Journal of Southeast Asian Orthopaedics最新文献

{"title":"Closed Spontaneous Rupture of the Flexor Tendon in Zone 3: A Case Series","authors":"Navapong Thitiworakarn, MD, Chaiyos Vinitpairot, MD, Surut Jianmongkol, MD","doi":"10.56929/jseaortho.v46i2.24","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i2.24","url":null,"abstract":"Purpose: The pathophysiology of spontaneous rupture is not fully understood. Spontaneous rupture has been questioned, as some authors have stated that most spontaneous ruptures cannot be attributed to a cause or have not yet been investigated. Zone 3 was the most common place for flexor tendon ruptures to happen on their own, but the risk factor was not found.\u0000Methods: From 2019 to 2022, we recorded four cases of closed rupture of the flexor tendon in zone 3 caused by agricultural activity. The history of all patients such as steroid injections, pain, and underlying conditions, was reviewed. Some parts of the tendon, debrided from the injury site, were sent for pathologic examination. The final range of motion and activity were recorded.\u0000Results: All our patients had acute symptoms while gripping tools and excavating dirt during gardening. All flexor tendon ruptures occurred in zone 3, and were repaired by core and epitendinous suture. There was no actual condition believed to be the cause of the rupture. All patients achieved nearly full range of motion in the final follow-up.\u0000Conclusions: A firm grip while performing agricultural tasks appears to be a risk factor of closed rupture flexor tendon. Although it is uncommon for a closed rupture of a flexor tendon injury to occur without ascertainable causes, this condition should be recognized while facing weakness or an inability to flex the finger.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"368 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116553461","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 Dynamic Versus Static Lag Screw Modes for Short Cephalomedullary Nails in the Treatment of Unstable Intertrochanteric Fractures: A Randomized Controlled Trial","authors":"Naruepol Ruangsillapanan, MD, Tana Rattanakitkoson, MD, Teerayut Ittimongkonkul, MD","doi":"10.56929/jseaortho.v46i2.156","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i2.156","url":null,"abstract":"Purpose: To compare the static locked and sliding proximal lag screw modes of short cephalomedullary nail in the treatment of unstable intertrochanteric fractures.\u0000Methods: Ninety-four patients (age>60 years) with low energy unstable intertrochanteric fractures were randomized for treatment into two groups. They were treated with static and sliding proximal lag screw modes of short cephalomedullary nail. The pre-operative variables, operative time, fluoroscopy time, blood loss, tip apex distance, and reduction quality were recorded for each patient. Post-operative follow-ups were undertaken every other week until bone union or implant failure occurred. Plain anteroposterior and lateral radiographs (both hip) were obtained at all visits. Ipsilateral leg length discrepancy (LLD), radiographic union score for hip complications, and fixation failure were recorded.\u0000Results: The mean follow-up time was 16.7 months (range 12–24). The mean bone union times of static locked (n=35) and sliding proximal (n=34) screw mode groups were 12.4 weeks and more than 11.2 weeks, respectively; the difference was not significant (p=0.213). The ipsilateral LLD of the sliding proximal (mean 4 mm) and static locked (mean 2 mm) screw mode groups showed a statistically significant difference (p<0.001). Post-operative complications (lag screw perforated to hip joint, lag screw cutout from the femoral head, and excessive inferolateral lag screw sliding) developed in 8.82% patients in sliding proximal group, whereas, no complications were reported in the static locked group.\u0000Conclusions: Treatment of unstable intertrochanteric fracture using static locked proximal lag screw mode of cephalomedullary nail showed some advantages over sliding proximal lag screw in terms of less complication and ipsilateral LLD; however, the bone union times were not different. Therefore, a static locked proximal screw mode is preferable over sliding proximal screw mode in treating unstable intertrochanteric fractures.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124909323","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 Between Minimally Invasive Anterolateral and Conventional Posterior Hip Approaches for Hemiarthroplasty in Hip Fractures","authors":"Pranpawee Rojcharoenngam, MD","doi":"10.56929/jseaortho.v46i2.22","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i2.22","url":null,"abstract":"Purpose: To compare the results between minimally invasive anterolateral and conventional posterior hip approaches for hemiarthroplasty in hip fractures.