Slaterdonnelly8341
Atypical subtrochanteric femoral fractures are a common problem associated with pycnodysostosis. Pycnodysostosis is a rare sclerotic bone disease caused by a mutation in the cathepsin K gene. Fracture healing in pycnodysostosis cases is typically inferior. Here, we report a case of bilateral atypical subtrochanteric femoral fractures in one patient with pycnodysostosis. The right subtrochanteric fracture was treated with open reduction and internal fixation (open plating), and united through primary bone healing, while the left one was treated with closed reduction and internal fixation (submuscular plating), and united through secondary bone healing. Although the time to bony union was delayed, fracture union after extramedullary osteosynthesis was obtained in both atypical fractures, demonstrating that both primary and secondary bone healing is possible in patients with pycnodysostosis.
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Musculoskeletal conditions are the leading contributor to global healthcare expenditure and with an increase in ageing global population, this number is projected to rise further.
To determine the top 100 most-cited studies in field of musculoskeletal rehabilitation and to conduct their bibliometric analysis.
Scopus was used for identification of studies, published in the field of musculoskeletal rehabilitation over last five decades.
Literature search was conducted in February 2021 with final Boolean search phrases being [(musculoskeletal) and (rehabilitation) and (musculoskeletal rehabilitation)]. In addition to number of citations, data was also collected for other variables such as title of study, topic of discussion, subdivisions of clinical and applied science involved in conduction of study, study design, journal and its impact factor, year of publication, and country where study was conducted.
The top 100 most-cited articles in musculoskeletal rehabilitation over the last 50years were published between 1973 and 2015. Total number of citations was 24,366, with an average of 243.66 citations per paper. Highest citation was reported by apaper on treatment of low back pain by Waddell G. The decade of 2000-2009 contributed maximum articles with highest number of publications from journal "Archives of Physical Medicine and Rehabilitation". Most of the publications were from United States and most common topic to feature among these articles was "Strength training".
This study identifies the top 100 most-cited articles in musculoskeletal rehabilitation and provides insight into its historical trends while serving as a guide for future research.
This study identifies the top 100 most-cited articles in musculoskeletal rehabilitation and provides insight into its historical trends while serving as a guide for future research.
Prosthetic joint infection (PJI) following total knee arthroplasty (TKA) and total hip arthroplasty (THA) can be a devastating diagnosis. Debridement, antibiotics and implant retention (DAIR) is a preferred treatment modality for acute PJI. A retrospective analysis of infected primary arthroplasties to evaluate the success of DAIR and factors influencing its outcomes.
We retrospectively reviewed all patients who underwent DAIR for PJI at our unit between 2010 and 2018. Patients who underwent revision surgery as an index procedure, arthroscopic washout and those with less than two years of follow-up were excluded. Treatment failure was defined as revision arthroplasty for recurrence of infection within 2years of the index procedure. Chi-square and Fischer's exact test were used to compare between patient factors and DAIR outcomes. Kaplan-Meier survival curve and log-rank test were used to analyse implant survivorship following DAIR.
Of the sixty patients (40 knees, 20 hips) who underwent DAIR, eighteen (13 knees, 5 hips) required revision arthroplasty within 2years accounting for a success rate of 70%. Predictive factors for revision were American Society of Anaesthesiologist (ASA) score of greater than 2 (
= 0.021), BMI > 35 (
= 0.046), C Reactive protein (CRP) > 200mg/L (
= 0.007) and Staphylococcus aureus growth (
= 0.012). The five-year survival rate for DAIR was 70%, which remained constant after two years from DAIR.
Success rate of DAIR in PJI was 70% which was comparable to similar studies in the literature. ASA > 2, BMI > 35, CRP > 200 and staphylococcus aureus growth were predictors for DAIR failure. Implant survival rate and duration were better following DAIR in early-onset PJI.
200 and staphylococcus aureus growth were predictors for DAIR failure. Implant survival rate and duration were better following DAIR in early-onset PJI.Interphalangeal joints (IPJ) play a key role in hand function for performing activities of daily living and are frequently involved in complicated injuries resulting in significant functional limitations such as secondary arthritis and stiffness being the most challenging. In adult patients with more than 5 mm bone loss of the proximal articular surface who request a functional interphalangeal joint with minimal pain a vascularized joint transfer is a treatment choice. A unicondylar loss more than 5 mm wide in a 22-year-old carpenter is reported and illustrates our experience with a vascularized unicondylar transfer showing the advantages compared to the "classic" total joint transfer or distal interphalangeal (DIP) joint arthrodesis. By using this technique at the 12-month follow-up, we achieved no donor site complications, a good graft alignment, a good joint congruity, complete bone healing and a normal vascular patency with no signs of bone malunion or resorption of the graft.
This study aims to elucidate basic anatomic and geometric features of MCL, providing more accurate and detailed information, as guidance for surgeons, to improve patient's outcome of the treatment.
The anterior bundle (AB), posterior bundle (PB) and transverse bundle (TB) ligament of 56 fresh frozen Thai cadaveric elbows, were measured and recorded, comprise key ligament's geometric features, footprints and dimensions, and its relation to bony landmarks. Sagittal and coronal planes were used in respect of the anatomical position.
