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1.
Hakan Çiçek Ümit Tuhanioğlu Hasan Ulaş Oğur Fırat Seyfettinoğlu Murat Bozkurt 《Acta orthopaedica et traumatologica turcica》2018,52(2):92-96
Introduction
Patients with Su Type III fractures based on total knee arthroplasty (TKA) constitute a patient group with problematic treatment and management. Although it has difficulties, open reduction and internal fixation is one of the treatment options.Method
A retrospective evaluation was made of 22 patients surgically treated in our clinic with double locking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. The patients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS), WOMAC and radiological evaluations.Results
The mean follow-up period of the patients was 68.6 ± 15.5 months, with pain-free weight-bearing determined at 4.9 ± 1.1 months and mean radiological union at 18.5 ± 4.3 weeks. Revision was required because of non-union in 2 (9.09%) cases. The postoperative KSS value was 81.8 ± 7.8, the WOMAC value was 78.1 ± 5.3 and the T-score was ?3.3 ± 0.3. At the final follow-up examination, a correction loss (4.9° ± 1.5°) was determined in the mean knee valgus angle according to the mechanical axis, which was statistically significant but remained within the physiological limits (p = 0.21).Conclusion
In addition to providing the advantages of rigid fixation together with early and effective rehabilitation, satisfactory clinical and radiological results were obtained with the application of double locking plate and screw in the treatment of periprosthetic femoral fractures based on TKA, with osteoporosis.Level of evidence
Level IV, Therapeutic study. 相似文献2.
Hiroki Oba Takahiro Tsutsumimoto Mutsuki Yui Takayuki Kamanaka Hiroshi Ohta Hidemi Kosaku Hiromichi Misawa 《Journal of orthopaedic science》2017,22(4):670-675
Background
Residual leg numbness (LN) following lumbar surgery can lower patient satisfaction; however, prospective studies are sparse. The purpose of this study was to evaluate recovery from LN following decompression surgery for lumbar spinal stenosis (LSS).Methods
A total of 145 patients with LSS were enrolled. All patients underwent decompressive surgery, with or without spinal fusion, followed by a 12 month prospective follow-up. The degree of LN and leg pain (LP) was assessed using the visual analog scale (VAS), a patient-reported outcome measure.Results
Six patients dropped out, and we evaluated 139 patients (average age, 68.1 years). The average VAS-LN scores were 5.9 ± 2.6, 1.8 ± 2.3, 2.0 ± 2.5, 2.1 ± 2.6, 2.2 ± 2.5, and 2.1 ± 2.6, and the average VAS-LP scores were 5.7 ± 2.8, 1.2 ± 1.7, 0.9 ± 1.5, 1.4 ± 2.0, 1.4 ± 2.0, and 1.4 ± 1.9 preoperatively and at 2 weeks, 3, 6, 9, 12 months following the surgery, respectively. Significant improvement in VAS-LN and VAS-LP scores was observed during the first 2 weeks after the surgery. At 12 months after the surgery, the VAS-LN score was significantly greater than the VAS-LP score. The change in the VAS-LN score between the preoperative and 12 month-postoperative values was significantly smaller than that in the VAS-LP score. Multivariate logistic analyses revealed that preoperative symptom duration and preoperative dural sac cross-sectional area (DCSA) were the significant independent predictive factors for residual LN.Conclusions
Following lumbar decompression surgery, LN improved significantly during the first 2 weeks after surgery. However, the improvement in the VAS-LN score was less than in the VAS-LP score. Patients with longer preoperative symptom duration and narrow preoperative DCSA showed less LN improvement.Level of evidence
Level 3. 相似文献3.
