Journal of Orthopedics & Bone Disorders最新文献

{"title":"A Review of Necrotizing Fasciitis and the Utility of the Laboratory Risk Indicator for Necrotizing Fasciitis Score in its Early Diagnosis at a Rural Australian Hospital","authors":"K. A.","doi":"10.23880/jobd-16000226","DOIUrl":"https://doi.org/10.23880/jobd-16000226","url":null,"abstract":"Background: Necrotizing fasciitis is a life-threatening orthopaedic emergency. This paper is a retrospective review of confirmed cases of necrotizing fasciitis (NF) in a rural centre. The primary aim was to define the trends in incidence, microbiological profile, management and mortality. The secondary aim was to assess the accuracy of the LRINEC score as a tool to diagnose and distinguish NF from cellulitis and other non-necrotizing soft tissue infections (NNSTIs). Methods: A retrospective paper based, and computerized search of the medical records was undertaken to identify adult patients diagnosed with NF between January 2009 and January 2018 was conducted. An age matched control group was generated from a randomized sample of patients diagnosed with cellulitis over the same timeframe. LRINEC scores of the NF and control group were calculated and compared. Results: Forty-five patients with NF were identified. A decreasing trend in incidence was noted from 2011 (5.43 per 100000 per year) to 2016 (3.81 per 100000 per year), however 13 cases of necrotizing fasciitis presented in 2017 with an estimated incidence of 13.7 per 100000. The overall mortality of patients with NF was 15.6%. The genus Streptococcus was the most common isolate (47%) with Staphylococcus a close second (32.4%). The LRINEC score had a sensitivity of 61% and a specificity of 79% at a score of ≥ 6. Conclusion: LRINEC scores in isolation cannot be reliably used to distinguish between NF and NNSTIs. A high index of clinical suspicion and early surgical referral for surgical cut-down diagnosis is recommended.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics & Bone Disorders","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128138537","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":"Effects of Kinesiology Taping On Sleep Quality In Participants With Cronical Low Back Pain","authors":"Ö. Yükselmiş","doi":"10.21203/rs.3.rs-861113/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-861113/v1","url":null,"abstract":"\u0000 Our main aim in this study is to compare the effectiveness of conventional physical therapy in the context of sleep quality of participants with chronic low back pain and the effectiveness of kinesiology taping applied to the waist area in a very short time.40 participants (30 females, 10 males) whose age ranges ranged from 25 to 50 years were randomly divided into two groups (banding group and control group). In both groups, a home exercise program was given by applying therapeutic ultrasound for 5 minutes, TENS (Transcutaneous Electrical Nerve Stimulation) for 30 minutes and infrared for 30 minutes. In kinesiology taping groups, taping was applied to the waist region with the star technique, once for 48 hours. VAS (Visual Analog Scale) for pain, hip flexor flexibility test and hand-finger floor distance test for flexibility, Berg balance scale for balance, Beck anxiety scale for anxiety, Oswestry disability index for disability level, Tampa kinesiophobia scale for kinesiophobia, sleep quality Pittsburg sleep quality index and Nottingham life profiles were used for quality of life. Evaluations were made twice, before and after the treatment. The significance level was accepted as p <0.05.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"47 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123566104","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":"Effect of Massage Before or After Exercise on Delayed-onset Muscle Soreness in a Rat Model","authors":"Qingjum Wei, Qian Zhao, Jialing Gu, Jia Lin, Yan Zhu, Ziqi Song, Fenglei Li","doi":"10.21203/rs.3.rs-64773/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-64773/v1","url":null,"abstract":"\u0000 Background. Delayed-onset muscle soreness (DOMS), also known as tenderness of touch, refers to the pain caused by muscle mechanical stimulation, such as contraction and stretching. Chinese massage has been widely used in the treatment of sports fatigue and sports injury, but there is controversy in the efficacy. In this experiment, we established DOMS model in rats to observe the prevention and treatment effect of massage, to find the best time for intervention, and to provide scientific basis for the prevention and treatment of exercise fatigue.Methods. 130 male SD(sprague-dawley, SD) healthy rats were randomly divided into blank group, control group and massage group. Except for blank group, the other rats received DOMS model. Professionals applied kneading and twisting methods on both lower limbs of rats. The expression of IL-2, IL-6 and IL-8 in skeletal muscle of rats were determined by western blot, PCR and ELISA, and the content of serum creatine kinase was determined by ELISA. In addition, we measured the concentration of Ca2+, Ca2+-ATPase in mitochondria of skeletal muscle. The changes of skeletal muscle structure were observed by scanning electron microscopy.Result. After massage, the expression of IL-2, IL-6, IL-8 and CK decreased compared with control group (P < 0.01), the expression of IL-2, IL-6 and IL-8 in post massage group was lower than that in front massage group (P < 0.01), and the content of CK in front massage group was lower than that in post massage group(P < 0.01). The content of Ca2+ in front massage 24, 48 and 72h group was lower than that in post massage (P < 0.01), the concentration of Ca2+-ATPase in front massage 24h and 72h group was lower than that in post massage group (P < 0.05).Conclusion. Massage can prevent the injury of muscle and reduce the inflammatory reaction of muscle after exercise. It can also improve the activity of Ca2+-ATPase, enhance the transport of Ca2+ by mitochondria and protect the skeletal muscle.