306 research outputs found
A Rare Cause of Torticollis: Grisel Syndrome
No full textPainful torticollis in children requires specific attention. Grisel syndrome is diagnosed on suspicion in patients with recent or history of ongoing upper respiratory tract infections and in patients with restriction of movement or deformity following oto-rhino-laryngologic surgery. Pediatricians should be aware of this condition because early diagnosis and intervention are critical for prognosis in Grisel syndrome
Pseudo-arthrosis of the spine of the scapula: a case report with a delayed diagnosis
No full textScapular spine fractures are rare injuries. The aim of this study was to evaluate a late-diagnosed scapular spine pseudo-arthrotic patient. Because of the surrounding soft tissue mass and overlapping of the scapula with the thoracal bones on a roentgenogram, diagnosis may be missed or delayed for years. We present a case of scapular spine pseudo-arthrosis in a 50-year-old man, who sustained a traffic accident 2 years ago. He was treated as a soft tissue injury of the left shoulder and later as a rotator cuff tear. His scapular spine fracture was diagnosed as pseudo-arthrosis of the scapular spine with a diagnostic delay of 2 years. Isolated scapular spine fractures are rare, usually associated with other injuries and frequently treated non-operatively. Sagging of the acromion as a result of a scapular spine fracture may mimic supraspinatus outlet impingement. If a painful pseudo-arthrosis limits the function of a shoulder, fractured ends should be fixed until union occurs. Although scapular spine fractures are rarely seen, they must take place in the differential diagnosis of impingement syndromes of the shoulder
Traumatic hemipelvectomy: A case report and a review of the literature
No full textTraumatic hemipelvectomy is a life threatening, devastating pelvic injury with very low survival rates. Excessive loss of blood, related systemic problems and additional injuries about the gastrointestinal and genitourinary systems increase mortality of this severe sort of injury. A young, male farmer injured violently by an agricultural heavy machine; a survivor of traumatic hemipelvectomy is described in this case report
Effects of pregabalin on spinal fusion
No full textPurpose Gamma-aminobutyric acid analogues are commonly used to treat neuropathic and chronic pain before and after spinal surgery in recent years. Aim of this study is to investigate the influence of pregabalin on spinal fusion and to determine the proper pregabalin dose for postoperative utilization in a validated rat intertransverse spinal fusion. Methods Lumbar intertransverse fusion surgeries performed in four groups of rats according to a previously established rat model for posterolateral spinal fusion. All rats were followed up for 6 weeks at the postoperative period by administering oral pregabalin doses of 10 (D10), 30 (D30) and 100 mg/kg/day (D100) except the control group. All rats were killed after 6 weeks and evaluated in terms of manual palpation, radiographic investigation and histological analysis to investigate posterolateral fusion. Results Assessment of fusion with manual palpation revealed lower fusion rates in D100 group. In histological analysis, scores were significantly lower in D30 and D100 groups compared to the control group; this finding was interpreted as inhibition of spinal fusion. Radiographic evaluation did not reveal any significant statistical difference between groups. Conclusions Histological analysis and manual palpation results showed inhibition of spinal fusion formation with high doses of pregabalin. According to these results, administration of high-dose pregabalin should be avoided at the postoperative period until successful fusion is obtained in patients who undergo spinal fusion surgery. Graphic abstract These slides can be retrieved under electronic supplementary material
Comparison of AO, Schatzker, and three-column classification systems in tibial plateau fractures: Impact on functional outcomes
No full textObjectives: This study aimed to compare the AO, Schatzker, and Three-Column classification systems for tibial plateau fractures, focusing on their prognostic and functional outcome prediction and influence on clinical decisions across different trauma types. Patients and methods: In this retrospective study, we examined 49 patients (36 males, 11 females; mean age: 40.6 +/- 11.8 years; range, 19 to 67 years) with tibial plateau fractures between January 2011 and January 2017. The fractures were classified using the AO, Schatzker, and three-column systems. The main outcome measurements included functional scores (Knee Injury and Osteoarthritis Outcome Score [KOOS], Hospital for Special Surgery [HSS]), range of motion (ROM), duration of hospitalization, thigh atrophy, operation time, and the development of osteoarthritis. The impact of smoking was also assessed. Results: According to the AO classification, type B fractures obtained higher KOOS and HSS scores compared to type C fractures (p=0.013 and p=0.007, respectively). According to the Schatzker classification low-energy