Objective: Patella instability injuries are often sports-related and occur in young athletes. These injuries severely impact the season and career trajectory of high-level competitors. This is the first large epidemiological study that evaluates these injury events in NCAA athletes. Methods: Patellar instability injuries across 16 sports among NCAA men and women during the 2004-05 to 2013-14 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Patellar instability injuries per 100,000 Athlete-Exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre/regular/post-season) and time lost were compiled and calculated. Results: A total of 11,778,265 Athlete-Exposures (AE) were identified and included. 380 patellar instability injuries were identified (Injury Rate IR = 3.23 per 100,000 AEs). 91 (23.95%) were severe injuries with a significantly higher time loss from play (40.5 days) and risk of operative management (50.55%). The most common sports during which a patellar instability event occurred were Women’s Gymnastics (IR=7.87), Soccer (IR=5.83), and Basketball (IR=4.34) and Men’s Wrestling (IR=5.44), Football (IR=4.84), and Soccer (IR=3.06). Male athletes had a statistically significant higher risk of season or career-ending injuries in all patellar instability injuries (3.20% vs 0.89%, p=0.0013). Severe injuries were more likely to result from contact mechanisms (58.24% vs 40.66%). Conclusion: Patella instability injuries have a profound impact on the longevity and sustainability of a collegiate athletes’ career. The risk of recurrence once a patellar injury has occurred is significant and athletes often require surgery. While more female athletes sustained these injuries, male athletes were more likely to require operative management and sustain a season-ending injury.
目的:髌骨不稳定性损伤常与运动有关，多发于年轻运动员。这些伤病严重影响了高水平运动员的赛季和职业发展轨迹。这是第一个评估NCAA运动员受伤事件的大型流行病学研究。方法:使用NCAA损伤监测项目(NCAA- isp)对2004-05至2013-14学年NCAA男性和女性的16项运动的髌骨不稳定性损伤进行分析。每10万名运动员暴露(ae)的髌骨不稳定性损伤、手术率、年损伤和再损伤率、赛季状态(赛前/常规赛/赛季后)和损失时间进行了汇编和计算。结果:共发现并纳入11,778,265例运动员暴露(AE)。380例髌骨不稳定性损伤(损伤率IR = 3.23 / 100,000 ae)。91例(23.95%)为严重损伤，运动时间损失(40.5天)和手术治疗风险(50.55%)显著高于其他病例。发生髌骨不稳事件最常见的运动是女子体操(IR=7.87)、足球(IR=5.83)、篮球(IR=4.34)和男子摔跤(IR=5.44)、足球(IR=4.84)和足球(IR=3.06)。在所有髌骨不稳定性损伤中，男性运动员赛季或职业生涯结束损伤的风险更高(3.20% vs 0.89%， p=0.0013)。严重损伤更容易由接触机制引起(58.24% vs 40.66%)。结论:髌骨不稳定性损伤对大学生运动员职业生涯的寿命和可持续性有着深远的影响。一旦发生髌骨损伤，复发的风险是显著的，运动员通常需要手术。虽然更多的女性运动员遭受了这些伤害，但男性运动员更有可能需要手术治疗，并在赛季结束时受伤。
{"title":"Epidemiology of Patella Instability Injuries in Collegiate Level Athletes in the United States","authors":"Christine S. Williams","doi":"10.46889/josr.2022.3213","DOIUrl":"https://doi.org/10.46889/josr.2022.3213","url":null,"abstract":"Objective: Patella instability injuries are often sports-related and occur in young athletes. These injuries severely impact the season and career trajectory of high-level competitors. This is the first large epidemiological study that evaluates these injury events in NCAA athletes.\u0000\u0000Methods: Patellar instability injuries across 16 sports among NCAA men and women during the 2004-05 to 2013-14 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Patellar instability injuries per 100,000 Athlete-Exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre/regular/post-season) and time lost were compiled and calculated.\u0000\u0000Results: A total of 11,778,265 Athlete-Exposures (AE) were identified and included. 380 patellar instability injuries were identified (Injury Rate IR = 3.23 per 100,000 AEs). 91 (23.95%) were severe injuries with a significantly higher time loss from play (40.5 days) and risk of operative management (50.55%). The most common sports during which a patellar instability event occurred were Women’s Gymnastics (IR=7.87), Soccer (IR=5.83), and Basketball (IR=4.34) and Men’s Wrestling (IR=5.44), Football (IR=4.84), and Soccer (IR=3.06). Male athletes had a statistically significant higher risk of season or career-ending injuries in all patellar instability injuries (3.20% vs 0.89%, p=0.0013). Severe injuries were more likely to result from contact mechanisms (58.24% vs 40.66%).\u0000\u0000Conclusion: Patella instability injuries have a profound impact on the longevity and sustainability of a collegiate athletes’ career. The risk of recurrence once a patellar injury has occurred is significant and athletes often require surgery. While more female athletes sustained these injuries, male athletes were more likely to require operative management and sustain a season-ending injury.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131080856","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}
