BMC Musculoskeletal Disorders最新文献

{"title":"Is the phoenix sign phenomenon due to vasodilation? A double-blinded, randomized controlled trial comparing motor function recovery after diagnostic common fibular nerve block with lidocaine and papaverine.","authors":"Stephen L Barrett, Bailey Boyd, Sequioa DuCasse, Wajdi Nassier, Nia Mitchell, Artinder P Nagra, Miki Dalmau-Pastor, Dwayne S Yamasaki, Scott Nickerson","doi":"10.1186/s12891-024-07972-3","DOIUrl":"10.1186/s12891-024-07972-3","url":null,"abstract":"<p><strong>Background: </strong>Focal entrapment of the common fibular (peroneal) nerve (CFN) is the most common nerve entrapment in the lower extremity. Accurate diagnosis can be difficult due to co-existent pathology such as low back pathology. A 1% lidocaine block of CFN is often used to confirm the local entrapment pathology and demonstrate possibility of pain relief. A surprising, unexpected and temporary strengthening of CFN supplied ankle and foot muscles is occasionally produced, termed the Phoenix sign. Aetiology of this phenomenon has been puzzling, but restoration of neural circulation and nutrition via improved local blood flow has been postulated to be responsible.</p><p><strong>Methods: </strong>This is a double-blinded, randomized, prospective controlled trial of 20 patients, comparing 2 vasodilating agents and their ability to produce the Phoenix effect. Ultrasound guided infiltration of 0.3 mL 1% lidocaine or papaverine HCl 10 mg/mL was executed adjacent to CFN. Motor strength pre- infiltration and 4 min post-infiltration were measured for anterior compartment muscles utilizing MRC manual motor testing reported on a 0-5 scale. The extensor hallucis longus (EHL) muscle proved to be the most significant.</p><p><strong>Results: </strong>Average motor strength of the EHL improved from 2.2 (+/-0.40) to 4.9 (+/-0.32).) in the lidocaine group. In the papaverine group, pre-infiltration EHL motor strength averaging 2.1 (+/-0.93) improved to 4.4 (+/- 1.01) post-infiltration. Papaverine and lidocaine produced similar statistically significant increases in muscle strength (p = < 0.05).</p><p><strong>Conclusion: </strong>There was no difference between small local infiltrations of lidocaine or papaverine in production of increased anterior compartment EHL motor strength. It is most likely that the Phoenix Effect is explained by temporary local improvements in the microcirculation of the CFN vasa nervorum.</p><p><strong>Trial registration: </strong>NCT06637046 10/10/2024 Retrospectively registered.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the balance and gait characteristics of subjects with generalized joint hypermobility residing in high-altitude using wearable devices: a cross-sectional study.","authors":"Mingwei Liu, Luqi Guo, Jinpeng Lin, Yuepeng Cai, Xiaofan Huang, Yue Wu, Yu Zhang, Shaobai Wang","doi":"10.1186/s12891-024-07883-3","DOIUrl":"https://doi.org/10.1186/s12891-024-07883-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the characteristics of balance and gait functions in Generalized Joint Hypermobility (GJH) subjects residing in high-altitude areas.</p><p><strong>Methods: </strong>This study included 61 university students (28 with GJH and 33 healthy controls) all from the high-altitude region of Linzhi, Tibet Autonomous Region. The Riablo™ wearable intelligent rehabilitation assessment and training system was used to assess static balance (with eyes open and closed) and gait function (during flat walking) in both groups.</p><p><strong>Results: </strong>Compared to healthy subjects, GJH subjects exhibited significantly impaired balance, indicated by an increased distance of the center of pressure position from the ideal center of gravity(EO: P = 0.007, EC: P = 0.031) and greater amplitude of center of pressure displacements (EO: P = 0.043, EC: P = 0.032). Gait velocity(P = 0.007), stride length(P = 0.012), and swing stance phase of the gait cycle(P = 0.046) were significantly reduced in GJH subjects compared to healthy subjects. A significant increase in the flat-foot phase of the gait cycle(P = 0.022) was observed in GJH subjects compared to healthy subjects.</p><p><strong>Conclusion: </strong>The current study demonstrated that GJH subjects residing in high-altitude areas exhibit impairments in balance and gait, providing a basis for training and prevention strategies tailored for this population. And this study used the wearable intelligent rehabilitation evaluation and training system in high-altitude areas, providing methodological references for scientific research on balance and gait function under non laboratory conditions.</p><p><strong>Trial registration: </strong>Controlled Trials No.102772023RT133, Registered 13 October 2023.