The Open Orthopaedics Journal最新文献

{"title":"Proximal Humerus Fractures in Children: Experience from a Central London Paediatric Orthopaedic Service","authors":"W. Chae, Akib M Khan, S. Abbott, A. Assiotis","doi":"10.2174/1874325001913010202","DOIUrl":"https://doi.org/10.2174/1874325001913010202","url":null,"abstract":"Proximal humeral fractures are commonly observed in children who sustain falls whilst running, or from heights. Appropriate and correct treatment is key in order to avoid limb length discrepancy and functional deficiencies. Current treatment methods include non-operative management such as collar and cuff immobilisation, and operative methods such as elastic stable intramedullary nails or Kirschner wires. This paper aims to present the demographics of this patient population and our experience in managing patients with proximal humerus fractures in an urban tertiary referral centre.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"15 1","pages":"202-207"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83790332","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":"Functional Outcomes After Salvage Procedures for Wrist Trauma and Arthritis (Four-Corner Fusion, Proximal Row Carpectomy, Total Wrist Arthroplasty, Total Wrist Fusion, Wrist Denervation): A Review of Literature","authors":"I. Schmidt","doi":"10.2174/1874325001913010217","DOIUrl":"https://doi.org/10.2174/1874325001913010217","url":null,"abstract":"The aim of this article is to give practical insights for the clinician on: (1) biomechanical and clinical fundamentals of normal and impaired wrist motion; (2) difficulties in assessment of postoperative outcome between measured motion by the surgeon and self-reported outcome by the patient; (3) indications for each procedure; and (4) differences in functional outcome between partial and complete motion-preserving as well as complete motion-restricting salvage procedures.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"30 1","pages":"217-231"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78531938","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 Acute Carpal Tunnel Syndrome Secondary to Calcific Tendinitis: A Case Report","authors":"B. McRae, Lulian Nusem","doi":"10.2174/1874325001913010198","DOIUrl":"https://doi.org/10.2174/1874325001913010198","url":null,"abstract":"Acute carpal tunnel syndrome secondary to acute calcific tendinitis is a rarely reported entity and poses a diagnostic dilemma for clinicians due to its non-specific presenting symptoms. Urgent decompression of the carpal tunnel is required to preserve the median nerve. We describe a case of acute carpal tunnel syndrome in the dominant hand of a 66-year-old female patient secondary to calcific tendinitis. Decompression was performed with good clinical result. We present this case report in order to further the knowledge bank regarding acute calcific tendinitis to help future clinicians to identify and manage it.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83889956","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":"Intra-Operative 3-Dimensional Imaging (O-arm) in Foot and Ankle Trauma Surgery: Report of 2 Cases and Review of the Literature","authors":"L. Jeyaseelan, F. Malagelada, L. Parker, A. Panagopoulos, N. Heidari, A. Vris","doi":"10.2174/1874325001913010189","DOIUrl":"https://doi.org/10.2174/1874325001913010189","url":null,"abstract":"\u0000 \u0000 Intraoperative two-dimensional (2D) fluoroscopy is the standard imaging modality available to orthopaedic surgeons worldwide. It is well-accepted, however, multiplanar 3 dimensional (3D) CT scanning is superior to 2D imaging for visualising joint surfaces and is now a fundamental feature of the pre-operative planning of intra-articular fractures.\u0000 \u0000 \u0000 \u0000 We present two cases in which the use of 3D intraoperative imaging and the O-arm® (Medtronic, Minneapolis, USA) led to immediate intraoperative revision to optimise fixation and articular congruity. A review of the current literature is also provided.\u0000 \u0000 \u0000 \u0000 During the trial period of the O-arm at our major trauma centre, intra-operative imaging was used in the lower limb trauma setting. The O-arm was used intra-operatively in a comminuted pilon fracture and a displaced talus fracture. We recorded all the intra-operative events, including quality of reduction, implant positioning and operation time. Each patient was followed-up for 12 months post-operation and was finally assessed with x-rays and the AOFAS score.