scholarly journals Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jae-Yong Park ◽  
Hyong-Nyun Kim ◽  
Yoon-Suk Hyun ◽  
Jun-Sik Park ◽  
Hwan-Jin Kwon ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Weight Bearing ◽  
Operative Management ◽  
Foot And Ankle ◽  
Early Weight Bearing ◽  
Group A ◽  
Vas Scores ◽  
American Orthopaedic ◽  
Group B ◽  
Underlying Diseases

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

scholarly journals Effect of Teriparatide in Fracture Healing in Lower Limbs- An Interventional Study

2021 ◽  
Author(s):  
Sanjeev Kumar ◽  
Girish Sahni ◽  
Harjit K Singh Chawla ◽  
Daljinder Singh
Keyword(s):  
Functional Outcome ◽  
Adverse Reactions ◽  
Weight Bearing ◽  
Test Group ◽  
Control Group ◽  
Dash Score ◽  
Early Weight Bearing ◽  
Group A ◽  
Group B ◽  
Radiological Union

Introduction: Many of the trauma patients presenting to the orthopaedic departments suffer from lower limb fractures. This often leads to prolonged period of morbidity and absence from work. Fracture healing can be delayed in elderly patients, postmenopausal women and in communited fractures. Teriparatide (TPH) given subcutaneously for 6 to 9 months, in such cases, may promote clinical and radiological union of bone. Aim: To know the effect of TPH in improving clinical and radiological union and also to evaluate early weight bearing, improvement in pain and functional outcome. Materials and Methods: In this prospective interventional study, a total of 125 patients were initially enrolled for the study and then after meeting inclusion criteria total 104 patients were selected for the study. They were allocated into two groups by randomisation by 1:1 method-group A was test group of 52 cases in which subcutaneous injection TPH 20 mcg daily (for six months) was given along with standard dosage of calcium and vitamin D; while in 52 cases in group B (control group) only calcium and vitamin D were given. Injection TPH was started within 10 days of fracture and given for six months. No placebo injection was given in control group. Time to weight bearing, time to clinical and radiological union and pain by Visual Analogue Score (VAS) were noted at regular follow-up at one month, three months, six months and 12 months and were compared in both the groups. Functional outcome by Disabilities of the Arm, Shoulder and Hand (DASH) score was noted as an additional tool, as DASH score questionnaire shows many activities of daily living that require mobility and stability of lower limb too. Adverse reactions were noted and compared within test and control groups. The collected data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0 software and Mann-Whitney U test was used to calculate p-value. Results: Average time period for full weight bearing with or without support for test group A was 11±2.7 weeks and 16±1.8 weeks in control group B (p-0.001). Average time to clinical union in test group was 12±1.9 weeks and in control group 16±2.2 weeks (p-0.001). Average time to radiological union was 13±1.4 weeks in test group while 22±2.2 weeks in control group (p-0.001). Pain score by VAS and functional outcome by DASH were improved in test group (p-0.001). There was no difference in adverse reactions in both the groups (p>0.05). Conclusion: Regular intake of TPH 20 mcg subcutaneous daily for six months can reduce time to clinical and radiological fracture union, promote early weight bearing and provide better pain control. Hence, better functional outcome and prefracture ambulatory status can be achieved with no significant adverse events.

scholarly journals Comparison of Primary Hip Spica with Crossed Retrograde Intramedullary Rush Pins for the Management of Diaphyseal Femur Fractures in Children: A Prospective, Randomized Study

2013 ◽  
Vol 1 (1) ◽  
pp. 12-17
Author(s):  
Mohammad Ruhullah ◽  
Sanjay Shah ◽  
Hare Ram Singh ◽  
Dipak Shrestha
Keyword(s):  
Femur Fracture ◽  
Weight Bearing ◽  
Randomized Study ◽  
Femoral Fractures ◽  
Early Weight Bearing ◽  
Patients Âgés ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Group A ◽  
Group B