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influencing factors analysis of asymmetry in knee adduction moment among patients with unilateral knee osteoarthritis.","authors":"Yongjie Li, Runxin Luo, Shuwen Luo, Mengling Liu, Hongju Liu","doi":"10.1186/s12891-024-07956-3","DOIUrl":"https://doi.org/10.1186/s12891-024-07956-3","url":null,"abstract":"<p><strong>Background: </strong>The knee adduction moment(KAM) of both lower limbs in patients with unilateral knee osteoarthritis(KOA) exhibits asymmetry during walking, but the factors influencing this asymmetry remain unclear. This study aimed to explore the influencing factors of KAM asymmetry in patients with unilateral KOA.</p><p><strong>Methods: </strong>A total of 148 patients with unilateral medial compartment KOA were selected for this retrospective study, and general data such as gender, age, and duration of disease were collected. The hip-knee-ankle (HKA) angle, degree of pain, and knee-extension muscle strength on the affected side were assessed through radiographic outcomes, the visual analog scale(VAS), and the Biodex isokinetic system. The peak KAM of both lower limbs was analyzed using a BTS motion-capture system and force platform. The asymmetry index(ASI) of KAM was calculated, and the patients were further categorized into the KAM symmetry group(ASI value ≤ 10%) and the KAM asymmetry group(ASI value>10%).Binary logistic regression analysis was employed to analyze the factors influencing the asymmetry of KAM.</p><p><strong>Results: </strong>90 patients were categorized into the KAM asymmetry group, representing 60.8% of the cohort. A significant difference in the ASI value of KAM was observed between the two groups. Correlation analysis identified nine factors, including sex, age, and BMI, that were positively correlated with the ASI value of KAM. In contrast, knee-extension muscle strength and per-capita monthly household income were negatively correlated with the ASI value of KAM. Regression analysis revealed that being female(OR = 1.752), older age(OR = 2.472), increased BMI(OR = 1.535), larger varus angle(OR = 3.965), higher VAS score(OR = 2.617), Kellgren-Lawrence(K-L) grade IV(OR = 4.474), history of knee joint trauma(OR = 5.684), and living in a rural location(OR = 1.554) increased the risk of KAM asymmetry. Conversely, increased knee-extension muscle strength(OR = 0.758) and a per-capita monthly household income of 3000 ~ 6000 yuan(OR = 0.814) decreased the risk of KAM asymmetry.</p><p><strong>Conclusion: </strong>Female gender, older age, increased BMI, larger varus angle, higher VAS score, K-L grade IV, history of knee joint trauma, and living in a rural location are identified as risk factors for KAM asymmetry. Conversely, increased knee-extension muscle strength and a per-capita monthly household income of 3000 ~ 6000 yuan serve as protective factors against this asymmetry.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced bone cement distribution in percutaneous vertebroplasty using a curved guide wire: a propensity score matching analysis.","authors":"Xuyan Hu, Zijin Zhang, Yisong Yang, Gang Zhang, Shen Cao, Bing Yu, Yubing Zhang","doi":"10.1186/s12891-024-07951-8","DOIUrl":"https://doi.org/10.1186/s12891-024-07951-8","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fractures (OVCF) severely affect the quality of life in the aged population. Percutaneous vertebroplasty (PVP) alleviates pain and stabilizes vertebrae, but suboptimal bone cement distribution can cause complications. Hence, this study aimed to clarify whether a new technique for PVP, using a curved guide wire, enhances the distribution of bone cement and improves clinical outcomes in patients with OVCF.</p><p><strong>Methods: </strong>Patients with single-segment OVCF underwent PVP or curved guide wire percutaneous vertebroplasty (C-PVP). Propensity score matching (PSM) was employed to balanced the baseline characteristics. The primary outcomes were the visual analog scale (VAS) and Oswestry disability index (ODI) scores. The secondary outcomes included assessments of bone cement distribution, bone cement injection volume, radiological parameters, and general clinical results. Additionally, Complications and adverse events were documented.</p><p><strong>Results: </strong>After PSM analysis, each group comprised 54 patients, which significantly reduced baseline differences. The C-PVP group showed better clinical outcomes compared to the traditional PVP group. One month after surgery, the C-PVP group had significantly lower VAS and ODI scores (p < 0.001). These improvements persisted at six months and the final follow-up. Additionally, bone cement distribution scores were better (p < 0.001), injection volume was higher (p = 0.03), leakage was less frequent (p = 0.02), and adjacent vertebral fractures occurred less frequently (p = 0.04) in the C-PVP group. Radiological parameters and overall clinical outcomes revealed no significant differences between the two groups.