1,720,978 research outputs found
Epidemiologica, clinical, and diagnostic features of osteoarticular tuberculosis in Naples area (Southern Italy)
No full textTreatment of Proximal Scaphoid Non-union by Resection of the Proximal Pole and Palmaris Longus Interposition Arthroplasty
No full textThe purpose of this study was to determine the long-term clinical and radiographic outcome in a group of patients treated with resection of the proximal pole and tendon ball arthroplasty because of a scaphoid non-union
Effect of surgical correction of adolescent idiopathic scoliosis on the quality of life: a prospective study with a minimum 5-year follow-up
No full textPurpose: To prospectively evaluate the quality of life (QoL), functionality, and body image of subjects who had undergone surgery for adolescent idiopathic scoliosis (AIS) 5–12 years previously, and to identify the outcome predictors. Methods: The sample consisted of 87 patients for whom follow-up data were available out of a series of 91 patients who had surgery for AIS between 2002 and 2009. We assessed the preoperative, 1-year postoperative, and 5-year or more postoperative SF-36 and SRS-23 questionnaire scores. Longitudinal clinical and radiographic data also were evaluated. Changes in the patient-oriented outcomes were compared with age and sex-adjusted normative values. A multiple regression analysis was used to identify possible outcome predictors. Results: Preoperatively, patients had impaired QoL, functionality, and body image compared to age- and sex-matched healthy controls. Surgery led to significant improvement of the SF-36 and SRS scores at the one-year and final control date, but the final scores on SF-36’s physical indexes were lower than control subjects’ scores. No clinically relevant differences with the normative values were detected in the final SRS scores. The height of the residual rib hump negatively predicted the total SRS and self-image scores; a more caudal level of fusion correlated with more postoperative pain. Conclusions: Patients who underwent surgery for AIS a minimum of 5 years earlier had impaired self-reported physical QoL compared to control subjects, but they nevertheless performed better than before their surgery. Greater size of the residual hump and greater distal extension of the fusion area are negatively correlated with final self reported outcome
Functional outcome and short-term mortality after surgery for hip fractures
No full textIntroduction Hip fractures are associated with significant disability and mortality. We conducted a prospective study to investigate the mortality rate and functional ability in patients who underwent surgery for hip fracture over a one-year period.
Materials and methods One-hundred patients (72 females and 28 males; mean age, 78.2 years (range 32–102) surgically treated for hip fracture were prospectively followed-up for 1 year. Fifty-five and 45 patients sustained a trochanteric fracture or a fracture of the femoral neck, respectively. Daily-life activities (ADL scale), cognitive impairment (MMSE Scale), comorbidity (CIRS scale), functional status, and personal mobility were prospectively evaluated 4 months and 1 year after the operation by telephonic interviews with the patient, his/her relatives, or primary care providers. Mortality data was also recorded. Possible outcome predictors were evaluated by regression analysis.
Results The overall mortality rate at 1 year was 19 percent. Male sex, comorbidity, and a poor pre-fracture functional status were significant predictors of mortality. ADL scale and personal mobility significantly improved between 4-month and 1-year follow-up controls. Forty-five percent of patients without preoperative walking limitations dropped out their walking aids 1-year postoperatively. Patients with trochanteric fracture treated with hip prosthesis showed greater and faster postoperative functional improvement with respect to patients treated by gamma nail.
Discussion Current results represent the first report of a wider ongoing prospective study aimed to evaluate possible outcome predictors of hip fractures to be used to improve and personalize the surgical treatment. The preoperative functional status and comorbidities are major determinants of 4-month and 1-year postoperative mortality and ability of subjects.
Conclusions Our preliminary findings demonstrate the role of surgery in promoting the functional improvement of patients who sustained hip fracture
Componenti acetabolari in tantalio nella protesizzazione primaria dell'anca. Studio prospettico
No full textGli autori riportano eccellenti risultati clinici e radiografici con l'utilizzo di componenti acetabolari con rivestimento esterno in tantalio poroso nell'artroprotesi primaria dell'anc
HEMIARTHROPLASTY VERSUS TOTAL HIP ARTHROPLASTY FOR THE TREATMENT OF FEMORAL NECK FRACTURES. A PROSPECTIVE COMPARATIVE STUDY
No full textIntroduction: The treatment of femoral neck fractures may affect the postoperative functional outcome in the elderly. Objectives: This comparative prospective study was carried out to evaluate the outcome of total hip arthroplasty (THA) versus hemiarthroplasty for femoral neck fractures. Methods: We selected 80 patients (17 males and 63 females) who underwent hemiarthroplasty (40 cases; mean age 74,0 ± 5.5 years) or THA (40 cases; mean age 71,4 ± 6.5 years) for a femoral neck fracture at our Institutions between January 2011 and April 2012. These two therapeutic groups were carefully matched for their preoperative characteristics including age, gender, body mass index, ASA class, comorbidities (CIRS score), cognitive function (MMSE). Four- and twelve-month mortality, walking ability, and activities of daily living (ADL Index) were prospectively assessed in the two groups. Hip-related and general complications also were specifically noted. Models of multiple regression analysis were constructed to evaluate the effect of the surgical treatment (hemiarthroplasty or THA) on functional outcomes and mortality. Results: The mortality at 4 and 12 months was not significantly different in the two therapeutic groups. The walking ability at 4 months (P<0.05) and the ADL score at 4 months (P<0.01) and one year (P = 0.01) was superior in patients with THA as compared to those who underwent hemiarthroplasty. The pre-fracture functional level (P<0.001) and the use of THA versus hemiarthroplasty (P = 0.01) represented strong predictors of the four-month ambulatory activity and ADL Index. The use of THA versus hemiarthroplasty was not associated with a better one-year functional outcome. There was a higher risk of hip-related complications at four months in patients undergoing THA (P = 0.002). Conclusions: Despite more hip-related complications, THA can benefit patients with femoral neck fractures with higher four-month functional scores
Functional outcome and mortality after surgery for hip fracture
No full textINTRODUCTION
Hip fractures are associated with significant disability and mortality. A multicenter prospective
study is currently ongoing at our institutions to investigate the mortality and functionality of
patients with hip fracture. This is the report on the first 200 patients.
