Pub Date : 2022-11-17DOI: 10.1177/22104917221101409
M. Green, Ross Whetter, O. Al-Dadah
Background: Proximal humerus fractures and shoulder dislocations are relatively common. However, an associated rotator cuff tear is often missed with these injuries. The objective of this study was to assess the prevalence of a concomitant rotator cuff tear associated with common shoulder injuries. Methods: A cross-sectional epidemiological study of three patient populations: Group 1. Proximal Humerus Fractures; Group 2. Shoulder Dislocations; Group 3. Proximal Humerus Fracture-Dislocations. All patients within these three groups presented to and underwent subsequent management of their shoulder injury at a trauma unit. Management included both non-operative and operative intervention. Patients were evaluated for associated rotator cuff tears. Results: This study included a total of 196 patients: Group 1 = 146 Proximal Humerus Fractures; Group 2 = 37 Shoulder Dislocations; Group 3 = 13 Proximal Humerus Fracture-Dislocations. Of the 196 patients in total, 23 (11.7%) sustained a concomitant rotator cuff tear. The highest number of tears was found in Group 1 (n = 14). However, the highest percentage prevalence of tears was in Group 2 (18.9%). There was noted to be a higher prevalence of rotator cuff tears with increasing age. Twenty-two (95.7%) rotator cuff tears were detected in patients over 50 years of age. The vast majority of rotator cuff tears were detected by ultrasound (78.3%) as opposed to magnetic resonance imaging (21.7%). The majority of tears were full-thickness (60.9%). Of the 23 patients with a concomitant rotator cuff tear, 17 involved a single tendon (73.9%) and supraspinatus was most common (69.6%). Conclusions: A concomitant rotator cuff tear in association with a proximal humerus fracture, shoulder dislocation or proximal humerus fracture-dislocation is relatively common. The overall rotator cuff tear prevalence in this study was 11.9%. Rotator cuff tears are more likely to occur in patients over 50 years old and those sustaining a shoulder dislocation.
{"title":"Proximal humerus fractures and shoulder dislocations: Prevalence of concomitant rotator cuff tear","authors":"M. Green, Ross Whetter, O. Al-Dadah","doi":"10.1177/22104917221101409","DOIUrl":"https://doi.org/10.1177/22104917221101409","url":null,"abstract":"Background: Proximal humerus fractures and shoulder dislocations are relatively common. However, an associated rotator cuff tear is often missed with these injuries. The objective of this study was to assess the prevalence of a concomitant rotator cuff tear associated with common shoulder injuries. Methods: A cross-sectional epidemiological study of three patient populations: Group 1. Proximal Humerus Fractures; Group 2. Shoulder Dislocations; Group 3. Proximal Humerus Fracture-Dislocations. All patients within these three groups presented to and underwent subsequent management of their shoulder injury at a trauma unit. Management included both non-operative and operative intervention. Patients were evaluated for associated rotator cuff tears. Results: This study included a total of 196 patients: Group 1 = 146 Proximal Humerus Fractures; Group 2 = 37 Shoulder Dislocations; Group 3 = 13 Proximal Humerus Fracture-Dislocations. Of the 196 patients in total, 23 (11.7%) sustained a concomitant rotator cuff tear. The highest number of tears was found in Group 1 (n = 14). However, the highest percentage prevalence of tears was in Group 2 (18.9%). There was noted to be a higher prevalence of rotator cuff tears with increasing age. Twenty-two (95.7%) rotator cuff tears were detected in patients over 50 years of age. The vast majority of rotator cuff tears were detected by ultrasound (78.3%) as opposed to magnetic resonance imaging (21.7%). The majority of tears were full-thickness (60.9%). Of the 23 patients with a concomitant rotator cuff tear, 17 involved a single tendon (73.9%) and supraspinatus was most common (69.6%). Conclusions: A concomitant rotator cuff tear in association with a proximal humerus fracture, shoulder dislocation or proximal humerus fracture-dislocation is relatively common. The overall rotator cuff tear prevalence in this study was 11.9%. Rotator cuff tears are more likely to occur in patients over 50 years old and those sustaining a shoulder dislocation.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"10 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85947214","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 : 2022-11-17DOI: 10.1177/22104917221133562
A. C. Chan, K. Chui, Kb Lee, Wilson Li
Minimally invasive trans-symphyseal screw (TSS) for pubic symphysis diastasis was recently advocated, and its feasibility and reproducibility under 3D-navigation guidance are explored. Fifteen cases between 2016 and 2021 with a background of pubic symphysis diastasis are reviewed in this case series. Twenty-two TSS were inserted with an average Injury Severity Score of 35.3. Sixty percent received a one-stage procedure including fracture reduction, intra-operative 3D imaging, and planning followed by execution. The mean operative time and blood loss were 132 minutes and 160 ml, respectively. Average fracture healing was 5.8 months with two delayed unions at 9 months. The pubic symphysis distance was maintained in all cases at 6 months post-op. The average Marjeed score, Multicenter Study Group Pelvic Outcome Score, and Numeric pain rating scale were 60.2, 6.5, and 2.7, respectively. We conclude that 3D-navigation-guided percutaneous TSS restores pelvic stability and provides satisfactory pain control, and thus a safe and effective alternative to open reduction internal fixation.
