Orthopedic Research and Reviews最新文献

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Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management 部分厚度旋转袖撕裂的优化管理:临床思考与实践管理
IF 2
Orthopedic Research and Reviews Pub Date : 2022-02-01 DOI: 10.2147/ORR.S348726
T. Thangarajah, I. Lo
{"title":"Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management","authors":"T. Thangarajah, I. Lo","doi":"10.2147/ORR.S348726","DOIUrl":"https://doi.org/10.2147/ORR.S348726","url":null,"abstract":"Abstract Partial thickness rotator cuff tears have been diagnosed with increased frequency due to heightened awareness and an improvement in diagnostic modalities. When >50% of the tendon thickness has ruptured, intra-tendinous strain of the residual tendon increases. Surgery is generally confined to patients who have failed non-operative measures and have persistent symptoms. The rationale for repairing partial thickness tears lies in their limited self-healing capacity, and propensity to enlarge over time and progress to a full thickness defect. Although tear debridement and acromioplasty can improve pain and function, tear progression can occur, in addition to worse results being noted in bursal-sided defects. Several surgical strategies have been recommended but there is a lack of evidence to advocate one form of treatment over another. The aim of this narrative review is to discuss the treatment options for partial thickness tears of the rotator cuff.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47663461","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: 8
Postoperative Fluid Collections in Total Joint Arthroplasty: A Narrative Review 全关节置换术后液体收集:叙述性综述
IF 2
Orthopedic Research and Reviews Pub Date : 2022-02-01 DOI: 10.2147/ORR.S348919
Dylan Smith, G. Berdis, Vishavpreet Singh, Alexander Caughran, Matthew W. Bullock
{"title":"Postoperative Fluid Collections in Total Joint Arthroplasty: A Narrative Review","authors":"Dylan Smith, G. Berdis, Vishavpreet Singh, Alexander Caughran, Matthew W. Bullock","doi":"10.2147/ORR.S348919","DOIUrl":"https://doi.org/10.2147/ORR.S348919","url":null,"abstract":"Abstract A post-operative fluid collection (POFC) represents a common finding in both primary and revision total joint arthroplasty (TJA). Fortunately, most resolve on their own, but in instances where they become symptomatic, prompt identification and management are paramount, especially when they occur adjacent to a joint arthroplasty because of the increased the risk of developing a periprosthetic joint infection. A strong clinical suspicion with appropriate clinical exam is required along with select imaging modalities to arrive at a diagnosis. Meticulous surgical technique is crucial to prevent POFC, but new emerging treatments continue to evolve. This article presents an updated overview of incidence, pathophysiology, diagnosis, and management of POFC in the setting of TJA. We review the role of select imaging modalities as well as summarize current literature regarding new treatments such as sclerotherapy agents, acellular dermal matrices, and negative pressure wound therapy. Future studies are necessary to explore the interplay of inflammatory mediators in POFC formation and to define their role in fluid collection resolution.","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42564252","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: 3
Freehand Pedicle Screw Insertion in Spondylitis Tuberculosis Kyphosis Correction Using Cantilever Method: A Breach Rate Analysis of 168 Consecutive Screws. 悬臂法徒手置入椎弓根螺钉矫治结核性脊柱炎后凸:168颗连续螺钉的断裂率分析。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-28 eCollection Date: 2022-01-01 DOI: 10.2147/ORR.S349729
Didik Librianto, Ifran Saleh, Fachrisal Ipang, Dina Aprilya
{"title":"Freehand Pedicle Screw Insertion in Spondylitis Tuberculosis Kyphosis Correction Using Cantilever Method: A Breach Rate Analysis of 168 Consecutive Screws.","authors":"Didik Librianto,&nbsp;Ifran Saleh,&nbsp;Fachrisal Ipang,&nbsp;Dina Aprilya","doi":"10.2147/ORR.S349729","DOIUrl":"https://doi.org/10.2147/ORR.S349729","url":null,"abstract":"<p><strong>Background: </strong>The cantilever method is a standard for two-dimensional deformity correction, as in spondylitis tuberculosis kyphotic deformity. An accurate and secured pedicle screw placement as part of the correction tools is essential to accommodate reduction while preventing screw-related complications. Many literatures have described the pedicle screw misplacement in cases with \"normal\" bone quality (ie, scoliosis, Scheuermann's kyphosis, ankylosing spondylitis, trauma) or in the obviously abnormal bone such as osteoporosis. However, to our knowledge, the pedicle screw accuracy in cases of deformity correction of tuberculous kyphosis was not previously reported.