Formosan Journal of Musculoskeletal Disorders最新文献

{"title":"Modified knee extension training for treatment of patellar malalignment","authors":"Mingzhu Lee, Chi-Chuan Wu, Mei-Chuan Chen","doi":"10.6492/FJMD.201802_9(1).0004","DOIUrl":"https://doi.org/10.6492/FJMD.201802_9(1).0004","url":null,"abstract":"Background: Patients with patellar malalignment (PM) are common in orthopedic clinics. Conservative treatment first for PM is generally supported. Generally, reinforcing vastus medialis obliquus (VMO) strength is most convincing. Knee extension had been reported to be able to initiate VMO activities in electromyogram (EMG). Also, goosestep training had been reported to be able to upraise VMO/vatus lateralis (VL) ratio in EMG. Purpose: The purpose of this prospective study was to investigate clinical effects of modified knee extension training on treating lateral patellar tilt or subluxation. Methods: Thirty-seven consecutive adult patients (average: 52 years) were treated with modified knee extension training. It was performed once each day and each time needed 50 times (about one minute). Plain knee radiographs of anteroposterior, lateral, and Merchant's axial views were taken before treatment. Exclusion criteria were trochlear dysplasia (＞ 144° of sulcus angle), patellar alta or dislocation, symmetrical mediolateral patellofemoral (P-F) joint space (P-F index = 1), and snapping hips clinically. Ten weeks later, clinical outcome using modified Kujala score (5 items with 40 points) and Merchant's axial radiograph (congruence angle, lateral P-F angle, and P-F index) were compared statistically. Results: All 37 patients with 68 knees (32 bilaterally and 4 unilaterally) were followed at the outpatients' department (OPD) at 10-12 weeks. Before treatment, none of patients were satisfactory (average knee score: 27.2 points). At the latest follow-up, 89% of patients (33/37) were satisfactory (p ＜ 0.001) with an average knee score of 33.1 (p = 0.01). Only the P-F index was statistically significant before and after treatment (3.6 vs. 2.1, p ＜ 0.001) on Merchant's axial radiographs. Conclusion: The described technique may be one of excellent techniques for conservative treatment of PM. The technique is simple and an 89% success rate is relatively acceptable. The P-F index may be practical for follow-up of treatment effect.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"59 1","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74857277","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}

{"title":"External locked plating as the definitive treatment for open proximal tibial fractures-A biomechanical feasibility study","authors":"Jung-Ting Wang, Chin-Hsien Wu, Ching-Hou Ma, C. Yen, I. Jou, Y. Tu","doi":"10.6492/FJMD.201802_9(1).0003","DOIUrl":"https://doi.org/10.6492/FJMD.201802_9(1).0003","url":null,"abstract":"Background: Open proximal tibial fractures are associated with significant morbidity due to increased risks of infection, nonunion, malunion, knee stiffness, and possible amputation. Several authors demonstrated the benefits of bridging external fixation followed by definitive internal fixation once the soft-tissue envelope had sufficiently healed. We recently demonstrated the benefits of external locked plating followed by definitive internal fixation. Purpose: The purpose of this study was to evaluate the biomechanical feasibility of definitive external locked plating for open proximal tibial fractures. Methods: Two types of constructs were tested: (1) internal locked plate fixation (ILPF) and (2) external locked plate fixation (ELPF). Specimens were evaluated under static or dynamic axial loading to assess construct stiffness, strength, durability and failure mode. Results: The mean of construct strength of the ILPF and ELPF groups was 2147.4 ± 460.56 N and 793.2 ± 96.78 N, respectively. The mean of construct stiffness of the ILPF and ELPF groups was 384.01 ± 40.37 N/mm and 87.35 ± 7.40 N/mm, respectively. Conclusion: In this study, external locked plating showed biomechanical flexibility and could reduce construct stiffness to promote fracture healing by callus formation. However, ELPF constructs were not as strong as standard locked plating constructs. If we want to use ELPF constructs as definitive treatment, further biomechanical study to improve construct strength is warranted.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"14 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88622605","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}