Moving on an evolutionary sight, this article individualizes three basic human causative factors in adolescent idiopathic scoliosis developing inspiration, bipedal locomotion and lateralities. The integrative approach considers the neuromechanical coupling in respiration, introducing the concept of pneumofascial competition (section one) as the loop that occurs between inspired air and pleural fasciae and then global myofascia. Affordances (possibilities) and constraints of respiratory system match positions and movements of whole body, where the links between spine and periphery (limbs and head) play a determinant part: these connections, the one that involves the spinal transverse plane, are worked out in section two. Therefore, section two appears a decisive step in trying to solve some questions about human bipedal locomotion and its proficiency, again in a neuromechanical coupling view, with totally original considerations about the role of scapula and about the spine as a treble torsion spring. Finally, it is possible to trace out a new adolescent idiopathic scoliosis etiology (section three), adding a third factor: laterality. What is only human is the hyper stressed lateralization (s) by means of cultural requirements. The motor hyper specialization is another form of energy saving (automatism). Thus, all the article is about the evolutionary principle of costs minimizing. Adolescent idiopathic scoliosis is here seen as an evolutionary mismatch disease between human nature and human culture and every curve can be explained in an integrative way, where causes and effects develop a mutual self-powering cycle.
{"title":"An Evolutionary Adolescent Idiopathic Scoliosis Etiology Spine-Limbs Links, Inspiration and Laterality as Basic Factors","authors":"Alessandro Mariani","doi":"10.46889/josr.2022.3212","DOIUrl":"https://doi.org/10.46889/josr.2022.3212","url":null,"abstract":"Moving on an evolutionary sight, this article individualizes three basic human causative factors in adolescent idiopathic scoliosis developing inspiration, bipedal locomotion and lateralities. The integrative approach considers the neuromechanical coupling in respiration, introducing the concept of pneumofascial competition (section one) as the loop that occurs between inspired air and pleural fasciae and then global myofascia. Affordances (possibilities) and constraints of respiratory system match positions and movements of whole body, where the links between spine and periphery (limbs and head) play a determinant part: these connections, the one that involves the spinal transverse plane, are worked out in section two. Therefore, section two appears a decisive step in trying to solve some questions about human bipedal locomotion and its proficiency, again in a neuromechanical coupling view, with totally original considerations about the role of scapula and about the spine as a treble torsion spring. Finally, it is possible to trace out a new adolescent idiopathic scoliosis etiology (section three), adding a third factor: laterality. What is only human is the hyper stressed lateralization (s) by means of cultural requirements. The motor hyper specialization is another form of energy saving (automatism). Thus, all the article is about the evolutionary principle of costs minimizing. Adolescent idiopathic scoliosis is here seen as an evolutionary mismatch disease between human nature and human culture and every curve can be explained in an integrative way, where causes and effects develop a mutual self-powering cycle.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"962 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132948693","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}
Clavicle fractures account for 3% of all fractures in adult population. Usually, surgical treatment is the gold standard for fracture with dislocation > 2 cm, shortening > 2 cm and angulation > 30 ° or comminution, especially in young or active patients, due to the relatively high risk of non-union. In our study, we report the case of a 50-years old patient, with high functional requests, with a middle shaft clavicle fracture, presenting borderline criteria. We treated him conservatively with figure of 8-bandage for five weeks. After removal of the bandage, patient performed physiotherapy and at final follow-up patient showed a nearly complete ROM despite a non-optimal radiographic outcome. Conservative treatment is a valid option in borderline middle shaft fractures, even in mature patient requiring high functional outcomes.