{"title":"Three-dimensional navigation-guided percutaneous trans-symphyseal screw for mechanically unstable pubic symphysis diastasis","authors":"A. C. Chan, K. Chui, Kb Lee, Wilson Li","doi":"10.1177/22104917221133562","DOIUrl":"https://doi.org/10.1177/22104917221133562","url":null,"abstract":"Minimally invasive trans-symphyseal screw (TSS) for pubic symphysis diastasis was recently advocated, and its feasibility and reproducibility under 3D-navigation guidance are explored. Fifteen cases between 2016 and 2021 with a background of pubic symphysis diastasis are reviewed in this case series. Twenty-two TSS were inserted with an average Injury Severity Score of 35.3. Sixty percent received a one-stage procedure including fracture reduction, intra-operative 3D imaging, and planning followed by execution. The mean operative time and blood loss were 132 minutes and 160 ml, respectively. Average fracture healing was 5.8 months with two delayed unions at 9 months. The pubic symphysis distance was maintained in all cases at 6 months post-op. The average Marjeed score, Multicenter Study Group Pelvic Outcome Score, and Numeric pain rating scale were 60.2, 6.5, and 2.7, respectively. We conclude that 3D-navigation-guided percutaneous TSS restores pelvic stability and provides satisfactory pain control, and thus a safe and effective alternative to open reduction internal fixation.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"106 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77135872","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 : 2022-11-16DOI: 10.1177/22104917221128836
S. Y. Mak, Y. Siu, W. Chau, C. Lo, C. Ma
Introduction: Thoracolumbar spine fracture is one of the commonest spinal fractures. The treatment of choice of surgery is still controversial. This is a retrospective analysis of clinical and radiological outcomes of long and short segment stabilization for patients admitted with thoracolumbar fracture in our hospitals. Material and Method: Inclusion criteria included a single level of thoracolumbar fracture, excluding pre-existing deformity or spinal surgery, osteoporosis, and pathological fracture. Clinical parameters included visual analogue scale (VAS), operative time, intraoperative blood loss, and postoperative length of stay. Radiological parameters included wedge angle and anterior and posterior vertebral height ratio. Results: From June 2007 to May 2020, 56 patients (male = 31, female = 25) were recruited. There were 25 patients in the short segment group (open = 11, minimal invasive surgery (MIS) = 14) and 31 patients in the long segment group. Clinically, significantly better VAS at 6 months (1 vs. 1.96; p = 0.041), shorter post-op length of stay (16 days vs. 25 days; p = 0.01), and less blood loss (178 ml vs. 824 ml; p < 0.01) were found in the short segment group. Radiologically, the short segment group showed significantly better wedge angle at immediate (5° vs. 9.23°; p = 0.002) and long-term follow-up (7.41° vs. 11.43°; p = 0.01). Moreover, the short segment group has significantly better post-op anterior and posterior vertebral height ratios. Within the short segment group, the MIS group showed significantly less blood loss (82 ml vs. 303 ml; p < 0.01). However radiological parameters favour the open group. Discussion and Conclusion: For single-level thoracolumbar fracture, both long and short stabilizations were effective in reducing and stabilizing the fracture. However, the short segment group showed significantly superior results. Moreover, a minimally invasive technique in short segment stabilization showed even less blood loss but less optimal radiological results. Therefore, short segment stabilization could be the treatment of choice for traumatic thoracolumbar spine fractures.
