Acta Orthopaedica Belgica
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THE RELATIONSHIP BETWEEN ANKLE MORPHOLOGY AND OSTEOCHONDRITIS DISSECANS OF TALUS
No full textThe purpose of this study is to describe the impact of ankle morphology to osteochondritis dissecans of talus formation. 26 patients with traumatic osteochondritis dissecans, 30 patients with non-traumatic osteochondritis dissecans and 37 patients with normal ankle as a control group included to study. Two investigators conducted measurements. We used 5 morphological parameters. We found found a significant difference in the patients with osteochondritis dissecans of medial talus. In the traumatic group the average age of the patients was 42 years and number of males 2,7 times than females. Patients of non-traumatic group older than traumatic and in contrast to traumatic group, number of females were 1,72 times than males. Age distributions and also gender distribution of the groups were significantly different from each other. Traumatic osteochondritis dissecans occurs in younger ages. It might be correlated to higher trauma incidence of males in this age group
The outcome comparison of headless screws and Mini-plate for treating type B3 distal humerus fractures
No full textThe purpose of this retrospective study was to evaluate the outcome of headless screws and Mini-plate for treating Type B3 fractures of distal humerus. Seventeen patients with type B3 fracture were included and divided into headless screws group and Mini-plate group. Outcome was evaluated using Mayo Elbow Performance Score (MEPS), Short form 36 questionnaire (SF-36), visual analog score (VAS), and range of motion (ROM) at 12 months’ follow-up. All patients received a minimum follow-up of 12 months. Postoperative complications mainly included elbow stiffness, heterotrophic ossification and elbow instability. At 12months’ follow-up, the MEPS and physical components score of SF-36 in Mini-plate group were significantly higher than that in screw group. Moreover, cases undergoing Mini-plate treatment showed a tendency towards improved ROM of elbow and VAS. The Mini-plate was superior to headless screws on elbow function restoration in the management of type B3 distal humerus fractures
Association between the capitate-triquetrum distance and carpal collapse in static scapholunate instability
No full textLong-standing scapholunate instability frequently leads to progressive deterioration of the adjacent joint cartilages in a consistent repetitive sequence of arthritis. The purpose of this study was to investigate whether the capitate-triquetrum distance is related with the occurrence of carpal collapse in cases of static scapholunate instability. In this retrospective study, 41 patients formed two groups based on the capitate-triquetrum distance; twenty-four with distance of less than 5mm and 17 with distance of 5mm or more. No significant difference was detected with respect to age, sex distribution, dominant hand involvement, initial treatment and time from injury to final x-rays. Three patients (3/24, 12.5%) of the C-T < 5mm group and 10 patients (10/17, 58.8%) of the C-T ≥ 5mm group had no sign of carpal collapse. This difference was statistically significant (p=0.017). Capitate-triquetrum distance could reliably contribute in the decision making process in difficult cases of static scapholunate instability
Osteosynthesis in Schatzker v and vi tibial plateau fractures in patients older than 65 years — one or two plates?
No full textBackground: Bicondylar tibial plateau fractures in elderly patients are rare. Indications for new locking precontoured plates with angular stability are increasing because of the powerful fixation in osteoporotic bone and possibility of percutaneous use. However, literature is lacking regarding these specific fractures.Purpose: To analyze the results of surgical management of bicondylar tibial plateau fractures (Schatzker classification types V and VI) in patients older than 65 years, comparing those treated with one locking plate and those with two plates.Methods: 19 patients were analyzed regarding these parameters: hemoglobin decrease, plates used, preoperative CT, loss of reduction or coronal alignment, time to consolidation, apparition of osteoarthritis, complications, visual analog scale and Oxford Knee Score (OKS).Results: Mean OKS was 36.8 (19–48), with 4 patients (21.05%) having excellent function and 13 (68.4%) moderate. There were only 2 wound infections and 2 varus collapses in the preoperative period. Eleven patients developed radiological osteoarthritis that was not present at the time of trauma.Conclusion: Precontoured locking plates of bicondylar tibial plateau fractures in elderly patients provide mild to good function in approximately 90% of cases, although complications are observed in approximately 21% of patients.
Medium term outcomes of the Universal 2 total wrist arthroplasty in patients with degenerative or posttraumatic osteoarthritis of the wrist
No full textThis retrospective study reports medium term outcomes of 14 total wrist arthroplasties in patients with especially, non-rheumatoid,degenerative osteoarthritis and post-traumatic osteoarthritis. Information of fourteen patients, 6 men and 8 women with a mean age of 61 years, was collected before and after total wrist arthroplasty (Universal 2 prosthesis, Integra) carried out by a single surgeon. Pre-operative mobility was determined by range of motion and compared to post-operative range of motion. Post-operative function was determined using the DASH (The disabilities of the arm, shoulder and hand) score and the PRWE (patient-rated wrist evaluation and grip strength) score. Grip force between the operated and non-operated hand were compared. Three patients experienced complications. Range of motion improved post-operatively, although not significantly, due to an increase in palmar flexion. The mean DASH score was 20% and the mean total PRWE was 54%. This study shows that total wrist arthroplasty, using the Universal 2 wrist prosthesis, gives reasonable results (survival rate 84%) by decreasing pain while preserving range of motion in patients with degenerative osteoarthritis of the wrist after 5 years, although after 10 years the survival rate decreases steeply to 35%.