{"title":"Conservative Treatment of Medial Shaft Clavicle Fracture with Borderline Criteria: A Case Report","authors":"L. Gurrieri","doi":"10.46889/josr.2022.3211","DOIUrl":"https://doi.org/10.46889/josr.2022.3211","url":null,"abstract":"Clavicle fractures account for 3% of all fractures in adult population. Usually, surgical treatment is the gold standard for fracture with dislocation > 2 cm, shortening > 2 cm and angulation > 30 ° or comminution, especially in young or active patients, due to the relatively high risk of non-union. In our study, we report the case of a 50-years old patient, with high functional requests, with a middle shaft clavicle fracture, presenting borderline criteria. We treated him conservatively with figure of 8-bandage for five weeks. After removal of the bandage, patient performed physiotherapy and at final follow-up patient showed a nearly complete ROM despite a non-optimal radiographic outcome. Conservative treatment is a valid option in borderline middle shaft fractures, even in mature patient requiring high functional outcomes.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125357033","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: The objective of this study was to evaluate the intermediate term clinical and radiological results of a Bone preserving short stem hip implant being operated through a minimally invasive anterolateral hip approach. Methods: In 20 consecutive patients suffering from osteoarthritis with 25 affected hip joints (five cases were bilateral), the clinical and radiological results of 25 hip arthroplasties performed in one hospital between October 2009 and May 2014 through a minimally invasive anterolateral approach using a cementless short stem prosthesis type Aida and a cementless cup type Ecofit with a ceramic-on-ceramic pairing were evaluated prospectively. The median age of patients at time of surgery was 60 years (range, 42-71 years), 15 male (4 were bilateral) and 5 female patients (one was bilateral) were included in the study. The median clinical follow up was 30 months (range, 2-88 months) and the median radiological follow up was 30 months (range, 2-88 months). Results: Harris Hip Score improved from a median preoperative value of 53 to a median postoperative value of 96 (range, 73-100) at follow up. 22 hips (88%) showed an excellent postoperative Harris Hip Score, 2 hips (8%) a good postoperative Harris Hip Score and one hip (4%) a fair postoperative Harris Hip Score. Only two patients complained of postoperative thigh pain. Regarding patient satisfaction, 15 patients (60%) were very satisfied, 10 patients (40%) were satisfied. None was unsatisfied. Radiological analysis showed that 19 stems (76%) were with stable bony ingrowth, two cases (8%) showed stable fibrous ingrowth. Four cases need further follow up for proper evaluation of stem fixation. Conclusion: The intermediate term survival of the Aida short stem hip implant being operated through a minimally invasive anterolateral hip approach is very promising and achieving the goals of a standard hip arthroplasty.
{"title":"Minimally Invasive Anterolateral Approach Total Hip Arthroplasty Using Bone Preserving Short Femoral Stem: Intermediate Term Clinical and Radiological Results","authors":"M. Elkabbani","doi":"10.46889/josr.2022.3209","DOIUrl":"https://doi.org/10.46889/josr.2022.3209","url":null,"abstract":"Aim: The objective of this study was to evaluate the intermediate term clinical and radiological results of a Bone preserving short stem hip implant being operated through a minimally invasive anterolateral hip approach.\u0000\u0000Methods: In 20 consecutive patients suffering from osteoarthritis with 25 affected hip joints (five cases were bilateral), the clinical and radiological results of 25 hip arthroplasties performed in one hospital between October 2009 and May 2014 through a minimally invasive anterolateral approach using a cementless short stem prosthesis type Aida and a cementless cup type Ecofit with a ceramic-on-ceramic pairing were evaluated prospectively. The median age of patients at time of surgery was 60 years (range, 42-71 years), 15 male (4 were bilateral) and 5 female patients (one was bilateral) were included in the study. The median clinical follow up was 30 months (range, 2-88 months) and the median radiological follow up was 30 months (range, 2-88 months).\u0000\u0000Results: Harris Hip Score improved from a median preoperative value of 53 to a median postoperative value of 96 (range, 73-100) at follow up. 22 hips (88%) showed an excellent postoperative Harris Hip Score, 2 hips (8%) a good postoperative Harris Hip Score and one hip (4%) a fair postoperative Harris Hip Score. Only two patients complained of postoperative thigh pain. Regarding patient satisfaction, 15 patients (60%) were very satisfied, 10 patients (40%) were satisfied. None was unsatisfied. Radiological analysis showed that 19 stems (76%) were with stable bony ingrowth, two cases (8%) showed stable fibrous ingrowth. Four cases need further follow up for proper evaluation of stem fixation.\u0000\u0000Conclusion: The intermediate term survival of the Aida short stem hip implant being operated through a minimally invasive anterolateral hip approach is very promising and achieving the goals of a standard hip arthroplasty.