</p><p><strong>Methods: </strong>This is a retrospective study of 168 pedicle screws in 14 consecutive cases of spondylitis tuberculosis with kyphotic deformity. The cantilever reduction method with freehand screw insertion technique was done in all cases to correct the deformity. Postoperative computed tomography (CT) evaluation was done to evaluate screw position and breach rates.</p><p><strong>Results: </strong>Among the 168 screws, accurate pedicle screw placement was accomplished in 39.3% screws (Gertzbein-Robbins Grade A). The overall breach rate was 61.9%, which was most commonly occurred on the segment proximal to the apex of the deformity (p=0.001). The lateral breach was more common than the medial breach (52.3% vs 7.7%). The pedicle screw on the thoracal region has a greater breach incidence than those on the lumbar region especially those on T9, T10, and T11. There was no injury to the surrounding neurovascular and pleural structures. No revision surgeries were required.</p><p><strong>Conclusion: </strong>Freehand pedicle screw insertion in spondylitis tuberculosis kyphotic reduction has proved to be safe. However, the accuracy should be improved to prevent long-term screw-related complications.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/02/orr-14-17.PMC8807407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39583340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Pandemic Impact on Orthopaedic Trauma Practice: A Global Perspective. COVID-19 大流行对创伤骨科实践的影响:全球视角。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-25 eCollection Date: 2022-01-01 DOI: 10.2147/ORR.S345301
Abdallah S Al-Omran
{"title":"COVID-19 Pandemic Impact on Orthopaedic Trauma Practice: A Global Perspective.","authors":"Abdallah S Al-Omran","doi":"10.2147/ORR.S345301","DOIUrl":"10.2147/ORR.S345301","url":null,"abstract":"<p><strong>Background and objective: </strong>We conducted a systematic review to evaluate the global impact on orthopaedic trauma admissions during the COVID-19 crisis and compare it to that in Saudi Arabia.</p><p><strong>Methods: </strong>We conducted an extensive search of the PubMed and the Cochrane Central Register of Clinical Trials databases for articles published on orthopaedic trauma during the pandemic. We used the terms \"orthopaedic trauma\", \"coronavirus\", \"covid-19\", and \"Sars-cov-2\" for the search. We retrieved data to assess the impact of COVID-19 on orthopaedic and trauma patients attending hospitals during the pandemic. Secondary outcomes included reports from various regions of the world, differences in patient age, gender, and comparison to the nonlockdown period. We excluded questionnaires, surveys, reviews, and meta-analyses. The studies were divided based on where they were conducted: the Americas; the United Kingdom; Europe; Asia; the Middle East; and Australia, including New Zealand.</p><p><strong>Results: </strong>We retrieved 763 studies using the keywords and initially analyzed 70. We chose 23 studies for final analysis, which were all retrospective studies, from which we extracted 50% of our preset data. These articles included 16,383 patients who sought advice related to orthopaedic and trauma necessities during the pandemic. Before the pandemic, 61,559 patients sought advice for orthopaedic and trauma necessities. Most of the reports focused on adults, and in three studies, researchers reported on paediatric on orthopaedic patients. The average decrease in patients seeking orthopaedic and trauma assistance during the pandemic was 45.5 ± 20.4 (range 18.9-86%, <i>p</i> < 0.001). The largest decrease in patients seeking advice occurred in Asia (>60%), and the lowest occurred in Australia and New Zealand (about 20%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Presentations of orthopaedic trauma during the COVID-19 during pandemic lockdown was less but not as profoundly as one may have expected.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/c4/orr-14-9.PMC8800867.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39583339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Full Endoscopic Posterior Cervical Foraminotomy in Management of Foraminal Disc Herniation and Foraminal Stenosis. 全内窥镜颈椎后椎间孔切开术治疗椎间孔椎间盘突出和椎间孔狭窄。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-17 eCollection Date: 2022-01-01 DOI: 10.2147/ORR.S349701
Asrafi Rizki Gatam, Luthfi Gatam, Phedy, Harmantya Mahadhipta, Omar Luthfi, Ajiantoro, Syafrudin Husin, Dina Aprilya