Tao Zhang Jianzhong Hu Jianhuang Wu Jinyang Liu Shuangfei Ni Chunyue Duan 《Acta orthopaedica et traumatologica turcica》2018,52(4):277-282
Objective
The aim of this study was to evaluate the clinical outcomes of one-stage posterior debridement, interbody fusion, and instrumentation, combined with irrigation and drainage, for treating lumbar spondylodiscitis.Methods
The study included 23 patients (13 male and 10 female, mean age: 45 years) who had posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage for lumbar postoperative spondylodiscitis. The visual analog scale, Oswestry disability index, and lumbar lordosis angle were assessed before and after surgery to evaluate the clinical outcome.Results
The mean follow-up time was 27 (24–36) months. All patients tolerated the procedure well, and there were no instances of spondylodiscitis recurrence, though a dorsal dermal sinus developed in one patient after surgery. Infection was eliminated, as evidenced by the normalization of the erythrocyte sedimentation rates and C-reactive protein levels. The mean visual analog scale scores were significantly decreased after the operation. The mean lumbar lordosis angle before surgery was 21.61 ± 6.88° and the angle at the final follow-up was 31.61 ± 4.24°. The mean Oswestry disability index scores improved significantly both after the operation and at the follow-up visits (p < 0.05). Bone union was confirmed in all patients at a mean of 8.6 months post-operation, though this was not achieved until 2 years post-operation in one patient. All 3 patients who had neurological deficits showed great improvement at the last follow-up.Conclusion
Surgical management using one-stage posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage, might be an effective treatment option for lumbar postoperative spondylodiscitis.Level of evidence
Level IV, Therapeutic study. 相似文献4.
Victor R. Carlson Zachary D. Post Fabio R. Orozco Destiny M. Davis Rex W. Lutz Alvin C. Ong 《The Journal of arthroplasty》2018,33(3):700-703
Background
The forgotten joint score (FJS) is a recent scoring system that assesses how natural the prosthesis feels after total joint arthroplasty. Although the FJS has been extensively applied in populations with total hip prosthetics, less is known about the patients undergoing total knee arthroplasty (TKA). The purpose of this study is to investigate the temporal relationship between TKA and the FJS.Methods
We evaluated 566 patients after TKA using the FJS questionnaire. Scores were calculated at the follow-up intervals of 1 (n = 79), 6 (n = 78), 12 (n = 81), 24 (n = 100), 36 (n = 76), 48 (n = 75), and 60 (n = 77) months. The scores ranged from 0-100, with a higher score indicating a more natural or “forgotten” joint.Results
Postoperative FJS averages were 39.3 ± 27.4 at 1 month, 59.4 ± 28.3 at 6 months, 72.5 ± 24.2 at 1 year, 76.4 ± 23.4 at 2 years, 75.1 ± 24.2 at 3 years, 68.6 ± 28.7 at 4 years, and 64.4 ± 29.0 at 5 years. The average score at 1 month was significantly lower than the average scores at all other intervals. The average score at 6 months was significantly lower than the average scores at 12, 24, and 36 months. The average score at 60 months was significantly lower than the average score at 24 months.Conclusion
Based on the findings of this study, patients can expect marked improvement in the natural feel of the prosthesis during the first year after TKA, slight continued improvement at 2 and 3 years, and a decline after 4 years. 相似文献5.
Ali Cagdas Yorukoglu Ahmet Fahir Demirkan Nihal Buker 《Acta orthopaedica et traumatologica turcica》2018,52(4):294-298
Objective
The aim of this study was to describe an alternative fixation method for distal humeral extra-articular fractures through posterior approach using distal tibia anatomic locking plate; and to evaluate the patient's functional outcome and union condition.Methods
Eighteen patients (11 men and 7 women; average age of 37.0 ± 17.3 years (range: 18–73 years)) with a distal humeral extra-articular fracture who were treated with distal tibial medial locking plate were included into the study. The mean follow up time was 36.2 ± 16.7 (12–57) months. Functional results were evaluated with perception of pain, range of joint motion, grasp and pinch strengths.Results
Union was achieved in 17 of 18 patients. Only one patient had non-union due to infection and underwent debridement. The mean time for union was 7.8 ± 5.9 months (2–20). Patient perception of pain was X = 1.88 ± 2.50 and X = 4.55 ± 2.68, respectively, at rest and activity. The active ranges of joint motion were adequate for functional use. General functional state of affected extremity (DASH-T) was perfect (X = 27.14 ± 25.66), the performance of elbow joint was good (X = 84.44 ± 11.57). There were no differences in the comparison of grasp and pinch grip of patients with uninvolved extremity (p > 0.05).Conclusions
In distal humeral extra-articular fractures, use of distal medial tibia plate has advantages such as providing high rates for union, low rates for complication, and early return to work with early rehabilitation, therefore it may be considered a fixation choice that can be used for distal humeral extra-articular fractures.Level of evidence
Level IV, therapeutic study. 相似文献6.
