This study retrospectively reviewed 11 patients who underwent laparoscopic repair of large hiatal hernias with reinforcement of the diaphragmatic crura using various biologic grafts. Three different biologic grafts were used - acellular human dermal collagen in 6 patients, cellular porcine dermal implant in 1 patient, and porcine urinary bladder matrix in 4 patients. Outcomes were evaluated including perioperative data, complications, recurrence rates, and improvement in symptoms. The study found the laparoscopic repair of large hiatal hernias can be safely performed in rural hospitals using biologic grafts for crural reinforcement, with the choice of graft depending on availability, cost and surgeon preference.
This case report describes a rare occurrence of an aneurysmal bone cyst arising from an iliopubic chondromyxoid fibroma in a 20-year-old male patient. Imaging showed an osteolytic tumor in the left iliopubic ramus. The tumor was excised surgically and microscopic examination confirmed the diagnosis of chondromyxoid fibroma with areas consistent with an aneurysmal bone cyst. This case represents an unusual location for a chondromyxoid fibroma and confirms the rare association between aneurysmal bone cysts and chondromyxoid fibromas. The patient recovered well after surgery with no recurrence after one year of follow up.
This study examined whether hip involvement negatively impacts radiographic outcomes after lumbar pedicle subtraction osteotomy (PSO) in ankylosing spondylitis patients with thoracolumbar kyphosis. 44 patients underwent one-level lumbar PSO and were divided into two groups based on their hip involvement scores. Both groups had similar corrections of local kyphosis, but the group with hip involvement had significantly larger sagittal vertical axis and pelvic tilt postoperatively, indicating hip involvement can negatively impact radiographic outcomes after lumbar PSO. Additional osteotomies may be needed for patients with hip involvement to achieve satisfactory correction.
1) Multiple infection prevention measures were used in 54 patients undergoing ACL reconstruction surgery, including preoperative skin washing and bathing, intraoperative use of sterile drapes and instruments soaked in vancomycin solution, and postoperative rehabilitation.
2) No postoperative infections occurred in any patients over 6-18 months of follow-up. Knee function scores improved significantly from pre-operation levels.
3) The study suggests that using multiple prevention measures can successfully prevent infections after ACL reconstruction surgery and allow for good postoperative recovery of knee function.
1) A study compared the clinical results of using hollow screws versus plates for treating spiral fractures of the lower third of the tibia combined with posterior malleolar fractures.
2) 61 patients were treated with tibia plate fixation and either hollow screw fixation (34 patients) or plate fixation (27 patients) of the posterior malleolar fracture.
3) At 6-36 months follow up, all fractures healed well with no differences in healing time or infection rates between the two groups. Functional outcomes assessed using the Baird-Jackson scoring system also did not significantly differ between groups.
This research article evaluated the efficacy and safety of laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation for treating rectal cancer. 211 patients underwent either laparoscopic (131 patients) or open (80 patients) surgery. Results showed that both surgeries were successfully completed with no differences in lymph nodes removed or post-op complications. The laparoscopic group had shorter time to pass gas, get out of bed, and hospital stay. No differences were found in recurrence, mortality, or urinary/sexual dysfunction between groups. The study concludes that laparoscopic D3 lymphadenectomy combined with nerve preservation is a feasible and safe treatment for rectal cancer.
The document summarizes research on gait analysis of patients with spina bifida. It describes the three main types of spina bifida and their associated neurological impairments and functional classifications. Instrumental gait analysis is discussed as a tool to objectively measure biomechanical variables during walking. Results from gait analysis can inform treatment through assessing quality of ambulation, effects of orthotics, muscle function, and postoperative changes.
This study evaluated the safety and short-term efficacy of laparoscopic complete mesocolic excision (CME) compared to open CME for the treatment of right hemicolon cancer. The study retrospectively reviewed 88 patients - 40 who underwent laparoscopic CME and 48 who underwent open CME. The laparoscopic CME group had a longer operating time but shorter time to first flatus and time to get out of bed compared to the open CME group. There were no significant differences in the number of harvested lymph nodes, hospital stay length, or postoperative complications between the two groups. The study concluded that laparoscopic CME is a safe and effective minimally invasive surgery for right hemicolon cancer.
This study retrospectively reviewed 11 patients who underwent laparoscopic repair of large hiatal hernias with reinforcement of the diaphragmatic crura using various biologic grafts. Three different biologic grafts were used - acellular human dermal collagen in 6 patients, cellular porcine dermal implant in 1 patient, and porcine urinary bladder matrix in 4 patients. Outcomes were evaluated including perioperative data, complications, recurrence rates, and improvement in symptoms. The study found the laparoscopic repair of large hiatal hernias can be safely performed in rural hospitals using biologic grafts for crural reinforcement, with the choice of graft depending on availability, cost and surgeon preference.
This case report describes a rare occurrence of an aneurysmal bone cyst arising from an iliopubic chondromyxoid fibroma in a 20-year-old male patient. Imaging showed an osteolytic tumor in the left iliopubic ramus. The tumor was excised surgically and microscopic examination confirmed the diagnosis of chondromyxoid fibroma with areas consistent with an aneurysmal bone cyst. This case represents an unusual location for a chondromyxoid fibroma and confirms the rare association between aneurysmal bone cysts and chondromyxoid fibromas. The patient recovered well after surgery with no recurrence after one year of follow up.