fractures achieved higher KOOS and HSS scores than high-energy fractures (p=0.013 and p=0.026, respectively). One-column fractures had higher KOOS and HSS scores compared to two-column and three-column fractures (p=0.007 and p=0.001, respectively). Two-column fractures had a lower ROM compared to other column fractures (p=0.022). Shorter hospital stays were recorded for Schatzker low-energy fractures (p=0.016), whereas higher thigh atrophy was found in Schatzker high-energy fractures (p=0.022) and AO type C fractures (p=0.018). Longer operation times were observed in AO type C fractures (p=0.037) and Schatzker high-energy fractures (p=0.017). According to the Kellgren-Lawrence classification, AO type C fractures and three-column fractures yielded worse outcomes (p=0.039 and p=0.001, respectively). Smoking had a negative impact on functional KOOS and HSS scores across all groups (p=0.022 and p=0.001, respectively). Conclusion: This study highlights the predictive value of the AO, Schatzker, and Three-Column classification systems in determining functional outcomes and clinical data in tibial plateau fractures. Each system provides unique insights into different outcomes, suggesting their concurrent application may yield a more comprehensive prognosis
Functional results of patients treated with modular prosthetic replacement for bone tumors of the extremities
No full textObjectives: We evaluated functional results of patients who were treated with cemented modular prosthetic replacement for bone tumors of the extremities. Methods: The stud included 23 patients (12 males, 11 fey males mean age 49 years, range 14-81 years) who underwent wide resection and cemented endoprosthetic replacement with the TMTS (Turkish Musculoskeletal Tumor Society) prosthesis for bone tumors. Twelve patients (52.2%; mean age 63.5 years) had metastatic, 11 patients (47.8%; mean age 38 years) had primary tumors. The most common site of involvement was the femur (n=17). followed by the humerus (n=5). Functional evaluations were made with the Musculoskeletal Tumor Society (MSTS) scoring system. The mean followup up period was 24 months (range I to 108 months), being 30 months for primary, and 3 months for metastatic tumors. Results: Postoperative complications were seen in seven patients (30.4%), being local recurrences in three patients. During the follow-up period, I I patients died due to tumoral causes, distant metastasis developed in three patients, and nine patients were tumor-free. Survival was significantly better in patients with primary tumors (p<0.001). All the patients were able to walk without crutches in the postoperative period. The mean MSTS score was 58.9% (range 40% to 90%) in survivors, which was 71.5% (range 60% to 90%) for primary tumors, and 47.4% (range 40% to 73%) for metastatic tumors (p<0.001). Conclusion: Reconstruction with cemented modular endoprostheses is an appropriate surgical alternative in the treatment of large segmental defects after resection of extremity tumors, with satisfactory functional results particularly in primary tumors
Forty years of research trends in long-acting injectable antipsychotics: a bibliometric analysis
No full textMert, Alper/0000-0001-5944-9089Background Using long-acting injectable (LAI) antipsychotics is crucial for treating psychiatric illnesses, particularly those within the schizophrenia spectrum. Through bibliometric analysis, our study aimed to provide an understanding of the changes in research trends related to LAIs over the past 40 years.Methods We collected the publications from 1983 to 2023 related to research studies on LAIs included in the Web of Science database. Two thousand four hundred and twelve publications were selected based on specific criteria and analyzed using the VOSviewer software and the Biblioshiny app. We obtained and presented data on institutional analysis, country analysis, author and co-authorship analysis, journal analysis, funding agencies, and keyword citation numbers.Results From the period 1983-1992 to 2014-2023, the number of total publications showed a significant growth of 4.91. The majority (approximately 90%) of publications were produced in high-income countries. The private sector may play a significant role in research. The most crucial keywords were schizophrenia and risperidone.Conclusions The trend in LAI research is currently dynamic and ongoing. There seems to be an increasing connection between studies and LAIs that contain second-generation antipsychotics. The number of studies relating to the private sector is noteworthy
The analysis of the variables, affecting outcome in surgically treated tibia pilon fractured patients
