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Health economics for intra-capsular hip fractures undertaking fixation 髋关节囊内骨折固定术的卫生经济学研究
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.30
Anatole Wiik, Thomas Ashdown, Ian Holloway
BACKGROUND Hip fracture is a common musculoskeletal injury in the elderly requiring surgery worldwide. The operative mainstay of intra-capsular hip fractures is arthroplasty with a smaller proportion for fixation. AIM To determine the most beneficial method of fixation for patients with intra-capsular hip fractures. METHODS A registered audit from 2012-2018 was conducted on all intra-capsular hip fractures treated with 2 commonly used fixation methods. Patient notes, electronic records and clinical codes for cost benefit were evaluated. A validated quality of life measure was collected at least 1 year after surgery. RESULTS A total of 83 patients were identified with intra-capsular fractures undergoing fixation during the retrospective period. There were 47 cannulated cancellous screw and 36 sliding hip screw fixations with the case mix comparable for age, gender, co-morbidities and fracture configuration. There was no significant difference in blood loss, tip apex distance, radiation exposure, length of stay, radiological union time, collapse, avascular necrosis or re-operation between fixation methods. Logistic regression analysis demonstrated displaced intracapsular hip fractures correlated significantly with an undesirable outcome conferring a relative odds ratio of 7.25. There were 9 (19%) and 4 (11%) patients respectively, who required re-operation. There was no significant difference in health resource group tariff and implant cost with comparable EQ-5D and visual analogue scores. CONCLUSION No significant advantage was identified with differing fixation type, but irrespective there were a high number of patients requiring re-operation. This was predicted by initial fracture displacement and patient age. Arthroplasty may need to be carefully considered for health economics and patient benefit.
背景 髋关节骨折是全世界老年人常见的肌肉骨骼损伤,需要进行手术治疗。髋关节囊内骨折的主要手术方式是关节置换术,而固定术所占比例较小。目的 确定对髋关节囊内骨折患者最有利的固定方法。方法 对 2012-2018 年间所有采用两种常用固定方法治疗的髋关节囊内骨折进行登记审计。对患者笔记、电子记录和临床代码进行了成本效益评估。术后至少 1 年收集了经过验证的生活质量测量数据。结果 在回顾性研究期间,共有 83 名患者接受了囊内骨折固定术。其中47例采用松质骨螺钉固定,36例采用滑动髋螺钉固定,病例的年龄、性别、并发症和骨折结构相当。两种固定方法在失血量、顶端距离、辐射暴露、住院时间、放射学结合时间、塌陷、血管坏死或再次手术方面没有明显差异。逻辑回归分析表明,移位性囊内髋部骨折与不良后果有显著相关性,相对几率为 7.25。需要再次手术的患者分别为 9 人(19%)和 4 人(11%)。在 EQ-5D 和视觉模拟评分相当的情况下,医疗资源组关税和植入成本没有明显差异。结论 不同的固定方式没有明显的优势,但无论如何,需要再次手术的患者人数较多。最初的骨折移位和患者年龄预示了这一点。可能需要仔细考虑关节置换术的健康经济性和患者利益。
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引用次数: 0
Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures 股骨颈骨折老人直接前路与后路髋关节半人工关节置换术后的并发症发生率
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.22
T. Charles, N. Bloemers, Bilal Kapanci, Marc Jayankura
BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1% to 17%. This serious complication is associated with increased morbidity and mortality rates. Approaches to this surgery are still debated, with no consensus regarding the superiority of any single approach. AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches (PL) for hip hemiarthroplasty after femoral neck fractures. METHODS This is a comparative, retrospective, single-center cohort study conducted at a university hospital. Between March 2008 and December 2018, 273 patients (a total of 280 hips) underwent bipolar hemiarthroplasties (n = 280) for displaced femoral neck fractures using either the PL (n = 171) or the minimally invasive direct anterior approach (DAA) (n = 109). The choice of approach was related to the surgeons’ practices; the implant types were similar and unrelated to the approach. Dislocation rates and other complications were reviewed after a minimum follow-up of 6 mo. RESULTS Both treatment groups had similarly aged patients (mean age: 82 years), sex ratios, patient body mass indexes, and patient comorbidities. Surgical data (surgery delay time, operative time, and blood loss volume) did not differ significantly between the groups. The 30 d mortality rate was higher in the PL group (9.9%) than in the DAA group (3.7%), but the difference was not statistically significant (P = 0.052). Among the one-month survivors, a significantly higher rate of dislocation was observed in the PL group (14/154; 9.1%) than in the DAA group (0/105; 0%) (P = 0.002). Of the 14 patients with dislocation, 8 underwent revision surgery for recurrent instability (posterior group), and one of them had 2 additional procedures due to a deep infection. The rate of other complications (e.g. , perioperative and early postoperative periprosthetic fractures and infection-related complications) did not differ significantly between the groups. CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate (< 1%) than the PL.