This study examined whether hip involvement negatively impacts radiographic outcomes after lumbar pedicle subtraction osteotomy (PSO) in ankylosing spondylitis patients with thoracolumbar kyphosis. 44 patients underwent one-level lumbar PSO and were divided into two groups based on their hip involvement scores. Both groups had similar corrections of local kyphosis, but the group with hip involvement had significantly larger sagittal vertical axis and pelvic tilt postoperatively, indicating hip involvement can negatively impact radiographic outcomes after lumbar PSO. Additional osteotomies may be needed for patients with hip involvement to achieve satisfactory correction.
1) Multiple infection prevention measures were used in 54 patients undergoing ACL reconstruction surgery, including preoperative skin washing and bathing, intraoperative use of sterile drapes and instruments soaked in vancomycin solution, and postoperative rehabilitation.
2) No postoperative infections occurred in any patients over 6-18 months of follow-up. Knee function scores improved significantly from pre-operation levels.
3) The study suggests that using multiple prevention measures can successfully prevent infections after ACL reconstruction surgery and allow for good postoperative recovery of knee function.
1) A study compared the clinical results of using hollow screws versus plates for treating spiral fractures of the lower third of the tibia combined with posterior malleolar fractures.
2) 61 patients were treated with tibia plate fixation and either hollow screw fixation (34 patients) or plate fixation (27 patients) of the posterior malleolar fracture.
3) At 6-36 months follow up, all fractures healed well with no differences in healing time or infection rates between the two groups. Functional outcomes assessed using the Baird-Jackson scoring system also did not significantly differ between groups.
This research article evaluated the efficacy and safety of laparoscopic D3 lymphadenectomy combined with pelvic autonomic nerve preservation for treating rectal cancer. 211 patients underwent either laparoscopic (131 patients) or open (80 patients) surgery. Results showed that both surgeries were successfully completed with no differences in lymph nodes removed or post-op complications. The laparoscopic group had shorter time to pass gas, get out of bed, and hospital stay. No differences were found in recurrence, mortality, or urinary/sexual dysfunction between groups. The study concludes that laparoscopic D3 lymphadenectomy combined with nerve preservation is a feasible and safe treatment for rectal cancer.
The document summarizes research on gait analysis of patients with spina bifida. It describes the three main types of spina bifida and their associated neurological impairments and functional classifications. Instrumental gait analysis is discussed as a tool to objectively measure biomechanical variables during walking. Results from gait analysis can inform treatment through assessing quality of ambulation, effects of orthotics, muscle function, and postoperative changes.
This study evaluated the safety and short-term efficacy of laparoscopic complete mesocolic excision (CME) compared to open CME for the treatment of right hemicolon cancer. The study retrospectively reviewed 88 patients - 40 who underwent laparoscopic CME and 48 who underwent open CME. The laparoscopic CME group had a longer operating time but shorter time to first flatus and time to get out of bed compared to the open CME group. There were no significant differences in the number of harvested lymph nodes, hospital stay length, or postoperative complications between the two groups. The study concluded that laparoscopic CME is a safe and effective minimally invasive surgery for right hemicolon cancer.
This study evaluated the early rehabilitation effects of percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniations. 91 patients underwent PTED and were followed for 6 months. Results showed significantly reduced low back and leg pain based on VAS and ODI scores after surgery compared to before. No significant differences in low back pain scores at 3 days, 3 months, and 6 months post-op were found. PTED resulted in less trauma, fewer complications, and markedly shortened postoperative rehabilitation time, demonstrating it is a safe and effective treatment for lumbar disc herniations.
Arthroscopic Single Row Versus Double-Row Suture Anchor Rotator Cuff Repair |...Peter Millett MD
Twenty fresh-frozen cadaveric shoulders were randomly assigned to 4 arthroscopic repair techniques. The repair was performed as either a single-row suture anchor rotator cuff repair technique or 1 of 3 double-row techniques: diamond, mattress double anchor, or modified mattress double anchor. Angle of loading, anchor type, bone mineral density, anchor distribution, angle of anchor insertion, arthroscopic technique, and suture type and size were all controlled. Footprint length and width were quantified before and after repair. Displacement with cyclic loading and load to failure were determined. For more shoulder surgery and rotator cuff studies, visit Peter Millett, MD, The Steadman Clinic, Vail Colorado http://drmillett.com/shoulder-studies
The study compared cervical laminoplasty using piezosurgery osteotomy versus high-speed drilling in 60 patients. Piezosurgery osteotomy resulted in less intraoperative blood loss and postoperative drainage. Both groups showed improved JOA scores after surgery with no significant differences in outcomes. Piezosurgery osteotomy may be superior for operation time, blood loss, and drainage while providing similar safety and efficacy as high-speed drilling for cervical laminoplasty.
This research article studied parameters of the lower lumbar intervertebral foramen related to the superior articular process using X-ray imaging. X-rays of the lumbar spine from 104 adults were analyzed. Measurements were taken of the height, width, and other dimensions of the lower lumbar intervertebral foramen. The results found no significant gender differences in foramen parameters. Parameters related to the superior articular process, such as height and distance from bony landmarks, showed significant age-related differences between those aged 40-60 and over 60. This data supplements the intervertebral foramen database and provides a reference for individualized minimally invasive spine surgeries, especially in elderly patients over 60 years old.