\u0000Methods: The elderly patients who had undergone hip hemiarthroplasty for hip fractures in Maharaj Nakhon Si Thammarat Hospital, were randomly divided into two groups: minimally invasive anterolateral and posterior approach groups Data were collected from March 2020 to November 2021, which included the duration of the surgery, length of the surgical wound, intraoperative bleeding volume, postoperative days of walking with a walker, morphine dosage for pain relief, and postoperative complications.\u0000Results: No significant difference (P-value > 0.05) was found between the baseline data of patients in both the groups, which included sex, age, body mass index, underlying musculoskeletal disease, and drug usage. The minimally invasive anterolateral approach group used an average surgical time of 53.48 ± 8.22 min, while the conventional posterior approach group required 65 ± 20.41 min; the length of the surgical wound was 7.78 ± 0.87 and 13.78 ± 1.37 cm, respectively; the volume of intraoperative bleeding was 82.17 ± 48.94 and 195.65 + 163.24 ml, respectively; the postoperative days of walking with a walker were 3.09 ± 0.92 and 6.59 ± 2.52 days, respectively; and the postoperative analgesic doses of morphine were 6.59 ± 2.80 and 11.09 ± 3.89 mg, respectively. The blood transfusion was required in 4 patients in the minimally invasive anterolateral approach group, while it was required in 14 patients in the conventional posterior approach group. Statistically significant (P-value < 0.05). Postoperative complications included, prosthetic hip joint dislocation in a patient in each group and sciatic nerve neurapraxia in a patient in the conventional posterior approach group.\u0000Conclusions: Hip hemiarthroplasty with the minimally invasive anterolateral approach in elderly patients with hip fractures was found to be superior to the conventional posterior approach.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127608536","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":"Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease","authors":"Varinthorn Adulyanukosol, MD, Supphamard Lewsirirat, MD, Guntarat Chinvattanachot, MD","doi":"10.56929/jseaortho.v46i1.11","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.11","url":null,"abstract":"Purpose: To determine the factors associated with clinical and radiological outcomes in patients with Legg-Calve-Perthes disease (LCPD) treated with containment methods.\u0000Methods: This retrospective cohort study was conducted from 2007 – 2017. Patients diagnosed with LCPD in the fragmentation stage and treated using surgical containment methods were included. Study factors were age at diagnosis, preoperative radiographs analyzed for lateral pillar staging and Catterall classification. Outcome measurements were final follow-up radiograph, classified using modified Stulberg grading, and final clinical outcome, classified by Harris Hip Score.\u0000Results: We analyzed 44 hips. The average age of subjects during diagnosis and follow-up was 8.1 and 12.7 years, respectively. The average length of follow-up was 58.6 months. Nineteen hips were evaluated as “good” (Stulberg I or II), 22 hips as “fair” (Stulberg III), and four hips as “poor” (Stulberg IV); no hips were classified as Stulberg V. Although not significant, the combination of Salter osteotomy and femoral varus osteotomy yielded better outcomes than varus osteotomy alone in the group >8 years old (p=0.247). The median age of 7 (7 – 8) years old was correlated with “good to excellent” Harris Hip Score while median age of 9 years was significantly correlated with the score of “fair” and “poor” (p=0.018). Lateral pillar A and B yielded significantly better results than lateral pillar C (p=0.014).\u0000Conclusion: The containment methods demonstrated favorable outcomes when treating patients < 9 years. Lateral pillars A and B had good end results. Combined pelvic and femoral osteotomy can improve radiographic and clinical outcomes.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126856969","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":"Open Muscle-Preserving Pedicle Screws Fixation Versus Conventional Open Posterior Approach in Thoracolumbar Burst Fracture without Neurologic Injury","authors":"Urawit Piyapromdee, MD, Chanthong Budsayavilaimas, MD, Kongtush Choovongkomol, MD, Terdpong Tanaviriyachai, MD, Weera Sudprasert, MD","doi":"10.56929/jseaortho.v46i1.20","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.20","url":null,"abstract":"Introduction: Patients who sustained thoracolumbar spine fracture without neurological deficit often require surgical treatment. The conventional open posterior approach had some disadvantages including post-operative pain, blood loss, and duration of the operation. The minimally invasive approach, open muscle-preserving pedicle screw fixation, was proposed to have more benefit than the conventional approach. This study evaluated the clinical and perioperative outcomes of thoracolumbar burst fracture fixation using the open muscle-preserving approach and the conventional open posterior approach.