背景 据报道,半关节成形术后的脱位率从1%到17%不等。这种严重的并发症会增加发病率和死亡率。目前对该手术的方法仍有争议,对任何一种方法的优劣尚未达成共识。目的 比较股骨颈骨折后采用直接前路和后路(PL)髋关节半关节置换术后的早期并发症。方法 这是一项在一所大学医院进行的比较性、回顾性、单中心队列研究。2008年3月至2018年12月期间,273名患者(共280个髋关节)因股骨颈骨折移位接受了双极半关节置换术(n = 280),采用PL(n = 171)或微创直接前路(DAA)(n = 109)。手术方式的选择与外科医生的实践有关;植入物类型相似,与手术方式无关。至少随访 6 个月后,对脱位率和其他并发症进行复查。结果 两组患者的年龄(平均年龄 82 岁)、性别比例、体重指数和合并症均相似。两组的手术数据(手术延迟时间、手术时间和失血量)无明显差异。PL 组的 30 天死亡率(9.9%)高于 DAA 组(3.7%),但差异无统计学意义(P = 0.052)。在存活一个月的患者中,PL 组的脱位率(14/154;9.1%)明显高于 DAA 组(0/105;0%)(P = 0.002)。在14例脱位患者中,8例因复发性不稳定接受了翻修手术(后路组),其中1例因深部感染又进行了2次手术。其他并发症(如围手术期和术后早期假体周围骨折以及感染相关并发症)的发生率在各组之间没有显著差异。结论 这些研究结果表明,对股骨颈骨折患者采用DAA至双极半关节成形术的脱位率(< 1%)低于PL。
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引用次数: 0
Acetabular cup size trends in total hip arthroplasty 全髋关节置换术的髋臼杯尺寸趋势
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.39
Daniel Patrick McKenna, Alex Price, Timothy McAleese, Darren Dahly, Paul McKenna, May Cleary
BACKGROUND Total hip arthroplasty (THA) is a common procedure for end stage osteoarthritis. The learning curve for THA is complex and challenging. One of the most difficult skills to master is acetabular reaming. We wish to identify if experience in arthroplasty leads to preservation of more bone stock. AIM To investigate if increasing surgeon experience will predict an ever decreasing acetabular cup size. METHODS A retrospective case series of four attending orthopaedic surgeons was completed. All uncemented elective total hip arthroplasties since appointment were selected for inclusion. The size of acetabular cup used was noted and logistic regression was used to identify if a trend to smaller cups existed. RESULTS A total of 1614 subjects were included with a mean age of 64 years. Overall cups were on average 0.18mm smaller per year (95% confidence interval -0.25 to -0.11, P < 0.001). Individual surgeon trends showed cup sizes to decrease 0.27 mm/year for surgeon A, 0.02 mm/year for surgeon B, 0.15 mm/year for surgeon C and 0.29 mm/year for surgeon D. Three of the four surgeons had a more pronounced trend to smaller cups for male subjects than their female counterparts. CONCLUSION We found increasing surgeon experience to be associated with an ever-decreasing acetabular cup size. Smaller acetabular cup size may act as a surrogate marker of surgical proficiency by virtue of decreased acetabular reaming.