A simplified technique of esophageal self-expandable metallic stent placement...Peachy Essay
The advantages of the simplified technique are as follows: technical ease, cost-effectiveness, no exposure to radiation,
requirement of minimal manpower, and less time-consuming; these advantages make it the technique day-care procedure.
1. The study examined the effect of meniscus removal on anterior cruciate ligament (ACL)-deficient knee laxity using a navigation system.
2. It found that patients who underwent partial or total removal of the medial meniscus had significantly greater anterior tibial translation during Lachman and drawer tests, compared to patients with an isolated ACL injury.
3. Under pivot shift testing, all groups showed similar results except for anterior displacement, which was significantly greater in patients who underwent a meniscectomy.
This document summarizes a conference on hernia surgery and abdominal wall reconstruction held in London in February 2017. It discusses the need for centralized hernia surgery centers to improve outcomes. The document also provides details on hernia surgery volumes and trends at Aintree University Hospital from 2012-2016, showing a decline. It argues that Aintree needs to establish a dedicated hernia and abdominal wall reconstruction center to be competitive and reverse its declining hernia surgery volumes.
Difference in Early Results Between Sub-Acute and Delayed ACL reconstruction:...Henrik Illerström
This randomized controlled trial compared outcomes of sub-acute ACL reconstruction (within 8 days of injury) versus delayed ACL reconstruction (6-10 weeks post-injury). At 3 months, there were no differences in range of motion between groups. At 6 months, the sub-acute group showed less thigh muscle atrophy and better functional strength on hop tests, though isokinetic strength was similar. Both groups improved significantly on KOOS scores after reconstruction, with no differences between groups. The study suggests sub-acute ACL reconstruction is safe and may help preserve strength compared to delayed reconstruction.
This document contains a registration form for a dissertation topic comparing methods of determining condylar guidance. [1] The study will compare values obtained from interocclusal records in a semi-adjustable articulator to those obtained by tracing panoramic radiographs in 20 dentulous and 20 edentulous patients. [2] Ethical clearance has been obtained and the study will involve making interocclusal records and taking panoramic radiographs to measure condylar guidance in participants. [3]
The document describes a clinical trial that assessed the effects of using a Connecticut intrusion arch (CIA) with or without a distal bend on maxillary incisor and molar positions. 44 patients were randomly divided into two groups: one treated with a CIA without a distal bend, and one treated with a CIA with a distal bend. Cephalometric analysis found that the group without a distal bend experienced labial flaring and proclination of maxillary incisors, while the group with a distal bend experienced palatal inclination and retroclination of maxillary incisors. No significant differences were found between the groups for maxillary molar positions. The presence or absence of a distal bend in the CIA affects incis
Comparison Results between Patients with Developmental Hip Dysplasia Treated ...CrimsonPublishersOPROJ
Comparison Results between Patients with Developmental Hip Dysplasia Treated with Either Salter or Pemberton Osteotomy by Dello Russo Bibiana* in Orthopedic Research Online Journal
This study compared the effectiveness of Hawley retainers and two protocols for vacuum-formed retainers (VFRs) in maintaining orthodontic treatment results. 90 patients were randomly assigned to receive either a Hawley retainer, VFRs worn for 4 months full-time then nightly, or VFRs worn for 1 week full-time then nightly. Models at debond and 4 and 8 months post-treatment showed the Hawley group had significantly greater loss of upper arch length and increased crowding compared to the VFR groups, though lower arch measurements were similar. Both VFR protocols were more effective than Hawleys in maintaining the upper arch, and 4 months full-time wear provided better lower incis
This study examines 10 cases of acromioclavicular (AC) joint injuries in military personnel treated either conservatively or surgically. For conservatively treated grade I-II injuries, full function was regained within 6 months, while grade III-V injuries took 6-12 months. Surgically treated grade III injuries took 6 months to regain function and grade IV-V took 12-15 months. Functional outcomes were assessed at 3, 6, and 12 months, with UCLA shoulder scores improving significantly over time for both groups. The study concludes that precontoured clavicular hook plates provide good fixation for type III dislocations without additional ligament repair.
Study of functional outcome following arthroscopic anatomical ACL reconstruct...Dr.Avinash Rao Gundavarapu
This document summarizes a study examining the functional outcomes of 40 patients who underwent arthroscopic anatomical ACL reconstruction using autologous hamstring grafts. The study found significant improvements in stability scores (measured by IKDC, Lachman, anterior drawer, and pivot shift tests) at 6-month follow-up compared to pre-operation scores. Complications were minor, with 7.5% having superficial infections and 7.5% difficulty regaining full range of motion. The study concludes that anatomical ACL reconstruction is an excellent technique for restoring stability, especially in active patients.
This study evaluated the results of 42 patients who underwent arthroscopic repair of full-thickness rotator cuff tears using a side-to-side suturing technique without fixation to bone. At an average follow-up of over 5 years, 98% of patients reported good or excellent results on the UCLA shoulder scale. The mean UCLA score was 33, and the majority of patients reported excellent strength, minimal pain, and full function following the procedure. The study concluded that for select rotator cuff tears, a purely arthroscopic side-to-side repair can provide excellent long-term outcomes without the need for anchoring the repair to bone.