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130787645","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: Upper cervical spine instability in patients with Morquio´s syndrome is of common occurrence. Dysplastic odontoid is one of the prominent aetiologies behind the development of atlanto-axial instability which eventually leads to morbid vertebrogenic myelopathy. Material and Methods: We describe 10 children (7 boys and 3 girls) with the phenotype/genotype of Morquio´s syndrome (MPS IVA). Lumbar kyphosis occurs at the age of six months, followed by apparent waddling gait at the age of 3 years. Clinical phenotype and genotype are the baseline tools to set up a crystal clear long term management. Firstly, we proceed via clinical assessment of C1-2 instability. The latter is carried out with full dynamic lateral cervical spine radiographs. Instability can be visualized through the precise interpretations of the anatomical structures around the atlanto-axial segments. 3D sagittal CT scan has been applied to further localize the exact pathology. In 7 cases, there was an initial myelopathy at the level of the cranio-vertebral junction. Results: The most threatening complication of MPS IVA is the vertebrogenic myelopathy. The latter emerged as a notorious complication in connection with atlanto-axial instability and progressive thickening of the spinal cord due to accumulation of Glycosaminoglycan (GAGs). Vertebrogenic myelopathy have been encountered in seven children. All underwent decompression and stabilization of the cervical spine Conclusion: Patients with MPS IV, in their first year of life usually manifest growth deficiency and lumbar kyphosis, but unfortunately passed unnoticed by most of the paediatricians. Progressive dysplasia of the acetabulae is the reason behind the waddling gait. The misconception of generalized ligamentous hyper laxity accompanied with waddling gait were the main incentives of confusion among most of the paediatricians and physicians. Thereby, the false diagnosis of Duchenne Muscular dystrophy has been falsely considered by some colleagues. The purpose of this paper is threefold. First, overlooking the early mal-development of the backbone (lumbar kyphosis) is not a simple mistake. Second, marked ligamentous hyperlaxity warrants the attention toward cervical ligaments, and as ligaments are the main supporters of the craniocervical junction and spine stability, such abnormality demands prompt clinical attention. Third, is to assess the vertebral pathology and vertebrogenic myelopathy from the standpoint of syndromic assessment and the efficiency of decompression and stabilization operations.
{"title":"Vertebral Pathology and Vertebrogenic Myelopathy in Patients with Mucopolysaccharoidosis Type IV A (Morquio Syndrome)","authors":"A. Kaissi","doi":"10.46889/josr.2022.3210","DOIUrl":"https://doi.org/10.46889/josr.2022.3210","url":null,"abstract":"Background: Upper cervical spine instability in patients with Morquio´s syndrome is of common occurrence. Dysplastic odontoid is one of the prominent aetiologies behind the development of atlanto-axial instability which eventually leads to morbid vertebrogenic myelopathy.\u0000\u0000Material and Methods: We describe 10 children (7 boys and 3 girls) with the phenotype/genotype of Morquio´s syndrome (MPS IVA). Lumbar kyphosis occurs at the age of six months, followed by apparent waddling gait at the age of 3 years. Clinical phenotype and genotype are the baseline tools to set up a crystal clear long term management. Firstly, we proceed via clinical assessment of C1-2 instability. The latter is carried out with full dynamic lateral cervical spine radiographs. Instability can be visualized through the precise interpretations of the anatomical structures around the atlanto-axial segments. 3D sagittal CT scan has been applied to further localize the exact pathology. In 7 cases, there was an initial myelopathy at the level of the cranio-vertebral junction.\u0000\u0000Results: The most threatening complication of MPS IVA is the vertebrogenic myelopathy. The latter emerged as a notorious complication in connection with atlanto-axial instability and progressive thickening of the spinal cord due to accumulation of Glycosaminoglycan (GAGs). Vertebrogenic myelopathy have been encountered in seven children. All underwent decompression and stabilization of the cervical spine\u0000\u0000Conclusion: Patients with MPS IV, in their first year of life usually manifest growth deficiency and lumbar kyphosis, but unfortunately passed unnoticed by most of the paediatricians. Progressive dysplasia of the acetabulae is the reason behind the waddling gait. The misconception of generalized ligamentous hyper laxity accompanied with waddling gait were the main incentives of confusion among most of the paediatricians and physicians. Thereby, the false diagnosis of Duchenne Muscular dystrophy has been falsely considered by some colleagues. The purpose of this paper is threefold. First, overlooking the early mal-development of the backbone (lumbar kyphosis) is not a simple mistake. Second, marked ligamentous hyperlaxity warrants the attention toward cervical ligaments, and as ligaments are the main supporters of the craniocervical junction and spine stability, such abnormality demands prompt clinical attention. Third, is to assess the vertebral pathology and vertebrogenic myelopathy from the standpoint of syndromic assessment and the efficiency of decompression and stabilization operations.