Introduction: Femoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. We compared primary hip spica with closed reduction and fixation with retrogradely crossed Rush pins for diaphyseal femur fracture in 25 children of age group 3 to 13 years randomly distributed in each group.Methods: Fifty children with femoral fractures were evaluated; 25 of them underwent conservative treatment using immediate hip spica (group A) and 25 were treated with crossed retrograde Rush pins (group B). The patients ages ranged from 3 to 13 years (mean age 5.6±3.57 yrs).Results: Mean clinico-radiological consolidation was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing 7 weeks in group B and 14 weeks in group A. Mean hospital stay were 8 days in group B and 4 days in group A. Mean follow up period in group A was 16 months and group B was 17 months. Complications like angulation, shortening, infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is complication associated with this method of treatment. Conclusions: Intra-medullary crossed Rush pinning is an effective method of paediatric diaphyseal femur fracture fixation as compared to primary hip spica in terms of early weight bearing and restoration of normal anatomy.

scholarly journals Management of LC Type I (LC-1) Pelvic Injuries with Complete Sacral Fracture : Is there a Role for Solitary Anterior Fixation?

2021 ◽  
Author(s):  
Pengfei Wang ◽  
Syed Ali ◽  
Chen Fei ◽  
Binfei Zhang ◽  
Xing Wei ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Weight Bearing ◽  
Sacral Fracture ◽  
Fracture Reduction ◽  
Early Weight Bearing ◽  
Sacral Fractures ◽  
Pelvic Injuries ◽  
Group A ◽  
Group B

Abstract Background: Management of LC-1 type pelvic injuries, particularly in patients with complete sacral fracture (LC-1 PICSF, OTA type 61-B2.1) remains controversial. Specific indications for solitary fixation remain unclear, and there is a paucity of outcomes data in comparison to combined fixation. We undertook a retrospective study in patients with LC-1 PICSFs to compare outcomes between solitary anterior fixation and combined anterior-posterior fixation.Methods: A retrospective cohort study was conducted with enrollment from 2014 to 2015 at a single tertiary-referral center in China. Adults with operatively managed LC-1 PICSFs were enrolled. Patients with sacral displacement <1 cm as assessed by axial CT received solitary anterior ring fixation (Group A); patients with displacement ≥1 cm received combined fixation of both the anterior and posterior rings (Group B). Reduction was confirmed by manipulation under anesthesia. Patients followed up for at least 24 months post-operatively. Primary outcome was function (Majeed score). Secondary outcomes included intraoperative characteristics, pain (VAS score), quality of fracture reduction (Tornetta and Matta radiographic grading), rate of non-union, early weight-bearing status, and complication rate.Results: 68 (89%) of 76 enrolled patients completed follow-up. Patients in Group A exhibited improved operative times, less time under fluoroscopy, and less blood loss as compared to Group B. There were no significant differences between Groups A and B regarding quality of fracture reduction, rate of union, functional outcomes, or rate of complications. Notably, Group B patients were more likely to achieve full early weight-bearing.Conclusion: LC-1 PFCSFs can get benefits from ORIF; the treatment algorithm should be differently made following the degree of the sacral fractures displacement. Less than 1cm sacral fracture displacement may get good functional outcomes from solitary anterior fixation. However, for the sacral fractures displacement greater or equal to 1cm, both the anterior and posterior pelvic ring should be surgical stabilization.

Closed arthrodesis in infected neuropathic ankles using Ilizarov ring fixation

2020 ◽  
Vol 102-B (4) ◽  
pp. 470-477 ◽  
Author(s):  
Yaser Alammar ◽  
Anatoliy Sudnitsyn ◽  
Andrey Neretin ◽  
Sergey Leonchuk ◽  
Nikolay Mikhailovich Kliushin
Keyword(s):  
Operating Time ◽  
Deformity Correction ◽  
Ankle Arthrodesis ◽  
Ilizarov Method ◽  
Foot And Ankle ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator ◽  
Group A ◽  
American Orthopaedic ◽  
Group B