This document summarizes a study on the outcomes of occlusion treatment for amblyopia in children under 12 years old with strabismus. The study reviewed medical records of 38 Qatari children treated with occlusion therapy for strabismic amblyopia from 1992-2002. Good outcomes, defined as final visual acuity of 6/9 or better, were found in 73% of patients. Poor outcomes with visual acuity less than 6/9 occurred in 26% of patients. Factors like age at presentation, type of strabismus, presence of anisometropia and compliance did not significantly affect treatment outcomes.
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Effects of bonded rapid palatal expansion on the transverse dimensions of the...EdwardHAngle
The purpose of this study was to examine the maxillary response on the transverse dimensions to rapid palatal expansion (RPE) by using cone-beam computed tomography (CBCT).
Background: Distal femur fractures make up 6 to 7% of all femur fractures. Various plating options for distal femur fracture are conventional buttress plates, fixed-angle devices, and locking plates. This study was planned to evaluate and explore locking compression plate fixation in distal end femur fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.
Methods: The study was conducted as prospective clinical study in 20 skeletally mature patients with x-ray evidence of distal femur fracture fulfilling inclusion and exclusion criteria, operated with distal femur LCP plating. Patients were assessed radiologically and classified according to distal femur fracture classification and outcome graded as excellent, good, fair and poor based on Lysholm Knee Score.
Results: Out of 15 excellent outcome cases, 3 cases were type A1 fracture, 1 case had type A3, 2 cases had type B1 and B2 each, 5 cases had type C2 and 2 cases had type C3 fracture. 1 case with good outcome was type C3. 1 case with fair outcome was type B2. While 3 cases with poor outcome were type A1, A2 and C3.
Conclusions: The DF-LCP is an ideal implant to use for fractures of the distal femur. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A and C, osteoporotic and periprosthetic fractures.
Keywords: Distal femur, DF-LCP, Lysholm score, Periprosthetic fracture
This study evaluated the surgical management of 18 patients with posterior cruciate ligament (PCL) avulsions from the tibia using cannulated screw fixation. The average age was 29 years and most injuries were from road traffic accidents. Patients underwent open reduction and fixation of the avulsed PCL fragment with a cannulated screw. At an average follow up of 31 months, all patients had full range of motion and good knee stability. The average postoperative Lysholm score was 91, indicating excellent outcomes. The authors concluded that open reduction and fixation with a cannulated screw is an effective technique for tibial avulsion injuries of the PCL.
The document describes a retrospective case series of 10 patients with post-traumatic radioulnar synostosis who were treated using a triple therapy combination of preoperative radiotherapy, resection of heterotopic ossification and insertion of an anconeus interposition flap, and postoperative indomethacin. All 10 patients reported excellent postoperative Mayo elbow performance scores and significant improvements in range of motion compared to preoperatively. One patient experienced a complication that resolved with follow-up. The triple therapy combination was found to provide good functional outcomes and prevent recurrence of radioulnar synostosis.
This study evaluated the early rehabilitation effects of percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniations. 91 patients underwent PTED and were followed for 6 months. Results showed significantly reduced low back and leg pain based on VAS and ODI scores after surgery compared to before. No significant differences in low back pain scores at 3 days, 3 months, and 6 months post-op were found. PTED resulted in less trauma, fewer complications, and markedly shortened postoperative rehabilitation time, demonstrating it is a safe and effective treatment for lumbar disc herniations.
Arthroscopic Single Row Versus Double-Row Suture Anchor Rotator Cuff Repair |...Peter Millett MD
Twenty fresh-frozen cadaveric shoulders were randomly assigned to 4 arthroscopic repair techniques. The repair was performed as either a single-row suture anchor rotator cuff repair technique or 1 of 3 double-row techniques: diamond, mattress double anchor, or modified mattress double anchor. Angle of loading, anchor type, bone mineral density, anchor distribution, angle of anchor insertion, arthroscopic technique, and suture type and size were all controlled. Footprint length and width were quantified before and after repair. Displacement with cyclic loading and load to failure were determined. For more shoulder surgery and rotator cuff studies, visit Peter Millett, MD, The Steadman Clinic, Vail Colorado http://drmillett.com/shoulder-studies
The study compared cervical laminoplasty using piezosurgery osteotomy versus high-speed drilling in 60 patients. Piezosurgery osteotomy resulted in less intraoperative blood loss and postoperative drainage. Both groups showed improved JOA scores after surgery with no significant differences in outcomes. Piezosurgery osteotomy may be superior for operation time, blood loss, and drainage while providing similar safety and efficacy as high-speed drilling for cervical laminoplasty.
This research article studied parameters of the lower lumbar intervertebral foramen related to the superior articular process using X-ray imaging. X-rays of the lumbar spine from 104 adults were analyzed. Measurements were taken of the height, width, and other dimensions of the lower lumbar intervertebral foramen. The results found no significant gender differences in foramen parameters. Parameters related to the superior articular process, such as height and distance from bony landmarks, showed significant age-related differences between those aged 40-60 and over 60. This data supplements the intervertebral foramen database and provides a reference for individualized minimally invasive spine surgeries, especially in elderly patients over 60 years old.