背景 全髋关节置换术(THA)是治疗终末期骨关节炎的常见手术。全髋关节置换术的学习曲线复杂而具有挑战性。其中最难掌握的技能之一是髋臼铰孔。我们希望确定关节置换术中的经验是否会导致保留更多的骨量。目的 研究外科医生经验的增加是否会导致髋臼杯尺寸不断缩小。方法 对四名骨科主治医生进行了回顾性病例系列研究。所有自任命以来的非骨水泥选择性全髋关节置换术均被选入。记录所使用的髋臼杯大小,并使用逻辑回归法确定是否存在使用较小髋臼杯的趋势。结果 共纳入 1614 名受试者,平均年龄为 64 岁。总体而言,髋臼杯平均每年缩小 0.18 毫米(95% 置信区间 -0.25 至 -0.11,P < 0.001)。外科医生个体趋势显示,外科医生 A 的牙杯尺寸每年缩小 0.27 毫米,外科医生 B 每年缩小 0.02 毫米,外科医生 C 每年缩小 0.15 毫米,外科医生 D 每年缩小 0.29 毫米。结论 我们发现,外科医生经验的增加与髋臼杯尺寸的不断缩小有关。较小的髋臼杯尺寸可作为手术熟练程度的替代标志,因为髋臼铰孔减少了。
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引用次数: 0
Association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women 绝经后中年女性血清雌二醇水平与阑尾瘦体重指数之间的关系
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.45
Fang Jin, Yan-Fei Wang, Zhong-Xin Zhu
BACKGROUND Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions. AIM To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data. METHODS This study included 673 postmenopausal women, aged 40-59 years, from the National Health and Nutrition Examination Survey between 2013 and 2016. Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index (ALMI). When non-linear associations were found by using weighted generalized additive model and smooth curve fitting, two-piecewise linear regression models were further applied to examine the threshold effects. RESULTS There was a positive association between serum E2 level and ALMI. Compared to individuals in quartile 1 group, those in other quartiles had higher ALMI levels. An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting, and the inflection point was identified as a serum E2 level of 85 pg/mL. CONCLUSION Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women, suggesting that low serum E2 levels play an important in the loss of muscle mass in middle-aged postmenopausal women.
背景 以前对绝经期雌激素流失与骨骼肌质量之间关系的研究得出了相互矛盾的结论。目的 利用基于人口的数据,评估中年绝经后妇女血清雌二醇水平与阑尾瘦体重指数之间的关系。方法 本研究纳入了 673 名绝经后女性,年龄在 40-59 岁之间,她们来自 2013 年至 2016 年间的美国国家健康与营养调查(National Health and Nutrition Examination Survey)。采用加权多变量线性回归模型评估血清 E2 水平与阑尾瘦体重指数(ALMI)之间的关联。当使用加权广义相加模型和平滑曲线拟合发现非线性关联时,进一步应用双片段线性回归模型来检验阈值效应。结果 血清 E2 水平与 ALMI 呈正相关。与四分位数 1 组的个体相比,其他四分位数组的个体具有更高的 ALMI 水平。通过加权广义相加模型和平滑曲线拟合,发现血清 E2 水平与 ALMI 之间存在倒 U 型曲线关系,并确定血清 E2 水平达到 85 pg/mL 时为拐点。结论 我们的研究结果表明,中年绝经后妇女的血清 E2 水平与 ALMI 之间存在倒 U 型曲线关系,这表明低血清 E2 水平是导致中年绝经后妇女肌肉质量下降的重要原因。
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引用次数: 0
Scoliocorrector Fatma-UI for correction of adolescent idiopathic scoliosis: Development, effectivity, safety and functional outcome 用于矫正青少年特发性脊柱侧凸的脊柱侧凸矫正器 Fatma-UI:开发、有效性、安全性和功能结果
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.61
P. Phedy, I. H. Dilogo, Wresti Indriatmi, Sugeng Supriadi, Marcel Prasetyo, Fitri Octaviana, Zairin Noor