Aims Infected and deformed neuropathic feet and ankles are serious challenges for surgical management. In this study we present our experience in performing ankle arthrodesis in a closed manner, without surgical preparation of the joint surfaces by cartilaginous debridement, but instead using an Ilizarov ring fixator (IRF) for deformity correction and facilitating fusion, in arthritic neuropathic ankles with associated osteomyelitis. Methods We retrospectively reviewed all the patients who underwent closed ankle arthrodesis (CAA) in Ilizarov Scientific Centre from 2013 to 2018 (Group A) and compared them with a similar group of patients (Group B) who underwent open ankle arthrodesis (OAA). We then divided the neuropathic patients into three arthritic subgroups: Charcot joint, Charcot-Maire-Tooth disease, and post-traumatic arthritis. All arthrodeses were performed by using an Ilizarov ring fixator. All patients were followed up clinically and radiologically for a minimum of 12 months to assess union and function. Results The union rate for Group A was 81% (17/21) while it was 84.6% (33/39) for Group B. All the nonunions in Group A underwent revision with an open technique and achieved 100% union. Mean duration of IRF was 71.5 days (59 to 82) in Group A and 69 days (64.8 to 77.7) in Group B. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was similar in both groups. The postoperative hospital stay was shorter in Group A (21 days (SD 8)) than Group B (28 days (SD 9)). In the latter Group there were more problems with wound healing and greater requirement for antibiotic treatment. The mean operating time was 40 minutes (SD 9) in Group A compared to 80 minutes (SD 13) in Group B. Recurrence of infection occurred in 19% (4/21) and 15.5% (6/39) for Group A and Group B respectively. Conclusion We found CAA using an IRF to be an effective method for ankle arthrodesis in infected neuropathic foot and ankle cases and afforded comparable results to open methods. Due to its great advantages, Ilizarov method of CAA should always be considered for neuropathic ankles in suitable patients. Cite this article: Bone Joint J 2020;102-B(4):470–477.

The Charcot Reconstruction Preoperative Prognostic Score's Evaluation with Complication Rate and Functional Outcome

2021 ◽  
Vol 111 (5) ◽  
Author(s):  
Necip Selcuk Yontar ◽  
Lercan Aslan ◽  
Ata Can ◽  
Tahir Ogut
Keyword(s):  
Medical Records ◽  
Functional Outcomes ◽  
Prognostic Score ◽  
Complication Rates ◽  
Foot And Ankle ◽  
Group A ◽  
Patient’S Outcome ◽  
American Orthopaedic ◽  
Group B

Background Charcot's neuroarthropathy (CN) treatment is still controversial, and the results are controversial. Owing to patient comorbidities, surgical intervention carries a high risk of complications. Thus, foreseeing the possible results of planned treatment is crucial. We retrospectively evaluated the Charcot Reconstruction Preoperative Prognostic Score (CRPPS) in patients with surgically treated CN. Methods Twenty-two feet of 20 patients were included in the study. Two groups were formed according to their CRPPS. Twelve patients with values less than 4 were defined as group A, and eight patients with values of 4 or greater were defined as group B. Mean follow-up was 61 months (range, 5–131 months). Groups were compared according to American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Disability Index (FADI) scores, and complication rates. Results Group A and B mean AOFAS scores were 76.83 (range, 71–85) and 70.5 (range, 20–85), respectively. All of the patients were improved according to AOFAS and FADI scores, but no correlation was found with the CRPPS. None of the group A patients required additional intervention, but five patients in group B underwent revision surgery. No amputations were performed. Conclusions The CRPPS is focused on feasibility. The data needed to fill the scoring system is easily obtainable from medical records even retrospectively, and the score is helpful to predict a patient's outcome after CN-related surgery. Herein, CRPPS values of 4 or greater were related to high complication rates and lower functional outcomes.

scholarly journals The influence of previous arthroscopic treatment on subsequent primary total knee arthroplasty: the comparison between bilateral knees of the same patient

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kuishuai Xu ◽  
Liang Zhang ◽  
Rui Shen ◽  
Cailin Wang ◽  
Tianyu Li ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Recovery ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Arthroscopic Treatment ◽  
Functional Scores ◽  
Group A ◽  
Vas Scores ◽  
Total Knee ◽  
Group B