胸腰椎骨折是最常见的脊柱骨折之一。手术治疗的选择仍存在争议。本文回顾性分析我院收治的胸腰椎骨折患者采用长节段和短节段稳定治疗的临床和影像学结果。材料和方法:纳入标准包括单一级别的胸腰椎骨折，排除先前存在的畸形或脊柱手术，骨质疏松症和病理性骨折。临床参数包括视觉模拟评分(VAS)、手术时间、术中出血量、术后住院时间。放射学参数包括楔角和前后椎体高度比。结果:2007年6月至2020年5月，共纳入56例患者(男31例，女25例)。短节段组25例(开放11例，微创手术14例)，长节段组31例。临床方面，6个月时VAS明显改善(1 vs. 1.96;P = 0.041)，术后住院时间较短(16天vs. 25天;P = 0.01)，出血量较少(178 ml vs. 824 ml;P < 0.01)。放射学上，短节段组在即刻表现出更好的楔形角(5°vs. 9.23°;P = 0.002)和长期随访(7.41°vs. 11.43°;p = 0.01)。此外，短节段组术后前后椎体高度比明显更好。在短段组中，MIS组的失血量显著减少(82 ml vs 303 ml;p < 0.01)。然而放射学参数有利于开放基团。讨论与结论:对于单节段胸腰椎骨折，长、短固定均可有效复位和稳定骨折。然而，短节段组表现出明显更好的结果。此外，微创短节段稳定技术的失血量更少，但放射学效果较差。因此，短节段稳定可作为创伤性胸腰椎骨折的治疗选择。
{"title":"Long segment versus short segment stabilization in thoracolumbar spine fracture: A retrospective clinical and radiological analysis","authors":"S. Y. Mak, Y. Siu, W. Chau, C. Lo, C. Ma","doi":"10.1177/22104917221128836","DOIUrl":"https://doi.org/10.1177/22104917221128836","url":null,"abstract":"Introduction: Thoracolumbar spine fracture is one of the commonest spinal fractures. The treatment of choice of surgery is still controversial. This is a retrospective analysis of clinical and radiological outcomes of long and short segment stabilization for patients admitted with thoracolumbar fracture in our hospitals. Material and Method: Inclusion criteria included a single level of thoracolumbar fracture, excluding pre-existing deformity or spinal surgery, osteoporosis, and pathological fracture. Clinical parameters included visual analogue scale (VAS), operative time, intraoperative blood loss, and postoperative length of stay. Radiological parameters included wedge angle and anterior and posterior vertebral height ratio. Results: From June 2007 to May 2020, 56 patients (male = 31, female = 25) were recruited. There were 25 patients in the short segment group (open = 11, minimal invasive surgery (MIS) = 14) and 31 patients in the long segment group. Clinically, significantly better VAS at 6 months (1 vs. 1.96; p = 0.041), shorter post-op length of stay (16 days vs. 25 days; p = 0.01), and less blood loss (178 ml vs. 824 ml; p < 0.01) were found in the short segment group. Radiologically, the short segment group showed significantly better wedge angle at immediate (5° vs. 9.23°; p = 0.002) and long-term follow-up (7.41° vs. 11.43°; p = 0.01). Moreover, the short segment group has significantly better post-op anterior and posterior vertebral height ratios. Within the short segment group, the MIS group showed significantly less blood loss (82 ml vs. 303 ml; p < 0.01). However radiological parameters favour the open group. Discussion and Conclusion: For single-level thoracolumbar fracture, both long and short stabilizations were effective in reducing and stabilizing the fracture. However, the short segment group showed significantly superior results. Moreover, a minimally invasive technique in short segment stabilization showed even less blood loss but less optimal radiological results. Therefore, short segment stabilization could be the treatment of choice for traumatic thoracolumbar spine fractures.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87368179","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 : 2022-11-16DOI: 10.1177/22104917221136281
Rameez A Musa, Mansi J Patel, Yash Radharaman Gupta, Parth K Shah, Monil S Solanki, Neel M Bhavsar
Background: Recurrent shoulder dislocation leading to shoulder instability is a cumbersome clinical problem for patients and orthopedicians. Due to a lack of knowledge in young patients of developing countries, there is a delay in presentation from the first time of dislocation. The aim of this retrospective study was to evaluate the functional and radiographic outcomes of patients with shoulder instability after the Congruent Arc Latarjet procedure. Methods: From January 2018 to November 2021, 20 patients with history of recurrent shoulder dislocation having glenohumeral instability were treated surgically in our institute. Open Congruent Arc Latarjet procedure was performed in 20 patients. Functional outcomes were assessed preoperatively and postoperatively based on American Shoulder and Elbow Surgeons (ASES) score, the visual analog scale (VAS) for pain, ROWE score, and Active range of motion in the diseased shoulder. Results: Twenty shoulders of 20 patients were evaluated for a mean period of 24 months postoperatively. At the time of the latest consultation, the range of motion and the shoulder functional evaluations based on ROWE score which was 89.64 ± 5.71 (range 80–95) improved from 20.36 ± 8.87 (range 10–30), p = 0.001. The mean preoperative ASES score was 22.60 ± 1.09 (range 20.6–25) which improved to 72.50 ± 7.33 (range 52.8–77.2), p = 0.001, which is definitely improved. The overall re-dislocation rate was 0% (0 of 20). In our study, 60% had excellent outcomes, 30% had good outcomes, and 10% had fair outcomes. Conclusion: The Congruent Arc Latarjet procedure for the treatment of recurrent shoulder dislocation with glenoid bone loss of >20% is a successful and efficient method with better outcomes in daily work profile and no further episode of redislocation.