{"title":"Full Endoscopic Posterior Cervical Foraminotomy in Management of Foraminal Disc Herniation and Foraminal Stenosis.","authors":"Asrafi Rizki Gatam,&nbsp;Luthfi Gatam,&nbsp;Phedy,&nbsp;Harmantya Mahadhipta,&nbsp;Omar Luthfi,&nbsp;Ajiantoro,&nbsp;Syafrudin Husin,&nbsp;Dina Aprilya","doi":"10.2147/ORR.S349701","DOIUrl":"https://doi.org/10.2147/ORR.S349701","url":null,"abstract":"<p><strong>Background: </strong>The development of full endoscopic procedures enables surgeons to visualize the operative field very clearly. Posterior foraminotomy using endoscopy was developed as a minimally invasive procedure to reduce the complication of the anterior cervical approach and to preserve the segmental motion without decreasing the effectiveness of nerve decompression. Our aim is to evaluate the result of full endoscopic posterior cervical foraminotomy in our center.</p><p><strong>Methods: </strong>This is a prospective single-arm study of 65 foraminal disc herniation and foraminal stenosis patients that underwent full endoscopic posterior foraminotomy procedures. All patients were routinely observed for 12-months duration to evaluate Visual Analog Score (VAS) of the neck, arm, and modified Macnab criteria.</p><p><strong>Results: </strong>Arm pain VAS decreased significantly compared with the pre-operation state (p < 0.001, 0.034, 0.001 on immediate post-operative, 6-months follow-up, and 12-months follow-up, respectively) even though 6.15% of patients had hypesthesia on follow-up. There was no neck pain observed during 1 year follow-up, and modified Macnab criteria showed a good outcome following full endoscopic posterior foraminotomy.</p><p><strong>Conclusion: </strong>Full endoscopic posterior foraminotomy provides good nerve decompression with all the benefits of endoscopic spine procedure.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/2c/orr-14-1.PMC8812322.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Gunshot Wounds: Ballistics, Pathology, and Treatment Recommendations, with a Focus on Retained Bullets. 枪伤:弹道学、病理学和治疗建议,重点是残留子弹。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-01 DOI: 10.2147/ORR.S378278
Gracie R Baum, Jaxon T Baum, Dan Hayward, Brendan J MacKay
{"title":"Gunshot Wounds: Ballistics, Pathology, and Treatment Recommendations, with a Focus on Retained Bullets.","authors":"Gracie R Baum,&nbsp;Jaxon T Baum,&nbsp;Dan Hayward,&nbsp;Brendan J MacKay","doi":"10.2147/ORR.S378278","DOIUrl":"https://doi.org/10.2147/ORR.S378278","url":null,"abstract":"<p><p>As the epidemic of gunshot injuries and firearm fatalities continues to proliferate in the United States, knowledge regarding gunshot wound (GSW) injury and management is increasingly relevant to health-care providers. Unfortunately, existing guidelines are largely outdated, written in a time that high-velocity weapons and deforming bullets were chiefly restricted to military use. Advances in firearm technology and increased accessibility of military grade firearms to civilians has exacerbated the nature of domestic GSW injury and complicated clinical decision-making, as these weapons are associated with increased tissue damage and often result in retained bullets. Currently, there is a lack of literature addressing recent advances in the field of projectile-related trauma, specifically injuries with retained bullets. This review aims to aggregate the available yet dispersed findings regarding ballistics, GSW etiology, and treatment, particularly for cases involving retained projectiles.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/ff/orr-14-293.PMC9462949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Management of Syndesmosis Injury: A Narrative Review. 韧带联合损伤的处理:叙述回顾。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-01 DOI: 10.2147/ORR.S340533
Jiayong Liu, Daniel Valentine, Nabil A Ebraheim
{"title":"Management of Syndesmosis Injury: A Narrative Review.","authors":"Jiayong Liu,&nbsp;Daniel Valentine,&nbsp;Nabil A Ebraheim","doi":"10.2147/ORR.S340533","DOIUrl":"https://doi.org/10.2147/ORR.S340533","url":null,"abstract":"<p><p>The syndesmosis is an important fibrous joint that plays a crucial role in normal ankle weight-bearing and movements. Syndesmosis injuries include disruption of one or more of the ligaments comprising the distal tibiofibular syndesmosis and are commonly associated with ankle fractures. The treatment of grade 1 syndesmosis injury should be conservative, such as immobilization for one to three weeks followed by gradual return to activity. For the treatment of grade 2 syndesmosis injury, if it was stable enough, the patients still could be managed with conservative therapies. But majority of them strongly favor surgical treatment. For the treatment of grade 3 syndesmosis injury, it should treat with surgical reconstruction. If syndesmosis injury is associated with ankle fractures, surgical reduction, fixation, and reconstruction are usually required. Common surgical treatment methods include syndesmosis screws, composed of either metallic or bioabsorbable material; fibula intramedullary nails; and dynamic button-suture fixation, TightRope or ZipTight. Each method has advantages and disadvantages which must be considered while determining which treatment will provide the best outcomes depending on the patient's needs. Continued exploration of new materials, devices, and methods for surgical fixation is necessary for advancement in this field.