BACKGROUND Adolescent idiopathic scoliosis remains a major problem due to its high incidence, high risk, and high cost. One of the aims of the management in scoliosis is to correct the deformity. Many techniques are available to correct scoliosis deformity; however, they are all far from ideal to achieve three-dimensional correction in scoliosis. AIM To develop a set of tools named Scoliocorrector Fatma-UI (SCFUI) to aid three-dimensional correction and to evaluate the efficacy, safety, and functional outcome. METHODS This study consists of two stages. In the first stage, we developed the SCFUI and tested it in finite element and biomechanical tests. The second stage was a single-blinded randomized clinical trial to evaluate the SCFUI compared to direct vertebral rotation (DVR). Forty-four subjects with adolescent idiopathic scoliosis were randomly allocated into the DVR group (n = 23) and SCFUI group (n = 21). Radiological, neurological, and functional outcome was compared between the groups. RESULTS Finite element revealed the maximum stress of the SCFUI components to be between 31.2 - 252 MPa. Biomechanical analysis revealed the modulus elasticity of SCFUI was 9561324 ± 633277 MPa. Both groups showed improvement in Cobb angle and sagittal profile, however the rotation angle was lower in the SCFUI group (11.59 ± 7.46 vs 18.23 ± 6.39, P = 0.001). Neurological and functional outcome were comparable in both groups. CONCLUSION We concluded that SCFUI developed in this study resulted in similar coronal and sagittal but better rotational correction compared to DVR. The safety and functional outcomes were also similar to DVR.
背景 青少年特发性脊柱侧弯症发病率高、风险大、费用高,因此一直是个大问题。治疗脊柱侧弯的目的之一是矫正畸形。目前有许多矫正脊柱侧弯畸形的技术,但要实现脊柱侧弯的三维矫正,这些技术还远远不够理想。目的 开发一套名为 "脊柱侧弯矫正器 Fatma-UI(SCFUI)"的工具,用于辅助三维矫正,并评估其有效性、安全性和功能结果。方法 本研究包括两个阶段。第一阶段,我们开发了 SCFUI,并对其进行了有限元和生物力学测试。第二阶段是单盲随机临床试验,评估 SCFUI 与直接椎体旋转(DVR)的比较。44 名患有青少年特发性脊柱侧凸的受试者被随机分配到 DVR 组(23 人)和 SCFUI 组(21 人)。比较两组的放射学、神经学和功能结果。结果 有限元显示 SCFUI 组件的最大应力在 31.2 - 252 兆帕之间。生物力学分析显示,SCFUI 的弹性模量为 9561324 ± 633277 兆帕。两组患者的 Cobb 角和矢状面均有所改善,但 SCFUI 组的旋转角度较低(11.59 ± 7.46 vs 18.23 ± 6.39,P = 0.001)。两组患者的神经和功能预后相当。结论 我们得出结论,与 DVR 相比,本研究中开发的 SCFUI 具有相似的冠状面和矢状面矫正效果,但旋转矫正效果更好。安全性和功能性结果也与 DVR 相似。
{"title":"Scoliocorrector Fatma-UI for correction of adolescent idiopathic scoliosis: Development, effectivity, safety and functional outcome","authors":"P. Phedy, I. H. Dilogo, Wresti Indriatmi, Sugeng Supriadi, Marcel Prasetyo, Fitri Octaviana, Zairin Noor","doi":"10.5312/wjo.v15.i1.61","DOIUrl":"https://doi.org/10.5312/wjo.v15.i1.61","url":null,"abstract":"BACKGROUND\u0000 Adolescent idiopathic scoliosis remains a major problem due to its high incidence, high risk, and high cost. One of the aims of the management in scoliosis is to correct the deformity. Many techniques are available to correct scoliosis deformity; however, they are all far from ideal to achieve three-dimensional correction in scoliosis.\u0000 AIM\u0000 To develop a set of tools named Scoliocorrector Fatma-UI (SCFUI) to aid three-dimensional correction and to evaluate the efficacy, safety, and functional outcome.