scholarly journals Fosfato β-Tricálcico Monobloco no Tratamento de Fraturas Proximais do Úmero Cirúrgicas

2016 ◽  
Vol 29 (1) ◽  
pp. 41 ◽  
Author(s):  
Marco Sarmento ◽  
Samuel Martins ◽  
Jacinto Monteiro
Keyword(s):  
Bone Graft ◽  
Range Of Motion ◽  
Tricalcium Phosphate ◽  
Functional Results ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

<p><strong>Introduction:</strong> The proximal humeral fractures are becoming more frequent, with a greater tendency for its surgical treatment by osteosynthesis with plate and locked screws. The mechanical and biological failure in these fractures and devices, despite the evolution of this type of implants, highlighted the synthetic bone grafts became an option.<br /><strong>Material and Methods:</strong> Over a period of 96 months, patients considered were those with proximal humeral fractures treated surgically with a plate and locked screws, and in which β-tricalcium phosphate bone graft had been used. Functional results were evaluated by the shoulder range of motion as the radiological results.<br /><strong>Results:</strong> In 19 patients, with a medial follow up of 53 months, we obtained an average shoulder range of motion of 140º in abduction, 142º in forward flexion, 37º in external rotation and L3 hand position in internal rotation for a cefalo-diaphyseal angle of 136º.<br /><strong>Discussion:</strong> The β-tricalcium phosphate synthetic bone graft allows the maintenance of reduction after fixation of proximal humeral fractures stabilized with plate and locked screws. This reduction which means the maintenance of cefalo-diaphyseal angle is in close relationship with functional results as shown by shoulder range of motion in all planes.<br /><strong>Conclusion:</strong> The β-tricalcium phosphate synthetic bone graft should be seen as an adjuvant therapy in extramedullary fixation of proximal humeral fractures, especially those with greater comminution of the medial calcar.</p>

scholarly journals Fosfato β-Tricálcico Monobloco no Tratamento de Fraturas Proximais do Úmero Cirúrgicas

2016 ◽  
Vol 29 (1) ◽  
pp. 41
Author(s):  
Marco Sarmento ◽  
Samuel Martins ◽  
Jacinto Monteiro
Keyword(s):  
Bone Graft ◽  
Range Of Motion ◽  
Tricalcium Phosphate ◽  
Functional Results ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

<p><strong>Introduction:</strong> The proximal humeral fractures are becoming more frequent, with a greater tendency for its surgical treatment by osteosynthesis with plate and locked screws. The mechanical and biological failure in these fractures and devices, despite the evolution of this type of implants, highlighted the synthetic bone grafts became an option.<br /><strong>Material and Methods:</strong> Over a period of 96 months, patients considered were those with proximal humeral fractures treated surgically with a plate and locked screws, and in which β-tricalcium phosphate bone graft had been used. Functional results were evaluated by the shoulder range of motion as the radiological results.<br /><strong>Results:</strong> In 19 patients, with a medial follow up of 53 months, we obtained an average shoulder range of motion of 140º in abduction, 142º in forward flexion, 37º in external rotation and L3 hand position in internal rotation for a cefalo-diaphyseal angle of 136º.<br /><strong>Discussion:</strong> The β-tricalcium phosphate synthetic bone graft allows the maintenance of reduction after fixation of proximal humeral fractures stabilized with plate and locked screws. This reduction which means the maintenance of cefalo-diaphyseal angle is in close relationship with functional results as shown by shoulder range of motion in all planes.<br /><strong>Conclusion:</strong> The β-tricalcium phosphate synthetic bone graft should be seen as an adjuvant therapy in extramedullary fixation of proximal humeral fractures, especially those with greater comminution of the medial calcar.</p>

scholarly journals Range of motion of diabetic frozen shoulder recovers to the contralateral level

2016 ◽  
Vol 44 (6) ◽  
pp. 1191-1199 ◽  
Author(s):  
Heidi Vastamäki ◽  
Leena Ristolainen ◽  
Martti Vastamäki
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Functional Results ◽  
Shoulder Range Of Motion ◽  
Constant Murley Score ◽  
Patients With Diabetes ◽  
The Mean ◽  
Shoulder Range

Objective To determine whether frozen shoulder heals equally well in patients with and without diabetes and whether dependency on insulin affects the outcome. Methods We retrospectively examined 178 patients with idiopathic frozen shoulder; 27 patients had diabetes. We evaluated range of motion, pain, and functional results. The mean follow-up was 9.7 years (SD, 7.1 years). Results In the presence of frozen shoulder, range of motion did not differ between patients with and without diabetes. At follow-up, range of motion in all directions of both the affected and unaffected shoulders of patients with diabetes was inferior to that of patients without diabetes. Among patients with diabetes, range of motion of the once-frozen shoulder reached the level of the unaffected shoulder. Patients with and without diabetes experienced similar pain except during exertion. The Constant–Murley score was not significantly different between the two groups, and insulin dependency did not lead to worse outcomes. Conclusion Frozen shoulder heals well in patients with diabetes.