OBJECTIVES
1) To evaluate the functional outcome and mortality after hip fracture 2) To identify predictors of
mortality, functionality, and personal autonomy on variable follow-up intervals in patients who
sustained hip fracture.
METHODS
Two-hundred consecutive patients (142 females and 58 males; mean age = 78.6 ± 13 years)
admitted to our hospitals for hip fracture were telephonically interviewed 4 months and 1 year
after the treatment. Personal and medical data were collected on hospital admission and were
compared to the follow-up data of all patients, using a validated examination set dealing with
daily life activities (ADL scale), cognitive status (MMSE Scale), comorbidity (ASA and CIRS
scales), and personal mobility. Mortality data was also recorded. Possible outcome predictors
were checked with multivariate regression analysis. SPSS software was used for database and
statistics.
CONCLUSION
This ongoing prospective study is aimed to evaluate mortality and functionality after hip fracture
as well as to identify possible outcome predictors to be used to improve and personalise the
surgical treatment. This first report shows that the preoperative functional status and
comorbidities are major determinants of 4-month and one-year postoperative mortality and
functional status of subjects who sustained a hip fractur
Mobilità ed autonomia personale dopo frattura del femore prossimale. Studio prospettico
No full textGrave perdita di mobilità ed indipendenza nelle ADL in soggetti con frattura dell'estremo prossimale del femore seguiti prospetticamente a 4 e 6 mesi con interviste telefoniche
Assessment of deep vein thrombosis using routine pre- and postoperative duplex Doppler ultrasound in patients with pelvic trauma : a prospective study
No full textAims: The aims of this study were to assess the pre- and postoperative incidence of deep vein thrombosis (DVT) using routine duplex Doppler ultrasound (DUS), to assess the incidence of pulmonary embolism (PE) using CT angiography, and to identify the factors that predict postoperative DVT in patients with a pelvic and/or acetabular fracture. Methods: All patients treated surgically for a pelvic and/or acetabular fracture between October 2016 and January 2020 were enrolled into this prospective single-centre study. The demographic, medical, and surgical details of the patients were recorded. DVT screening of the lower limbs was routinely performed using DUS before and at six to ten days after surgery. CT angiography was used in patients who were suspected of having PE. Age-adjusted univariate and stepwise multiple logistic regression analysis were used to determine the association between explanatory variables and postoperative DVT. Results: A total of 191 patients were included. A DVT was found preoperatively in 12 patients (6.3%), of which six were proximal. A postoperative DVT was found in 42 patients (22%), of which 27 were proximal. Eight patients (4.2%) had a PE, which was secondary to a DVT in three. None of the 12 patients in whom a vena cava filter was implanted prophylactically had a PE. Multivariate logistic regression analysis indicated that the association with the need for spinal surgery (odds ratio (OR) 19.78 (95% confidence interval (CI) 1.12 to 348.08); p = 0.041), intramedullary nailing of a long bone fracture (OR 4.44 (95% CI 1.05 to 18.86); p = 0.043), an operating time > two hours (OR 3.28 (95% CI 1.09 to 9.88); p = 0.035), and additional trauma surgery (OR 3.1 (95% CI 1.03 to 9.45); p = 0.045) were statistically the most relevant independent predictors of a postoperative DVT. Conclusion: The acknowledgement of the risk factors for the development of a DVT and their weight is crucial to set a threshold for the index of suspicion for this diagnosis by medical staff. We suggest the routine use of the DUS screening for DVT in patients with a pelvic and/or acetabular fracture before and six to ten days after surgery. Cite this article: Bone Joint J 2022;104-B(2):283-289
Componenti in tantalio nella chirurgia protesica primaria e di revisione
No full textI componenti acetabolari primari in tantalio poroso garantiscono risultati clinici e radiografici soddisfacenti a 4 anni dall’impianto grazie alle favorevoli caratteristiche di osteointegrazione di questo biomateriale
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