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124398839","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 \"Horse Saddle\" Sign: A New Ultrasound Sign for Osteoarthritis","authors":"D. Jj","doi":"10.23880/jobd-16000215","DOIUrl":"https://doi.org/10.23880/jobd-16000215","url":null,"abstract":"Objective: To assess the sensitivity and specificity of the “horse saddle” sign in the diagnosis of osteoarthritis Methods: An exploratory clinical comparative cross-sectional study where an ultrasound of the hands and comparative radiographs in PA view were performed on patients with osteoarthritis, inflammatory arthritis and healthy patients seen in the Rheumatology clinic of the Vall de Hebron Hospital. Age, sex and time of evolution of the disease were collected as clinical variables. The MCP, PIP and DIP joints from the second to the fifth finger of both hands were viewed with grayscale in longitudinal and transverse plane of both the dorsal and palmar face, assessing for osteophytes, synovitis and the horse saddle sign. Results: A total of 38 patients with osteoarthritis, 20 patients with inflammatory arthritis (8 psoriatic, 9 RA, 1 LES, 1 PMR and 1 Sjogren) and 2 healthy patients were assessed. It was found that the horse saddle sign had a sensitivity of 66.7% and specificity of 86.4% in osteoarthritis showing a p-value of 0.052 by means of the chi-square test. 87% of patients with the horse saddle sign had osteoarthritis and only in 2 patients with RA and in the patient with LES. Conclusion: The horse saddle sign is an ultrasound sign with good sensitivity and specificity for the diagnosis of hand osteoarthritis comparable to other classic ultrasound signs such as osteophytes and synovitis.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125387154","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":"Approach to the Treatment of Diabetic Foot OsteomyelitisInsertion of Bioactive BONALIVE Via Plantar Approach and Consequently External Fixation for Diabetic Foot Osteomyelitis: A Case Report","authors":"A. Liberson","doi":"10.23880/jobd-16000235","DOIUrl":"https://doi.org/10.23880/jobd-16000235","url":null,"abstract":"Diabetic foot osteomyelitis (DFO) is a clinical problem with a high risk of amputation, and it is always a complication of a preexisting infected foot wound. Prevalence can be as high as 60%. There is no consensus in the current literature regarding the management of these patients and this remains an unsolved challenge for the case manager. Surgical therapy, antibiotic therapy, or conservative treatment are among the current common treatments. Each one of them has its inherent advantage and disadvantages. In the past few years, Bioactive and soluble glasses have had the potential for use in wound healing and infection eradication. The use of new bone substitutes aims to support the load of the bone segments and to ensure the eradication of the infectious process. The approach to the infection is also a challenge. We present the management of a case of DFO that has been treated by systemic antibiotics and the insertion of bioglass, Bonalive, via plantar approach and additional external fixation. This novel way of treatment allows the closure of a diabetic ulcer that was already planned for below-knee amputation (BKA) in other institutions. A long follow-up shows the resolution of the infectious process, no ulcer recurrence, and persistent recovery of the ability to walk. Our results are in line with current literature that suggests bioglass may be considered a useful option to manage DFO and achieve healing with a very conservative approach.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"198 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123347917","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":"A Rare Case of Verrucous Carcinoma of Foot","authors":"N. S","doi":"10.23880/jobd-16000218","DOIUrl":"https://doi.org/10.23880/jobd-16000218","url":null,"abstract":"Verrucous carcinoma is a rare, locally invasive, well-differentiated, and low-grade squamous cell carcinoma, with low metastatic potential. To our knowledge such cases reported are only finger counting numbers. In this case report, we present a rare case of a patient with an ulcerative lesion in the plantar foot that clinically and radiographically faced with a dilemma whether it was an osteomyelitis or deep mycosis or viral warts with secondary infection. The initial surgical approach consisted of wide excision of the malignant neoplasm including some normal tissue too. Definite diagnosis is by histopathology only.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114358046","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":"Congenital Oblique Talus Spontaneous Reduction-Case Report","authors":"A. Gharaibeh","doi":"10.23880/jobd-16000236","DOIUrl":"https://doi.org/10.23880/jobd-16000236","url":null,"abstract":"Congenital oblique talus is a very rare condition which presents as an isolated deformity or in association with neuromuscular and/or genetic disorders. Pathoanatomically the deformity shows a dislocated talonavicular and subtalar joint. The ethiology and pathogenesis are still not finally determined, although in some cases a genetic basis has been identified. The clinical picture is that of a flat longitudinal arch. Clinical diagnosis is confirmed by plain radiographic imaging of anteroposterior and lateral views. Congenital oblique talus should not be confused with other deformities of the foot, such as congenital vertical talus, which with stress view X-Ray can be reduced. The object of treatment of congenital oblique talus is to restore a normal anatomical relationship between the talus, navicular bone and calcaneus. Good early results of modified non-operative treatment using serial manipulations, physiotherapy, special shoes or cast treatment may change therapeutic concepts.