\u0000Methods: A prospective cohort study from June 2016 to June 2017 of the open muscle-preserving pedicle screw fixation approach was done compared to the historical control of the conventional open posterior approach from May 2015 to May 2016. The post-operative pain score, blood loss, duration of operation and clinical outcome were analyzed.\u0000Results: Twenty-three patients were enrolled in the muscle-preserving approach group, and 27 patients treated with the conventional open posterior approach were the control group. Post-operative VAS was significantly better in the muscle-preserving group (P<0.001). The mean operating time was significantly shorter in the muscle-preserving group (60.4±17.3 min. vs. 90.9±18.9 min., p<0.001). Moreover, the mean intra-operative blood loss of the muscle-preserving group was also significantly lower (156.96±96.3ml. vs. 269.26±147.6ml., p=0.003).\u0000Conclusion: Our study results indicate a superiority of the open muscle-preserving approach over the conventional open posterior approach for a thoracolumbar burst fracture without neurologic injury in terms of post-operative pain score, blood loss and duration of operation. The open muscle-preserving approach is an alternative treatment for thoracolumbar burst fractures.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121322686","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":"Surgical Treatment and Outcomes of Adjacent Segmental Disease by Additional Extension-fixation Decompression and Fusion without Removing Prior Fixation by Using Domino Connector","authors":"Satapong Pisuitthanakan, MD, Chakkraphan Tantrakansakun, MD, Pradit Tantammaroj, MD, Pairoj Warachit, MD","doi":"10.56929/jseaortho.v46i1.21","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.21","url":null,"abstract":"Purpose: Adjacent segmental disease (ASDis) represents symptomatic adjacent segment degeneration causing pain or neurological deficit. Revision lumbar decompression and extended spinal fusion remain the surgical gold standard. The surgical technique removes all prior implants (pedicle screw and rods) and applies the new implant to previous surgical sites while extending fixation across adjacent segments with fusion; however, it leads to soft tissue trauma, massive blood loss, prolonged operative time, and an increased fixation cost. This study aimed to present the use of a domino connector for connecting the old rod and new rod for extension fixation without removing prior fixation as an alternative technique.\u0000Methods: This study retrospectively analyzed the data of 14 patients with ASDis who underwent revision surgery with the use of a domino connector for connecting the old rod and new rod for extension fixation without the removal of prior fixation.\u0000Results: All the patients were aged 59–85 years with a mean age of 67.2 years. The mean duration of ASDis was 4.38 years postoperatively. The patients were grouped according to the modified MacNab criteria as follows: no patient in the excellent group, 12 patients in the good group, and two patients in the fair group.\u0000Conclusions: This surgical technique for treating failed back surgery syndrome reduces the extent of the surgery by employing rod connectors without prior instrument revision. It can serve as an alternative for the operative technique for treating patients with ASDis.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130348621","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":"Clinical Study of a New Design Percutaneous Transpedicular Biopsy System for Spinal Tuberculosis","authors":"Suwat Roschan, MD","doi":"10.56929/jseaortho.v46i1.9","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.9","url":null,"abstract":"Purpose: Despite some spinal tuberculosis cases having typical imaging findings, histological/ microbiological evidence is required for definitive diagnosis and management. Percutaneous biopsy is suitable for histopathologic and bacteriologic evaluation of vertebral lesions, as it is a quick and minimally invasive technique to obtain specimens from deep structures and is advantageous for open surgical biopsy. Based on a minimally invasive technique, herein, we describe a newly designed percutaneous transpedicular biopsy system for lumbar vertebral lesion biopsy.\u0000Methods: Fifty-six patients who underwent percutaneous transpedicular vertebral biopsy under fluoroscopic guidance were evaluated. Biopsy specimens were obtained by passing a proprietary 6-mm diameter biopsy instrument through the pedicle and into the disease site under C-arm fluoroscopy. Specimens were sent for histological and bacteriologic analyses.\u0000Results: There were 36 males and 20 female patients of mean age 47.64 years (range 22-80 years).  