Emrah Kovalak Tolga Atay Cem Çetin İ. Meltem Atay Mustafa Onur Serbest 《Acta orthopaedica et traumatologica turcica》2018,52(1):37-43
Objective
Whether surgical or conservative treatment is more effective in allowing patients to return to physical activity after anterior cruciate ligament (ACL) injury is controversial. We sought to compare mid-term outcome measures between isolated ACL tear patients who underwent reconstruction followed by closed kinetic chain exercises and those who underwent neuromuscular training only.Methods
We retrospectively evaluated patients with ACL tears who underwent post-surgery CKC strength training after ACL reconstruction (Group A), and patients who only underwent neuromuscular training (Group B) with a minimum follow-up time of 5 years. Surgical techniques, rehabilitation, assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile of the patient were evaluated.Results
Overall, 43 patients were included in Group A (mean age, 32.56 ± 4.89; Tegner activity scale, 5) and 39 patients in Group B (31.67 ± 7.27; 5). Patients in both groups returned to their regular physical activity level after a similar time frame (Group A: average, 12 months; Group B, average, 13.4 months). The mean Lysholm knee score was 88.52 ± 7.65 in Group A and 86.21 ± 13.72 in Group B. Mean distances for the one-leg hop test for Group A were 135.21 ± 31.66 and 145.36 ± 42.10 mm in the reconstructed and uninjured knees, respectively. In Group B, the mean hop distances were 132.47 ± 28.13 and 147.89 ± 21.45 mm in the rehabilitated and uninjured knees, respectively. No statistical difference was observed between the groups for any of the parameters evaluated, including assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile.Conclusion
Our data suggest that early surgical reconstruction may not be a prerequisite to returning to recreational physical activities after injury in patients with ACL tears.Level of evidence
Level IV, therapeutic study. 相似文献7.
Takashi Namikawa Hiroshi Taneichi Satoshi Inami Hiroshi Moridaira Daisaku Takeuchi Yo Shiba Yutaka Nohara 《Journal of orthopaedic science》2017,22(3):415-419
Background
Hybrid constructs have been widely used to surgically correct thoracic adolescent idiopathic scoliosis (AIS). To enhance the correction obtained with hybrid constructs, we perform concave rib head resection and convex costovertebral release as posterior release procedures. The objective of the study was to evaluate coronal and sagittal curve correction in patients with adolescent idiopathic scoliosis (AIS) treated with hybrid constructs combined with concave rib head resection and convex transverse process resection as posterior release procedures.Methods
The records of 24 patients with Lenke type 1 or 2 AIS treated with hybrid constructs combined with posterior release procedures were retrospectively reviewed. The mean age at surgery was 14.3 years. The mean follow-up period was 33.0 months (range, 24–60 months). Radiographs were evaluated before surgery, immediately postoperatively, and at latest follow-up.Results
The average preoperative Cobb angle of the main thoracic (MT) curve was 58.1 ± 12.6° (range, 45–88°). The MT curve was corrected to 12.8 ± 9.0° (range, 0–38°) immediately after surgery. At the latest follow-up, the average Cobb angle was 13.6 ± 9.9° (range, 0–44°; correction, 77.5 ± 14.0%). The average loss of coronal correction was 0.8°. The average preoperative flexibility of the MT curve was 54.6 ± 17.4%. The average Cincinnati correction index was 1.53 ± 0.48 at the latest follow-up. The average preoperative thoracic kyphosis (TK) was 13.7 ± 12.0° (range, ?12–34°). Immediately after surgery, TK was corrected to 18.6 ± 5.9° (range, 10–29°). At the latest follow-up, TK measured 18.1 ± 6.5° (range, 6–32°).Conclusions
Hybrid instrumentation combined with concave rib head resection and convex transverse process resection as posterior release procedures achieved satisfactory coronal and sagittal curve correction with little loss of correction at 2-year follow-up. 相似文献8.