Medial support by fibula bone graft in angular stable plate fixation of proximal humeral fractures: an in vitro study with synthetic bone

2011 ◽  
Vol 20 (5) ◽  
pp. 740-746 ◽  
Author(s):  
Georg Osterhoff ◽  
Daniel Baumgartner ◽  
Philippe Favre ◽  
Guido A. Wanner ◽  
Hans Gerber ◽  
...  
Keyword(s):  
Bone Graft ◽  
Plate Fixation ◽  
In Vitro Study ◽  
Vitro Study ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Synthetic Bone ◽  
Medial Support

scholarly journals Electronic Moxibustion for Breast Cancer-Related Lymphedema: A Pilot Clinical Trial

2020 ◽  
Vol 19 ◽  
pp. 153473542096285
Author(s):  
Kyungsun Han ◽  
Ojin Kwon ◽  
Hyo-Ju Park ◽  
Ae-Ran Kim ◽  
Boram Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Range Of Motion ◽  
Upper Limb ◽  
Life Questionnaire ◽  
Breast Cancer Patients ◽  
Shoulder Range Of Motion ◽  
Breast Cancer Related Lymphedema ◽  
Shoulder Range

This is a preliminary study to investigate the feasibility of electronic moxibustion in breast cancer patients with upper limb lymphedema. As current treatment options for lymphedema are unsatisfactory and time consuming, there have been attempts to manage symptoms using integrative treatments. Electronic moxibustion was developed to compensate for the shortcomings of conventional moxibustion and is widely used in clinical practice. However, there have been no studies on using electronic moxibustion in breast cancer-related lymphedema. To investigate the feasibility of electronic moxibustion in treating breast cancer-related lymphedema, this study included subjects who completed primary cancer treatment at least 6 months ago and had more than 10 mm difference in arm circumference of upper limbs. All subjects were assigned to the treatment group. Subjects were treated with 16 sessions (30 minutes/session) of electronic moxibustion for 8 weeks followed by 4 weeks of follow-up. For outcome measures, upper limb circumferences, shoulder range of motion, bioimpedance analysis, and quality of life questionnaire were assessed. All 10 subjects completed the study. The effective index showed 38.21% reduction after treatment ( P = .0098) and 29.35% ( P = .0039) after 4 weeks of follow-up compared to the baseline. The reduction of lymphedema was most prominent at 10 cm above the elbow crease, where the mean reduction of circumference difference was 7.5 mm ( P = .0430) and continued to improve after treatment (mean reduction of 8.3 mm, P = .0156). There was significant improvement in shoulder range of motion only in flexion and internal rotation at week 9. There were 7 adverse events, and most were irrelevant to the treatment. Only 1 participant had a mild burn on the acupuncture point. Here, we demonstrate for the first time that electronic moxibustion treatment is a feasible treatment for breast cancer-related lymphedema. Electronic moxibustion may reduce differences in upper limb circumference and improve shoulder range of motion. A future comparative clinical trial is needed to confirm the clinical efficacy of this treatment.

scholarly journals 405 Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in The Management of Gustilo IIIB Open Fractures

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Aljawadi ◽  
I Madhi ◽  
T Naylor ◽  
M Elmajee ◽  
A Islam ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cortical Thickness ◽  
Bone Graft Substitute ◽  
Fracture Site ◽  
Open Fractures ◽  
X Rays ◽  
Radiographic Images ◽  
Synthetic Bone ◽  
Synthetic Bone Graft

Abstract Background Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling. Method Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed. Results 34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (&gt;90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had &lt; 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients. Conclusions Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.

Effectiveness of arthroscopic management of idiopathic shoulder stiffness: A meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Ya-Dong Wang ◽  
Yu-Xiang Ming ◽  
Yong-Hua Pang ◽  
Wei-Nan Chen ◽  
Xu-Hua Zong ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Shoulder Stiffness ◽  
Capsular Release ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Capsular Release ◽  
Shoulder Range

BACKGROUND: Persisting shoulder stiffness adversely affects quality of life by causing pain and motion restrictions especially in patients with diabetes. OBJECTIVE: The aim of this study was to evaluate the outcomes of arthroscopic capsular release in patients with idiopathic shoulder stiffness. METHOD: A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. Random-effects meta-analyses were performed to estimate the changes at latest follow-up in scores of the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angelis (UCLA) scales, Visual Analogue Scale (VAS), and shoulder range of motion. RESULTS: Nineteen studies were included. The follow-up duration was 42 months [95% confidence interval (CI): 32, 51]. Improvements in scores of the Constant, ASES, UCLA scales, and VAS were 48.3 [95% CI: 38.0, 58.6], 44.6 [95% CI: 24.6, 64.6], 19.3 [95% CI: 16.6, 22.0], and -6.1 [95% CI: -6.9, -5.4] respectively (P< 0.05 all). Improvements in the shoulder range of motion were: abduction 82.0 [95% CI: 65.0, 98.9]; forward flexion 75.9 [95% CI: 59.7, 92.1]; external rotation 43.2 [95% CI: 37.5, 49.0]; and internal rotation 25.4 [95% CI: 15.2, 35.5] degrees; P< 0.05 all). CONCLUSION: Arthroscopic capsular release effectively improves shoulder function in patients with idiopathic shoulder stiffness.