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/43/orr-14-471.PMC9749496.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10748699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Lower Back Pain Caused by the Impact of COVID-19 Quarantine on Physical Activity and Daily Sitting Among Adult Saudi Arabian Populations in Jeddah: A Cross-Sectional Study. COVID-19隔离对吉达沙特阿拉伯成年人身体活动和日常坐着的影响引起的下背部疼痛:一项横断面研究。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-01 DOI: 10.2147/ORR.S386995
Lutf Ahmed Abumunaser, Kawther Ali Alfaraj, Lujain Khalid Kamal, Renad Abdullah Alzahrani, Maram Misfer Alzahrani, Alzahraa Bader AlAhmed
{"title":"Lower Back Pain Caused by the Impact of COVID-19 Quarantine on Physical Activity and Daily Sitting Among Adult Saudi Arabian Populations in Jeddah: A Cross-Sectional Study.","authors":"Lutf Ahmed Abumunaser,&nbsp;Kawther Ali Alfaraj,&nbsp;Lujain Khalid Kamal,&nbsp;Renad Abdullah Alzahrani,&nbsp;Maram Misfer Alzahrani,&nbsp;Alzahraa Bader AlAhmed","doi":"10.2147/ORR.S386995","DOIUrl":"https://doi.org/10.2147/ORR.S386995","url":null,"abstract":"<p><strong>Purpose: </strong>During the COVID-19 quarantine period, most outdoor activities and events were banned, resulting in a decrease in physical activity (PA) and prolonged sitting (PS) time, which are significant factors in the development of lower back pain (LBP). The aim of this study was to evaluate the association between physical inactivity and daily sitting time during quarantine with LBP among the Saudi Arabian population.</p><p><strong>Patients and methods: </strong>In this cross-sectional study conducted at King Abdulaziz University Hospital, 288 participants were recruited using an online, self-administered questionnaire in Arabic. It consisted of 21 questions assessing back pain, PA, and daily sitting time before and during quarantine. The main outcome measures included demographics, low back pain levels, daily sitting time, and PA level.</p><p><strong>Results: </strong>The participants consisted of 236 women and 52 men aged 18-65 years. During quarantine, 74% of participants sat most of the time and did not exercise or performed less exercise. Furthermore, almost half of the participants did not engage in PA both before and during the quarantine. There was an increase in the prevalence of LBP, with only 44.8% of participants presenting with LBP before quarantine and 59.4% having it during quarantine. A statistically significant association was found between daily sitting time and LBP (P=0.007) and PA and LBP (P=0.045) during quarantine. However, there was no significant association between age and painkiller use for LBP (P=0.251).</p><p><strong>Conclusion: </strong>Our study highlights the relationship of physical inactivity and PS during quarantine with an increase in the prevalence and intensity of LBP. The limitations of the study include the use of self-reports, a small sample size, and unequal survey distribution. A well-distributed survey with a larger sample size is necessary to obtain an adequate representation of the entire Saudi population.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/6d/orr-14-477.PMC9759024.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10461857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiation in Adolescent Idiopathic Scoliosis Management: Estimated Cumulative Pre-Operative, Intra-Operative, and Post-Operative Exposure. 辐射治疗青少年特发性脊柱侧凸:估计术前、术中和术后累积暴露。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-01 DOI: 10.2147/ORR.S387369
Alexander Duke, Richard Marchese, David E Komatsu, James Barsi