No full textIntroduction: Treatment of tibia pilon fractures is challenging. Outcome after tibia pilon fractures depend on multiple factors. Aim of this study is to evaluate the potential variables that are known to affect the outcome after tibia pilon fractures. Patients and methods: Forty patients with 42 tibia pilon fractures with a one-year follow-up, who had undergone surgical treatment between January 2007 and June 2011, were evaluated, retrospectively. Patients were divided into 3 groups regarding the choice of surgical treatment (Group A-22 patients treated with open reduction-internal fixation; Group B-9 patients treated with mini-open reduction-internal fixation and external fixation; and Group C-11 patients treated with closed reduction-external fixation). Fractures were classified using Muller-AO and Ruedi/Allgower classifications. Quality of reduction was evaluated using Ovadia and Beals' criteria. All patients underwent functional assessment using AOFAS ankle-hindfoot scale and Teeny-Wiss scoring system at the last follow-up. Results: Mean age of the patients was 49 (20-80). There were eight 43-B3, six 43-C1, twelve 43-C2 and sixteen 43-C3 fractures according to Muller-AO classification and ten type 1, ten type 2 and twenty two type 3 fractures according to Ruedi/Allgower classification. There were 15 (35.7%) open fractures. No statistically significant relation was found between quality of reduction and type of surgery. Also no significant relation was found between the type of surgery and functional scores. No significant correlation was found between functional scores and Muller-AO classification, but functional scores were found significantly worse in Ruedi/Allgower type 3 fractures. Functional scores were found significantly related to the quality of reduction. Early complications were seen in 22 and late complications were seen in 9 fractures. No statistically significant relation was found between complications, type of surgery and functional scores. Conclusion: The most important factor affecting outcome in surgically treated tibia pilon fractures was quality of reduction. Poor functional scores were found independent from the type of surgery and quality of reduction in Ruedi/Allgower type 3 fractures, which was characterized with articular surface comminution and metaphyseal impaction. (C) 2013 Elsevier Ltd. All rights reserved
Carpal tunnel syndrome in manual tea harvesters
No full textObjectives: This study aims to present the physiopathological and surgical aspects of carpal tunnel syndrome (CTS) related to manual tea harvesting based on nerve conduction studies and clinical scoring systems. Patients and methods: Clinical and neurophysiological scores as well as clinical and occupational variables were statistically analyzed using Boston questionnaire, modified criteria of Italian CTS study group, and modified neurophysiologic grading system of Italian CTS study group in 56 agricultural laborers who underwent surgery due to severe CTS. Results: A statistically significant correlation was found among the clinical stages of the patients and age, working duration and duration of symptoms. There was a statistically significant relationship among neurophysiologic grades of the CTS in patients and the duration of symptoms and functional outcomes before and after surgery. Conclusion: We concluded that manual tea harvesting might be an occupational risk factor for work-related CTS development. Surgical treatment of CTS among manual tea harvesters revealed satisfactory results
Postoperative evaluation of quality of life in lumbar spinal stenosis patients following instrumented posterior decompression
No full textAbstract
Objectives: Spinal stenosis is a clinical condition in which bone and soft tissues compress the spinal canal, neuronal foramina and nerve roots. In this study, we aimed to evaluate the effectiveness of surgical treatment on patient satisfaction. Our sample included 64 patients with degenerative lumbar spinal stenosis on whom posterior decompression and instrumentation was applied. \r\nMethods: In this retrospective study, files of 64 patients who underwent posterior decompression surgery with instrumentation for degenerative lumbar spinal stenosis between March 2004 and April 2008 were examined. Patients were evaluated with Japanese Orthopaedic Association (JOA) form, form of degenerative lumbar spinal stenosis and the most recent postoperative orthopedic inspection findings for a minimum of one year after surgery. \r\nResults: Mean age of patients was 59.9 years and mean follow-up was 27.9 months. When evaluated using the Japanese Orthopaedic Association form, postoperative scores in 63.5% of the patients improved. Based on this postoperative improvement; Japanese Orthopaedic Association scores were found statistically significant (p<0.001). Gender (p=0.651), age (p=0.192), with the length of complaint (p=0.095), time passed after surgery (p=0.933), number of laminectomy level (p=0.997), deformity before operation (p=0.773) and systemic disease were not statistically correlated with improvement based upon Japanese Orthopaedic Association scores (p=0.052). But Japanese Orthopaedic Association scores were found to have improved (83%) in cases with no systemic diseases. \r\nConclusion: Our findings show that posterior decompression surgery with instrumentation is a useful treatment modality for patients with severe degenerative lumbar spinal stenosis. There is no secondary factor affecting improvement and instability after surgery is not observed in patient groups
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