</p><p><strong>Conclusion: </strong>The use of curved guide wire in PVP significantly improves bone cement distribution and injection volume, resulting in better clinical efficacy in patients with OVCF.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening of hub genes for sepsis-induced myopathy by weighted gene co-expression network analysis and protein-protein interaction network construction.","authors":"Jianhao Wang, Kun Han, Jinshuai Lu","doi":"10.1186/s12891-024-07967-0","DOIUrl":"https://doi.org/10.1186/s12891-024-07967-0","url":null,"abstract":"<p><p>Sepsis-induced myopathy is one of the serious complications of sepsis, which severely affects the respiratory and peripheral motor systems of patients, reduces their quality of life, and jeopardizes their lives, as evidenced by muscle atrophy, loss of strength, and impaired regeneration after injury. The pathogenesis of sepsis-induced myopathy is complex, mainly including cytokine action, enhances free radical production in muscle, increases muscle protein hydrolysis, and decreases skeletal muscle protein synthesis, etc. The above mechanisms have been demonstrated in existing studies. However, it is still unclear how the overall pattern of gene co-expression affects the pathological process of sepsis-induced myopathy. Therefore, we intend to identify hub genes and signaling pathways. Weighted gene co-expression network analysis was our main approach to study gene expression profiles: skeletal muscle transcriptome in ICU patients with sepsis-induced multi-organ failure (GSE13205). After data pre-processing, about 15,181 genes were used to identify 13 co-expression modules. Then, 16 genes (FEM1B, KLHDC3, GPX3, NIFK, GNL2, EBNA1BP2, PES1, FBP2, PFKP, BYSL, HEATR1, WDR75, TBL3, and WDR43) were selected as the hub genes including 3 up-regulated genes and 13 down-regulated genes. Then, Gene Set Enrichment Analysis was performed to show that the hub genes were closely associated with skeletal muscle dysfunction, necrotic and apoptotic skeletal myoblasts, and apoptosis in sepsis-induced myopathy. Overall, 16 candidate biomarkers were certified as reliable features for more in-depth exploration of sepsis-induced myopathy in basic and clinical studies.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A M-PEEK rod system to stabilize spinal motion after graded facetectomy: a finite element study.","authors":"Yi-An Li, Shih-Liang Shih, Hsin-Chang Chen","doi":"10.1186/s12891-024-07949-2","DOIUrl":"https://doi.org/10.1186/s12891-024-07949-2","url":null,"abstract":"<p><strong>Background: </strong>Resecting the facet joint to relieve nerve pain can lead to spinal instability, deformity, and abnormal pressure on the anterior of the intravertebral disc. To mitigate these issues, surgeons often limit the amount of bone removed during facetectomy or stabilize the spine by fusion to maintain lumbar stability. This study aimed to assess how a M-PEEK rod system influenced the stability of the lumbar spine during graded facetectomy.</p><p><strong>Methods: </strong>Facetectomy was performed on a validated L1-L5 finite element model which was then simulated both with and without the M-PEEK rod system.</p><p><strong>Results: </strong>In extension, models implanted with M-PEEK in the interspinous space of L3/L4 experienced a 35.2% decrease in range of motion (ROM) at L3/L4, while others saw an 8.4-24.8% increase. For axial rotation, the ROM at L3/L4 increased by 2.2-5.4% in models with the M-Rod, and by 4.9-12.9% in models without the implant. In lateral flexion, the ROM at L3/L4 increased by 8.4-14.3% in models without a PEEK M-Rod (facetectomy only), with adjacent segments experiencing a 6.5% decrease in ROM in the implanted models. Overall, the difference in ROM between the intact and implanted models was minimal.</p><p><strong>Conclusions: </strong>Facetectomy involving the removal of 50% or more of the facet joint significantly increases range of motion and maximum intradiscal pressure, potentially accelerating disc degeneration, as shown in our finite element study. Stabilizing the segment with an M-PEEK rod may limit excessive motion, providing stability and maintaining intradiscal pressure closer to that of an intact model.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement properties of the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score in patients with chronic low back pain.","authors":"Claudia Regina Moya, Tatiane da Silva, Leonardo Oliveira Pena Costa","doi":"10.1186/s12891-024-07946-5","DOIUrl":"https://doi.org/10.1186/s12891-024-07946-5","url":null,"abstract":"<p><strong>Background: </strong>A task force from the US National Institute of Health aimed to establish parameters for surveys with patients with chronic low back pain (LBP) by recommending the use of the Patient-Reported Outcome Measurement Information System 29-item (PROMIS-29) questionnaire and the stratification according to the Impact Score. We aimed to assess the internal consistency, reliability, measurement error, construct validity and responsiveness of the Brazilian-Portuguese version of the PROMIS-29 questionnaire (version 2.1) and the Impact Score in patients with chronic LBP.