scholarly journals The Effects of Body Mass Index on Softball Pitchers’ Hip and Shoulder Range of Motion

2020 ◽  
Vol 05 (01) ◽  
pp. E8-E13
Author(s):  
Kenzie B. Friesen ◽  
Adam W. Anz ◽  
Jeffrey R. Dugas ◽  
James R. Andrews ◽  
Gretchen D. Oliver
Keyword(s):  
Body Mass Index ◽  
Body Composition ◽  
Range Of Motion ◽  
Body Mass ◽  
Mean Difference ◽  
Additional Stress ◽  
Maximal Velocity ◽  
Strength And Conditioning ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

AbstractCurrently it is hypothesized that increased body mass index may contribute to overuse injuries. Thus, if hip or shoulder range of motion is affected by body mass index, pitchers may be placing additional stress on joints as they seek to pitch at maximal velocity. The purpose of this study was to examine if range of motion at the hips and shoulders were related to body mass index classification. A sample of 147 female softball pitchers (17.0±4.2 years; 167.6±11.8 cm; 70.6±17.5 kg; body mass index=24.8±4.7 kg/m2) participated. Bilateral hip and shoulder range of motion were assessed. Multivariate analysis of variance results indicated body mass index [Wilks’ Λ=0.742, F=1.722, p=0.014, η2=0.095] significantly affected range of motion of the shoulder and hip. Post hoc results indicated the underweight group had significantly more range of motion than the obese group in hip internal range of motion on both the throwing side (mean difference=12.39, p=0.005) and glove side (mean difference=11.98, p=0.004). Although body composition is not overly emphasized among softball pitchers, the current study reveals excess weight may inhibit proper mechanics. Coaches, athletic trainers, strength and conditioning personnel, and athletes should acknowledge the role that body composition can play in affecting pitch outcomes.

scholarly journals Synthetic bone graft versus autograft or allograft for spinal fusion: a systematic review

2016 ◽  
Vol 25 (4) ◽  
pp. 509-516 ◽  
Author(s):  
Zorica Buser ◽  
Darrel S. Brodke ◽  
Jim A. Youssef ◽  
Hans-Joerg Meisel ◽  
Sue Lynn Myhre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Bone Graft ◽  
Spinal Fusion ◽  
Comparative Studies ◽  
Functional Outcomes ◽  
Retrospective Studies ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Bone Graft Substitutes

The purpose of this review was to compare the efficacy and safety of synthetic bone graft substitutes versus autograft or allograft for the treatment of lumbar and cervical spinal degenerative diseases. Multiple major medical reference databases were searched for studies that evaluated spinal fusion using synthetic bone graft substitutes (either alone or with an autograft or allograft) compared with autograft and allograft. Randomized controlled trials (RCT) and cohort studies with more than 10 patients were included. Radiographic fusion, patient-reported outcomes, and functional outcomes were the primary outcomes of interest. The search yielded 214 citations with 27 studies that met the inclusion criteria. For the patients with lumbar spinal degenerative disease, data from 19 comparative studies were included: 3 RCTs, 12 prospective, and 4 retrospective studies. Hydroxyapatite (HA), HA+collagen, β-tricalcium phosphate (β-TCP), calcium sulfate, or polymethylmethacrylate (PMMA) were used. Overall, there were no differences between the treatment groups in terms of fusion, functional outcomes, or complications, except in 1 study that found higher rates of HA graft absorption. For the patients with cervical degenerative conditions, data from 8 comparative studies were included: 4 RCTs and 4 cohort studies (1 prospective and 3 retrospective studies). Synthetic grafts included HA, β-TCP/HA, PMMA, and biocompatible osteoconductive polymer (BOP). The PMMA and BOP grafts led to lower fusion rates, and PMMA, HA, and BOP had greater risks of graft fragmentation, settling, and instrumentation problems compared with iliac crest bone graft. The overall quality of evidence evaluating the potential use and superiority of the synthetic biological materials for lumbar and cervical fusion in this systematic review was low or insufficient, largely due to the high potential for bias and small sample sizes. Thus, definitive conclusions or recommendations regarding the use of these synthetic materials should be made cautiously and within the context of the limitations of the evidence.

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