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132879187","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: Congenital Central Hypoventilation Syndrome (CCHS), is a condition characterized by ventilatory impairment that results in arterial hypoxemia. Studies revealed that the vast majority of patients with CCHS are free from any associated pulmonary, cardiac or brainstem pathologies. Material and Methods: F.R is a 20 -year-old- Austrian-girl presented in my consultation seeking advice for her unpleasant clinical history. In her early life, seizures were the first serious clinical presentation. Followed later on with hypertension, bouts of respiratory dysfunction and impairment of consciousness. In 2019 she underwent surgical intervention to remove a 2 cm hamartoma (posterior upper aspect of the right thigh). Few years later, another hamartoma on the ventral side of the tongue has been identified as well. Early on, she received the diagnosis of Mediterranean fever syndrome and the geneticist encountered homozygosity to the MEFV M694V mutation as the reason behind the constellation of the current unpleasant symptomatology. Later on a presumptive diagnosis of Ehlers-Danlos syndrome-hypermobile type has been suggested in other Medical Institutions. We proceeded with our documentation via clinical and radiological phenotypic characterizations. Results: Clinical examination showed growth above the 97th percentile (overgrowth) with no specific facial dysmorphic features. She manifested generalized ligamentous hyper laxity. Her ligamentous hyperlaxity was compatible with 6 points out of 9 in correlation with Beighton scoring test. On the bases of skeletal survey; lateral skull radiograph showed features of mastoid and temporal bone characterized with extensive-pneumatization. Axial CT scan shows bilateral hyper-pneumatization of the temporal bones, demonstrating expansion of aerial spaces with loss of the bony trabeculae and thinning of the mastoid bone. Mastoid cells appear to be in communication with a large intracranial epidural air cavity in the temporal and parietal regions. Reformatted CT scan of temporal bone, through coronal and axial images, at the level of the cavum tympani and the mastoid, showed a defect in the right tegmen appeared as cloudy/ opaque lesions around the cavum and the surrounding air cells. Contrast- enhanced computed CT angiography of the cervical and cerebral vasculature showed unusual malalignment and spiral twisting along several vascular segments resulted in the mal-development of basilar artery stenosis without atherosclerosis. The current patient manifested overgrowth syndromic entity with a constellation of osseous and vascular abnormalities resulted in a clinical course of congenital central hypoventilation syndrome. Conclusion: The etiology behind the extension of pneumatization has most likely occurred because of defective ossification of the occipito-mastoid synchondrosis . The reason behind the extension of pneumatization into the occipital and parietal bone is probably due to incomplete closure of the occ
{"title":"Morbid Constellation of Osseous and Vascular Abnormalities in a Female Patient with Congenital Central Hypoventilation/Overgrowth Syndrome","authors":"A. Kaissi","doi":"10.46889/josr.2022.3208","DOIUrl":"https://doi.org/10.46889/josr.2022.3208","url":null,"abstract":"Background: Congenital Central Hypoventilation Syndrome (CCHS), is a condition characterized by ventilatory impairment that results in arterial hypoxemia. Studies revealed that the vast majority of patients with CCHS are free from any associated pulmonary, cardiac or brainstem pathologies.\u0000\u0000Material and Methods: F.R is a 20 -year-old- Austrian-girl presented in my consultation seeking advice for her unpleasant clinical history. In her early life, seizures were the first serious clinical presentation. Followed later on with hypertension, bouts of respiratory dysfunction and impairment of consciousness. In 2019 she underwent surgical intervention to remove a 2 cm hamartoma (posterior upper aspect of the right thigh). Few years later, another hamartoma on the ventral side of the tongue has been identified as well. Early on, she received the diagnosis of Mediterranean fever syndrome and the geneticist encountered homozygosity to the MEFV M694V mutation as the reason behind the constellation of the current unpleasant symptomatology. Later on a presumptive diagnosis of Ehlers-Danlos syndrome-hypermobile type has been suggested in other Medical Institutions. We proceeded with our documentation via clinical and radiological phenotypic characterizations.