{"title":"The congruent arc latarjet procedure – Its functional outcomes in recurrent anterior shoulder dislocation with critical glenoid bone loss","authors":"Rameez A Musa, Mansi J Patel, Yash Radharaman Gupta, Parth K Shah, Monil S Solanki, Neel M Bhavsar","doi":"10.1177/22104917221136281","DOIUrl":"https://doi.org/10.1177/22104917221136281","url":null,"abstract":"Background: Recurrent shoulder dislocation leading to shoulder instability is a cumbersome clinical problem for patients and orthopedicians. Due to a lack of knowledge in young patients of developing countries, there is a delay in presentation from the first time of dislocation. The aim of this retrospective study was to evaluate the functional and radiographic outcomes of patients with shoulder instability after the Congruent Arc Latarjet procedure. Methods: From January 2018 to November 2021, 20 patients with history of recurrent shoulder dislocation having glenohumeral instability were treated surgically in our institute. Open Congruent Arc Latarjet procedure was performed in 20 patients. Functional outcomes were assessed preoperatively and postoperatively based on American Shoulder and Elbow Surgeons (ASES) score, the visual analog scale (VAS) for pain, ROWE score, and Active range of motion in the diseased shoulder. Results: Twenty shoulders of 20 patients were evaluated for a mean period of 24 months postoperatively. At the time of the latest consultation, the range of motion and the shoulder functional evaluations based on ROWE score which was 89.64 ± 5.71 (range 80–95) improved from 20.36 ± 8.87 (range 10–30), p = 0.001. The mean preoperative ASES score was 22.60 ± 1.09 (range 20.6–25) which improved to 72.50 ± 7.33 (range 52.8–77.2), p = 0.001, which is definitely improved. The overall re-dislocation rate was 0% (0 of 20). In our study, 60% had excellent outcomes, 30% had good outcomes, and 10% had fair outcomes. Conclusion: The Congruent Arc Latarjet procedure for the treatment of recurrent shoulder dislocation with glenoid bone loss of >20% is a successful and efficient method with better outcomes in daily work profile and no further episode of redislocation.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"14 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85550292","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 : 2022-11-03DOI: 10.1177/22104917221136283
Mostafa A Badawy, Ahmed M Kholeif, Y. Radwan, Ahmed M EL Sersawy
Background: Flexible flatfoot is a common condition that is characterized by hindfoot valgus with longitudinal medial-arch collapse. Many strategies for treatment have been reported but according to the current literature, controversy remains. Objectives: To compare the clinical and radiological outcomes of medializing calcaneal osteotomy utilizing modified step plate and subtalar arthroereisis utilizing conical subtalar implant for patients with symptomatic flexible pes planus. Methods: A prospective, randomized, double center study was conducted between May 2017 and May 2019 at the Foot and Ankle Department of Cairo University Hospital and El Sahel Teaching Hospital on 26 patients (37 feet) with flexible flat feet to compare between medial displacement calcaneal osteotomy using modified locked step plate (group A) compromising 17 feet and arthroereisis using subtalar implant (group B) compromising 20 feet. Results: By the end period of the study, 25 males and 12 females were available for our analysis of results with a mean follow-up period of 10.14 months (range 7–14 months), clinical scoring (American Orthopaedic Foot and Ankle Society score, Foot Functional Index) with radiological analysis revealed a non-significant difference between both groups, the overall complication rate was 16.2%. Conclusion: Both medial displacement calcaneal osteotomy and subtalar arthroereisis significantly improved radiographic and subjective clinical outcome measures in the surgical treatment of painful flexible planovalgus feet. The less-invasive nature and lower potential morbidity suggest that judicious use of arthroereisis implants is an appropriate alternative.