\u0000 \u0000 \u0000 \u0000 In both the cases, either fracture reduction or the implant position/usage that was observed with 2D fluoroscopy was revised following a 3D intra-operative scan. No postoperative complications were noted and the healing process was uneventful. X-rays at the final follow-up were excellent and acceptable for the talus and pilon fracture, respectively, with corresponding clinical results and AOFAS score.\u0000 \u0000 \u0000 \u0000 Although frequently used in spinal surgery, to the best of our knowledge, the use of intra-operative 3D techniques in lower limb trauma is sparse and sporadically reported. We present our cases in which the most current innovative imaging techniques influenced intra-operative outcomes without compromising patient safety. We feel that this is a real example of how innovation can positively influence patient care.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74786462","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 Combined Lambrinudi and Ankle Arthrodesis with Ring External Fixation in the Long-term Severe Neuromuscular Equinocavovarus Deformity with Ankle and Hindfoot Osteoarthritis: The Cases Presentation and Modified Guideline of Treatment","authors":"P. Rajbhandari, C. Angthong, J. Zang, S. Qin, A. Veljkovic","doi":"10.2174/1874325001913010183","DOIUrl":"https://doi.org/10.2174/1874325001913010183","url":null,"abstract":"\u0000 \u0000 Severe equinocavovarus deformity develops from various causes and generally results in major disability that affects patient’s mobility and quality of life. It can be divided into neuromuscular and non-neuromuscular deformities, including two major subtypes: i.e., paralytic and spastic. In addition, ankle osteoarthritis could be caused by prolonged or progressive foot deformity.\u0000 \u0000 \u0000 \u0000 The present report proposes a modification of the accepted treatment algorithm and Lambrinudi’s surgical technique with ankle and hindfoot arthrodesis to correct theses challenging deformities with the long-term condition.\u0000 \u0000 \u0000 \u0000 Two equinocavovarus cases were included, one in a 54-year old male and the second in a 63-year old female with paralaytic and spastic etiologies respectively. Patient’s deformity correction was acceptable. Each patient demonstrated improved outcomes due to a postoperative plantigrade foot and ankle position. No significant complications were encountered during the course of care and last follow-up. The mean follow-up time was 26 months.\u0000 \u0000 \u0000 \u0000 Severe long term neuromuscular equinocavovarus deformities are a challenging disability in the foot and ankle surgery. The present article proposes a modified guideline of treatment illustrated in two representative case studies of long-term paralytic and spastic equinocavovarus deformities. These conditions can be treated surgically using the stepwise approach as demonstrated in this article with acceptable outcomes.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75081255","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":"Suprascapular Neuropathy in Overhead Athletes: A Systematic Review of Aetiology and Treatment Options","authors":"P. Surya, R. Pankhania, S. Islam","doi":"10.2174/1874325001913010177","DOIUrl":"https://doi.org/10.2174/1874325001913010177","url":null,"abstract":"Suprascapular neuropathy is often overlooked as a cause for shoulder pain in overhead athletes and can be misdiagnosed for many months, even years. With recent advancements in the understanding of the condition as well as its treatment methods, suprascapular neuropathy is now being diagnosed more frequently. However with a multitude of treatment options, it can be difficult to choose the optimal management. In this systematic review, we have carried out a detailed literature search about suprascapular neuropathy looking into evidence-based diagnostic workup and treatment modalities available. Repetitive overhead activities, rotator cuff tear and direct compression of the nerve by space-occupying lesion are important etiologies for suprascapular neuropathy. Whilst MRI is widely used for the identification of space-occupying lesions and rotator cuff injury; Electromyography (EMG) and Nerve Conduction Studies (NCS) remain gold standards for confirming injury to the nerve. Conservative treatment modalities including physiotherapy and activity modification, nerve blocks, arthroscopic and open surgical interventions are the main treatment options for suprascapular neuropathy.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86001813","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":"Characteristic Movement of the Ribs, Thoracic Vertebrae while Elevating the Upper Limbs - Influences of Age and Gender on Movements","authors":"Hisayoshi Tachihara, J. Hamada","doi":"10.2174/1874325001913010170","DOIUrl":"https://doi.org/10.2174/1874325001913010170","url":null,"abstract":"\u0000 \u0000 The rib cage, such as the thoracic spine and ribs, influences glenohumeral mobility and the development of shoulder disorders.