{"title":"Radiation in Adolescent Idiopathic Scoliosis Management: Estimated Cumulative Pre-Operative, Intra-Operative, and Post-Operative Exposure.","authors":"Alexander Duke,&nbsp;Richard Marchese,&nbsp;David E Komatsu,&nbsp;James Barsi","doi":"10.2147/ORR.S387369","DOIUrl":"https://doi.org/10.2147/ORR.S387369","url":null,"abstract":"<p><strong>Background: </strong>Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis affecting adolescents, with approximately 2-4% of children being diagnosed. Crucial to the diagnosis and management are radiographic imaging, which allow physicians to assess and treat - from initial visits through surgical planning and post-operative management. While initial stages require low levels of exposure to radiation, via x-rays, as patients progress in disease severity exposure becomes larger with pre-operative, intra-operative and post-operative CT scans. While many studies have evaluated exposure during AIS treatment, few have assessed the cumulative radiation exposure adolescents receive during their evaluation. The purpose of our study is to complete a comprehensive review on cumulative radiation exposure and determine what stages in AIS treatment expose patients to the highest level of radiation over a duration of 2 years.</p><p><strong>Methods: </strong>A retrospective chart review of 109 AIS cases (29M, 80F), mean age 14.9 ± 2.3 years was completed to assess and quantify each imaging modality used. Employing a radiation detector, each imaging modality was then assessed, and estimated radiation exposures were determined. Statistical analysis was completed utilizing averaged patient exposures during each selected period in AIS management.</p><p><strong>Results: </strong>Mean estimated radiation doses (StDev) were 60.94 mrem (±0.609 mrem) for two x-rays (full-length AP and lateral radiograph of the entire spine), 12.92 mrem (±1.292 mrem) for each fluoroscopy exposure, and 1340.60 mrem (±13.406 mrem) per CT scan. Based on these values, estimated subject exposures were calculated. The total estimated radiation exposure over a 2-year period was 5572.74 mrem (±1428.88 merm) or 2786.37 mrem (±714.43 mrem) per year.</p><p><strong>Conclusion: </strong>The two-year cumulative radiation exposure is below the recommended exposure by Nuclear Regulatory Commission and OSHA. As expected, CT exposure presents the largest radiation exposure to patients with AIS throughout their operative management.</p><p><strong>Level of evidence: </strong>III, retrospective study.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/36/orr-14-487.PMC9809375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A New Test for the Advanced Diagnosis of Lateral Elbow Tendinopathy with Concomitant Intrasubstance Tear: Failure to Resist Extension Effort (the Free Test). 肘关节外侧肌腱病变伴物内撕裂的一种新的高级诊断方法:不能抵抗伸展力(自由试验)。
IF 2
Orthopedic Research and Reviews Pub Date : 2022-01-01 DOI: 10.2147/ORR.S364050
Cristóbal Greene, Guillermo Droppelmann, Nicolás García, Carlos Jorquera, Arturo Verdugo
{"title":"A New Test for the Advanced Diagnosis of Lateral Elbow Tendinopathy with Concomitant Intrasubstance Tear: Failure to Resist Extension Effort (the Free Test).","authors":"Cristóbal Greene,&nbsp;Guillermo Droppelmann,&nbsp;Nicolás García,&nbsp;Carlos Jorquera,&nbsp;Arturo Verdugo","doi":"10.2147/ORR.S364050","DOIUrl":"https://doi.org/10.2147/ORR.S364050","url":null,"abstract":"<p><strong>Background: </strong>Lateral elbow tendinopathy (LET) is one of the most common causes of musculoskeletal pain. The diagnosis is based on the clinical history and different physical maneuvers. Ultrasound (US) is a complementary diagnostic method to detect degenerative tendon changes and intrasubstance tears (IST). To date, there is no available physical maneuver to identify an IST in patients with LET.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy of an index test to detect an IST confirmed by ultrasound in patients with LET.</p><p><strong>Methods: </strong>A diagnostic retrospective study was performed. Patients who presented medical records with LET were recruited. Two orthopaedic surgeons developed the physical maneuver. The index test was considered positive when the position failed to resist the wrist extension maximum effort. Clinical findings were associated with confirmation of IST by US. Data were calculated using diagnostic accuracy, sensitivity, and specificity with 95% confidence intervals.</p><p><strong>Results: </strong>Thirty-nine patients (39 elbows) were analyzed, 25 (64%) women and 14 (36%) men, with an average age of 47.7 years. The index test's sensitivity was 0.86 (95% CI, 0.67-0.96). Accuracy was 0.79 (95% CI, 0.64-0.91), and the specificity was 0.64 (95% CI, 0.31-0.89).</p><p><strong>Conclusion: </strong>The index test presented very good sensitivity and good accuracy in patients with LET with US diagnostic confirmation of IST.</p><p><strong>Level of evidence: </strong>Diagnostic study, Level III.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/c5/orr-14-495.PMC9809378.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10857051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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