A simplified technique of esophageal self-expandable metallic stent placement...Peachy Essay
The advantages of the simplified technique are as follows: technical ease, cost-effectiveness, no exposure to radiation,
requirement of minimal manpower, and less time-consuming; these advantages make it the technique day-care procedure.
1. The study examined the effect of meniscus removal on anterior cruciate ligament (ACL)-deficient knee laxity using a navigation system.
2. It found that patients who underwent partial or total removal of the medial meniscus had significantly greater anterior tibial translation during Lachman and drawer tests, compared to patients with an isolated ACL injury.
3. Under pivot shift testing, all groups showed similar results except for anterior displacement, which was significantly greater in patients who underwent a meniscectomy.
This document summarizes a conference on hernia surgery and abdominal wall reconstruction held in London in February 2017. It discusses the need for centralized hernia surgery centers to improve outcomes. The document also provides details on hernia surgery volumes and trends at Aintree University Hospital from 2012-2016, showing a decline. It argues that Aintree needs to establish a dedicated hernia and abdominal wall reconstruction center to be competitive and reverse its declining hernia surgery volumes.
Difference in Early Results Between Sub-Acute and Delayed ACL reconstruction:...Henrik Illerström
This randomized controlled trial compared outcomes of sub-acute ACL reconstruction (within 8 days of injury) versus delayed ACL reconstruction (6-10 weeks post-injury). At 3 months, there were no differences in range of motion between groups. At 6 months, the sub-acute group showed less thigh muscle atrophy and better functional strength on hop tests, though isokinetic strength was similar. Both groups improved significantly on KOOS scores after reconstruction, with no differences between groups. The study suggests sub-acute ACL reconstruction is safe and may help preserve strength compared to delayed reconstruction.
This document contains a registration form for a dissertation topic comparing methods of determining condylar guidance. [1] The study will compare values obtained from interocclusal records in a semi-adjustable articulator to those obtained by tracing panoramic radiographs in 20 dentulous and 20 edentulous patients. [2] Ethical clearance has been obtained and the study will involve making interocclusal records and taking panoramic radiographs to measure condylar guidance in participants. [3]
The document describes a clinical trial that assessed the effects of using a Connecticut intrusion arch (CIA) with or without a distal bend on maxillary incisor and molar positions. 44 patients were randomly divided into two groups: one treated with a CIA without a distal bend, and one treated with a CIA with a distal bend. Cephalometric analysis found that the group without a distal bend experienced labial flaring and proclination of maxillary incisors, while the group with a distal bend experienced palatal inclination and retroclination of maxillary incisors. No significant differences were found between the groups for maxillary molar positions. The presence or absence of a distal bend in the CIA affects incis
Comparison Results between Patients with Developmental Hip Dysplasia Treated ...CrimsonPublishersOPROJ
Comparison Results between Patients with Developmental Hip Dysplasia Treated with Either Salter or Pemberton Osteotomy by Dello Russo Bibiana* in Orthopedic Research Online Journal
This study compared the effectiveness of Hawley retainers and two protocols for vacuum-formed retainers (VFRs) in maintaining orthodontic treatment results. 90 patients were randomly assigned to receive either a Hawley retainer, VFRs worn for 4 months full-time then nightly, or VFRs worn for 1 week full-time then nightly. Models at debond and 4 and 8 months post-treatment showed the Hawley group had significantly greater loss of upper arch length and increased crowding compared to the VFR groups, though lower arch measurements were similar. Both VFR protocols were more effective than Hawleys in maintaining the upper arch, and 4 months full-time wear provided better lower incis
This study examines 10 cases of acromioclavicular (AC) joint injuries in military personnel treated either conservatively or surgically. For conservatively treated grade I-II injuries, full function was regained within 6 months, while grade III-V injuries took 6-12 months. Surgically treated grade III injuries took 6 months to regain function and grade IV-V took 12-15 months. Functional outcomes were assessed at 3, 6, and 12 months, with UCLA shoulder scores improving significantly over time for both groups. The study concludes that precontoured clavicular hook plates provide good fixation for type III dislocations without additional ligament repair.
Study of functional outcome following arthroscopic anatomical ACL reconstruct...Dr.Avinash Rao Gundavarapu
This document summarizes a study examining the functional outcomes of 40 patients who underwent arthroscopic anatomical ACL reconstruction using autologous hamstring grafts. The study found significant improvements in stability scores (measured by IKDC, Lachman, anterior drawer, and pivot shift tests) at 6-month follow-up compared to pre-operation scores. Complications were minor, with 7.5% having superficial infections and 7.5% difficulty regaining full range of motion. The study concludes that anatomical ACL reconstruction is an excellent technique for restoring stability, especially in active patients.
This study evaluated the results of 42 patients who underwent arthroscopic repair of full-thickness rotator cuff tears using a side-to-side suturing technique without fixation to bone. At an average follow-up of over 5 years, 98% of patients reported good or excellent results on the UCLA shoulder scale. The mean UCLA score was 33, and the majority of patients reported excellent strength, minimal pain, and full function following the procedure. The study concluded that for select rotator cuff tears, a purely arthroscopic side-to-side repair can provide excellent long-term outcomes without the need for anchoring the repair to bone.