\u0000 METHODS\u0000 This study consists of two stages. In the first stage, we developed the SCFUI and tested it in finite element and biomechanical tests. The second stage was a single-blinded randomized clinical trial to evaluate the SCFUI compared to direct vertebral rotation (DVR). Forty-four subjects with adolescent idiopathic scoliosis were randomly allocated into the DVR group (n = 23) and SCFUI group (n = 21). Radiological, neurological, and functional outcome was compared between the groups.\u0000 RESULTS\u0000 Finite element revealed the maximum stress of the SCFUI components to be between 31.2 - 252 MPa. Biomechanical analysis revealed the modulus elasticity of SCFUI was 9561324 ± 633277 MPa. Both groups showed improvement in Cobb angle and sagittal profile, however the rotation angle was lower in the SCFUI group (11.59 ± 7.46 vs 18.23 ± 6.39, P = 0.001). Neurological and functional outcome were comparable in both groups.\u0000 CONCLUSION\u0000 We concluded that SCFUI developed in this study resulted in similar coronal and sagittal but better rotational correction compared to DVR. The safety and functional outcomes were also similar to DVR.","PeriodicalId":506838,"journal":{"name":"World Journal of Orthopedics","volume":"117 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139614951","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}
引用次数: 0
Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study 小儿肱骨远端骨折的流行病学调查:美国保险理赔数据库研究
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.52
Kyle J. Klahs, Jake E Dertinger, Grant T Mello, Kevin Thapa, Alexis B. Sandler, E'Stephan J Jesus Garcia, Nata Parnes
BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types: Supracondylar (SC), lateral condyle (LC), and medial epicondyle (ME) fractures. AIM To evaluate the epidemiology of pediatric distal humerus fractures (SC, LC, and ME) from an American insurance claims database. METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC, LC and ME fractures based on the IBM Truven MarketScan® Commercial and IBM Truven MarketScan Medicare Supplemental databases. Patients from 2015 to 2020 were queried for treatments, patient age, sex, length of hospitalization, and comorbidities. RESULTS A total of 1133 SC, 154 LC, and 124 ME fractures were identified. SC fractures had the highest percentage of operation at 83%, followed by LC (78%) and ME fractures (41%). Male patients were, on average, older than female patients for both SC and ME fractures. CONCLUSION In the insurance claims databases used, SC fractures were the most reported, followed by LC fractures, and finally ME fractures. Age was identified to be a factor for how a pediatric distal humerus fractures, with patients with SC and LC fractures being younger than those with ME fractures. The peak age per injury per sex was similar to reported historic central tendencies, despite reported trends for younger physiologic development.