Abstract Background To explore whether previous arthroscopic knee surgery affects future total knee arthroplasty (TKA) results or not. Methods A total of 56 patients with the previous arthroscopic treatment on one knee underwent subsequent bilateral total knee arthroplasty in our hospital from September 2012 to July 2018. Data on each patient were collected in regards to changes in postoperative clinical and functional scores, various other scores, as well as postoperative functional recovery and complications. We defined the knees with a previous arthroscopic history as group A, and the counter side as group B. The Knee Society clinical score, functional scores, range of motion (ROM), finger joint size (FJS), visual analogue scale (VAS) scores were assessed before and after surgery. Using the Kolmogorov-Smirnov Test to test the normality of continuous variables, and the chi-square test to compare the rate of reoperation and complications between two groups. For all statistical comparisons, P < 0.05 was considered significant. Results There were no statistically significance differences found in postoperative Knee Society clinical scores and functional scores between group A and group B, as well as in ROM, FJS, VAS scores and local complications. Conclusion There were no statistically significant differences found in postoperative functional recovery and complications in patients, who underwent total knee arthroplasty with previous knee arthroscopy.

scholarly journals Preliminary Results of Subtalar Arthroereisis with Vulpius Procedure for Symptomatic Flatfoot in Patients with Type I Osteogenesis Imperfecta

2020 ◽  
Vol 18 (1) ◽  
pp. 67
Author(s):  
Cheng-Min Hsu ◽  
Sheng-Chieh Lin ◽  
Kuan-Wen Wu ◽  
Ting-Ming Wang ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Osteogenesis Imperfecta ◽  
Weight Bearing ◽  
Life Quality ◽  
Type I ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Viable Approach ◽  
American Orthopaedic

In this retrospective study, we aim to assess the safety and feasibility of adapting subtalar arthroereisis (SA) for type I osteogenesis imperfecta (OI) patients with symptomatic flatfoot. From December 2013 to January 2018, six type I OI patients (five girls and one boy, 12 feet) with symptomatic flexible flatfoot were treated with SA and the Vulpius procedure. All the patients were ambulatory and skeletally immature with failed conservative treatment and unsatisfactory life quality. The median age at the time of surgery was 10 years (range 5–11), and the median follow-up period was 55 months (range 33–83). All functional and radiographic parameters improved (p < 0.05) after the procedure at the latest follow-up. The median American Orthopaedic Foot and Ankle Society ankle-hindfoot scale improved from 68 (range 38–80) to 95 (range 71–97). All of the patients ambulated well without significant complications. The weight-bearing radiographs showed maintained correction of the tarsal bone alignment with intact bony surfaces adjacent to implants during the post-operative follow-up period. This is the very first study on symptomatic flatfoot in pediatric patients with type I OI. Our data suggest that SA is a potentially viable approach, as functional improvements and maintained radiographic correction without significant complication were observed.

scholarly journals Non-locking buttress plate in distal tibial metaphyseal fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 87-91
Author(s):  
Norman Lamichhane ◽  
Bhogendra Bahadur KC ◽  
Chandra Bahadur Mishra ◽  
Sabita Dhakal
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Delayed Union ◽  
Full Weight Bearing ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Metaphyseal Fractures

Background: Treatment of distal tibial metaphyseal fractures is often challenging and no single technique has been unanimously advocated. Open reduction and internal fixation with plates and screws allows better restoration of anatomical alignment but with more soft tissue complication. Simultaneous fixation of the fibula is not universally carried out. This study aims at evaluation of the outcome of plating technique and the effect of fixation of fibula fracture in treatment of distal tibial metaphyseal fractures. Material and methods: Thirty-one cases (14 cases in Group A with concomitant distal fibula fracture and 17 cases in Group B without distal fibula fracture) were analyzed retrospectively for the mean duration of full weight bearing, mean union time and complications, and compared. Results: The mean time for full weight bearing and radiological union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively. 16.1% of cases had post-operative complications including one case of deep infection and malalignment of 6 degree varus (following delayed union) was seen in one case of Group A. Range of motion (ROM) at ankle was not problem in any of the cases except the one delayed union which had 5 degrees of dorsiflexion and 15 degrees of plantiflexion. Conclusion: Open reduction and internal fixation with plate and screws in distal tibial metaphyseal fracture is more economic means of treatment modality with comparable incidence of post-union malalignment and union time,though more soft tissue complications compared to other modalities. Fixation of fibula fracture aids in reducing the incidence of malalignment.