Biopsies were performed on 56 lumbar vertebral bodies. The average operative time were 15.6 minutes (range 13-18 minutes). All 56 patients (54 tubercular pathology, one metastasis, and one osteoporotic fracture with chronic nonspecific inflammation) had definitive histological/ microbiological diagnosis. Two patients (3.57% of 56 patients) developed a biopsy site small hematoma.\u0000Conclusions: A newly designed percutaneous transpedicular biopsy system was successfully used for lumbar vertebral biopsy under local anesthesia. It was easy to use and was safe with a low complication rate for definitive diagnosis of lumbar spinal tuberculosis and could be performed with minimal morbidity and high diagnostic yield as an outpatient procedure.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133925606","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 Posterior and Paraspinal Approaches for the Treatment of Thoracolumbar Burst Fractures: A Randomized Controlled Trial","authors":"Satapong Pisuitthanakan, MD","doi":"10.56929/jseaortho.v46i1.12","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.12","url":null,"abstract":"Purpose: Burst fractures cause over half of all thoracolumbar fractures, for which the posterior approach has been considered the standard approach. The paraspinal approach has proven safe and effective for thoracolumbar injury. This study aimed to compare the clinical and radiographic outcomes between the two approaches.\u0000Methods: This randomized controlled trial included 24 patients with isolated thoracolumbar burst fractures between July 2016 and August 2018. Patients were categorized into two groups: paraspinal and posterior approaches. The primary outcome was postoperative pain on days 1, 2, 3, and 14. The corrected Cobb’s angle; operation time; intraoperative blood loss; opioid usage on days 1, 2, and 3; Oswestry Disability Index (ODI, Thai version); and percentage reduction loss at 3 months were secondary outcomes. Participants were assessed on post-intervention days 1, 2, 3, 14, and 90.\u0000Results: The mean visual-analog-scale (VAS) scores on postoperative days 1, 2, 3, and 14 (8.6 ± 0.8, 7.1 ± 0.6, 5.5 ± 1.3, 5.5 ± 0.8); intraoperative blood loss (395.8 ± 113.7 mL); opioid usage on days 2 and 3 (13 ± 1.5 mg, 8.3 ± 1.9 mg); and postoperative ODI (23.5 ± 3.5) were significantly lower (P<0.05) in the paraspinal-approach group than in the posterior-approach group (mean VAS on postoperative days 1, 2, 3, and 14 [9.2 ± 0.5, 8.3 ± 0.3, 7.5 ± 0.8, 6.7 ± 0.5]; intraoperative blood loss [590 ± 70.1 mL]; opioid usage on days 2 and 3 [15.8 ± 1.9 mg, 11.7 ± 1.6 mg]; and postoperative ODI [40 ± 4.2]). There was no statistical differences in operative time, corrected Cobb’s angle, and percentage reduction loss.\u0000Conclusions: The paraspinal approach is significantly advantageous over the conventional posterior approach regarding postoperative pain, intraoperative blood loss, opioid usage, and ODI at 3 months, thus corroborating the minimally invasive concept.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124969009","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":"Total Hip Replacement Using Imageless Computer Navigation for Femoral Neck Fracture in Elderly Patients","authors":"Jithayut Sueajui, MD, Yingyong Suksathien, MD","doi":"10.56929/jseaortho.v46i1.10","DOIUrl":"https://doi.org/10.56929/jseaortho.v46i1.10","url":null,"abstract":"Purpose: To determine the incidence of dislocation after total hip replacement (THR) using imageless computer navigation in older adults with femoral neck fractures.\u0000Methods: A retrospective review of femoral neck fractures in older adults who underwent THR with imageless computer navigation between January 2018 and December 2019 was performed. We evaluated the dislocation rate as the primary outcome measure. Furthermore, we evaluated the acetabular component position using computed tomography, functional outcome using the Barthel index score, and perioperative complications as secondary outcomes.\u0000Results: Of the 50 patients who underwent THR, no dislocation was found after a follow-up period of at least 6 months. The mean acetabular cup abduction and anteversion angles were 37.6° (range 32.5°-42°, SD = 1.91°) and 11.1° (range 8.9°-19.2°, SD = 4.02°), respectively. Functional outcomes evaluated using the Barthel index at 6 months follow-up showed that 86% were excellent (mean 17 of 20) (range 7-20, SD = 3.27). A total of 87% of all patients returned to their pre-injury status. Five patients (10%) died after 6 months of follow-up, and all 5 died within 30 days after surgery. There were no cases of revision surgery at 6 months follow-up.\u0000Conclusions: THR with imageless computer navigation can provide promising stable hip replacement in elderly patients with femoral neck fractures without dislocation during short-term follow-up.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115789552","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}