{"title":"Slipped capital femoral epiphysis due to pituitary hypoplasia related panhypopituitarism: Case report and review of literature","authors":"Chun-Cheng Chen, Hsuan-Chih Liu, Po-Chang Huang, Chung-Da Wu","doi":"10.6492/FJMD.201802_9(1).0005","DOIUrl":"https://doi.org/10.6492/FJMD.201802_9(1).0005","url":null,"abstract":"Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in adolescents, and it has a prevalence of 10.8 cases per 100,000 children. SCFE in adults is uncommon, with only 22 cases reported in the literature, and only 10 of them were related to panhypopituitarism. This article presents a 26-year-old man with panhypopituitarism who developed pain in the left hip and knee that proved to be a slipped femoral capital epiphysis, he was treated by in situ pinning and hormone replacement therapy. Most patients with congenital hypopituitarism present at young age when short stature is noted during childhood. This case with normal body height and had no medical care until the presentation of SCFE, which is unusual for hypopituitarism.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"2 1","pages":"27-29"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87062040","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}

{"title":"Fracture of the stem-neck junction in non-modular total hip arthroplasty: A case report","authors":"Wei Liao, T. Kwok","doi":"10.6492/FJMD.201802_9(1).0007","DOIUrl":"https://doi.org/10.6492/FJMD.201802_9(1).0007","url":null,"abstract":"Fracture of non-modular femoral stem-neck junction failure after total hip arthroplasty is rare. We present a case of 52-year-old man with a fractured metal femoral stem-neck junction in a non-modular total hip replacement. The patient attended to emergency room with a fracture of the prosthetic neck of the femoral metal implant. The patient undergone a revision hip arthroplasty by splitting the femur for broken stem and implanting a new femoral stem with femoral wiring. Ceramic insert placed over the top of the acetabular ring was assembled with cement, and optimal neck length ceramic head was chosen.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"150 1","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79482328","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}

{"title":"Middle term result of two-stage total knee arthroplasty for prosthetic knee joint infection","authors":"Y. Hsueh, Feng-Chen Kao, Jih-Hsi Yeh, C. Yen, Y. Tu","doi":"10.6492/FJMD.201802_9(1).0001","DOIUrl":"https://doi.org/10.6492/FJMD.201802_9(1).0001","url":null,"abstract":"Introduction: The treatment of periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a challengeable task. Two-stage exchange arthroplasty is a commonly used treatment for chronic PJI. Purpose: The aim of this study was to investigate the successful rate and possible failure risk factors in patients undergoing a planned two-stage exchange arthroplasty for treatment of knee PJI. Methods: From March 2004 to February 2015, we retrospectively reviewed 35 patients have more than 36 months clinical follow-up with periprosthetic knee joint infections. The clinical outcomes were recorded to define the successful or fail treatment for the periprosthetic knee joint infections. Multiple factors such as obesity, comorbidities, diabetes, were recorded and analyzed to evaluate the risk factors of poor outcome. Results: Five patients were unable to receive second stage surgery with cement spacer retained due to variable reasons. Three patients ended with amputation due to uncontrolled infectious process. Overall 27 patients received two-stage exchange arthroplasty to treat knee PJI were analyzed in this study. However, two patients were loss follow-up during the period between 1st and 2nd time surgery. Two patients were treated with static cement spacer due to poor soft tissue condition. These 4 patients were excluded and overall 23 patients were included and analyzed. Overall success rate is 78.26%. 4 patients with recurrent infection were treated with additional surgical debridement. One patient with recurrent infection was treated with the second time two-stage arthroplasty. All of these patients were successful treated without further recurrent infection. Conclusion: We found that failure rate is increasing when considerate the failure between first stage and second stage surgery. In addition, patients without more than 36 months follow-up may have infection free due to honeymoon period but still in risk of reinfection.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"511 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80870857","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}

