ISRN orthopedics最新文献

{"title":"Treatment of ganglion cysts.","authors":"Matthew Suen,&nbsp;B Fung,&nbsp;C P Lung","doi":"10.1155/2013/940615","DOIUrl":"https://doi.org/10.1155/2013/940615","url":null,"abstract":"<p><p>Ganglion cysts are soft tissue swellings occurring most commonly in the hand or wrist. Apart from swelling, most cysts are asymptomatic. Other symptoms include pain, weakness, or paraesthesia. The two main concerns patients have are the cosmetic appearance of the cysts and the fear of future malignant growth. It has been shown that 58% of cysts will resolve spontaneously over time. Treatment can be either conservative or through surgical excision. This review concluded that nonsurgical treatment is largely ineffective in treating ganglion cysts. However, it advised to patients who do not surgical treatment but would like symptomatic relief. Compared to surgery, which has a lower recurrence rate but have a higher complication rate with longer recovery period. It has been shown that surgical interventions do not provide better symptomatic relief compared to conservative treatment. If symptomatic relief is the patient's primary concern, a conservative approach is preferred, whilst surgical intervention will decrease the likelihood of recurrence. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"940615"},"PeriodicalIF":0.0,"publicationDate":"2013-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/940615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32457884","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}

{"title":"The retroacetabular angle determines the safe angle for screw placement in posterior acetabular fracture fixation.","authors":"Ayman M A Tadros,&nbsp;Thomas R Oxland,&nbsp;Peter O'Brien","doi":"10.1155/2013/432675","DOIUrl":"https://doi.org/10.1155/2013/432675","url":null,"abstract":"<p><p>Introduction. A method for the determination of safe angles for screws placed in the posterior acetabular wall based on preoperative computed tomography (CT) is described. It defines a retroacetabular angle and determines its variation in the population. Methods. The retroacetabular angle is the angle between the retroacetabular surface and the tangent to the posterior acetabular articular surface. Screws placed through the marginal posterior wall at an angle equal to the retroacetabular angle are extraarticular. Medial screws can be placed at larger angles whose difference from the retroacetabular angle is defined as the allowance angles. CT scans of all patients with acetabular fractures treated in our institute between September 2002 to July 2007 were used to measure the retroacetabular angle and tangent. Results. Two hundred thirty one patients were included. The average (range) age was 42 (15-74) years. The average (range) retroacetabular angle was 39 (30-47) degrees. The average (range) retroacetabular tangent was 36 (30-45) mm. Conclusions. Placing the screws at an average (range) angle of 39 (33-47) degrees of anterior inclination with the retroacetabular surface makes them extraarticular. Angles for medial screws are larger. Safe angles can be calculated preoperatively with a computer program. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"432675"},"PeriodicalIF":0.0,"publicationDate":"2013-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/432675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32449886","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}

{"title":"Dorsally comminuted fractures of the distal end of the radius: osteosynthesis with volar fixed angle locking plates.","authors":"Paritosh Gogna,&nbsp;Harpal Singh Selhi,&nbsp;Rohit Singla,&nbsp;Ashish Devgan,&nbsp;Narender Kumar Magu,&nbsp;Pankaj Mahindra,&nbsp;Mohammad Yamin","doi":"10.1155/2013/131757","DOIUrl":"https://doi.org/10.1155/2013/131757","url":null,"abstract":"<p><p>Background. Dorsally comminuted distal radius fractures are unstable fractures and represent a treatment challenge. The objective of this study was to evaluate the functional and radiological outcome of dorsally comminuted fractures of the distal radius fixed with a volar locking plate. Patients and Methods. Thirty-three consecutive patients with dorsally comminuted fractures of the distal end of the radius were treated by open reduction and internal fixation with AO 2.4 mm (n = 19)/3.5 mm (n = 14) volar locking distal radius plate (Synthes, Switzerland, marketed by Synthes India Pvt. Ltd.). There were 7 type A3, 8 type C2, and 18 type C3 fractures. The patients were followed up at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Subjective assessment was done as per Disabilities Arm, Shoulder, and Hand (DASH) questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist; the radiological determinants were radial angle, radial length, volar angle, and ulnar variance. The final assessment was done as per Demerit point system of Saito. Results. There were 23 males and 10 females with an average age of 44.12 ± 18.63 years (18-61 years). Clinicoradiological consolidation of the fracture was observed in all cases at a mean of 9.6 weeks (range 7-12 weeks). The average final extension was 58.15° ± 7.83°, flexion was 54.62° ± 11.23°, supination was 84.23° ± 6.02°, and pronation was 80.92° ± 5.54°. Demerit point system of Saito yielded excellent results in 79% (n = 26), good in 18% (n = 6), and fair in 3% (n = 1) patients. Three patients had loss of reduction but none of the patients had tendon irritation or ruptures, implant failure, or nonunion at the end of an one-year followup. Conclusion. Volar locking plate fixation for dorsally comminuted distal radius fractures results in good to excellent functional outcomes despite a high incidence of loss of reduction and fracture collapse. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"131757"},"PeriodicalIF":0.0,"publicationDate":"2013-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/131757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32451569","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}