</p><p><strong>Methods: </strong>A prospective cohort study was carried out with patients with chronic LBP who were receiving physiotherapy treatment in clinics in São Paulo and Vitória cities, Brazil. The sample included 102 patients with chronic LBP, aged between 18 and 80 years, and with the ability to read and write in the Brazilian-Portuguese language. Exclusion criteria were patients with serious spinal conditions, cognitive impairment, pregnant women, and patients who had undergone lumbar surgery within the past six months. The PROMIS-29 questionnaire, the 12-item Short-Form Health Survey and the Roland-Morris Disability Questionnaire were applied. The PROMIS-29 questionnaire was reapplied after 24 hours and 4 weeks.</p><p><strong>Results: </strong>The PROMIS-29 questionnaire showed Cronbach's Alpha values between 0.81 (anxiety) and 0.91 (depression). The ICC_2.1 ranged from 0.85 (95% CI: 0.77 to 0.89) to 0,97 (CI 95%: 0.95 to 0.98). The SEM values ranged between 0.85 (physical function) and 2.62 (ability to participate in social roles and activities). The Impact Score showed Cronbach's Alpha, ICC_2.1 and SEM values of 0.91, 0.97 (95% CI: 0.95 to 0.98) and 0.56, respectively. The PROMIS-29 questionnaire and the Impact Score showed sufficient construct validity. The PROMIS-29 questionnaire showed moderate responsiveness, while the Impact Score showed sufficient responsiveness.</p><p><strong>Conclusions: </strong>Both the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score showed sufficient internal consistency, reliability, construct validity and responsiveness in Brazilian patients with chronic LBP. The results support the US National Institutes of Health's recommendation to use the PROMIS-29 questionnaire and the Impact Score in patients with chronic LBP. We suggest that future studies evaluate the structural validity of the Brazilian-Portuguese version of the PROMIS-29 questionnaire.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervention for impending pathological fractures at proximal femur is associated with lower mortality rates in patients with intermediate-to-high risk according to the Katagiri-New score.","authors":"Toshiyuki Nishimoto, Hirokazu Shimizu, Masatake Matsuoka, Daisuke Takahashi, Tomohiro Shimizu, Norimasa Iwasaki, Ken Kuwahara, Tamotsu Soma, Hiroaki Hiraga, Akira Iwata","doi":"10.1186/s12891-024-07838-8","DOIUrl":"https://doi.org/10.1186/s12891-024-07838-8","url":null,"abstract":"<p><strong>Background: </strong>Prophylactic intervention for impending pathological fractures (IF) is associated with improved survival in patients with long-bone metastasis. However, information regarding whether the tumor burden and/or physical status are associated with survival benefits of intervention for IF is lacking.</p><p><strong>Methods: </strong>This multicenter retrospective study investigated 121 patients who underwent surgery for 63 impending and 58 complete metastatic fractures of the proximal femur between 2008 and 2023. After matching for age, sex, body mass index, and Katagiri-New score, 42 patients with IF were compared with 42 patients with complete pathological fractures. The 1-year mortality rate was considered the primary outcome, and was compared and stratified by risk based on the Katagiri-New score. The 1-year mortality rate was evaluated according to the surgical method in the subgroup analysis of patients with IF.</p><p><strong>Results: </strong>The 1-year mortality rate was significantly lower in patients with IF with intermediate-to-high risk(p = 0.04), whereas no difference was observed in patients with low-to-high risk. IF was associated with a significantly higher rate of home discharge (p < 0.01) and improved post-operative ambulatory function (p = 0.07). The subgroup analysis of patients with IF revealed no difference in the survival rate between nailing and hemiarthroplasty.</p><p><strong>Conclusion: </strong>Patients with intermediate-to-high risk IF based on the Katagiri-New score had a lower mortality rate than those who underwent surgery for pathological fractures. A higher rate of home discharge was observed in patients with IF. Based on the Katagiri-New score, survival benefits can be obtained from prophylactic intervention for IF of the proximal femur in patients with intermediate-to high-risk.