1,721,245 research outputs found
Aseptic Bone Forearm Nonunions Treated by Plate and Opposite Allograft Strut
No full textAseptic Bone Forearm Nonunions Treated by Plate and Opposite Allograft Stru
The clubfoot over the centuries through the documentation present in the literature and art
No full textThe aim of this paper is to review all treatment methods of the clubfoot over the years through the documentation present in the literature and art with the aim of better understanding the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. The initial part of this paper traces the most representative iconographic representations of clubfoot in history to describe how his presence was witnessed since ancient times. Hippocrates, the father of medicine, was the first to present written references about treatment methods of clubfoot. After the dark period of the Middle Ages, during the Renaissance, there were more detailed studies on the disease, with the creation of the first orthopedic orthotics, designed to correct the deformity with the help of famous names in medicine's history. In the XVIII century, as we witness the birth of orthopedics as a distinct discipline in medicine, more and more brilliant minds developed complex orthoses and footwear with the aim of obtaining a proper correction of the deformity. In the last part of the paper, there is a description of the main surgical techniques developed over the years until the return to conservative treatment methods such as the Ponseti method, internationally recognized as the gold standard of treatment, despite the presence of some unresolved issues such as the possible recurrence of the disease
Autoimmunity in intervertebral disc herniation: from bench to bedside
No full textIntroduction: The cause of low back pain and the pathophysiology of lumbar pain and sciatica have recently been reconsidered basing on current knowledge on cellular and molecular mediators of inflammation. Several cytokines have been considered as potential therapeutic targets to contrast sciatica in patients with disc herniation, and supportive studies suggest a leading role of TNF-α in this contest: therefore, clinical trials have tested TNF-α inhibitors in the clinical setting of the patient with radicular pain secondary to an herniated disc. Areas covered: The current review deals with the autoimmune theory of disc herniation and its role in determining radiculopathy and neuropathic pain. It also reports the recent evidences that led to the introduction of anti-TNF-α drugs into the clinical setting as a biological therapy for radiculopathy and disc herniation. Expert opinion: Targeting the TNF-α pathway has demonstrated controversial effects in the tested study population and available results only report a short-term follow-up. More confirmatory studies in terms of long-term clinical results, complications, more effective route of administration and cost-effective analysis are required to establish the real role of this biological therapy in the treatment of patients with disc herniation and neuropathy. © 2013 Informa UK, Ltd
Fracture of ceramic bearing surfaces following total hip replacement: A systematic review
No full textCeramic bearing surfaces are increasingly used for total hip replacement, notwithstanding that concern is still related to ceramic
brittleness and its possible mechanical failure. The aim of this systematic review is to answer three questions: (1) Are there risk
factors for ceramic component fracture following total hip replacement? (2) Is it possible to perform an early diagnosis of ceramic
component failure before catastrophic fracture occurs? (3) Is it possible to draw guidelines for revision surgery after ceramic
components failure? A PubMed and Google Scholar search was performed and reference citations from publications identified
in the literature search were reviewed. The use of 28 mm short-neck femoral head carries an increased risk of fracture. Acetabular
component malposition might increase the risk of ceramic liner fractures. Synovial fluid microanalysis and CT scan are promising
in early diagnosis of ceramic head and liner failure. Early revision is suggested in case of component failure; no consensus exists
about the better coupling for revision surgery. Ceramic brittleness remains a major concern. Due to the increased number of ceramic
on ceramic implants, more revision surgeries and reports on ceramic components failure are expected in the future. An algorithm
of diagnosis and treatment for ceramic hip failure is proposed
In vitro experimental studies and numerical modeling to investigate the biomechanical effects of surgical interventions on the spine