Outcomes of alveolar soft part sarcoma from a regional tumour unit
No full textIntroduction: We present six cases of alveolar soft part sarcoma (ASPS). All patients were identified from records at our regional institute and treated between 2000 and 2010. ASPS are slow growing highly malignant tumours, often with metastatic spread at initial presentation.Patients & Methods: The mean age of the patients was 28.5 years (21 to 36), with four males and two females. Diagnosis was based on radiological and histological features. All patients had primary surgical resection (five wide local excisions, one marginal excision for extensive widespread disease) and adjuvant radiotherapy.Results: Four lesions involved the lower limb, one involved the upper limb and one originated from the retroperitoneal space. One patient presented late with pulmonary metastases and had marginal excision of the ASPS and died 2.6 years later. Recurrence occurred in two-fifths of the remaining patients at a mean of 6 months.Conclusion: Alveolar soft part sarcoma has a poor prognosis. Our data suggests that patients are managed with an agreed disease staging protocol, radical resection and kept under close surveillance with interval imaging in a specialist bone tumour unit
Bipolar Release Technique In Neglected Congenital Muscular Torticollis
No full textBackground Congenital Muscular Torticollis (CMT) is the third most common congenital musculoskeletal anomaly.After the age of 5 years, the efficiency of the surgery is controversial. . The aim of this prospective study was to report the functional and cosmetic results after bipolar release of the sternocleidomastoid muscle (SCM) in patients older than 5 years of age. Method : Between 2012 and 2015, 8 patients with a mean age of 17.3 years (range, 7 - 22 years) were diagnosed with neglected CMT and were surgically treated. The bipolar release technique was performed in all patients under general anesthesia. Physiotherapy was started immediately after surgery. Preoperative and final assessment was made again using Lee's scoring system.Conclusions Patients with congenital muscular torticollis can benefit from surgical treatment even in adulthood. Bipolar release of the SCM muscle should be considered even in adults with irreversible deformities such asfacial asymmetry with low complication rates
The efficacy of acromioplasty in the arthroscopic repair of full-thickness rotator cuff tears: a systematic review and meta-analysis of prospective randomized studies
No full textThe purpose of this study was to determine the role of acromioplasty in the arthroscopic repair of full-thickness rotator cuff tears. All randomized and quasi-randomized controlled trials evaluating the outcomes of with and without acromioplasty were included in our meta-analysis. After the studies were selected by two reviewers, data were collected and extracted independently. Five prospective randomized studies involving 465 patients were included. The current meta-analysis did not show any significant difference between acromioplasty and nonacromioplasty groups with regard to the outcomes for American Shoulder and Elbow Surgeons score, Constant-Murley score, University of California-Los Angeles score (P = .17, .05, and .13, respectively). There were also no significant difference in VAS for pain and reoperation rate between the two groups (P = .87, and .57, respectively). There was no statistically significant difference in clinical outcomes for patients undergoing arthroscopic rotator cuff repair with and without acromioplasty at short-term follow-up
Arthroscopic Treatment of Greater Tuberosity Fractures: Retrospective Review of Clinical and Functional Outcomes
No full textPurpose: The purpose of this retrospective study was to analyze the clinical and functional outcomes and discuss the value of arthroscopic suture bridge technique in patients with isolated greater tuberosity fractures.Methods: Between October 2009 and July 2014, 37 patients with greater tuberosity fractures were analyzed. Thirteen of these patients were treated with arthroscopic reduction and fixation. Analysis of the clinical outcome was performed by comparing final range of motion, UCLA and Constant score. Radiological outcome was analyzed with time for union.Results: Postoperative results were analyzed by range of motion, UCLA and constant score. Each figure resulted as: UCLA from 27 to 35 (average: 29); range of motion in forward flexion from 160° to 180° (average: 173°); Constant score from 69 to 100 (average: 73). Conclusions: Using arthroscopic treatment with a suture-bridge technique can be a useful method in terms of clinical and functional outcomes and be considered as a viable alternative to conventional open technique
EVALUATION OF MOEBIUS SYNDOROME WITH HAND MANIFESTATITONS
No full textBackground: Moebius Syndrome (MS) is characterized by congenital paralysis of the 6th and 7th cranial nerves, sometimes combined with deficits in cranial nerves and with limb anomalies. We reported that identifying common upper extremity orthopedic manifestations of this syndrome would asist physicians who care for affected patients to promtly establish a dignosis and treatment plan.Material Method: Our internal medical record system was queried and a keyword search for “Möbius/Moebius Syndrome” was conducted. The clinical data collected for each patient consisted of age at diagnosis, date of first and date of final follow-up, treatment type, treatment duration, and complications from treatment. Clinical data collected for hand and upper limb deformities included effected side, diagnosis, surgical procedures, and any post-op complications. All data was collected from radiographic images including X-ray, ultrasound, CT, and MRI imaging, and clinical, physical therapy, orthotics, and operative notes. Conclusion : As regards older reports, it is realized that abnormalities in upper extremity in MS is associated with PS. We wish that this descriptive study will be helpful for those physicians who encounter this rare disease, in terms of identifying and providing timely treatment for associated upper extremity abnormalities and for assisting in counseling patients.