\u0000 \u0000 \u0000 \u0000 To evaluate movements of the ribs, thoracic vertebrae during bilateral arm elevation and to clarify the characteristic influences of age and gender.\u0000 \u0000 \u0000 \u0000 Subjects comprised 33 healthy individuals divided into a young group (10 males, 7 females; mean age, 25 years) and a middle-aged group (8 males, 8 females; mean age, 52 years). Chest CT was performed with two arm positions: arms hanging downwards; and arms elevated at 160°. Images were three-dimensionally reconstructed to evaluate rib movement, extension angle of thoracic vertebrae.\u0000 \u0000 \u0000 \u0000 Maximal movement was observed at the fifth rib, and rib movement decreased with increasing distance from the fifth rib in both the groups. In males, movement of the second to fourth ribs was smaller in the middle-aged group than in the young group (p < 0.05). Movement of the first to ninth ribs was smaller in females than in males (p < 0.05). No significant difference in the extension angle of the thoracic vertebrae was found.\u0000 \u0000 \u0000 \u0000 Fifth rib movement is the largest among all ribs during bilateral arm elevation. Reduction of upper rib movement initially arises as an age-related degradation in males. Women exhibit less rib movement during bilateral arm elevation.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80969345","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":"Arthrodesis of the Distal Interphalangeal Joint and the Thumb Interphalangeal Joint: A Retrospective Comparison of Kirschner Wires and the Acutrak 2 Headless Compression Screw","authors":"J. Vedel, R. W. Jørgensen, C. H. Jensen","doi":"10.2174/1874325001913010166","DOIUrl":"https://doi.org/10.2174/1874325001913010166","url":null,"abstract":"\u0000 \u0000 Headless compression screws have become first choice for achieving arthrodesis in the distal interphalangeal joint and thumb interphalangeal joint. Only few comparisons between headless compression screws and other methods have been published.\u0000 \u0000 \u0000 \u0000 To assess healing and complication rate after arthrodesis of the distal interphalangeal joint or the thumb interphalangeal joint using a headless compression screw or Kirschner wires.\u0000 \u0000 \u0000 \u0000 A retrospective analysis of 148 consecutive primary fusions performed with the Acutrak 2 headless compression screw (n=107) or K-wires (n=41) was conducted. Healing was assessed clinically and radiographically at 6 to 8 weeks postoperatively.\u0000 \u0000 \u0000 \u0000 In 89% of cases fusion had been achieved at 6 to 8 weeks postoperatively using the headless compression screw. 7 cases healed after 8 weeks. Secondary surgery with screw removal was required in 11 cases due to screw prominence, infection or non-union.\u0000 In 71% of cases fusion had been achieved at 6 to 8 weeks postoperatively using Kirschner wires showing a lower fusion rate at this stage as compared to the headless compression screw group (p<0.05). 9 joints in the Kirschner wire group fused at some point after 8 weeks of follow up yielding a total fusion rate of 93% which was similar to 96% in the headless compression screw group (p>0.05). One infection occurred in the Kirschner wire group.\u0000 \u0000 \u0000 \u0000 Arthrodesis can be achieved with either a headless compression screw or Kirschner wires both showing equivalent total fusion rates though fusion may occur earlier using a headless compression screw.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90100885","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":"Intraoperative Cultures in Reimplantation of a Two-Stage Protocol: Only 1 vs. At Least 2 Positive Microbiological Results","authors":"J. Cordero-Ampuero, Ana Ortega-Columbrans, E. Garcia-Rey, E. Garcia-Cimbrelo","doi":"10.2174/1874325001913010159","DOIUrl":"https://doi.org/10.2174/1874325001913010159","url":null,"abstract":"The main reason for using a two-stage exchange in Prosthetic Joint Infection (PJI) is that bacteria are completely eradicated in reimplantation surgery. However, reports of a positive culture in the second surgery are growing. The number of positive intraoperative cultures and their influence on final results is not well-established.To compare epidemiological characteristics, infection recurrence and clinical evolution of patients with only onevs.at least two positive cultures based on our series of cases with positive cultures in reimplantation surgery.Retrospective study of 55 patients was conducted prospectively. They were