{"title":"Comparative study between medial displacement calcaneal osteotomy using modified step plate and arthroereisis for management of planovalgus feet","authors":"Mostafa A Badawy, Ahmed M Kholeif, Y. Radwan, Ahmed M EL Sersawy","doi":"10.1177/22104917221136283","DOIUrl":"https://doi.org/10.1177/22104917221136283","url":null,"abstract":"Background: Flexible flatfoot is a common condition that is characterized by hindfoot valgus with longitudinal medial-arch collapse. Many strategies for treatment have been reported but according to the current literature, controversy remains. Objectives: To compare the clinical and radiological outcomes of medializing calcaneal osteotomy utilizing modified step plate and subtalar arthroereisis utilizing conical subtalar implant for patients with symptomatic flexible pes planus. Methods: A prospective, randomized, double center study was conducted between May 2017 and May 2019 at the Foot and Ankle Department of Cairo University Hospital and El Sahel Teaching Hospital on 26 patients (37 feet) with flexible flat feet to compare between medial displacement calcaneal osteotomy using modified locked step plate (group A) compromising 17 feet and arthroereisis using subtalar implant (group B) compromising 20 feet. Results: By the end period of the study, 25 males and 12 females were available for our analysis of results with a mean follow-up period of 10.14 months (range 7–14 months), clinical scoring (American Orthopaedic Foot and Ankle Society score, Foot Functional Index) with radiological analysis revealed a non-significant difference between both groups, the overall complication rate was 16.2%. Conclusion: Both medial displacement calcaneal osteotomy and subtalar arthroereisis significantly improved radiographic and subjective clinical outcome measures in the surgical treatment of painful flexible planovalgus feet. The less-invasive nature and lower potential morbidity suggest that judicious use of arthroereisis implants is an appropriate alternative.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89579680","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 : 2022-11-03DOI: 10.1177/22104917221101410
H. R. Güngör, Gökhan Bayrak, Hakan Zora, R. Şavkın, N. Büker
Objective Foot and/or ankle (F/A) problems may be encountered in medial uni-compartmental knee (UKA) patients postoperatively due to the limb alignment changes and alterations in weight bearing of F/A. This study aimed to evaluate the risk factors and the incidence of foot and ankle (F/A) problems in (UKA) arthroplasty patients. Methods Patients who underwent UKA between 2016 and 2019 in our clinic were evaluated and the presence of F/A problems was recorded. Radiologic evaluations included hip knee ankle angle (HKA), medial proximal tibial angle, posterior tibial slope angle, talar tilt angle, talar inclination, talar dome to mechanical axis (TDMA), and talocrural angle (TCA) measured on preoperative and follow-up long-leg standing radiographs. The range of motion, Q angles, and muscle strengths were measured. Visual analog scale, physical performance limitations, and patient-reported activity limitations were evaluated for all patients. Patients with reported F/A problems were additionally evaluated with Foot Functional Index. Results Forty-four patients (38 female, 6 male; mean age 58.66 ± 8.6 years; mean BMI 31.30 ± 3.81, mean follow-up period 34.22 ± 18.95 months) were included in the study. There were 13 patients (29.5%) with reported F/A problems. Postoperative comparison of patients with and without F/A problems showed statistically significant differences in only WOMAC and SF12 physical health sub-scores (p = 0.002, p = 0.003, respectively). There was no significant postoperative change in TDMA in patients with F/A problems (p > 0.05) in contrast to patients without F/A problems (p = 0.006). There was no statistically significant difference in preoperative TCA measurements between groups (p = 0.79). Comparison of knee and ankle radiologic measurements between groups demonstrated significant difference only in postoperative HKA measurements (−2.82 ± 2.53 vs. −0.80 ± 3.12, p = 0.033). Conclusion F/A problems adversely affecting the functional status were frequent in our cohort of UKA patients. Postoperative residual varus deformity may be a risk factor for this. Therefore, if slight varus alignment is aimed at UKA patients, preoperative F/A status should be evaluated.