{"title":"Comparison of rush pins with titanium elastic nails for treatment of pediatric femoral shaft fractures","authors":"Ping-Yeh Chiu, Wei-Chun Lee, Wen-E. Yang, Chia-Hsieh Chang, Hsuan-Kai Kao","doi":"10.6492/FJMD.20160904","DOIUrl":"https://doi.org/10.6492/FJMD.20160904","url":null,"abstract":"Background: Pediatric femoral shaft fracture accounts for 1-2% of all pediatric fractures. Closed reduction and internal fixation with intramedullary devices is the treatment of choice for children older than 4 years. However, antegrade intramedullary devices are associated with concerns regarding possibility of injury to the vascular supply of the proximal femur. Therefore, retrograde titanium elastic nails (TENs) have become increasingly popular in recent years. Purpose: The purpose of this study was to compare the clinical outcomes of children with femoral shaft fractures treated with antegrade Rush pin and retrograde TENs. Methods: After obtaining the approval of the review board, we retrospectively reviewed the charts of 61 children who presented with femoral shaft fractures between 1991 and 2010. Thirty-eight boys and 23 girls (mean age: 8.8 years) were studied. Thirty-two children were treated with a Rush pin and the other 29 children with TENs. The radiographic and clinical outcomes were compared between the two groups. Results: The coronal alignment of the femur was not significantly different between the two groups (2.46° vs. 1.07°, p = 0.16). However, the sagittal bowing is significantly greater in children treated with TENs (1.2° vs. 7.7°, p ＜ 0.001). Leg length discrepancy is 2.4mm and 2.7mm longer than the uninjured side in Rush pin and TENs group respectively (p = 0.85). No femoral head osteonecrosis or proximal femoral deformity was revealed on the final radiographs. The clinical outcomes were comparable between the two groups. Conclusion: The outcomes in the children treated with a Rush pin inserted through the tip of the greater trochanter were not inferior to those treated with TENs. Therefore, the Rush pin may continue to be an alternative device if the TENs are not affordable or not available in medical facilities.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"19 1","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88672728","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}

{"title":"The ＂tractor trailer＂ sign of traumatic both medial and lateral bucket-handle meniscal tears on the same knee - A case report","authors":"L. Yang, Hsueh-Che Lu","doi":"10.6492/FJMD.20160406","DOIUrl":"https://doi.org/10.6492/FJMD.20160406","url":null,"abstract":"Most traumatic bucket handle knee meniscal tear is unilateral, either medial or lateral, and often associated with various degree injury of anterior cruciate ligament (ACL). However, simultaneous injury of both medial and lateral menisci on the same knee is very rare. We reported a case of both medial and lateral traumatic bucket handle meniscal tears on the same knee. The magnetic resonance images (MRIs) could demonstrate both medial and lateral bucket-handle meniscal fragments displaced into the inter-condylar notch. Quadruple sign was noted in three consecutive coronal MRIs, demonstrating four structures in the inter-condylar notch: the ACL, posterior cruciate ligament (PCL) and both the medial and lateral bucket-handle meniscal fragments. The mid oblique sagittal MRIs demonstrated both the displaced medial and lateral bucket-handle meniscal fragments in the inter-condylar notch, appearing like as a ＂tractor trailer.＂ Under arthroscopic examination, the ACL was congested, edematous but grossly intact. Attempted reduction of both medial and lateral displaced bucket handle meniscal fragments failed. Arthroscopic medial and lateral partial meniscectomy was then performed. At a follow-up examination one year later, the knee was relatively stable with no instability. The range of motion was full and free. No local pain and tenderness was noted. The patient was instructed to avoid heavy work to prevent early osteoarthritis.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"55 1","pages":"128-133"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73521617","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}

