Current Issue : July - September Volume : 2021 Issue Number : 3 Articles : 8 Articles
Background. To evaluate the clinical and radiological results of closed reduction, distraction using an external fixator, and percutaneous fixation in patients with Bennet and Rolando fractures. Methods. Patients over 18 years of age, who had isolated fracture at the base of the first metacarpal bone, had no previous functional limitations and pain complaints, were regularly followed up, and had fixation using K-wire combined with an external fixator, were included. Arthrosis was evaluated according to Eaton and Littler classification. Pain intensity was evaluated using the visual analogue scale (VAS) on a 0–10 scale. Furthermore, patients were questioned regarding limitations in their daily activities and hobbies. Pinch and grasp strengths were evaluated. Results. *irteen of the patients were male and five were female, with a mean age of 31.5 ± 12.5 years. *e surgical procedure was performed on the right extremity in 12 patients and left extremity in six patients. Twelve patients were found to have Bennet fractures, whereas six patients had Rolando fractures. *e mean follow-up period of the patients was found to be 29.6 ± 5.4 months. *e VAS score was rated as 2 in one patient and 1 in one patient. Other patients had a pain VAS score of 0. *e mean Quick-DASH score was calculated to be 1.20. No statistical difference was found in pinch strength between the two extremities (p > 0.05). No difference was observed in terms of the range of motion (p > 0.05). Conclusion. Fixation using K-wire combined with an external fixator has more benefits than its disadvantages and is superior to other methods in the intra-articular fractures of the first metacarpal bone....
Background. Fractured stem of the hip prosthesis is well documented in the literature. Although it is rare, it is considered as a challenging problem. Many techniques have been described to solve this problem. Purpose of the Study. Evaluation of the effect of anterolateral bone window for extraction of the cemented femoral stem of hemiarthroplasty in revision total hip replacement. Methods. (e study included eight revision hip arthroplasties in eight patients, with a broken stem of cemented ((ompson) hemiarthroplasty, which has been revised by the anterolateral proximal femoral window. All cases received cemented cups and cement-in-cement stems, except one case who received cementless long stem. Clinical follow-up of cases by Harries hip score (HHS) and X-ray. Results. Functional improvement of HHS of all cases, with no signs of loosening, after a mean follow-up period of 1.5 years. Conclusion. Extraction of broken stem is a challenging procedure. Many techniques have been described for revision of cases with a fractured stem of hip prosthesis, but we think that the anterolateral femoral bone window is a reproducible technique due to the characteristics of simplicity, short-time procedure, less invasive, not requiring extra instruments, and can be successful for most patients....
Background. Fall-related injury is the common cause of unintentional injury and premature death among people with visual impairment. So far, the knowledge about fall-related injuries among medically diagnosed visual impairment people living in lowand middle-income countries is scarce. Hence, this study is a preliminary attempt to assess the fall-related injury and its determinants among adult people with medically diagnosed visual impairment individuals. Methods. An institutional-based crosssectional study was conducted from March to July 2018 with a total sample size of 337 study participants. ,e study participants were recruited by using a systematic random sampling method. Univariable and multivariable binary logistic regression model analysis was used to identify predictors of fall-related injuries with IBM Statistical Package for Social Sciences version 23. Results. A total of 320 adults with visual impairments participants have participated in this study. ,e finding of this study was reported as follows: 24.7% of (95% CI: 20.0–29.4%) adults with visual impairments experienced one or more fall-related injuries. ,e main predictors of fall-related injuries identified by multivariate analysis were severity of visual impairment: moderate (AOR, 2.91; 95% CI: 1.23 – 6.87), severe (AOR, 3.58; 95% CI: 1.26–10.17), cause of visual impairment: cataract (AOR, 10.63; 95% CI: 2.49 – 45.26), diabetic retinopathy (AOR, 15.35; 95% CI: 2.51–93.96), taking medication (AOR, 6.35; 95% CI: 2.93–13.75), having family support (AOR, 2.13; 95% CI: 1.08 – 4.19), and depression (AOR 3.82, 95% CI: 1.27–11.45). Conclusion. Soft tissue injuries were the most common fall-related injuries reported by the study participants. ,e severity of visual impairment, the cause of visual impairment, taking one or more medication, having family support, and having depression were significant predictors of fall-related injuries....
Introduction. Expectations for limb length differences after TKA are important for patient perception and outcomes. Limb length discrepancies may occur due to postoperative leg length increases, which can lead to decreased patient functionality and satisfaction and even possible litigation. 'e purpose of this study is to examine the frequency and extent of limb lengthening among various preoperative deformities and between two different implant systems. Methods. Preoperative and postoperative full-length standing radiographs were obtained between August 2018 and August 2019 to measure mechanical axis and limb length of operative limbs. Demographic information such as age, sex, and BMI was also collected. Patients were grouped into categories for pre- and postoperative subgroup analysis: valgus, varus, customized implant, and conventional implant. Regression analysis was performed to evaluate significant relationships. Results. Of the 121 primary TKAs analyzed, 62% of the knees showed an increase in limb length after TKA, with an average lengthening of 5.32 mm. Preoperative varus alignment was associated with a mean lengthening of 3.14 mm, while preoperative valgus alignment was associated with a mean lengthening of 16.2 mm. Overall, there were no statistically significant differences in limb lengths pre- and postoperatively (p � 0.23) and no significant changes in limb length for any subgroup. Further, no variables were associated with limb length changes (p � 0.49), including the use of customized implants (p � 0.2). Conclusions. Limb lengthening after TKA is common and, on average, occurs more significantly in valgus knees. No significant difference in limb lengthening could be demonstrated using customized over conventional implants. Preoperative counseling is important to manage patient expectations....