{"title":"Foot and/or ankle problems following limb alignment changes in uni-compartmental knee arthroplasty","authors":"H. R. Güngör, Gökhan Bayrak, Hakan Zora, R. Şavkın, N. Büker","doi":"10.1177/22104917221101410","DOIUrl":"https://doi.org/10.1177/22104917221101410","url":null,"abstract":"Objective Foot and/or ankle (F/A) problems may be encountered in medial uni-compartmental knee (UKA) patients postoperatively due to the limb alignment changes and alterations in weight bearing of F/A. This study aimed to evaluate the risk factors and the incidence of foot and ankle (F/A) problems in (UKA) arthroplasty patients. Methods Patients who underwent UKA between 2016 and 2019 in our clinic were evaluated and the presence of F/A problems was recorded. Radiologic evaluations included hip knee ankle angle (HKA), medial proximal tibial angle, posterior tibial slope angle, talar tilt angle, talar inclination, talar dome to mechanical axis (TDMA), and talocrural angle (TCA) measured on preoperative and follow-up long-leg standing radiographs. The range of motion, Q angles, and muscle strengths were measured. Visual analog scale, physical performance limitations, and patient-reported activity limitations were evaluated for all patients. Patients with reported F/A problems were additionally evaluated with Foot Functional Index. Results Forty-four patients (38 female, 6 male; mean age 58.66 ± 8.6 years; mean BMI 31.30 ± 3.81, mean follow-up period 34.22 ± 18.95 months) were included in the study. There were 13 patients (29.5%) with reported F/A problems. Postoperative comparison of patients with and without F/A problems showed statistically significant differences in only WOMAC and SF12 physical health sub-scores (p = 0.002, p = 0.003, respectively). There was no significant postoperative change in TDMA in patients with F/A problems (p > 0.05) in contrast to patients without F/A problems (p = 0.006). There was no statistically significant difference in preoperative TCA measurements between groups (p = 0.79). Comparison of knee and ankle radiologic measurements between groups demonstrated significant difference only in postoperative HKA measurements (−2.82 ± 2.53 vs. −0.80 ± 3.12, p = 0.033). Conclusion F/A problems adversely affecting the functional status were frequent in our cohort of UKA patients. Postoperative residual varus deformity may be a risk factor for this. Therefore, if slight varus alignment is aimed at UKA patients, preoperative F/A status should be evaluated.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"5 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81533319","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 : 2022-09-27DOI: 10.1177/22104917221123340
Maheshwar Lakkireddy, G. Taduri, Manohar Kandakatla, Nagesh Cherukuri, Raju Iyengar, Chandrashekar Patnala, Madhulatha Karra
Introduction: Amputation is a painful functional experience and optimal rehabilitation of an amputee is a team effort. Functional restitution depends on many factors including the type of prosthesis available. We report our experience of providing advanced artificial limbs at free of cost to the underprivileged through a state-sponsored pilot initiative. Material and methods: This is a retrospective cohort study of amputees who have been rehabilitated with advanced artificial limbs through the Department of Orthopaedics at Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India from the years 2017 to 2021. Prostheses were procured through rate contract and monitory support was provided by the state. Evaluation, fitment and functional restitution were supervised by the orthopaedic surgeons to the utmost satisfaction of the amputees. Results: A total of 136 subjects received 142 advanced artificial limbs. Out of 136 subjects, 130 received unilateral and 6 subjects received bilateral prosthesis. Ninety-two percent (n = 125) were men and 8% (n = 11) were women. Eighty-eight (n = 125) were lower limb prosthesis and 12% (n = 17) were upper limb prosthesis. All the amputees fitted with advanced artificial limbs were highly satisfied at the end of the procedure and were confident of independent living. Conclusion: Appropriate rehabilitative measures are required for amputees to lead an independent life. Paucity of institutional support and monitory challenges preclude them from advanced prosthesis. State-sponsored, institute-based supply of advanced artificial limbs at free of cost to the beneficiaries is a replicable and feasible option for optimal rehabilitation of amputees with appropriate prosthesis.
{"title":"State-sponsored institute-based provision of advanced artificial limbs for rehabilitation of amputees","authors":"Maheshwar Lakkireddy, G. Taduri, Manohar Kandakatla, Nagesh Cherukuri, Raju Iyengar, Chandrashekar Patnala, Madhulatha Karra","doi":"10.1177/22104917221123340","DOIUrl":"https://doi.org/10.1177/22104917221123340","url":null,"abstract":"Introduction: Amputation is a painful functional experience and optimal rehabilitation of an amputee is a team effort. Functional restitution depends on many factors including the type of prosthesis available. We report our experience of providing advanced artificial limbs at free of cost to the underprivileged through a state-sponsored pilot initiative. Material and methods: This is a retrospective cohort study of amputees who have been rehabilitated with advanced artificial limbs through the Department of Orthopaedics at Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India from the years 2017 to 2021. Prostheses were procured through rate contract and monitory support was provided by the state. Evaluation, fitment and functional restitution were supervised by the orthopaedic surgeons to the utmost satisfaction of the amputees. Results: A total of 136 subjects received 142 advanced artificial limbs. Out of 136 subjects, 130 received unilateral and 6 subjects received bilateral prosthesis. Ninety-two percent (n = 125) were men and 8% (n = 11) were women. Eighty-eight (n = 125) were lower limb prosthesis and 12% (n = 17) were upper limb prosthesis. All the amputees fitted with advanced artificial limbs were highly satisfied at the end of the procedure and were confident of independent living. Conclusion: Appropriate rehabilitative measures are required for amputees to lead an independent life. Paucity of institutional support and monitory challenges preclude them from advanced prosthesis. State-sponsored, institute-based supply of advanced artificial limbs at free of cost to the beneficiaries is a replicable and feasible option for optimal rehabilitation of amputees with appropriate prosthesis.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"13 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84976888","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 : 2022-09-13DOI: 10.1177/22104917221116387
H. Gutiérrez-Espinoza, F. Araya-Quintanilla, Sebastián Pinto-Concha, W. Sepúlveda-Loyola, R. Ramírez‐Vélez, Jorge Fuentes-Contreras
Background The most common complication in the surgery for rotator cuff (RC) tears is postoperative shoulder stiffness. The evidence for the postoperative treatment of this condition is scarce. This study assessed the effects of a postoperative program at the onset of shoulder stiffness following arthroscopic RC repair. Methods A single-group pre- and post-test design was included. Participants performed a 6-week program. Primary outcomes were shoulder and upper limb function assessed with the Constant–Murley and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires, respectively. Secondary outcomes included pain intensity at rest and during movement with the visual analog scale (VAS), and shoulder range of motion assessed with a goniometer. Results A total of 115 adult males were included. The intervention produced a positive effect on the Constant–Murley (+35.6 points, p<0.001) and DASH questionnaire (−26.2 points, p = 0.005); VAS at rest (−2.8 cm, p<0.001); VAS at movement (−2.7 cm, p<0.001); and shoulder ROMs. Conclusion The program showed clinically and statistically significant benefits in most of the functional outcomes in the study participants.