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical intervention for distal radial fractures with concurrent ulnar styloid fractures may be beneficial for the elderly patients: a retrospective study.","authors":"Yong Kuan Lim, Wen-Tien Wu, Cheng-Huan Peng, Ting-Kuo Yao, Chia-Ming Chang, Hao-Wen Chen, Tzai-Chiu Yu, Ing-Ho Chen, Jen-Hung Wang, Ya-Chu Chang, Kuang-Ting Yeh","doi":"10.1186/s12891-024-07964-3","DOIUrl":"10.1186/s12891-024-07964-3","url":null,"abstract":"<p><strong>Background: </strong>Distal radius fractures are highly prevalent among older adults. Ulnar styloid fractures frequently accompany distal radius fractures, raising concerns about treatment outcomes due to the risk of distal radioulnar joint (DRUJ) instability. This study investigated the necessity of surgical intervention (open reduction internal fixation; ORIF) for distal radius fractures in very old patients with coexisting ulnar styloid fractures.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 96 patients aged ≥ 80 years with AO classification 23-A2 to 23-B3 distal radius fractures with concomitant ulnar styloid fracture between 2019 and 2022 was performed. Patients were excluded if they were aged < 80 years, had a preinjury Barthel index of < 90, or had high-energy multiple trauma. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score assessed at 3, 6, and 12 months. We compared the DASH score and their trajectories between the ORIF and conservative treatment groups.</p><p><strong>Results: </strong>ORIF group demonstrated significantly better DASH functional scores (25.31 ± 4.71) at the 12-month follow-up compared with the conservative group (34.42 ± 8.03; p < 0.001). Treatment choice was identified as a significant predictor of DASH scores at 12 months, with ORIF significantly improved patient's wrist function and demonstrated a β coefficient of - 9.11 (95% confidence interval: -11.95 to - 6.27, p < 0.001). The other factors investigated, namely age, lowest T-score, and medical history of diabetes mellitus, hypertension, coronary artery disease, cerebrovascular accidents, cancer, and dementia, did not exhibit a significant association with the 12-month DASH scores in the adjusted model (p > 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that very old patients with distal radius fracture accompanied by ulnar styloid fractures may benefit from ORIF to achieve optimal long-term functional recovery.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synoviocyte detachment: an overlooked yet crucial histological aspect in rheumatoid arthritis.","authors":"Bihua Wang, Jianbin Li, Yiping Huang, Rui Wu","doi":"10.1186/s12891-024-07935-8","DOIUrl":"10.1186/s12891-024-07935-8","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is a prevalent autoimmune disorder that leads to chronic joint inflammation, deformity, disability, and systemic complications. This study aimed to analyze the clinical characteristics and synovial pathology of RA patients with synoviocyte detachment, and explore the factors associated with this phenomenon.</p><p><strong>Methods: </strong>This was a retrospective cohort study included RA patients who underwent synovial biopsy at our center from April to September 2023. Demographic, clinical, laboratory, and synovial histological data were retrospectively collected from medical records at the time of joint synovial biopsy in patients. Microscopic examination of hematoxylin and eosin (HE)-stained synovial tissue sections categorized the samples into synoviocyte detachment and no-synoviocyte detachment groups. Clinical characteristics and synovial pathological changes were compared between the two groups, and the factors associated with synoviocyte detachment were explored through logistic regression analysis.</p><p><strong>Results: </strong>Fifty-five RA patients were enrolled; 45 were females, and the mean age was 53.4 ± 11.8 years. Nine RA patients exhibited synoviocyte detachment. A total of 46 RA patients in the no-synoviocyte detachment group (15 with a normal lining layer and 31 with synovial cell proliferation) were included. Compared with the no-synoviocyte detachment group, the synoviocyte detachment group presented higher RF, ESR, CRP and DAS28-CRP levels (P < 0.05). The synoviocyte detachment group exhibited more prominent neovascularization (P < 0.05). ESR, DAS28-CRP and synovial neovascularization were risk factors associated with synoviocyte detachment in RA patients.</p><p><strong>Conclusion: </strong>RA patients with synoviocyte detachment exhibit elevated clinical disease activity, marked by pronounced synovial pathology featuring increased neovascularization and less inflammatory cell infiltration. A significant reduction in lymphocyte count compared with patients with synovial cell proliferation was also observed.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}