Hiroki Oba Jun Takahashi Takahiro Tsutsumimoto Shota Ikegami Hiroshi Ohta Mutsuki Yui Hidemi Kosaku Takayuki Kamanaka Hiromichi Misawa Hiroyuki Kato 《Journal of orthopaedic science》2017,22(4):641-646
Background
Lumbar decompression surgery is often used to treat neurological symptoms of the lower extremity as a result of lumbar disease. However, this method also leads to the improvement of the accompanying low back pain (LBP). We studied the extent of LBP improvement after lumbar decompression surgery without fusion and the associated preoperative factors.Methods
Patients (n = 140) with lumbar spinal stenosis (n = 90) or lumbar disc herniation (n = 50) were included. To evaluate the change in LBP, VAS scores and the Oswestry disability index scores were measured before surgery and 2 weeks, 3 months, and 6 months after surgery. The predictors of residual LBP were investigated using logistic regression analyses.Results
In total, 140 patients were examined. The VAS scores for LBP before surgery and 2 weeks, 3 months, and 6 months after surgery were 4.4 ± 3.0 (mean ± standard deviation), 1.1 ± 1.5, 1.3 ± 1.8, and 1.9 ± 2.2, respectively. LBP significantly improved 2 weeks after surgery (P < 0.001), stabilized between 2 weeks and 3 months after surgery, but was significantly aggravated 3–6 months after surgery (P < 0.001). At 6 months after surgery, 67 (47.9%) patients had a VAS score of >1. The predictors of residual LBP included severe preoperative LBP, degenerative scoliosis and the size of the Cobb angle. The independent predictors, determined by multivariate analysis were degenerative scoliosis and the size of the Cobb angle.Conclusions
LBP was alleviated at 2 weeks after lumbar decompression surgery for lumbar disc herniation and lumbar spinal stenosis. The predictors of residual LBP after decompression included more severe LBP at baseline, degenerative scoliosis and the size of Cobb angle.Level of evidence
Level 3. 相似文献9.
Objective
Besides severe organ shortage, hepatitis C virus (HCV) infection is an important obstacle for kidney transplantation because of long waiting times on deceased kidney donor waiting lists. We aimed to evaluate calling number of candidates according to HCV serology.Method
A total of 404 adults on the deceased donor waiting list invited for cadaveric transplantation was evaluated. Demographic data, waiting time, calling number for transplantation, and viral serology were obtained during the 6-year period.Results
Mean waiting duration and calling number of all patients were 42.7 ± 34 months and 1.56 ± 4.37 times, respectively. Twenty-six candidates had chronic HCV infection and 12 of 26 were HCV RNA–positive. Mean waiting duration and calling number in anti-HCV–positive candidates were significantly higher compared with anti-HCV–negative candidates (85.3 ± 38.8 vs 39.8 ± 31.6 months, and 10.8 ± 10.3 vs 0.92 ± 2.6 times, respectively; P < .001). Mean waiting duration and total calling number in HCV-RNA–positive candidates were significantly higher than in HCV-RNA–negative ones (107.5 ± 7.5 vs 66.2 ± 44.8 months; P = .018; 15 ± 9.7 vs 7.3 ± 9.8 times, respectively; P = .026).Conclusions
Chronic HCV infection is an important issue leading to longer waiting time on the list. Our observation showed that waiting durations of anti-HCV–positive candidates were longer than that of negative patients, although they had more frequent opportunity for transplantation. 相似文献10.