This document summarizes a study on the outcomes of occlusion treatment for amblyopia in children under 12 years old with strabismus. The study reviewed medical records of 38 Qatari children treated with occlusion therapy for strabismic amblyopia from 1992-2002. Good outcomes, defined as final visual acuity of 6/9 or better, were found in 73% of patients. Poor outcomes with visual acuity less than 6/9 occurred in 26% of patients. Factors like age at presentation, type of strabismus, presence of anisometropia and compliance did not significantly affect treatment outcomes.
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Effects of bonded rapid palatal expansion on the transverse dimensions of the...EdwardHAngle
The purpose of this study was to examine the maxillary response on the transverse dimensions to rapid palatal expansion (RPE) by using cone-beam computed tomography (CBCT).
Background: Distal femur fractures make up 6 to 7% of all femur fractures. Various plating options for distal femur fracture are conventional buttress plates, fixed-angle devices, and locking plates. This study was planned to evaluate and explore locking compression plate fixation in distal end femur fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.
Methods: The study was conducted as prospective clinical study in 20 skeletally mature patients with x-ray evidence of distal femur fracture fulfilling inclusion and exclusion criteria, operated with distal femur LCP plating. Patients were assessed radiologically and classified according to distal femur fracture classification and outcome graded as excellent, good, fair and poor based on Lysholm Knee Score.
Results: Out of 15 excellent outcome cases, 3 cases were type A1 fracture, 1 case had type A3, 2 cases had type B1 and B2 each, 5 cases had type C2 and 2 cases had type C3 fracture. 1 case with good outcome was type C3. 1 case with fair outcome was type B2. While 3 cases with poor outcome were type A1, A2 and C3.
Conclusions: The DF-LCP is an ideal implant to use for fractures of the distal femur. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A and C, osteoporotic and periprosthetic fractures.
Keywords: Distal femur, DF-LCP, Lysholm score, Periprosthetic fracture
This study evaluated the surgical management of 18 patients with posterior cruciate ligament (PCL) avulsions from the tibia using cannulated screw fixation. The average age was 29 years and most injuries were from road traffic accidents. Patients underwent open reduction and fixation of the avulsed PCL fragment with a cannulated screw. At an average follow up of 31 months, all patients had full range of motion and good knee stability. The average postoperative Lysholm score was 91, indicating excellent outcomes. The authors concluded that open reduction and fixation with a cannulated screw is an effective technique for tibial avulsion injuries of the PCL.
The document describes a retrospective case series of 10 patients with post-traumatic radioulnar synostosis who were treated using a triple therapy combination of preoperative radiotherapy, resection of heterotopic ossification and insertion of an anconeus interposition flap, and postoperative indomethacin. All 10 patients reported excellent postoperative Mayo elbow performance scores and significant improvements in range of motion compared to preoperatively. One patient experienced a complication that resolved with follow-up. The triple therapy combination was found to provide good functional outcomes and prevent recurrence of radioulnar synostosis.
Open debridement and radiocapitellar replacement in primary and post-traumati...Alberto Mantovani
Background: Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral
joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) prosthesis
has recently been developed for the treatment of lateral elbow arthritis. However, few data have been
published on LRE results.
Materials and methods: A prospective multicenter study was designed to assess LRE preliminary results.
There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11
and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis.
Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score
(MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick
Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months.
Results: At the last follow-up, the mean improvement of MEPS and m-ASES was 35 (P ¼ .001) and 34
(P ¼ .001) respectively; the average Quick DASH decreased by 29 (P ¼ .001). Average range of motion
was improved by 35 (P ¼.001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in
3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant
survival rate was 100%.
Conclusion: LRE showed promising results in this prospective investigation. Most patients had an
uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional
recovery at short-term follow-up. Further studies with longer follow-up are warranted.
Calcaneal Lengthening Using Bone Substitute Graft for Neurological Flatfoot T...CrimsonPublishersOPROJ
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To compare the different approaches and effects of pararectus approach, modified stoppa approach and ilioinguinal approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
: To compare the different approaches and effects
of pararectus approach, modified stoppa approach and ilioinguinal
approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
To compare the different approaches and effects
of pararectus approach, modified stoppa approach and ilioinguinal
approach in the treatment of acetabular fractures.
Comparison of Clinical Efficacy of Surgical Approaches for Acetabular Fracturessemualkaira
Through regression sorting, 44 patients with acetabular fractures who were hospitalized in our unit from September 2012 to September 2017 were summarized. Three surgical methods were used, and the operation time, intraoperative blood loss, postoperative complications, fracture reduction satisfaction and hip function were recorded in the three groups.
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DR deepak chahar polpiteal cyst arthroscopyDeepak Chahar
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This study examines a two-stage revision technique using antibiotic-impregnated cement spacers to treat chronically infected total knee arthroplasties. 45 infected knee prostheses underwent revision, with a minimum 5-year follow-up. The technique involved removal of the infected prosthesis and placement of an antibiotic cement spacer. After infection clearance, the spacer was removed and a new prosthesis implanted. Infection was eradicated in 95.6% of cases, with significant pain reduction and functional improvement. While sometimes requiring extensive surgical approaches, this two-stage technique remains the standard treatment for chronic knee prosthesis infection.