{"title":"Humeral shaft fractures secondary to hand grenade throwing.","authors":"Bahattin Kerem Aydin,&nbsp;Ramazan Akmese,&nbsp;Mustafa Agar","doi":"10.1155/2013/962609","DOIUrl":"https://doi.org/10.1155/2013/962609","url":null,"abstract":"<p><p>A series of five cases were presented in which similar fractures of the shaft of the humerus occurred during the hand grenade throwing activity during the military education. All the fractures were in the 1/3 distal humeral shaft, and butterfly fragments were accompanying in two soldiers. All the fractures healed without any clinical complications with conservative treatment. The mechanism of the fracture is discussed with reference to the recent literature. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"962609"},"PeriodicalIF":0.0,"publicationDate":"2013-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/962609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32458336","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}

{"title":"Vitamin d status and spine surgery outcomes.","authors":"William J Rodriguez,&nbsp;Jason Gromelski","doi":"10.1155/2013/471695","DOIUrl":"https://doi.org/10.1155/2013/471695","url":null,"abstract":"<p><p>There is a high prevalence of hypovitaminosis D in patients with back pain regardless of whether or not they require surgical intervention. Furthermore, the risk of hypovitaminosis D is not limited to individuals with traditional clinical risk factors. Vitamin D plays an essential role in bone formation, maintenance, and remodeling, as well as muscle function. Published data indicate that hypovitaminosis D could adversely affect bone formation and muscle function in multiple ways. The literature contains numerous reports of myopathy and/or musculoskeletal pain associated with hypovitaminosis D. In terms of spinal fusion outcomes, a patient may have a significant decrease in pain and the presence of de novo bone on an X-ray, yet their functional ability may remain severely limited. Hypovitaminosis D may be a contributing factor to the persistent postoperative pain experienced by these patients. Indeed, hypovitaminosis D is not asymptomatic, and symptoms can manifest themselves independent of the musculoskeletal pathological changes associated with conditions like osteomalacia. It appears that vitamin D status is routinely overlooked, and there is a need to raise awareness about its importance among all healthcare practitioners who treat spine patients. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"471695"},"PeriodicalIF":0.0,"publicationDate":"2013-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/471695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32449888","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}

{"title":"The Correlation of Serum Metal Ions with Functional Outcome Scores at Three-to-Six Years following Large Head Metal-on-Metal Hip Arthroplasty.","authors":"Sheethal Prasad Patange Subbarao,&nbsp;Ibrahim A Malek,&nbsp;Khitish Mohanty,&nbsp;Phillip Thomas,&nbsp;Alun John","doi":"10.1155/2013/173923","DOIUrl":"https://doi.org/10.1155/2013/173923","url":null,"abstract":"<p><p>Based on success of hip resurfacing, large head Metal on Metal (MoM) hip arthroplasty has gained significant popularity in recent years. There are growing concerns about metal ions related soft tissue abnormalities. The aim of this study was to define a correlation of metal ions with various functional outcome scores following large head MoM hip arthroplasty. Consecutive cohort of 70 patients (76 hips) with large head MoM hip arthroplasty using SL-Plus femoral stem and Cormet acetabular component were prospectively followed up. An independent observer assessed the patients which included serology for metal ion levels and collection of Oxford Hip, Harris hip, WOMAC, SF-36 & modified UCLA scores. Median serum cobalt and chromium levels were 3.10 μg/L (0.35-62.92) and 4.21 μg/L (0.73-69.27) with total of median 7.30 μg/L (2.38-132.19). The median Oxford, Harris, WOMAC, SF-36 and modified UCLA scores were 36 (6-48), 87 (21-100), 36 (24-110), 104 (10-125), and 3 (1-9), respectively. Seventeen patients had elevated serum cobalt and chromium levels ≥7 μg/L. There was no significant correlation between serum metal ion levels with any of these outcome scores. We recommend extreme caution during follow up of these patients with large head MoM arthroplasty. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"173923"},"PeriodicalIF":0.0,"publicationDate":"2013-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/173923","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32451570","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}

{"title":"Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients.","authors":"Ratto Nicola","doi":"10.1155/2013/329452","DOIUrl":"https://doi.org/10.1155/2013/329452","url":null,"abstract":"<p><p>The management of the polytraumatized orthopedic patient remains a challenging issue. In recent years many efforts have been made to develop rescue techniques and to promote guidelines for the management of these patients. Currently controversies persist between two orthopedic approaches: the Early Total Care and the Damage Control Orthopedics. An overview of the current literature on the orthopedic management of polytrauma patient is provided. Subsequently, femoral shaft fractures, representing extremely common lesions, and pelvic ring injuries, that are associated with a high mortality rate, are analyzed in detail. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"329452"},"PeriodicalIF":0.0,"publicationDate":"2013-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/329452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32451573","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}