scholarly journals Surgical Treatment Outcomes for Everted Bursal Flap of Delaminated Supraspinatus Tear

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199042
Author(s):  
Hyungsuk Kim ◽  
Chu Hwan Byun ◽  
Sung Bin Han ◽  
Hyun Seok Song
Keyword(s):  
Los Angeles ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Level Of Evidence ◽  
Supraspinatus Tear ◽  
Functional Scores ◽  
Group A ◽  
Vas Scores ◽  
Group B

Background: Although everted bursal flaps of delaminated tears have been reported, few studies have reported radiologic images, arthroscopic findings, and clinical results after repair. Purpose: To compare the repair outcomes of everted delaminated tears with those of classic delaminated supraspinatus tears. Study Design: Cohort study; Level of evidence, 3. Methods: Among 153 patients who underwent arthroscopic rotator cuff repair for a delaminated supraspinatus tear, everted bursal flap tears were observed in 24 patients upon arthroscopy (group A). Another 24 patients with classic delaminated supraspinatus tears, matched for age and sex, were selected for group B. Magnetic resonance imaging (MRI) and ultrasonography were performed preoperatively and postoperatively. Patients were evaluated using a visual analog scale (VAS) for pain as well as functional scores (American Shoulder and Elbow Surgeons [ASES] score, Constant score, and University of California Los Angeles shoulder score). Scores were compared preoperatively and at final follow-up (mean follow-up, 32 months). Results: Patients in both groups A and B reported improved VAS and functional scores at the final follow-up. In group A, preoperative VAS scores were higher and functional scores were poorer than in group B. Subacromial effusions with tendon swelling on preoperative MRI were more common in group A. During follow-up ultrasonography, group A patients exhibited persistent subacromial effusion. However, VAS scores at final follow-up were significantly better in group A (0.4 ± 0.7) than in group B (1.6 ± 1.4) ( P < .001), and ASES scores at final follow-up were better in group A (84.3 ± 4.3) than in group B (77.0 ± 10.2) ( P = .005). Conclusion: Everted bursal flap delaminated tears were associated with higher VAS scores and poorer functional scores preoperatively. Although subacromial effusions were experienced by group A during the early postoperative period, clinical outcomes at final follow-up were significantly better for everted delaminated tears compared with classic delaminated tears.

COMPARISON OF IMMEDIATE EFFECT ON APPLICATION OF REMOTE SELFMYOFASCIAL RELEASE ON POSTERIOR CHAIN FLEXIBILITY IN ASYMPTOMATIC YOUNG INDIVIDUALS

2021 ◽  
pp. 26-27
Author(s):  
Rishika Balani ◽  
Tanvi Patole
Keyword(s):  
Weight Bearing ◽  
Plantar Fascia ◽  
Knee Extension ◽  
Post Intervention ◽  
Chain Flexibility ◽  
Myofascial Release ◽  
Outcomes Measures ◽  
Group A ◽  
Group B ◽  
Plantar Fascia Release

Aim of study: The aim of the study was to compare the immediate effect on application of remote self- myofascial release on posterior chain exibility in asymptomatic young individuals. Material and Method: 44 subjects were assigned into two groups, Group (A) Plantar fascia release and Group (B) Suboccipital release. Outcomes measures used were Sit and reach test (SRT), Active knee extension test (AKE) and Weight bearing lunge test. Result: There was a signicant difference in SRT and AKE on left side between group A and B. Within the same group there was a signicant improvement in outcome measures post intervention. Conclusion: There was an immediate increase in exibility of the hamstrings, gastrocnemius-soleus muscles and lumbar spine ROM through remote self- myofascial release.

Sign in / Sign up

Export Citation Format

Share Document