\u0000\u0000Results: Clinical examination showed growth above the 97th percentile (overgrowth) with no specific facial dysmorphic features. She manifested generalized ligamentous hyper laxity. Her ligamentous hyperlaxity was compatible with 6 points out of 9 in correlation with Beighton scoring test. On the bases of skeletal survey; lateral skull radiograph showed features of mastoid and temporal bone characterized with extensive-pneumatization. Axial CT scan shows bilateral hyper-pneumatization of the temporal bones, demonstrating expansion of aerial spaces with loss of the bony trabeculae and thinning of the mastoid bone. Mastoid cells appear to be in communication with a large intracranial epidural air cavity in the temporal and parietal regions. Reformatted CT scan of temporal bone, through coronal and axial images, at the level of the cavum tympani and the mastoid, showed a defect in the right tegmen appeared as cloudy/ opaque lesions around the cavum and the surrounding air cells. Contrast- enhanced computed CT angiography of the cervical and cerebral vasculature showed unusual malalignment and spiral twisting along several vascular segments resulted in the mal-development of basilar artery stenosis without atherosclerosis. The current patient manifested overgrowth syndromic entity with a constellation of osseous and vascular abnormalities resulted in a clinical course of congenital central hypoventilation syndrome.\u0000\u0000Conclusion: The etiology behind the extension of pneumatization has most likely occurred because of defective ossification of the occipito-mastoid synchondrosis . The reason behind the extension of pneumatization into the occipital and parietal bone is probably due to incomplete closure of the occ","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127484527","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}
Objective: There is ample literature demonstrating significant health risks associated with radiation exposure, yet there is no standardized radiation safety training for Canadian orthopaedic surgery residents. This is the first national survey investigating the prevalence of radiation safety training and radiation safety practices in Canadian orthopaedic residency programs. Methods: A nationaln online survey was distributed to orthopaedic residents currently enrolled in a Canadian program from all post-graduate (PGY) levels who were fluent in English or French with a medical doctorate or equivalent training. Fellows, international elective or observer ship students were excluded. Results: Overall response rate across Canada was 41% (n=116). Most respondents (94%, n=102) were concerned about the negative effects of radiation, yet only 11% (n=12) felt confident with their radiation safety knowledge. Of the residents who felt confident in their knowledge, only 42% (n=5) answered all three radiation safety screening questions correctly. Overall, 58% (n=66) of respondents had undergone some form of radiation safety training. Compliance with protective lead was high (92%, n=93) when available, but 82% (n=92) of respondents cited issues accessing properly fitting lead. Only 18% (n=20) of orthopaedic residents reported routinely wearing dosimeters. Conclusion: Limited access to properly fitting protective lead, poor radiation safety knowledge, and lack of routine radiation monitoring could be placing residents at risk for poor health outcomes in the future. These results provide impetus for orthopaedic residency programs across Canada to implement higher safety standards in the form of standardized radiation safety training, routine dosimeter use, improved lead availability, and continued abidance to radiation safety protocols.
{"title":"Assessment of Radiation Safety Training, Practices and Knowledge amongst Canadian Orthopaedic Resident Training Programs","authors":"Schneider P, Bourget-Murray J","doi":"10.46889/josr.2022.3207","DOIUrl":"https://doi.org/10.46889/josr.2022.3207","url":null,"abstract":"Objective: There is ample literature demonstrating significant health risks associated with radiation exposure, yet there is no standardized radiation safety training for Canadian orthopaedic surgery residents. This is the first national survey investigating the prevalence of radiation safety training and radiation safety practices in Canadian orthopaedic residency programs.\u0000\u0000Methods: A nationaln online survey was distributed to orthopaedic residents currently enrolled in a Canadian program from all post-graduate (PGY) levels who were fluent in English or French with a medical doctorate or equivalent training. Fellows, international elective or observer ship students were excluded.\u0000\u0000Results: Overall response rate across Canada was 41% (n=116). Most respondents (94%, n=102) were concerned about the negative effects of radiation, yet only 11% (n=12) felt confident with their radiation safety knowledge. Of the residents who felt confident in their knowledge, only 42% (n=5) answered all three radiation safety screening questions correctly. Overall, 58% (n=66) of respondents had undergone some form of radiation safety training. Compliance with protective lead was high (92%, n=93) when available, but 82% (n=92) of respondents cited issues accessing properly fitting lead. Only 18% (n=20) of orthopaedic residents reported routinely wearing dosimeters.\u0000\u0000Conclusion: Limited access to properly fitting protective lead, poor radiation safety knowledge, and lack of routine radiation monitoring could be placing residents at risk for poor health outcomes in the future. These results provide impetus for orthopaedic residency programs across Canada to implement higher safety standards in the form of standardized radiation safety training, routine dosimeter use, improved lead availability, and continued abidance to radiation safety protocols.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"473 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115946596","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}