背景肱骨远端肘部骨折是儿童患者最常见的外伤性骨折之一,主要分为三种类型:肱骨髁上骨折(SC)、肱骨外侧髁骨折(LC)和肱骨内上髁骨折(ME)。目的 从美国保险理赔数据库中评估小儿肱骨远端骨折(SC、LC 和 ME)的流行病学。方法 根据 IBM Truven MarketScan® Commercial 和 IBM Truven MarketScan Medicare Supplemental 数据库,对 17 岁及以下、ICD 9 和 10 编码为 SC、LC 和 ME 骨折的患者进行回顾性审查。查询了 2015 年至 2020 年期间患者的治疗方法、患者年龄、性别、住院时间和合并症。结果 共发现 1133 例 SC 型骨折、154 例 LC 型骨折和 124 例 ME 型骨折。SC骨折的手术比例最高,为83%,其次是LC骨折(78%)和ME骨折(41%)。在 SC 型和 ME 型骨折中,男性患者的平均年龄高于女性患者。结论 在所使用的保险理赔数据库中,SC 骨折的报告最多,其次是 LC 骨折,最后是 ME 骨折。年龄是造成小儿肱骨远端骨折的一个因素,SC和LC骨折的患者比ME骨折的患者年轻。尽管有报告称生理发育呈年轻化趋势,但每种性别每次受伤的高峰年龄与报告的历史中心趋势相似。
{"title":"Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study","authors":"Kyle J. Klahs, Jake E Dertinger, Grant T Mello, Kevin Thapa, Alexis B. Sandler, E'Stephan J Jesus Garcia, Nata Parnes","doi":"10.5312/wjo.v15.i1.52","DOIUrl":"https://doi.org/10.5312/wjo.v15.i1.52","url":null,"abstract":"BACKGROUND\u0000 Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types: Supracondylar (SC), lateral condyle (LC), and medial epicondyle (ME) fractures.\u0000 AIM\u0000 To evaluate the epidemiology of pediatric distal humerus fractures (SC, LC, and ME) from an American insurance claims database.\u0000 METHODS\u0000 A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC, LC and ME fractures based on the IBM Truven MarketScan® Commercial and IBM Truven MarketScan Medicare Supplemental databases. Patients from 2015 to 2020 were queried for treatments, patient age, sex, length of hospitalization, and comorbidities.\u0000 RESULTS\u0000 A total of 1133 SC, 154 LC, and 124 ME fractures were identified. SC fractures had the highest percentage of operation at 83%, followed by LC (78%) and ME fractures (41%). Male patients were, on average, older than female patients for both SC and ME fractures.\u0000 CONCLUSION\u0000 In the insurance claims databases used, SC fractures were the most reported, followed by LC fractures, and finally ME fractures. Age was identified to be a factor for how a pediatric distal humerus fractures, with patients with SC and LC fractures being younger than those with ME fractures. The peak age per injury per sex was similar to reported historic central tendencies, despite reported trends for younger physiologic development.","PeriodicalId":506838,"journal":{"name":"World Journal of Orthopedics","volume":"78 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526242","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}
引用次数: 0
Surgical treatment of an old avulsion fracture of the ischial tuberosity and ischial ramus: A case report 陈旧性髂骨结节和髂嵴撕脱性骨折的手术治疗:病例报告
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.94
Zi-Ru Chen, Shi-Jie Liao, Fu-Chun Yang
BACKGROUND Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports activities. According to previous literature, the most commonly involved sports are soccer, sprinting, and gymnastics, in descending order. Dance-induced avulsion fracture of the ischial tuberosity and ischial ramus is extremely clinically rare. CASE SUMMARY A case of a neglected avulsion fracture of the ischial tuberosity and ischial ramus was diagnosed in a young female dancer who complained of pain and restricted movement of her right hip. She stated that she had suffered the injury while performing a split leap during a dance performance 9 mo prior. Eventually, she underwent surgery and obtained satisfactory treatment results. CONCLUSION Early diagnosis of these fractures is important to ensuring early proper treatment towards a quicker recovery. For old fractures with nonunion and chronic buttock pain, surgery is a preferred therapeutic choice with good treatment outcomes.