背景肩袖撕裂手术中最常见的并发症是术后肩僵硬。关于这种情况的术后治疗的证据很少。本研究评估了关节镜下RC修复后出现肩关节僵硬的术后方案的效果。方法采用单组试验前后设计。参与者进行了一个为期6周的项目。主要结果是分别用Constant-Murley和手臂、肩膀和手的残疾(DASH)问卷评估肩部和上肢功能。次要结果包括休息时和运动时的疼痛强度(视觉模拟评分(VAS))和肩关节活动度(角计)。结果共纳入115名成年男性。干预对Constant-Murley问卷(+35.6分，p<0.001)和DASH问卷(- 26.2分，p = 0.005)产生积极影响;静止VAS (- 2.8 cm, p<0.001);运动时VAS (- 2.7 cm, p<0.001);和肩带rom。结论该方案在研究参与者的大多数功能结果中显示出临床和统计学上显著的益处。
{"title":"Effects of a postoperative program in patients with shoulder stiffness following arthroscopic rotator cuff repair","authors":"H. Gutiérrez-Espinoza, F. Araya-Quintanilla, Sebastián Pinto-Concha, W. Sepúlveda-Loyola, R. Ramírez‐Vélez, Jorge Fuentes-Contreras","doi":"10.1177/22104917221116387","DOIUrl":"https://doi.org/10.1177/22104917221116387","url":null,"abstract":"Background The most common complication in the surgery for rotator cuff (RC) tears is postoperative shoulder stiffness. The evidence for the postoperative treatment of this condition is scarce. This study assessed the effects of a postoperative program at the onset of shoulder stiffness following arthroscopic RC repair. Methods A single-group pre- and post-test design was included. Participants performed a 6-week program. Primary outcomes were shoulder and upper limb function assessed with the Constant–Murley and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires, respectively. Secondary outcomes included pain intensity at rest and during movement with the visual analog scale (VAS), and shoulder range of motion assessed with a goniometer. Results A total of 115 adult males were included. The intervention produced a positive effect on the Constant–Murley (+35.6 points, p<0.001) and DASH questionnaire (−26.2 points, p = 0.005); VAS at rest (−2.8 cm, p<0.001); VAS at movement (−2.7 cm, p<0.001); and shoulder ROMs. Conclusion The program showed clinically and statistically significant benefits in most of the functional outcomes in the study participants.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"107 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79326155","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 : 2022-07-26DOI: 10.1177/22104917221116392
S. Ortu, Enrico Fiori, I. Bagnoli, Angiola Valente, F. Pisanu, G. Caggiari, C. Doria, L. Milano
Introduction Morton’s neuroma (MN) is a neuropathic metatarsalgia that causes pain in the plantar aspect of the forefoot generally between the third and fourth metatarsal heads. Treatment can be nonoperative or surgical. Among nonoperative procedures, alcohol injections are still commonly used as considered simple, relatively safe and well-tolerated treatment. However, they present transient and minor complications. Methods Two hundred patients with a diagnosis of MN underwent ultrasound-guided injections with a 47.5% alcohol solution between 2013 and 2020. We reviewed the current literature to highlight the known complications of this treatment, comparing them to the complications developed by our patients. Results Three patients out of 200 patients, developed necrosis of skin and subcutaneous tissue not described in previous studies about MN. Conclusions Our study focuses attention on the complications subsequent to the alcohol injection therapy for MN. Patients and surgeons should be aware that in a small number of cases this therapy can be burdened by necrotic complications of the skin.