David S. Demos Mark F. Berry Leah M. Backhus Joseph B. Shrager 《The Journal of thoracic and cardiovascular surgery》2017,153(5):1182-1188
Objective
Surgeons have hesitated to adopt minimally invasive diaphragm plication techniques because of technical limitations rendering the procedure cumbersome or leading to early failure or reduced efficacy. We sought to demonstrate efficacy and durability of our thoracoscopic plication technique using a single running suture.Methods
We retrospectively reviewed patients who underwent our technique for diaphragm plication since 2008. We used a single, buttressed, double-layered, to-and-fro running suture with additional plicating horizontal mattress sutures as needed.Results
Eighteen patients underwent thoracoscopic plication from 2008 to 2015. There were no operative mortalities and 2 unrelated late deaths. Median hospital stay was 3 days (range, 1-12). Atrial fibrillation occurred in 1 patient (5.5%), pneumonia occurred in 2 patients (11%), reintubation occurred in 1 patient (5.5%), and ileus occurred in 1 patient (5.5%). Of 14 patients with complete follow-up, median follow-up was 29.4 months (range, 3.4-84.7). Significant increases between preoperative and postoperative pulmonary function tests (% predicted values) were found for mean forced expiratory volume in 1 second (73.5% ± 3.5% to 88.8% ± 4.5%, P = .002) and mean forced vital capacity (70.6% ± 3.5% to 82.3% ± 3.5%, P = .002). Preoperative mean Baseline Dyspnea Index was 8.1 ± 0.7. Mean Transitional Dyspnea Index 6 months postoperatively was 7.1 ± 0.6 (moderate to major improvement). Transitional Dyspnea Index at last contact (median 29.4 months postoperatively) was 7.2 ± 0.6 (P = .38). Compared with previously published results, this is at least equivalent.Conclusions
Thoracoscopic diaphragm plication with a running suture is safe and achieves excellent early and long-term improvements. This addresses technical challenges of tying multiple interrupted sutures by video-assisted thoracoscopic surgery without any apparent compromise to efficacy or durability. 相似文献11.
Nasibeh Vatankhah Younes Jahangiri Gregory J. Landry Robert B. McLafferty Nabil J. Alkayed Gregory L. Moneta Amir F. Azarbal 《Journal of vascular surgery》2017,65(2):478-483
Objective
The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds.Methods
The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer.Results
The subjects' mean age was 59.4 ± 13.0 years, and 67 (66%) were male. Final outcome was complete healing in 24 ulcers (20%), minor amputation in 58 (48%) and major amputation in 16 (13%), and 22 chronic ulcers (18%) at the last follow-up (median follow-up time, 6.8 months). In multivariate analysis, higher NLR (odds ratio, 13.61; P = .01) was associated with higher odds of nonhealing.Conclusions
NLR can predict odds of complete healing in diabetic foot ulcers independent of wound infection and other factors. 相似文献12.
Ko Matsudaira Hiroyuki Oka Norimasa Kikuchi Yuri Haga Takayuki Sawada Sakae Tanaka 《Journal of orthopaedic science》2017,22(2):224-229
Background
The STarT Back Tool classifies patients into low-, medium-, or high-risk groups according to risk for chronic low back pain. The Japanese version of the STarT Back Tool (STarT-J) has been translated and psychometrically validated. The present analysis investigated the predictive ability of the STarT-J.Methods
Baseline data were collected through an online survey conducted with Japanese patients with low back pain. Long-term outcomes were assessed in a 6-month follow-up survey. Clinical outcomes at 6 months were evaluated with a pain numerical rating scale, the Roland–Morris Disability Questionnaire, and the EuroQol 5 Dimension. Differences in these scores among the three STarT-J risk groups were analyzed. Participants' perceived changes in low back pain and overall health status were examined to determine associations between the chronicity of low back pain at 6 months and STarT-J risk groups.Results
Data of 1228 volunteers who responded to the baseline and follow-up surveys were included in this analysis. Mean ± standard deviation (SD) scores for the pain numerical rating scale and the Roland–Morris Disability Questionnaire were highest in the high-risk group (5.6 ± 1.9 and 9.6 ± 7.5) and lowest in the low-risk group (3.9 ± 1.6 and 2.1 ± 3.5). Mean ± SD EuroQol 5 Dimension index scores were lowest in the high-risk group (0.66 ± 0.20) and highest in the low-risk group (0.86 ± 0.14). A small percentage of high-risk patients (5.3%) perceived improvement in low back pain at the 6-month follow-up.Conclusions
The STarT-J predicted 6-month pain and disability outcomes. The STarT-J is an easy-to-use tool to screen for patients who are more likely to have chronic low back pain, and may be useful to initiate stratified care in primary care settings. 相似文献13.