No full textThis paper offers a comprehensive systematic review of biomechanical research on the spine and on in vitro and numerical methods of investigation. This review focuses on interventions on the ligaments, on the facets, and on the lamina (facetectomies, laminectomies, and laminoplasties). Surgical interventions on the facets and lamina in some cases yield dissatisfactory clinical follow-up. Patient outcome is strongly related to the effects that such interventions have on the biomechanical functionality of the spine. The papers examined include those addressing the untreated spine (range of motion and stiffness), but the focus is on experimental and numerical investigations studying the role of the ligaments and of the posterior structures (including their role in granting spine stability and the biomechanical behavior of each ligament). The papers were classified based on the different investigation approaches. In vitro experiments exploit dedicated biomechanical spine testers to measure the mechanical properties of physical specimens. Numerical modeling (multibody dynamics, finite-element analysis) allows predicting the effect of different conditions. All the papers indicate that interventions on the ligaments, facets, and lamina increase range of motion and decrease stability. The quantitative results show great variability across studies. This review shows how it is possible to use in vitro and numerical methods to investigate the biomechanical effects of surgical interventions
Correction to: Surgical correction of double major adolescent idiopathic scoliosis
No full textUnfortunately, the affiliation of the author group has been incorrectly published in original version. The complete correct affiliation of all authors should read as follows
The biological respect of the posterolateral bundle in ACL partial injuries. Retrospective analysis of 2 different surgical management of ACL partial tear in a population of high-demanding sport patients
No full textIntroduction: Most of the techniques described in the literature for the repair of chronic partial ACL tears do not spare the intact portion of the ligament. Aim of this study was to perform a retrospective analysis of the results obtained from the same ACL reconstructive surgical technique applicated by sparing or not AM bundle in a population of 42 sports patients. Materials and methods: From 2010 to 2012, 42 patients who suffered ACL partial tear injury with rupture of posterolateral bundle were randomly divided in two groups homogenous for sex, age and sport-level activities. The first group with 22 patients performed ACL reconstruction with ST-GR over-the-top technique sacrificing the anteromedial (Removing AMT Group) remaining bundle intact; otherwise, the second group with 20 patients performed the same ACL reconstruction using only ST and maintaining AM bundle (Sparing AMT Group). All the patients were followed up by MRI evaluation at 12 months and clinical evaluation with IKDC score, Tegner score at 6, 12, 24, 36, 48 and 60 months. KT-1000 instrument was performed at 12 months. The results were analyzed statistically to evaluate differences between the two groups in terms of subjective outcome, and stability and for all the tests P < 0.05 was considered significant. Results: We did not observe any failure at final follow-up. IKDC subjective score at final follow-up in Removing AMT Group was 91.2 ± 2.3 in Sparing AMT Group was 92.4 ± 2.7. Tegner score at final follow-up was 7.2 ± 2.1 for Removing AMT Group and 7.8 ± 1.8 for Sparing AMT Group. Arthrometric evaluation performed with KT-1000 at final follow-up showed a side-to-side difference of 0.9 ± 1.3 mm in the Removing AMT Group against 0.8 ± 1.0 mm in the Sparing AMT Group. Return time to the sport was 7.1 months for Removing AMT Group otherwise 6.1 months for the Sparing AMT Group. Conclusions: Both the described techniques in this study demonstrated to be able to guarantee a successful outcome. However, although no statistically significant differences were evident in terms of subjective and objective outcome between these techniques some evident benefits were evident using the sparing bundle technique in Sparing AMT Group such as better clinical scores at the final follow-up and an earlier return to sport activity
Correction to: Spino-pelvic balance and surgical treatment of L5-S1 isthmic spondylolisthesis
No full textUnfortunately, the affiliation of the author group has been incorrectly published in original version. The complete correct affiliation of all authors should read as follows
Full-field in vitro investigation of hard and soft tissue strain in the spine by means of Digital Image Correlation
No full textThe spine deserves careful biomechanical investigation, because of the different types of degeneration deriving from daily stress, trauma, and hard and soft tissue pathologies. Many biomechanical studies evaluated the range of motion, structural stiffness of spine segments under different loading conditions, without addressing the strain distribution. Strain gauges have been used to measure strain in the vertebral body, in a pointwise way.What is currently missing is a method to measure the distribution of strain in the soft tissues (intervertebral discs and ligaments), and an integration between measurements in the hard and soft tissues. Digital Image Correlation (DIC) is a recently developed optical technique, which allows measuring the distribution of displacements and deformation in a contact-less way. It can provide a full-field view of the examined surface under load. DIC can therefore give a more complete knowledge of the biomechanics of the spine
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