{"title":"Treatment of AO Type C Fractures of the Distal Part of the Humerus through the Bryan-Morrey Triceps-Sparing Approach.","authors":"J A Fernández-Valencia,&nbsp;E Muñoz-Mahamud,&nbsp;J R Ballesteros,&nbsp;S Prat","doi":"10.1155/2013/525326","DOIUrl":"https://doi.org/10.1155/2013/525326","url":null,"abstract":"<p><p>Several alternative approaches have been described to avoid the complications related to the olecranon osteotomy used to treat distal articular humerus fractures. The published experience with the triceps-sparing approach is scant. In this prospective study, a total of 12 patients with an articular humeral fracture were treated using this approach. At a mean followup of 1,7 years, the average range of motion was 112.8° (range from 85° to 135°); the elbow flexion averaged 125.5° (range from 112° to 135°) and the deficit of elbow extension 14.6° (range from 0° to 30°). All the elbows were stable. The Mayo Elbow Performance Score (MEPS) averaged 93.3 (range from 80 to 100). In the present series no failure of the triceps reattachment to the olecranon was found, and all the patients recalled returning to their previous daily life activities without impairment with a satisfactory MEPS. As a conclusion, the triceps-sparing approach can be considered for treating distal articular humerus fractures. We consider that three clinical settings can be more favorable to use this approach: those cases in which a total elbow prosthesis might be needed, cases of ipsilateral diaphyseal fracture, or presence of previous hardware in the olecranon. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"525326"},"PeriodicalIF":0.0,"publicationDate":"2013-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/525326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32455890","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}

{"title":"TEFTOM: A Promising General Trauma Expectation/Outcome Measure-Results of a Validation Study on Pan-American Ankle and Distal Tibia Trauma Patients.","authors":"Michael Suk, Monica Daigl, Richard E Buckley, Cleber A J Paccola, Dean G Lorich, David L Helfet, Beate Hanson","doi":"10.1155/2013/801784","DOIUrl":"10.1155/2013/801784","url":null,"abstract":"<p><p>Background. In orthopedics, there is no instrument specifically designed to assess patients' expectations of their final surgery outcome in general trauma populations. We developed the Trauma Expectation Factor Trauma Outcome Measure (TEFTOM) to investigate the fulfilment of patients' expectations one year after surgery as a measure of general trauma surgical outcomes. The aim of this paper was to assess the psychometric characteristics of this new general trauma outcome measure. Methods. The questionnaire was tested in 201 ankle and distal tibia fracture patients scheduled for surgery. Patients were followed up for twelve months. The TEFTOM questionnaire was evaluated for its criterion validity, internal consistency, reproducibility, and responsiveness. Results. TOM showed good criterion validity against the American Academy of Orthopaedic Surgeons Foot and Ankle Scale (Pearson's correlation coefficient = 0.69-0.77). Internal consistency was acceptable for TEF (Cronbach's alpha = 0.65-0.76) and excellent for TOM (Cronbach's alpha = 0.76-0.85). Reproducibility was moderate to very good (intraclass coefficient correlation (ICC) ≥0.67) for TEF and very good (ICC ≥0.92) for TOM. TOM also proved to be responsive to changes in patients' condition over time (Wald test; P < 0.001). Conclusions. TEFTOM is a promising tool for measuring general trauma outcomes in terms of patients' expectation fulfilment that proved to be valid, internally consistent, reproducible, and responsive to change. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"801784"},"PeriodicalIF":0.0,"publicationDate":"2013-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32457880","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}

{"title":"Comparing the In Vitro Stiffness of Straight-DCP, Wave-DCP, and LCP Bone Plates for Femoral Osteosynthesis.","authors":"José Ricardo Lenzi Mariolani,&nbsp;William Dias Belangero","doi":"10.1155/2013/308753","DOIUrl":"https://doi.org/10.1155/2013/308753","url":null,"abstract":"<p><p>The objective of this study was to compare the Locking Compression Plate (LCP) with the more cost-effective straight-dynamic compression plate (DCP) and wave-DCPs by testing in vitro the effects of plate stiffness on different types of diaphyseal femur fractures (A, B, and C, according to AO classification). The bending structural stiffness of each plate was obtained from four-point bending tests according to ASTM F382-99(2008). The plate systems were tested by applying compression/bending in different osteosynthesis simulation models using wooden rods to simulate the fractured bone fragments. Kruskal-Wallis test showed no significant difference in the bending structural stiffness between the three plate models. Rank-transformed two-way ANOVA showed significant influence of plate type, fracture type, and interaction plate versus fracture on the stiffness of the montages. The straight-DCP produced the most stable model for types B and C fractures, which makes its use advantageous for complex nonosteoporotic fractures that require minimizing focal mobility, whereas no difference was found for type A fracture. Our results indicated that DCPs, in straight or wave form, can provide adequate biomechanical properties for fixing diaphyseal femoral fractures in cases where more modern osteosynthesis systems are cost restrictive. </p>","PeriodicalId":89787,"journal":{"name":"ISRN orthopedics","volume":"2013 ","pages":"308753"},"PeriodicalIF":0.0,"publicationDate":"2013-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/308753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32451571","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}