{"title":"Complications of alcohol injections for Morton’s neuroma","authors":"S. Ortu, Enrico Fiori, I. Bagnoli, Angiola Valente, F. Pisanu, G. Caggiari, C. Doria, L. Milano","doi":"10.1177/22104917221116392","DOIUrl":"https://doi.org/10.1177/22104917221116392","url":null,"abstract":"Introduction Morton’s neuroma (MN) is a neuropathic metatarsalgia that causes pain in the plantar aspect of the forefoot generally between the third and fourth metatarsal heads. Treatment can be nonoperative or surgical. Among nonoperative procedures, alcohol injections are still commonly used as considered simple, relatively safe and well-tolerated treatment. However, they present transient and minor complications. Methods Two hundred patients with a diagnosis of MN underwent ultrasound-guided injections with a 47.5% alcohol solution between 2013 and 2020. We reviewed the current literature to highlight the known complications of this treatment, comparing them to the complications developed by our patients. Results Three patients out of 200 patients, developed necrosis of skin and subcutaneous tissue not described in previous studies about MN. Conclusions Our study focuses attention on the complications subsequent to the alcohol injection therapy for MN. Patients and surgeons should be aware that in a small number of cases this therapy can be burdened by necrotic complications of the skin.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"15 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76042725","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 : 2022-06-01DOI: 10.1177/22104917221092163
Gyneshwar Tonk, Pradeep KR Yadav, S. Agarwal, Kalom Jamoh
Background: The aim of this study is to compare morbidities at the donor site in autologous bone harvesting from an anterior iliac crest via the outer cortex, inner cortex and table splitting technique. Methods: The randomized, prospective and comparative study was conducted in 60 patients who were treated with bone grafting as a part of their treatment plan. Group A underwent the outer cortex technique (20 patients), Group B underwent the inner cortex technique (20 patients) and Group C underwent the table splitting technique (20 patients). The comparison of morbidities associated with various techniques of anterior iliac crest bone graft harvesting was done for a period of one year. Results: Most common morbidity observed was pain, measured by the visual analogue scale score (60/60, 100% of patients). The visual analogue scale score was significantly higher for the outer cortex group followed by the inner cortex group, and then the lowest score was for the table splitting group (p < 0.05). Followed by numbness (40/60, 66%), least in the table splitting group and maximum in the outer cortex group (p < 0.05). Next was abnormal gait, which was mostly seen in patients with the outer table method and least in the table split group (p < 0.05). Other complications were infections (4), itching at the surgical site (3) and hematoma (1). There were no significant difference regarding scar satisfaction among comparison groups. Conclusion: we conclude that few differences do exist in harvest-site morbidities between different techniques used in our study. Overall, the most common morbidity observed were pain, numbness and abnormal gait. However, the table splitting group has the lowest morbidity, therefore bone harvesting by the table splitting appears to be a very good option.
{"title":"Donor site morbidity in autologous bone grafting – A comparison between different techniques of anterior iliac crest bone harvesting: A prospective study","authors":"Gyneshwar Tonk, Pradeep KR Yadav, S. Agarwal, Kalom Jamoh","doi":"10.1177/22104917221092163","DOIUrl":"https://doi.org/10.1177/22104917221092163","url":null,"abstract":"Background: The aim of this study is to compare morbidities at the donor site in autologous bone harvesting from an anterior iliac crest via the outer cortex, inner cortex and table splitting technique. Methods: The randomized, prospective and comparative study was conducted in 60 patients who were treated with bone grafting as a part of their treatment plan. Group A underwent the outer cortex technique (20 patients), Group B underwent the inner cortex technique (20 patients) and Group C underwent the table splitting technique (20 patients). The comparison of morbidities associated with various techniques of anterior iliac crest bone graft harvesting was done for a period of one year. Results: Most common morbidity observed was pain, measured by the visual analogue scale score (60/60, 100% of patients). The visual analogue scale score was significantly higher for the outer cortex group followed by the inner cortex group, and then the lowest score was for the table splitting group (p < 0.05). Followed by numbness (40/60, 66%), least in the table splitting group and maximum in the outer cortex group (p < 0.05). Next was abnormal gait, which was mostly seen in patients with the outer table method and least in the table split group (p < 0.05). Other complications were infections (4), itching at the surgical site (3) and hematoma (1). There were no significant difference regarding scar satisfaction among comparison groups. Conclusion: we conclude that few differences do exist in harvest-site morbidities between different techniques used in our study. Overall, the most common morbidity observed were pain, numbness and abnormal gait. However, the table splitting group has the lowest morbidity, therefore bone harvesting by the table splitting appears to be a very good option.","PeriodicalId":42408,"journal":{"name":"Journal of Orthopaedics Trauma and Rehabilitation","volume":"12 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85984289","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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