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1.
Suresh Kumar Masilamani Annamalai Rachel Buckingham John Cashman 《Journal of children's orthopaedics》2007,1(2):107-113
The treatment of Legg-Calvé-Perthes disease remains controversial. The aim of this survey was to ascertain the current management
strategies of this condition amongst UK paediatric orthopaedic surgeons, with particular regard to containment procedures
in the fragmentation phase. Questionnaires were distributed at the January 2006 meeting of the British Society for Children’s
Orthopaedic Surgery (BSCOS) and was posted to all absent members. The results showed a great deal of variability not only
in the treatment of Perthes disease, but also in the decision-making processes. Consideration must now be given to a carefully
constructed national multi-centre prospective randomised controlled study into the optimum management of this disease 相似文献
2.
3.
Recent studies show comparable results of arthroscopic shoulder stabilization techniques compared with the gold standard open Bankart reconstruction. Great technical advances and ever-increasing surgeon experience have rendered pathology once deemed an indication for open surgery as treatable by arthroscopic means. With this movement toward a more universal application of all-arthroscopic techniques, we might consider the following question: Is there ever a need to open? To answer this question, we must first consider normal anatomy and then appreciate the contribution of deranged pathoanatomy to recurrent instability in each individual case. The surgeon must then determine whether this is best addressed via an arthroscopic or open technique. Arthroscopy, as compared with open stabilization procedures, holds the potential benefits of decreased morbidity rates, early functional rehabilitation, and improved range of motion. Despite potential advantages, arthroscopic stabilization is clearly contraindicated when a significant pathologic lesion contributing to recurrent instability cannot be adequately addressed as a result of the limitations of current techniques or instrumentation. On the basis of this principle, we believe that sizable glenohumeral bone defects remain the only absolute contraindication to an all-arthroscopic approach. Many complicating issues, such as attenuated capsule, humeral avulsion of the glenohumeral ligament lesions, cases of revision surgery, and collision or contact athletes, exist and warrant close attention. We prefer to think of these situations as “challenges” for which both arthroscopic and open surgery should be considered, rather than as true contraindications to arthroscopic shoulder stabilization. We are, by no means, advocating arthroscopic treatment in all cases of shoulder instability, because this would represent a gross oversimplification of the issues at hand. However, we do acknowledge that the steadfast contraindications to arthroscopic shoulder stabilization are decreasing every day. 相似文献
4.
Eichi Itadera Yoshimasa Miyake Yoichi Nakatsuka Hirofumi Akazawa Shigeru Mitani Kiyoshi Aoki 《Journal of orthopaedic science》1996,1(4):252-258
We report satisfactory results with a new operative treatment, conducted via an extensive anterolateral approach, involving
360 degree circumferential capsulotomy, for residual subluxation in congenital dislocation of the hip (CDH). Long-term radiographic
results of this procedure (group A) were compared retrospectively with the results of partial capsulotomy (group B), which
preserved the posteroinferior joint capsule. The mean center edge angle in group A (22.5°) was greater than that in group
B (16.0°). Satisfactory results were achieved in 11 of 15 hips (73%) (Severin class I or II) in group A, and in 5 of 12 hips
(42%) in group B. These results suggest that whole circumferential capsulotomy can remove obstacles to complete reduction,
and that acetabular development can be expected in hips reduced by the procedure, without the performance of innominate osteotomy.
We believe that our technique is a useful alternative for the treatment of residual subluxation in CDH. 相似文献
5.
In the attempt to gain a broader understanding of the causal relationships behind work-related symptoms of pain in the human
shoulder, monitoring of arm position is crucial. Different methods have been used with varying accuracy. A video-based stereometry
system, using infra-red light and reflecting markers for motion analysis, has been introduced for measurements in the fields
of ergonomics, biomechanics and sports medicine. The purpose of this study is to investigate the sources of error in using
this system for posture registration of the upper limb. Measurements are performed on a calibration fixture, on a mechanical
model of the upper limb and on a subject with an exoskeleton. Particular, attention is given to inconsistencies and relative
errors due to the finite geometrical precision with which the markers are positioned in the calibration fixture and on the
studied objects, the limited capability to align the objects relative to the coordinate system of the calibration fixture
and the errors connected to angular measurements using protractors etc. It is concluded that the system makes a valuable addition
to existing instruments for non-contact posture measurement, and produces position data with an adequate accuracy in normal
handling. 相似文献
6.
Louis F. McIntyre MD 《Operative Techniques in Sports Medicine》1997,5(4):233-237
Multidirectional shoulder instability is a common affliction and is increasingly recognized as a debilitating condition in young, athletic patients. Most patients with this condition are in their third decade and have a history of macrotrauma or repetitive microtrauma. Complaints range from frank instability to instability with pain, or to pain alone. These patients may display clinical signs of instability, impingement, or both on physical examination. Generalized ligamentous laxity or shoulder laxity alone are usually present. A positive sulcus sign remains the most sensitive clinical test in distinguishing these patients, even though no data is available on the sensitivity or specificity of this examination. The greater majority of patients are successfully treated with an exercise program stressing rotator cuff and scapular stabilizer strengthening. When patients do not respond to conservative treatment, open capsular shift has been recommended to restore joint stability. Early successes with the arthroscopic treatment of anterior shoulder instability have led to the development of similar procedures for the treatment of multidirectional instability. This paper describes an arthroscopic, multiple suture capsulorrhaphy for the treatment of multidirectional shoulder instability, which is a modification of the procedure advocated by Caspari and reviews the 2-year results of the first 19 patients treated. 相似文献
7.
Stephen S. Burkhart MD 《Operative Techniques in Sports Medicine》1997,5(4):204-214
Arthroscopic repair of rotator cuff tears is now possible. By using the biomechanical principles of margin convergenceand the balance of force couples, even large cuff defects can be repaired. Suture anchors are particularly suitable for arthroscopic repairs, and a corkscrew anchor design lends itself to a trans-tendon approach 相似文献
8.
Arthroscopic shoulder surgery has become a safe tool for evaluation and treatment of a wide range of shoulder problems with few complications. With ever-improving technology (and commitment to motor skill development among arthroscopists), we can expect to maintain this low rate despite increasing procedure complexity. Avoiding complications in arthroscopic shoulder surgery requires careful preoperative planning, judicious patient selection, a thorough understanding of arthroscopic anatomy, and facility with arthroscopic techniques. 相似文献
9.
Surgical Principles
Radical arthroscopic synovectomy of rheumatoid shoulder and elbow.
Revised Version from: Operat. Orthop. Traumatol. 4 (1992), 112–129 (German Edition). 相似文献
10.