diagnosed with chronic PJI, treated with a two-stage protocol and at least three intraoperative cultures were obtained in the second stage. These cultures were negative in 28 patients. Fourteen patients showed two or more cultures with the same microorganism and they were denominated patients with positive cultures. Thirteen patients showed only one positive culture, and they were considered contaminated. Both groups of patients (positive cultures and contaminated ones) received the second cycle of oral antibiotics for 6 months. Functional results were evaluated with the Harris Hip Score (hips) or Knee Society Clinical Rating Score (KSCRS) (knees).There were no significant differences between patients with positive or contaminated cultures for age (p=0.420) and sex (p=0.385). The knee was involved in 13/14 positive and in only 6/13 contaminated patients (p=0.013).Staphylococcus epidermidiswas the predominant isolate, but there were differences between positive (methicillin-resistant in 7/14 patients) and contaminated cultures (methicillin-sensitive in 6/13). There were no differences in the prevalence of polymicrobial cultures (p=0.785) or coincidence with cultures from the first stage (p=0.257). Three infection recurrences have appeared in patients with positive cultures (3/13, 21%) and none in patients with contaminated cultures. There are no differences in HSS or KSCRS when comparing final functional results between groups (p=0.411).The prevalence of positive cultures in reimplantation surgery is higher than expected (25%), and more frequent in women and in knee arthroplasties. The most frequently involved microorganism isStaphylococcus epidermidis, but antibiotic sensitivity varies between patients with positive cultures (methicillin-resistant) and those with contaminated cultures (methicillin-sensitive). There were no infection recurrences in patients with contaminated cultures, but those with positive cultures present a risk of over 20%.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76803278","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":"Diagnostic and Therapeutic Challenges of a Slipped Capital Femoral Epiphysis in a Low and Middle Income Country: A Case Report and Literature Review","authors":"A. Mbonda, L. W. Tchuenkam, J. Tochie, S. Abogo, R. Essomba","doi":"10.2174/1874325001913010152","DOIUrl":"https://doi.org/10.2174/1874325001913010152","url":null,"abstract":"\u0000 \u0000 Slipped Capital Femoral Epiphysis (SCFE) is an incapacitating orthopedic disease, particularly affecting older children and adolescents and caused by the sliding of the proximal femoral epiphysis on the metaphysis. SCFE has a clinical polymorphism, compounded with a certain diagnostic variability among health practitioners and the relatively high cost of its surgical management contribute to the diagnostic delay observed in most developed countries as well as developing ones. Herein, we report the case of SCFE in an adolescent Cameroonian, with emphasis on its diagnostic and therapeutic challenges in Low and Middle-Income Countries (LMICs), in a bit to improve on timely recognition and management by clinicians in these settings.\u0000 \u0000 \u0000 \u0000 A 10-year-old girl has presented with unilateral right thigh pain of more than one year duration associated with a limping gait and no fever. Before the referral to our health facility, she consulted several general practitioners in rural areas and pediatricians in the city with no definite diagnosis. On the basis of the clinical and the imaging studies, the diagnosis of stable right SCFE with moderate displacement was made. Under general anesthesia, the patient underwent open reduction and internal fixation with three pins under c-arm fluoroscopy. Clinical and radiological follow-up till one year after surgical intervention were satisfactory. The pins were removed after one year of fixation confirming a good bone fusion in plain x-ray. Her clinical examination and radiological follow-up three years after removal of the pins were satisfactory.\u0000 \u0000 \u0000 \u0000 The case report illustrates that SCFE often a missed diagnosis in LMICs. This is worrisome because delayed diagnosis may lead to long-term complications such as avascular necrosis and early degenerative joint disease. Although the above case was missed by several clinicians and finally diagnose late, the present case highlights the need for a high index of clinical suspicion in order to timely diagnose and timely manage SCFE to avert potential long-term physical disabilities and psychological trauma in children.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75104816","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}