Purpose: The etiology understanding is the corner stone for proper management of the spine deformities in patients with neuromuscular disorders. Methods: Progressive spine deformities have been encountered in 71 patients. All showed different forms of neuromuscular disorders. We proceeded with applying prompt evaluation criteria which was mainly based on the etiological diagnosis of each type of NMS (clinical phenotype and genotype). Assessing the Functional Independence Measure (FIM), we observed deterioration in some aspects. The Cobb’s angle was assessed in two occasion’s i.e prior to corrective surgeries plus the post-surgery results. Followed by one year postoperative re-assessment. Surgical corrections have been performed via posterior pedicle screw fixation. Results: Surgical correction to re-align the C-shaped thoracolumbar scoliosis. Lumbar hyper lordosis were common in cerebral palsy patients, though decreased thoracic kyphosis or even thoracic lordosis occurs more frequently in Duchenne Muscular atrophy patients. There was noticeable improvement in functional status according to Functional Independence Measure (FIM). Conclusion: Etiology understanding is the paramount element in re-aligning corrective surgeries of the spine in patients with progressive spine deformities. We concluded that rigid hyper lordosis has been and still the key problem encountered in patients with neuromuscular disorders.
{"title":"The Etiological Understanding of Spine Deformities in Patients with Neuromuscular Disorders","authors":"E. Filatov","doi":"10.46889/josr.2022.3206","DOIUrl":"https://doi.org/10.46889/josr.2022.3206","url":null,"abstract":"Purpose: The etiology understanding is the corner stone for proper management of the spine deformities in patients with neuromuscular disorders.\u0000\u0000Methods: Progressive spine deformities have been encountered in 71 patients. All showed different forms of neuromuscular disorders. We proceeded with applying prompt evaluation criteria which was mainly based on the etiological diagnosis of each type of NMS (clinical phenotype and genotype). Assessing the Functional Independence Measure (FIM), we observed deterioration in some aspects. The Cobb’s angle was assessed in two occasion’s i.e prior to corrective surgeries plus the post-surgery results. Followed by one year postoperative re-assessment. Surgical corrections have been performed via posterior pedicle screw fixation.\u0000\u0000Results: Surgical correction to re-align the C-shaped thoracolumbar scoliosis. Lumbar hyper lordosis were common in cerebral palsy patients, though decreased thoracic kyphosis or even thoracic lordosis occurs more frequently in Duchenne Muscular atrophy patients. There was noticeable improvement in functional status according to Functional Independence Measure (FIM).\u0000\u0000Conclusion: Etiology understanding is the paramount element in re-aligning corrective surgeries of the spine in patients with progressive spine deformities. We concluded that rigid hyper lordosis has been and still the key problem encountered in patients with neuromuscular disorders.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114498894","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}
M. Elkabbani, K. Youssef, M. Ragab, O. Ibrahim, A. Osman, A. Dragoș, S. Tarabichi
Introduction: Total Knee Replacement (TKA) surgeries are frequently performed surgeries used to treat knee osteoarthritis. Several methods of medial soft tissue balancing in the varus knee during total knee replacement surgeries have been reported. Traditionally, they included releasing the superficial Medial Collateral Ligament (sMCL) in severe varus cases by several methods. However, this release can create instability in the knee. The aim of this study was to create an algorithm for soft tissue release in varus osteoarthritic knees and to evaluate its efficacy in achieving intraoperative gap balancing without releasing the superficial MCL. Materials and Methods: One hundred and five varus osteoarthritic knees who received primary posterior stabilized total knee arthroplasties between October 2015 and January 2016 were included in this study. Varus deformities ranged between 10 to 40 degrees. Sequential balancing was done into 5 steps: step 1 – releasing of deep MCL, step 2 – excision of osteophytes, step 3 – excision of scarred tissue in the posteromedial corner, step 4 – excision of the posteromedial capsule and step 5 – release of semimembranosus. The V-STAT® Variable Soft Tissue Alignment Tensor was used to ensure a balanced medial and lateral gap following each step. Once the gaps were balanced, no further soft tissue release were carried out. Results: All knees were balanced without releasing the superficial MCL ligament. The maximum release step necessary was: step 1 (0 cases), step 2 (31 cases), step 3 (35 cases), step 4 (25 cases) and step 5 (14 cases). Conclusion: Superficial medial collateral ligament should not be released during intraoperative varus knees soft tissue balancing in posterior stabilized total knee arthroplasties. Preserving the superficial MCL is beneficial in maintaining implant stability without any increase in the constraint level of the implant even in cases with severe deformity.
