of the overall survival-adjusted hazard ratio of 8.7 (95%CI 2.7-28), p<0.001. Conclusion: Patients with neoadjuvant RT had lower cumulative radiation doses and fewer acute adverse skin reactions. There was no increased risk of postoperative wound complication compared to adjuvant RT. The LR-free survival, metastasis-free survival and overall survival were comparable in both groups. Our results suggested that postponing surgery to eight weeks after neoadjuvant RT and primary wound closure were associated with fewer wound complications, but further studies were warranted.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"15 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151649","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}
Pub Date : 2023-12-25DOI: 10.46889/josr.2023..4310
Mladen Stojanovic
Objective: The epidemic of COVID-19 virus in Serbia began on March 6, 2020 with the first confirmed positive test. The pandemic affected all spheres of life, especially the functioning of the health system. The newly introduced measures in the fight against the spread of the epidemic in Serbia included a curfew lasting 54 days, as well as limited working hours of state services, catering and sports facilities and a ban on mass gatherings of the population. As the introduced measures significantly affected the freedom of movement and activity of the population, the aim of this paper was to compare the distribution of fractures that were operatively cared for at our Clinic with the same period in 2019. Methods: The observed period in both years lasted from March 6 to December 31. There were 651 operated trauma patients in 2019 and 630 in 2020. Patients were divided into groups of fractures based on their anatomical localization. Groups were then compared in number of patients, as well as the age and sex distribution. Results: Our results showed that there is no statistically significant difference in the total number of operated patients in the two observed time intervals. The most common were fractures of the trochanteric region and fractures of the lower leg with almost identical age and sex distribution. Only the number of malleolar fractures and proximal humerus fractures showed a significant decline in the pandemic year. Conclusion: Despite the difficult working conditions in the newly emerging epidemiological situation, the scope of traumatological activities of our Clinic has remained almost unchanged. Approximately identical number of operated trauma patients in the two observed intervals indicates that most of our patients suffer injuries during daily activities at home, which were not affected by restriction of movement and other pandemic conditions.
{"title":"Operative Treatment of Patients with Fractures During COVID-19","authors":"Mladen Stojanovic","doi":"10.46889/josr.2023..4310","DOIUrl":"https://doi.org/10.46889/josr.2023..4310","url":null,"abstract":"Objective: The epidemic of COVID-19 virus in Serbia began on March 6, 2020 with the first confirmed positive test. The pandemic affected all spheres of life, especially the functioning of the health system. The newly introduced measures in the fight against the spread of the epidemic in Serbia included a curfew lasting 54 days, as well as limited working hours of state services, catering and sports facilities and a ban on mass gatherings of the population. As the introduced measures significantly affected the freedom of movement and activity of the population, the aim of this paper was to compare the distribution of fractures that were operatively cared for at our Clinic with the same period in 2019. Methods: The observed period in both years lasted from March 6 to December 31. There were 651 operated trauma patients in 2019 and 630 in 2020. Patients were divided into groups of fractures based on their anatomical localization. Groups were then compared in number of patients, as well as the age and sex distribution. Results: Our results showed that there is no statistically significant difference in the total number of operated patients in the two observed time intervals. The most common were fractures of the trochanteric region and fractures of the lower leg with almost identical age and sex distribution. Only the number of malleolar fractures and proximal humerus fractures showed a significant decline in the pandemic year. Conclusion: Despite the difficult working conditions in the newly emerging epidemiological situation, the scope of traumatological activities of our Clinic has remained almost unchanged. Approximately identical number of operated trauma patients in the two observed intervals indicates that most of our patients suffer injuries during daily activities at home, which were not affected by restriction of movement and other pandemic conditions.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159618","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 objective of this work was to evaluate the clinical and radiological results; and the quality of life of patients with THA at final follow-up. Patients and Method: This was a prospective, multicenter, multi-operator study, which was carried out in patients with THA, between January 1, 2014 and December 31, 2022. The clinical evaluation was carried out with the PMA, Devane and WOMAC activity scores. Radiologically, the analysis focused on the inclination of the cup, the peri-prosthetic lines and the bony integration of the implants. Results: 85 patients were re-evaluated out of 145; 60 were lost to follow-up including 16 due to death, the average follow-up was 5.85 years. The average age was 51.81 years (39-85). The functional scores were generally satisfactory at the last follow-up with a mean PMA, Devane and WOMAC score of 15.8 respectively; 2 and 76.54 and a rate of resumption of sexual intercourse after THA of 54.11%. The mechanical complications were: 8 revisions for prosthetic loosening, 4 wear and osteolysis, 02 periprosthetic margins. The patients were much more optimistic than the surgeon: 94.73% of the patients judged their results to be excellent or good while the surgeon only accepted 85.96%. Conclusion: Degenerative hip joint pathologies seem to be increasing due to the incidence of complications of sickle cell disease. The need for joint replacement is growing despite the still expensive cost. At the last follow-up, the overall results are satisfactory and a rate of resumption of sexual intercourse after THA of 54.11%. Chronic pain and muscle atrophy have had a significant impact on quality of life and sexual activity. Our study confirms the medium-term reliability of dual mobility with a survival rate of 90.60%. These results must be tempered because of the occurrence of long-term complications, linked to the risk of dual mobility in young subjects.
{"title":"Functional, Radiological Results and Quality of Life after Primary Total Hip Arthroplasty","authors":"","doi":"10.46889/josr.2023.4309","DOIUrl":"https://doi.org/10.46889/josr.2023.4309","url":null,"abstract":"Introduction: The objective of this work was to evaluate the clinical and radiological results; and the quality of life of patients with THA at final follow-up.\u0000\u0000Patients and Method: This was a prospective, multicenter, multi-operator study, which was carried out in patients with THA, between January 1, 2014 and December 31, 2022. The clinical evaluation was carried out with the PMA, Devane and WOMAC activity scores. Radiologically, the analysis focused on the inclination of the cup, the peri-prosthetic lines and the bony integration of the implants.\u0000\u0000Results: 85 patients were re-evaluated out of 145; 60 were lost to follow-up including 16 due to death, the average follow-up was 5.85 years. The average age was 51.81 years (39-85). The functional scores were generally satisfactory at the last follow-up with a mean PMA, Devane and WOMAC score of 15.8 respectively; 2 and 76.54 and a rate of resumption of sexual intercourse after THA of 54.11%. The mechanical complications were: 8 revisions for prosthetic loosening, 4 wear and osteolysis, 02 periprosthetic margins. The patients were much more optimistic than the surgeon: 94.73% of the patients judged their results to be excellent or good while the surgeon only accepted 85.96%.\u0000\u0000Conclusion: Degenerative hip joint pathologies seem to be increasing due to the incidence of complications of sickle cell disease. The need for joint replacement is growing despite the still expensive cost. At the last follow-up, the overall results are satisfactory and a rate of resumption of sexual intercourse after THA of 54.11%. Chronic pain and muscle atrophy have had a significant impact on quality of life and sexual activity. Our study confirms the medium-term reliability of dual mobility with a survival rate of 90.60%. These results must be tempered because of the occurrence of long-term complications, linked to the risk of dual mobility in young subjects.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"11 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138943926","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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