{"title":"Comparison of the efficacy of hyperbaric oxygen therapy in patients with postoperative spinal and extremity wound lnfections","authors":"N. Lau, Chia-Wei Chang, Tsung-Ting Tsai, C. Niu, P. Lai, T. Fu, L. Chen, Wen‐Jer Chen","doi":"10.6492/FJMD.20160503","DOIUrl":"https://doi.org/10.6492/FJMD.20160503","url":null,"abstract":"Background: Hyperbaric oxygen (HBO) has been shown to promote the healing of ischemic and infected tissue; therefore, it may be useful for treating non-healing postoperative wound infection. The purpose of this study was to compare the efficacy of HBO therapy in the treatment of postoperative spinal and extremity wound infections. Methods: From 1995 to 2011, 284 patients with postoperative wound infection were enrolled in this study and divided into 2 groups: groups I, 26 patients (spinal wound infection) and group II, 235 patients (upper and lower extremities wound infection). HBO therapy was indicated when infection showed no improvement of clinical symptoms/signs and laboratory testing following appropriate antibiotic therapy for at least 2 weeks. All patients received HBO therapy one cycle (20 times) as an adjunctive treatment, and the following data were collected retrospectively: age, sex, comorbidity (diabetes mellitus, liver cirrhosis, and end-stage renal disease), and type of bacteria (gram-positive, gram-negative, and anaerobic). These clinical results and outcomes after HBO therapy were analyzed Results: Sex and diabetes mellitus incidence were significantly different between the 2 groups; the extremities infection group had more male and fewer diabetic patients. No significant difference between the groups was found in terms of other factors, comorbidity, or type of bacteria. Although the overall clinical outcome after HBO treatment was not significantly different between the groups, the spinal group showed a higher percentage of excellent results after infection with a gram-positive pathogen. Conclusion: Patients with post-operative spinal wound infection under HBO therapy have similar treatment responses to patients with the extremities wound infection. Clinical outcomes are not affected by comorbidities such as diabetes mellitus, liver cirrhosis, or end-stage renal disease. Therefore, HBO therapy is recommended as an adjunctive treatment for postoperative spinal wound infection.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"10 1","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72969756","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}

{"title":"Posterior epidural migration of a sequestered lumbar disc - Two cases report","authors":"L. Yang, Lin-Hsue Yang","doi":"10.6492/FJMD.20160309","DOIUrl":"https://doi.org/10.6492/FJMD.20160309","url":null,"abstract":"Posterior migration of a sequestered disc fragment to the posterior epidural space is extremely rare due to the natural anatomical barriers of the thecal sac. Only cases were reported in the literature. It often causes severe neurological impairment, such as cauda equine syndrome. Accurate diagnosis is difficult because magnetic resonance images may mimic those of other more common posterior epidural mass lesions. We reported two cases of posterior epidural migration of sequestered discs. Both two patients responded well to operation with complete relief of symptoms.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"14 1","pages":"123-127"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90059553","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}

{"title":"Autogenous palmaris longus tendon grafting for rupture of extensor pollicis longus tendon after distal radius fractures","authors":"Chun-Lang Kuo, Sheng-Tsai Hung, Hung-Maan Lee, Bo-Jian Lin, J. Shih","doi":"10.6492/FJMD.20160629","DOIUrl":"https://doi.org/10.6492/FJMD.20160629","url":null,"abstract":"Background: Secondary rupture of the extensor pollicis longus (EPL) tendon is a known complication following distal radius fracture. While surgical options for EPL tendon tear have been extensively investigated, the surgical results of free tendon graft reconstruction for patients with EPL tendon rupture after distal radius fracture are relatively unexplored. Purpose: We aimed to investigate the outcomes of autogenous palmaris longus (PL) tendon grafting for treating EPL tendon rupture after distal radius fracture. Methods: The study included 9 adult patients (2 male, 7 female; age range, 30-78 years; mean age, 56.7 years) with delayed EPL tendon rupture after distal radius fracture treated at the Taoyuan Armed Forces General Hospital between September 2000 and September 2011. In our hospital, we adopted a protocol for EPL tendon reconstruction that uses the ipsilateral PL tendon. A dynamic splint was applied, and a rehabilitation program including wrist motion and occupational therapy was started within 3 days postoperatively. Extension lag at the interphalangeal joint of the injured thumbs, as well as Geldmacher scores were recorded. Results: At the final follow-up (15-34 months), the extension lag at the interphalangeal joint of the involved thumb had improved significantly (p ＜ 0.05), from a preoperative mean value of 41.7° (range, 35°-60°) to a postoperative mean value of 3.8° (range, 0°-6°). Regarding the Geldmacher scores, 5 patients (55%) achieved ＂excellent＂ results, and 4 (45%) achieved ＂good＂ results. No patients experienced tendon re-rupture, wound infections, nerve injury, or other complications. Conclusions: In this short-term follow-up study, using free PL grafts for treating EPL tendon rupture was found to provide good outcomes, suggesting that tendon grafting using the PL tendon is an effective method to treat delayed EPL tendon rupture after distal radius fracture.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"16 1","pages":"114-122"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89237255","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}