Ger Bennink Sho Torii Marieke Brugmans Martijn Cox Oleg Svanidze Elena Ladich Thierry Carrel Renu Virmani 《The Journal of thoracic and cardiovascular surgery》2018,155(6):2591-2601.e3
Objective
To evaluate the safety and the short-term function of a novel pulmonary valved conduit (Xeltis Pulmonary Valved Conduit; XPV) up to 12 months in a sheep model.Methods
XPV and Hancock bioprosthetic valved conduits (H, used as control) were implanted in adult sheep in the pulmonary artery position. Animals were killed at 2 months (n = 6 XPV), 6 months (n = 6 XPV and n = 3 H), and 12 months (n = 6 XPV) and examined histologically. During follow-up, function of the device as well as diameter of both XPV and H were assessed by transthoracic echocardiography.Results
Of 18 animals that received an XPV, 15 survived until they were killed; 3 animals that received H survived the planned observational interval. XPV showed mild neointimal thickening and degradation beginning at 2 months with an ongoing process until 12 months. Only 1 of the 18 animals with XPV had significant calcification at 6 months. Pathologic specimen did not show any significant narrowing of the conduit whereas neointimal thickness showed a peak at 6 months. Inflammatory process reached a maximum at 6 months and the degradation process at 12 months. Gel permeation chromatography analysis showed molecular weight loss beginning at 2 months with a peak at 12 months for the conduit with slower absorption for the leaflets. The wall of the H conduits showed more neointimal thickening, narrowing, and calcification compared with XPV, but the leaflets demonstrated minimal changes.Conclusions
Both conduits demonstrated an acceptable safety and functionality. Significant calcification was rarely observed in the XPV, whereas the H developed more neointimal thickness with calcification of the porcine aortic root portion of the wall. 相似文献14.
H.C. Hsu S. Enosawa T. Yamazaki S. Tohyama J. Fujita K. Fukuda E. Kobayashi 《Transplantation proceedings》2017,49(1):153-158
Background
With the goal of in vivo cultivation of human hepatocytes that have not been sufficient in full differentiation in vitro, the advantage of neonatal thymectomy was verified on expansion of xenogeneic human hepatocyte in the micro-miniature pig (MMP).Methods
The thymus was excised immediately after the birth of the MMPs via cesarean section. Newborns were fed by artificial feeding under specific pathogen-free conditions. The thymectomized and nonthymectomized littermates were transplanted with human hepatocytes via a portal vein with or without partial hepatectomy at the MMP adult stage.Results
The growth of thymectomized MMPs and the sham operated littermates was not significantly different; the former weighed 1.98 ± 0.30 kg (average ± standard deviation, n = 4) and the latter weighed 2.28 ± 0.39 kg (n = 4) at 1 month of age, and 17.48 ± 1.92 kg and 16.75 ± 2.68 kg at 12 months of age. Blood thymosin α1 concentrations in the thymectomy group were significantly lower than in the control group (0.22 ± 0.05 ng/mL vs 0.46 ± 0.16 ng/mL; n = 4, 12 months old, P = .029). After human hepatocyte transplantation, human albumin levels were detectable on day 28 in the peripheral blood of the thymectomy plus hepatectomy group (14.3 ± 4.9 ng/mL [± range, n = 2]) but were not detectable even on day 21 in the control group.Conclusions
Neonatal thymectomy was successfully achieved in infantile MMPs born via cesarean section. These pigs were considered to be an ideal in vivo bioreactor for human hepatocytes. 相似文献15.