This document discusses a study on the management of intra-articular fractures of the calcaneus (heel bone) using a combined percutaneous and minimal internal fixation technique. 22 patients with this fracture were treated with minimal incision and fixation using a single cancellous screw and 2 K-wires. At follow-up of 26 months on average, all fractures had healed without complications. Patients were evaluated using the Modified Rowe Score and outcomes were rated as excellent for 10 patients, good for 10 patients, and satisfactory for 2 patients, with an average score of 80. The technique aims to minimize complications by using minimal soft tissue dissection and implants.
Biocartilage to Treat Osteochondral Defects of the Talus: Case Report and Tec...Jennifer Gerres, DPM
The document describes a case study and technique using BioCartilage to treat a large osteochondral defect of the talus. The key points are:
1) A 24-year old male presented with ankle pain and imaging revealed a 1.2cm x 1.6cm osteochondral defect of the talus.
2) The defect was excised and microdrilled. BioCartilage, a micronized hyaline cartilage allograft, mixed with blood or PRP was used to fill the defect.
3) BioCartilage offers advantages over other techniques like autografts in eliminating donor site morbidity and over ACI in being a single-stage procedure without wait time.
Abstract
Objective: To assess the outcome of arthroscopic release in patients with cronicalchronic lateral epicondylitis. Materials and methods: Arthroscopic release in three patients with lateral epicondylitis was performed. The Mayo Elbow Performance Index (or Mayo Elbow Performance score) was used pre and post surgical treatment. Sample: Two females and one male. The patients were principal labourers and not athletes. Patients had significant pain and pain was the principal symptom that affected the score of the performance index.
Results: Scores on the performance index improved after surgery. No neurological complications were reported and early return to normal daily activities was noted.
Conclusion: Arthroscopic treatment was an alternative safe and effective method for treating chronic lateral epicondiyitis in three cases. This method makes it possible to simultaneously scan the articulation to diagnostic and treatment associated diseases. It is necessary most wide assays and comparative studies for establish sure treatment protocols.
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2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
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2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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2. Orthopedic Research Online Journal
2/4
Ortho Res Online J
How to cite this article: Osvandré L, Paulo P, Carlos C, Alaor B, Cristiano G. Bankart Lesion: Comparison between Open and Arthroscopic Techniques. Ortho
Res Online J. 1(5). OPROJ.000523. 2018. DOI: 10.31031/OPROJ.2018.01.000523
Volume 1 - Issue - 5
b. Did not give outpatient segments at least 1 year post
operative.
c. Incomplete medical records.
d. Surgical failures that necessitated reintervention due to poor
positioning of the anchors.
Aftertheinclusioncriteriaexclusionstage,56patientsremained.
Of these, 38 were operated by the arthroscopic technique and 18
by the open technique. All patients were operated by members of
the Brazilian Society of Shoulder and Elbow Surgery. The choice of
the surgical technique and the type of material used was according
to the surgeon’s choice and taking into account the release of the
material by the agreements or budgetary possibilities when the
surgeries were private.
Arthroscopic technique is performed by general anesthesia
associated with brachial plexus block. Patient in the beach chair
position and the operated limb was submitted to traction as
required in the intraoperative period. Posterior portal for intra-
articular visualization with saline solution infusion. Bankart lesion
is identified and debridement of the glenoid bone border and
release of the medialized capsule and labrum is realized. We use
multiple bio-absorbable anchors according to the extent of the
lesion for capsular-labral repair. Centering of the humeral head on
theglenoidmustbeobserveaftercompletederepair,demonstrating
good positioning. Skin incisions are close with 4-0 nylon.
Open technique is performed by general anesthesia too,
associated with brachial plexus block. Deltopectoral approach
is preferred. Tenotomy of the subscapular tendon is performed
1cm medial to the lesser tuberosity along with the joint capsule.
Identification of the Bankart lesion, debridement of the glenoid
bone and release of the medialized capsule and labrum were
performed. Suture metallic anchors were used for labral
reconstruction and capsular shift retencionament. Subscapular
tendon repair is performed with braided non-absorbable suture. At
the end performed hemostasis and suture by plans up to the skin.
Rehabilitation protocol:
a. Immobilization with sling for 3-6 weeks, depending on the
size of the lesion.
b. Initiate daily movement of hands and elbows from the first
postoperative period.
c. Scapular exercises, with sling, after 2 weeks postoperatively.
d. Pendulum exercises after removal of sling.
e. After 1-2 weeks exercises to gain range of motion and up to 3
months to avoid exercises in zone of instability (maximum external
rotation, abduction and extension of the shoulder).
f. After 3 months, from the date of surgery, exercises to gain
strength of the rotator cuff and scapular girdle, starting with
isometric and after active.
g. Return to sports activities, depending on the degree of
contact, in 6-8 months.
Results
Fifty-six patients were operated with 67.8% (n= 38) by the
arthroscopic technique and 32.2% (n= 18) by the open technique.
The results obtained show a predominance of Bankart lesion in
males 87.5% (n= 49) in relation to females 12.5% (n= 7) (Table 1-3).
Failure was observed in 9.2% (n= 3) of the cases operated by the
arthroscopic technique and 0% (n= 0) in which the open technique
was performed. The correlation of the mean with the clinical and
functional results demonstrates advantage of the arthroscopic
technique in the stability and mobility criteria. The open technique
demonstrates advantage in the criteria: less pain, function and final
Carter-Rowe functional outcome.