背景: 颧骨结节撕脱性骨折是临床上比较罕见的创伤类型,主要发生在青少年的竞技体育活动中。根据以往的文献,最常见的运动依次为足球、短跑和体操。舞蹈导致的髂骨结节和髂嵴撕脱性骨折在临床上极为罕见。病例摘要 一位年轻的女舞蹈演员被诊断为被忽视的峡部结节和峡部嵴撕脱性骨折,她主诉右髋部疼痛且活动受限。她说自己是在 9 个月前的一次舞蹈表演中做劈叉跳跃时受伤的。最终,她接受了手术,并获得了满意的治疗效果。结论 此类骨折的早期诊断非常重要,可确保尽早进行适当治疗,以加快康复速度。对于伴有不愈合和慢性臀部疼痛的陈旧性骨折,手术是首选的治疗方法,治疗效果良好。
{"title":"Surgical treatment of an old avulsion fracture of the ischial tuberosity and ischial ramus: A case report","authors":"Zi-Ru Chen, Shi-Jie Liao, Fu-Chun Yang","doi":"10.5312/wjo.v15.i1.94","DOIUrl":"https://doi.org/10.5312/wjo.v15.i1.94","url":null,"abstract":"BACKGROUND\u0000 Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports activities. According to previous literature, the most commonly involved sports are soccer, sprinting, and gymnastics, in descending order. Dance-induced avulsion fracture of the ischial tuberosity and ischial ramus is extremely clinically rare.\u0000 CASE SUMMARY\u0000 A case of a neglected avulsion fracture of the ischial tuberosity and ischial ramus was diagnosed in a young female dancer who complained of pain and restricted movement of her right hip. She stated that she had suffered the injury while performing a split leap during a dance performance 9 mo prior. Eventually, she underwent surgery and obtained satisfactory treatment results.\u0000 CONCLUSION\u0000 Early diagnosis of these fractures is important to ensuring early proper treatment towards a quicker recovery. For old fractures with nonunion and chronic buttock pain, surgery is a preferred therapeutic choice with good treatment outcomes.","PeriodicalId":506838,"journal":{"name":"World Journal of Orthopedics","volume":"76 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526518","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}
引用次数: 0
Effective time, correction speed and termination time of hemi-epiphysiodesis in children 儿童半骨骺成形术的有效时间、矫正速度和终止时间
Pub Date : 2024-01-18 DOI: 10.5312/wjo.v15.i1.1
Jian-Fa Zeng, Yuyin Xie, Can Liu, Zhenqi Song, Zheng Xu, Zhong-Wen Tang, Jie Wen, Sheng Xiao
In children with asymmetric growth on the medial and lateral side of limbs, if there still remains growth potential, the guided growth technique of hemi-epiphysiodesis on one side of the epiphysis is recognized as a safe and effective method. However, when the hemi-epiphysiodesis start to correct the deformities, how many degrees could hemi-epiphysiodesis bring every month and when to remove the hemi-epiphysiodesis implant without rebound phenomenon are still on debate. This article reviews the current studies focus on the effective time, correction speed and termination time of hemi-epiphysiodesis.
对于四肢内外侧生长不对称的儿童,如果仍有生长潜力,在一侧骨骺进行半骨骺成形术的引导生长技术被认为是一种安全有效的方法。然而,半骨骺成形术何时开始矫正畸形、半骨骺成形术每个月能矫正多少度、何时取出半骨骺成形术植入物才不会出现反弹现象等问题仍存在争议。本文回顾了目前的研究,重点是半骺成形术的有效时间、矫正速度和终止时间。
{"title":"Effective time, correction speed and termination time of hemi-epiphysiodesis in children","authors":"Jian-Fa Zeng, Yuyin Xie, Can Liu, Zhenqi Song, Zheng Xu, Zhong-Wen Tang, Jie Wen, Sheng Xiao","doi":"10.5312/wjo.v15.i1.1","DOIUrl":"https://doi.org/10.5312/wjo.v15.i1.1","url":null,"abstract":"In children with asymmetric growth on the medial and lateral side of limbs, if there still remains growth potential, the guided growth technique of hemi-epiphysiodesis on one side of the epiphysis is recognized as a safe and effective method. However, when the hemi-epiphysiodesis start to correct the deformities, how many degrees could hemi-epiphysiodesis bring every month and when to remove the hemi-epiphysiodesis implant without rebound phenomenon are still on debate. This article reviews the current studies focus on the effective time, correction speed and termination time of hemi-epiphysiodesis.","PeriodicalId":506838,"journal":{"name":"World Journal of Orthopedics","volume":"113 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139615546","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}
引用次数: 0
期刊
World Journal of Orthopedics
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