Joyce White Lisa Coppola Andrea Skomurski Emma Mitchell-Rekrut 《Journal of hand therapy》2018,31(3):390-397
Study Design
Cross-sectional clinical measurement study.Introduction
The carpometacarpal (CMC) joint of the thumb is a complex joint making accurate measurement of range of motion (ROM) challenging. There are limited normative data available to base rehabilitative decisions, which is unfortunate as this joint is frequently affected by arthritis and is critical to hand function.Purpose of the Study
To provide passive ROM values for the first CMC joint and investigate the effects of age and gender.Methods
Ninety-six healthy subjects were divided into 4 age groups of equal gender: 20-34, 35-49, 50-64, and 65+ years. Six-inch plastic universal goniometers were used to take 3 measurements of flexion, extension, and abduction of the dominant hand.Results
Mean ROM values were 21.7 ± 6.8 degrees of flexion, 19.5 ± 5.7 degrees of extension, and 51.1 ± 5.5 degrees of abduction. There was a weak negative correlation (r = ?0.22; P = .03) between age and abduction and a difference between 2 age groups. No other relationship or difference due to age, gender, or interactions reached significance.Conclusions
These normative ROM values for adults can be used by clinicians assessing patients for impaired motion at the CMC joint. No differences in flexion, extension, and abduction due to age and gender were supported, except for a small decrease (4.5°) in abduction in adults 65+ years compared with those of 35-49 years.Level of Evidence
3. 相似文献16.
Bina Eftekharsadat Peyman Roomizadeh Shervin Torabi Fariba Heshmati-Afshar Fatemeh Jahanjoo Arash Babaei-Ghazani 《Journal of hand therapy》2018,31(4):437-442
Study Design
Randomized controlled trial.Introduction
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. To date, no previous study has evaluated the efficacy of topical Lavendula stoechas (Lavender) oil in CTS patients.Purpose of the Study
To investigate the effectiveness of topical Lavender essential oil in pain intensity, isometric pinch strength, electrophysiological features, and functional status of patients with mild to moderate CTS.Methods
Forty eight patients with mild to moderate CTS were enrolled in this randomized placebo-controlled trial. Group A was treated with night wrist orthotic and topical lavender oil ointment. Group B was treated with night wrist orthotic and a placebo ointment. Patients were evaluated at baseline, and after 40 days of intervention with Boston CTS questionnaire (BCTQ), visual analog scale (VAS) for pain, pinch grip strength, power grip, median compound motor action potential latency, and median sensory nerve action potential latency.Results
At the end of the study period, both groups improved significantly in terms of BCTQ, VAS, isometric pinch powers, and electrodiagnosis study parameters. However, group A showed significantly greater improvements in BCTQ (mean difference, 0.39 ± 0.31 vs 0.6 ± 0.35; P = .03), VAS (3.37 ± 1.86 vs 1.33 ± 2.07; P = .001), and pinch grip strength (0.73 ± 0.63 vs 0.27 ± 0.54; P = .01) than group B. No significant differences in power grip, median compound motor action potential latency, and median sensory nerve action potential latency were seen between the 2 groups.Conclusion
This study was the first trial of topical lavender oil used in patients with CTS. Wrist orthotic combined with topical lavender oil was more effective than orthotic and placebo in treatment of mild to moderate CTS.Level of Evidence
1b. 相似文献17.
Wenzhao Xing Lei Sun Liang Sun Changcheng Liu Zhigang Kong Jian Cui Zhiguo Zhang 《Journal of orthopaedic science》2018,23(1):112-116
Background
Minimally invasive surgery in knee arthroplasty can reduce postoperative pain and the rehabilitation period. The goal of this study was to explore the therapeutic effect of minimally invasive arthrolysis in post-traumatic knee stiffness.Methods
From March 2002 to March 2016, a prospective investigation was performed on seventy post-traumatic knee stiffness patients treated with minimally invasive knee arthrolysis or conventional knee arthrolysis. Curative effect was evaluated according to Judet's criteria. Operative time, incision length, blood loss, the angle of intraoperative release and the final postoperative joint mobility in two groups were compared using the student's t-test.Results
The mean follow up time was 15.37 ± 4.93 months (ranged from 6 months to 2 years).The excellent and good rate was significantly higher in minimally invasive group (95.0%) than conventional arthrolysis group (73.33%) (P < 0.05). Minimally invasive arthrolysis group had shorter operative time (29.38 ± 4.84 vs. 86.00 ± 9.77 min), smaller incision length (6.59 ± 0.86 vs. 20.47 ± 2.91 cm), less intraoperative blood loss (93.25 ± 15.26 vs. 473.33 ± 79.58 ml) and better postoperative final joint activity (104.75 ± 17.87° vs. 90.67 ± 19.64°) compared to conventional arthrolysis group (P < 0.001).Conclusions
The findings suggest that minimally invasive knee arthrolysis is a much better option for the treatment of post-traumatic knee stiffness due to its advantages such as shorter operative time, little trauma, less blood loss and better postoperative final joint activity. Further studies with a long term of follow-up are wanted. 相似文献18.