Introduction: During the 19th and 20th centuries, the Wars were the cause of many amputations among military and civilians. Despite the absence of armed conflict in our country, we notice a high frequency of major amputations in our activity. Objective: The aim of this work was to study the causes of major amputations observed in our practice in order to develop preventive measures. Materials and Method: This was a descriptive retrospective study over a 6-year period, from January 1, 2008 to December 31, 2014. The following parameters were studied: epidemiological aspects (age according to WHO age groups and gender of patients), type of amputation, level of amputation and causes. Results: Two hundred and fifty-two patients were included. The distribution of amputations by cause and age group showed two distinct entities: The forms of the young subject where there was a predominance of tumour and traumatic causes; and the forms of the elderly person caused by vascular infections and conditions. Infections were the main cause of amputation in both sexes. Conclusion: The causes of major limb amputations vary according to age and limb: tumor and trauma in young people and for the upper limb, infectious and vascular in the elderly and for the lower limb....
Purpose. Elevation of the sural artery flap with the sural nerve is associated with donor-site morbidities, such as postoperative sensory disturbance of the lower extremity. We evaluated the sensory disturbance of the lower extremity after elevation of the sural artery flap. Methods. +is study included 7 patients who underwent surgery using the sural artery flap. +e sensory disturbances immediately after surgery and at present were evaluated on a 10-point scale. +e influences of surgery on activities of daily living and patient satisfaction were also evaluated. Results. +e sensory disturbance was 4.48 immediately after surgery and 2.24 presently, and the difference between the timepoints was not statistically significant. +e influence of surgery on activities of daily living was 2.30, and the patient satisfaction was 7.90. Conclusion. It may be necessary to consider the sural artery flap, which does not include the sural nerve, to avoid unnecessary complications. When it is unavoidable to use the sural artery flap, including the sural nerve, it is important to thoroughly inform patients beforehand about the postsurgery sensory disturbance in the lower extremities....
Objectives. -e necessity of fibular fixation in distal tibia-fibula fractures remains controversial. -is study aimed to assess its impact on radiographic outcomes as well as rates of nonunion and infection. Methods. A systematic search of the electronic databases of PubMed, Embase, and Cochrane library was performed to identify studies comparing the outcomes of reduction and internal fixation of the tibia with or without fibular fixation. Radiographic outcomes included malalignment and malrotation of the tibial shaft. Data regarding varus/valgus angulation, anterior/posterior angulation, internal/external rotation deformity, and the rates of nonunion and infection were extracted and then polled. A meta-analysis was performed using the random-effects model for heterogeneity. Results. Additional fibular fixation was statistically associated with a decreased rate of rotation deformity (OR � 0.13; 95% CI 0.02–0.82, p � 0.03). However, there was no difference in the rate of malreduction between the trial group and the control group (OR � 0.86; 95% CI 0.27–2.74, p � 0.80). -ere was also no difference in radiographic outcomes of varus-valgus deformity rate (OR � 0.17; 95% CI 0.03–1.00, p � 0.05) or anterior-posterior deformity rate (OR � 0.76; 95% CI 0.02–36.91, p � 0.89) between the two groups. Meanwhile, statistical analysis showed no significant difference in the nonunion rate (OR � 0.62; 95% CI 0.37–1.02, p � 0.06) or the infection rate (OR � 0.81; 95% CI 0.18–3.67, p � 0.78) between the two groups. Conclusions. Additional fibular fixation does not appear to reduce the rate of varus-valgus deformity, anterior-posterior deformity, or malreduction. Meanwhile, it does not appear to impair the union process or increase the odds of infection. However, additional fibular fixation was associated with decreased odds of rotation deformity compared to controls....
Malignant musculoskeletal tumour may cause considerable burden to general health. (e fast growth combined with the tumour characteristics and its invasion capability resulted in the poor prognosis of malignant musculoskeletal tumour. Malignant musculoskeletal tumour may cause significant disability by destroying normal tissue that plays important role in body kinematics. (romboembolism, including deep vein thrombosis, pulmonary embolism, and other kinds of venous thromboembolism, is one of the most underestimated complications of musculoskeletal tumour. Normally, thrombosis ensues when pathologic factors overcame the body hemostatic regulatory capabilities, which will predispose the body to the formation of thrombus. Venous thromboembolism in musculoskeletal tumour may develop as a result of interaction between the tumour pathologic capabilities and its interaction with normal bodily functions. In this study, we reviewed the burden of musculoskeletal tumour and its complication on global health. (en, the review will focus on the pathologic and clinical aspect of thromboembolism in malignant musculoskeletal tumour, including pathophysiology, diagnosis, and treatment based on recent findings and literature....
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