{"title":"Soft Tissue Release for Varus Knees during Posterior Stabilized Total Knee Arthroplasty: A New Algorithm","authors":"M. Elkabbani, K. Youssef, M. Ragab, O. Ibrahim, A. Osman, A. Dragoș, S. Tarabichi","doi":"10.46889/josr.2022.3103","DOIUrl":"https://doi.org/10.46889/josr.2022.3103","url":null,"abstract":"Introduction: Total Knee Replacement (TKA) surgeries are frequently performed surgeries used to treat knee osteoarthritis. Several methods of medial soft tissue balancing in the varus knee during total knee replacement surgeries have been reported. Traditionally, they included releasing the superficial Medial Collateral Ligament (sMCL) in severe varus cases by several methods. However, this release can create instability in the knee. The aim of this study was to create an algorithm for soft tissue release in varus osteoarthritic knees and to evaluate its efficacy in achieving intraoperative gap balancing without releasing the superficial MCL.\u0000\u0000Materials and Methods: One hundred and five varus osteoarthritic knees who received primary posterior stabilized total knee arthroplasties between October 2015 and January 2016 were included in this study. Varus deformities ranged between 10 to 40 degrees. Sequential balancing was done into 5 steps: step 1 – releasing of deep MCL, step 2 – excision of osteophytes, step 3 – excision of scarred tissue in the posteromedial corner, step 4 – excision of the posteromedial capsule and step 5 – release of semimembranosus. The V-STAT® Variable Soft Tissue Alignment Tensor was used to ensure a balanced medial and lateral gap following each step. Once the gaps were balanced, no further soft tissue release were carried out.\u0000\u0000Results: All knees were balanced without releasing the superficial MCL ligament. The maximum release step necessary was: step 1 (0 cases), step 2 (31 cases), step 3 (35 cases), step 4 (25 cases) and step 5 (14 cases).\u0000\u0000Conclusion: Superficial medial collateral ligament should not be released during intraoperative varus knees soft tissue balancing in posterior stabilized total knee arthroplasties. Preserving the superficial MCL is beneficial in maintaining implant stability without any increase in the constraint level of the implant even in cases with severe deformity.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"45 4-5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133005135","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}
B. Sergio, Viera-Artiles Jaime, Valdiande-Gutiérrez José Julian, Grant Andrea
Objective: This experimental study intends to test a novel device for preventing unintentional camera rotation during arthroscopic knee procedures. Methods: The system consists on a multi-axis gyroscopic sensor that can be universally attached to any camera model in the market. A preliminary experience was designed to evaluate the operability of the device during actual arthroscopic meniscectomies. Results: The system provided accurate real-time insight about camera orientation in relation to a selected working plane. The system is more useful when used within the tibio-femoral space and in the anterior (suprapatellar) compartment. Conclusion: This device is able to assist orthopedics trainees and novel surgeons during arthroscopic training, reducing undesired camera rotation, disorientation, fatigue and surgical times.
{"title":"A Novel Device to Prevent Undesired Arthroscopic Camera Rotation","authors":"B. Sergio, Viera-Artiles Jaime, Valdiande-Gutiérrez José Julian, Grant Andrea","doi":"10.46889/josr.2021.2307","DOIUrl":"https://doi.org/10.46889/josr.2021.2307","url":null,"abstract":"Objective: This experimental study intends to test a novel device for preventing unintentional camera rotation during arthroscopic knee procedures. Methods: The system consists on a multi-axis gyroscopic sensor that can be universally attached to any camera model in the market. A preliminary experience was designed to evaluate the operability of the device during actual arthroscopic meniscectomies. Results: The system provided accurate real-time insight about camera orientation in relation to a selected working plane. The system is more useful when used within the tibio-femoral space and in the anterior (suprapatellar) compartment. Conclusion: This device is able to assist orthopedics trainees and novel surgeons during arthroscopic training, reducing undesired camera rotation, disorientation, fatigue and surgical times.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"595 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123189983","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：