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114733808","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":"Minimally Invasive Surgery for Anterior Pubic Rami Fractures Under Fluoro-Navigation Using the Medtronic O Arm System and Calcium Phosphate for Internal Fixation","authors":"James M Ray","doi":"10.23880/jobd-16000213","DOIUrl":"https://doi.org/10.23880/jobd-16000213","url":null,"abstract":"Introduction: The incidence of anterior pubic rami fractures in elderly female patients over the age of 65 has been reported to be 64 %. Osteoporosis plays a role with these fractures, as they are caused by minimal low energy injuries from a fall. Indications for internal fixation of anterior pelvic ring are controversial because of the etiology being low energy trauma and the location being a non-weight bearing surface. In contrast to conventional open pelvic surgery, percutaneous screw fixation has gained popularity in the treatment of pelvic fractures, mainly because of minimal soft tissue damage, less operative blood loss, early surgical intervention, and comfortable mobilization of the patient. The use of calcium phosphate as a form of internal fixation further advances the advantages of minimally invasive surgery for internal fixation with less morbidity by the use of screw fixation. The incorporation of fluoro-navigation is a new surgical technique in orthopedic trauma surgery. (Figure 1) This study is to report our clinical results of fluoro-navigation surgery in anterior pelvic pubic rami fractures using calcium phosphate as the fixation of choice. This is the first report of this method of treatment using a new combination of visualization and internal fixation. Materials and Methods: From April 2018 to December 2019, 30 patients with anterior pubic rami fractures were treated with percutaneous cannulated calcium phosphate delivery under Medtronic O arm (fluoro-navigation) control. There were 5 male and 25 females, with a mean age of 84.6 years (range 80-104) for females and mean age of 90 years (84 – 99) for the 5 males. According to the AO and Orthopedic Trauma Association classification, all were considered lateral compression types of fractures. All patients were operated on when their general medical condition stabilized after emergency management and admission. The pain score on admission was reported as 10/10 in all cases. Plain standard pelvic x-rays were obtained on admission as well as CT scans of the pelvis. All the anterior pubic rami fractures were fixed using percutaneous delivery of calcium phosphate with the Zimmer trocar system by one senior surgeon. The Medtronics O arm fluoro-navigation was used in all cases. The surgeon was familiar with the navigation system and had much experience in the computer-assisted percutaneous placement of the trocars. Results: A total of 30 patients were treated with this new combination of surgical treatment of anterior pubic rami fractures. No screws were inserted or found to be necessary for fracture treatment. Each case used 2 trocars from the kits supplied from Zimmer. One end delivery trocar was directed to the inferior pubic ramus fracture and the second which was a side delivery trocar was used for the superior pubic ramus fracture. A total of 10 cc of calcium phosphate was used in each case, 5 cc per trocar. The position of the trocars were placed using the fluoro-navigation contr","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123944521","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":"Vocation in Children’s Orthopaedics","authors":"Guerrini Alfredo Francisco","doi":"10.23880/jobd-16000219","DOIUrl":"https://doi.org/10.23880/jobd-16000219","url":null,"abstract":"","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114206817","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":"Factors Predicting Avascular Necrosis After Closed Reduction and Internal Fixation of Displaced Subcapital Fractures of the Hip","authors":"Ron Gurel","doi":"10.23880/jobd-16000228","DOIUrl":"https://doi.org/10.23880/jobd-16000228","url":null,"abstract":"Background: The main complications following closed reduction and internal fixation of displaced intracapsular femur fractures (DICFF) are avascular necrosis (AVN) and nonunion. Little is known about the factors that predict these complications. The purpose of this study was to assess the clinical and radiological risk factors of failure following closed reduction and internal fixation of DICFF among non-elderly patients. Methods: We retrospectively reviewed patients under the age of 65 years who underwent closed reduction and internal fixation of DICFF in our center from January 2007 to January 2018. The extracted data included baseline characteristics and the fixation method. Postoperative radiographs were obtained during follow-up visits in order to evaluate complications, such as AVN and nonunion. Results: In total, 90 patients were included in the study, with a mean follow-up of 6.5 years. Garden III fractures were associated with significantly lower rates of AVN (odds ratio [OR] = 0.304, 95%confidence interval [CI]: 0.101-0.916) compared to Garden IV fractures. Neutral and varus reduction positions had significantly higher rates of AVN (OR = 7.182, 95%CI: 1.951- 26.446) and (OR= 5.560, 95%CI: 1.130-27.351), respectively, compared to the valgus position. Longer surgery procedures were associated with a higher risk of AVN (OR = 1.018, 95%CI: 1.006-1.031). Conclusions: Both varus and neutral reduction positions as well as Garden IV classification served as predictive factors for failure following closed reduction and internal fixation of DICFF. The type of fixation (CCS vs Targon plate) and the Pauwel angle had no significant effect on the rates of AVN or nonunion following fracture reduction.","PeriodicalId":161495,"journal":{"name":"Journal of Orthopedics &amp; Bone Disorders","volume":"14 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113964708","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}