The mean distance between the center of AB origin and the apex of medial epicondyle is as follows 2.97 ± 2.21mm anteriorly, 4.73 ± 1.60mm inferiorly in the sagittal plane, and 4.23 ± 1.13mm deep from the epicondyle in the coronal plane. Its dimension is 6.23 ± 1.02mm in width and 45.97 ± 6.75mm in length. The ligament's insertion triangular shape has its base located 28.44 ± 3.51mm anterior from the posterior olecranon border, and 22.52 ± 2.49mm superior from the inferior ulnar border. The tip located 50.79 ± 4.86mm anterior from the posterior olecranon border and 17.64 ± 2.80mm superior from the inferior ulnar border.
Apprehension of the precise geometries and distances of the ligament's footprint relative to key anatomical point is crucial. This stereographically comprehended data are useful for surgeon as reference points to obtain stability, motion, kinetic, and kinematic properties of the elbow.
Level V evidence.
The online version contains supplementary material available at 10.1007/s43465-022-00648-x.
The online version contains supplementary material available at 10.1007/s43465-022-00648-x.
One of the most common fractures in the elderly population is a fracture of the neck of femur. Effective post-operative analgesia is a major challenge. Age-related co-morbidities restrict the choice of analgesics. The purpose of this study was to compare the efficacy and safety of transdermal buprenorphine [TDB] patch and conventional analgesics following hemiarthroplasty for intra-capsular fracture neck of femur.
This was a prospective, randomized control study done in 60 patients undergoing hemiarthroplasty for intra-capsular fracture neck of femur over a period of 2years. Patients were randomized in 2 groups. Group A received a combination of IV paracetamol and tramadol for first 48h followed by oral formulation. In Group B patients, a transdermal buprenorphine patch of 5mcg/h was applied at the beginning of surgery and was continued 2weeks post-operative.Pain score by VAS was observed both at rest and on movement and followed up till 14days post-operative. Primary target was to maintain a VAS ≤ 4. Rescue analgesic was given if the VAS was ≥ 6. Secondary targets were number of rescue analgesics required, adverse reactions and complications if any.
Group B had significantly lower pain scores at rest and during movement [
value 0.0012 to ≤ 0.0001], so was rescue analgesia requirement. No significant side effects were seen in TDB group.
TDB patch is safe and provides superior analgesia and compliance as compared to conventional analgesics in the post-operative period in proximal femur fracture surgeries.
TDB patch is safe and provides superior analgesia and compliance as compared to conventional analgesics in the post-operative period in proximal femur fracture surgeries.
The purpose of this study was to compare clinical and radiological outcomes of transtibial pullout technique and partial meniscectomy, and to establish prognostic factors in middle-aged patients with mild knee osteoarthritis.
A comparative case-control analysis was conducted. 65 patients between 40 and 60years of age were included into two groups 30 patients who underwent transtibial pullout technique (group 1) and 35 patients who underwent partial meniscectomy (group 2). Mean follow-up was set at 27.2months. this website Primary clinical outcomes included Knee injury and Osteoarthritis Outcome Score and Lysholm Knee Questionnare. Preoperative MRI and intraoperative arthroscopic findings were recorded. The correlation between these findings and patient-reported subjective outcome were assessed.
The transtibial pullout group exhibited significantly greater improvement in clinical outcomes. A univariate model revealed that the presence of preoperative meniscal extrusion, body mass index (> 30), osteochondral defect, and female gender were predictors of poor clinical outcome. Multivariate regression analysis showed meniscal extrusion and osteochondral defect as significant prognostic factors for both study groups.
Medial meniscus root repair leads to significantly improved clinical outcomes compared to partial meniscectomy in middle-aged patients with mild kneeosteoarthritis. Presence of meniscal extrusion, osteochondral defect, BMI > 30, and female gender were deemed as predictors of poor postoperativepatient-reported outcome.
III therapeutic case-control study.
III therapeutic case-control study.Hereditary Sensory and Autonomic Neuropathy (HSAN) Type II is an autosomal recessive genetic disease which presents predominantly with sensory neuropathy and neuropathic ulcers. HSAN Type II is a rare disease, and in the few cases that have been reported, the focus has been on identifying genetic markers of the disease. Orthopaedic conditions may be a major presentation of the disease, and the prevention of superficial trauma and foot care is the only definitive management.
The anterior tibial translation (ATT) in case of Anterior Cruciate Ligament (ACL) tear can lead to dynamic alterations of the extensor apparatus biomechanics. The aim of this study is to evaluate the dynamic effect of isolated ACL deficiency on patellar height. The hypothesis is that the ATT of ACL-insufficient knees dynamically reduces patellar height.
Skeletally mature patients who underwent ACL reconstruction using hamstring graft between January and December 2018 were included in this study.The Posterior Tibial Slope (PTS), Caton-Deschamps (CDI), modified Insall-Salvati (MISI), and Blackburne-Peel (BPI) indices were calculated in standard lateral and TELOS X-rays. The mean of the measurements calculated between two observers was used to compare these parameters.
95 patients (M 57; F 38; 95 knees) were included in the study with a mean age of 31.8years (16-56years old). Significant patellar height reduction (CDI 0.11 [-0.32; 0.31]; MISI 0.09 [-0.66; 0.30]) was reported in TELOS compared with standard lateral knee radiography (
< 0.