Christoph A. Nienaber Natzi Sakalihasan Rachel E. Clough Mohamed Aboukoura Enrico Mancuso James S.M. Yeh Jean-Olivier Defraigne Nick Cheshire Ulrich Peter Rosendahl Cesare Quarto John Pepper 《The Journal of thoracic and cardiovascular surgery》2017,153(2):S3-S11
Objective
Thoracic endovascular aortic repair (TEVAR) has demonstrated encouraging results and is gaining increasing acceptance as a treatment option for aortic aneurysms and dissections. Yet, its role in managing proximal aortic pathologies is unknown—this is important because in proximal (Stanford type A) aortic dissections, 10% to 30% are not accepted for surgery and 30% to 50% are technically amenable for TEVAR. We describe our case series of type A aortic dissections treated by using TEVAR.Methods
Between year 2009 and 2016, 12 patients with acute, subacute, or chronic type A aortic dissection with the proximal entry tear located between the coronaries and brachiocephalic artery were treated with TEVAR at 3 centers. Various stent-graft configurations were used to seal the proximal entry tear in the ascending aorta under rapid pacing.Results
A total of 12 patients (9 male, 3 female), mean age 81 ± 7 years, EuroSCORE II 9.1 ± 4.5, underwent TEVAR for the treatment of type A aortic dissection. Procedural success was achieved in 11 of 12 patients (91.7%). There was 1 minor stroke and 1 intraprocedural death. No additional deaths were reported at 30 days. At 36 months, there were 4 further deaths (all from nonaortic causes). The mean survival of these 4 deceased was 23 months (range 15-36 months). Follow-up computed tomography demonstrated favorable aortic remodeling.Conclusions
TEVAR is feasible and reveals promising early results in selected patients with type A aortic dissection who are poor candidates for surgical repair. The current iteration of stent-graft technology, however, needs to be adapted to features specific to the ascending aorta. 相似文献19.
Objective
The author evaluated graft and patient outcomes of renal allograft recipients with hepatitis B infection at National Kidney and Transplant Institute from January 2000 to December 2010.Methods
Retrospective study with patients who underwent renal transplant with HBV infection and group of HBV-negative patients in the same post-transplantation period. Data were gathered from the patients' in-hospital and out-patient clinic records and the MEDSYS database.Results
A total of 38 renal transplant recipients were followed up. Hepatitis B cases had a 410% increased risk of having graft failure compared to hepatitis B-negative patients. The mean duration of graft survival was 145.26 (±60.40) months (12 years) in HBV negative compared to 134.29 (±67.94) months (11 years) in HBV-positive post-transplant patients. There was no difference between hepatitis B-positive and B-negative groups in terms of patient survival. The mean duration of patient survival was 156.97 (±60.62) months (13 years) in HBV negative compared to 157.37 (±61.09) months (13 years) in HBV positive post-transplant patients. There was also no significant difference in the mean values of the glomerular filtration rate and level of proteinuria between the two groups.Conclusion
Although patient survival was similar in both groups, there was increased risk of graft failure in hepatitis B-positive patients. 相似文献20.
Ho Min Lee Young Sung Kim Suk Kang Min Young Lee Jong Pil Kim 《Journal of orthopaedic science》2018,23(1):137-143