Table 1: Epidemiological analysis of sex and surgical techniques.
Men Women Total
Arthroscopic
3.4
-60.70%
4
-7.10%
38
-67.80%
open
15
-26.70%
3
-5.40%
18
-32.20%
Total
49
-87.50%
7
-12.50%
56
-100%
Table 2: Epidemiological analysis of the first dislocation and
surgical techniques.
Arthroscopic Open Total
Less than 20 years
6
(-10.70%)
3
(-5.40%)
9
(-16.10%)
20 to 25 years
15
(-26.70%)
4
(-7.10%)
19
(-33.90%)
25 to 30 Years
9
(-16.10%)
4
(-7.10%)
13
(-23.20%)
30-40 years
5
(-8.90%)
3
(-5.40%)
8
(-14.20%)
40- 50 years
2
(-3.60%)
4
(-7.10%)
6
(-10.70%)
More than 50 years
1
(-1.70%)
1
(-1.70%)
2
(-3.40%)
Total
38
(-67.80%)
18
(-32.10%)
56
(-100%)
Table 3: Comparison between affected side and average number
of dislocations in which the patient seeks orthopedic assistance.
Dominant
Side Affected
Nodominant
Side Affected
Total
1 to 3 Dislocations
13
(-23.20%)
3
(-5.40%)
16
(-28.60%)
4 to 10 Dislocations
10
(-17.80%)
9
(-16.10%)
19
(-33.90%)
11 to 20
Dislocations
5
(-8.90%)
3
(-5.40%)
8
(-14.30%)
More than 20
Dislocations
5
(-8.90%)
8
-14.30%
13
-23.20%
Total
33
(-59%)
23
(-41%)
56
(-100%)
3. 3/4
Ortho Res Online JOrthopedic Research Online Journal
How to cite this article: Osvandré L, Paulo P, Carlos C, Alaor B, Cristiano G. Bankart Lesion: Comparison between Open and Arthroscopic Techniques. Ortho
Res Online J. 1(5). OPROJ.000523. 2018. DOI: 10.31031/OPROJ.2018.01.000523
Volume 1 - Issue - 5
There is divergence in the literature when the failure rate in the
procedures. They cite failure of the arthroscopic procedure: Barnes
et al 6%, Boileau et al 26%, Ryu et al 27%.When open technique,
Rowe et al., 8%, Hawkins et al., Levine et al., 20% and Walch et al.
These works do not compare techniques [8-15]. In this study, the
result of failure was 7.9% in the arthroscopic technique and 0% in
the open technique.
The work of Fabbriciani [16] and cols, 2006, comparing 30
Patients operated by open technical with 30 operated arthroscopic
technique peels, brought result with level I evidence in BOTH
techniques them in terms of stability provide or even as result
Stability However the open Technique could compromise the
recovery of the full range of shoulder movement. In this work the
results are in agreement with the one described in the literature
since the stability criterion showed no difference between the
techniques (Table 4-6).
Table 4: Correlation of surgical failure and surgical techniques.
Initial n N end Failure
Arthroscopic 38 35
3
(-9.20%)
Open 18 18
0
(0%)
Table 5: Correlation of mean and standard deviation with clinical
results and functional score.
Standard Deviation
Arthroscopic
Standard Deviation
Open
Pain 7.85± 2.78 8:33± 2:42
Anointing F 45.28± 7.94 45.83± 6.91
And stability 28.71± 5.60 28.33±4.85
Mobility 7.28± 2.80 7:22± 3:07
Rowe 89.14± 1.14 11:56 ±89.72
Table 6: T-test correlation for independent groups, significant
analysis and interpretation.
T P Interprets CaO
Dor (videoversus Open) -0.614 0.541 Ns
anointingF (videoversus
Open)
-0.247 0,805 Ns
And stability (videoversus
Open)
0.244 0.807 Ns
Mobility (videoversus Open) 0.0755 0.94 ***
Rowe (videoversus Open) -0,150 0.88 Ns
Regarding the mobility criterion, the patients operated by
arthroscopic presented better results. The work of Mohtadi [16]
JBJS - 2014 with a Level I Sample evidence how we recurrence
brainy 11% and 23% open procedures That We arthroscopic
procedures and Prove how brainy or functional outcome no
statistical significance. In this study, the relapse in the cases
operated by arthroscopy was also superior to the open surgery and
the final functional result was not statistically significant difference
between both techniques (Figure 1& 2).
Figure 1: Epidemiological distribution according to age
group.
Figure 2: Mean number of dislocations until the patient
seeks specialized orthopedic support.
Conclusion
It is possible to conclude with this work that:
a. Both techniques present good results, although few works in
the literature compare homogeneous groups of patients.
b. Thepossibilityoffurtherepisodesofdislocationisapparently
greater in the arthroscopic technique.
c. The arthroscopic technique seems to have a better result
when compared to mobility.
References
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4. Orthopedic Research Online Journal
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Ortho Res Online J
How to cite this article: Osvandré L, Paulo P, Carlos C, Alaor B, Cristiano G. Bankart Lesion: Comparison between Open and Arthroscopic Techniques. Ortho
Res Online J. 1(5). OPROJ.000523. 2018. DOI: 10.31031/OPROJ.2018.01.000523
Volume 1 - Issue - 5
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