6 research outputs found
Pelvic support hip reconstruction with internal devices : an alternative to Ilizarov hip reconstruction
Aim and objective: Ilizarov hip reconstruction (IHR) is a traditional method of salvaging chronic adolescent problem hips but faces practical problems from external fixators leading to reduced compliance. We present the same reconstruction utilising only internal devices with a modification in technique and aim to review early results. Materials and methods: We retrospectively evaluated eight patients between 2014 and 2017 with chronic painful hips treated by a two-stage reconstruction; stage 1 included femoral head resection and pelvic support osteotomy using double plating, while stage 2 comprised distal femoral osteotomy avoiding varus followed by insertion of retrograde magnetic nail for postoperative lengthening. Patients continued physiotherapy postoperatively while protecting from early weight-bearing. Results: At mean follow-up of 19 months (range 6–36), all osteotomies healed with bone healing index of 47 days/cm (range 30–72). Pain improved from 8.3 (range 7–9) to 2 (range 0–6), while limb length discrepancy got corrected from 4.3 cm (range 3–5) to 1.4 cm (range 0–2.5) at final follow-up. Trendelenburg sign was eliminated in three and delayed in five. No examples of infection or permanent knee stiffness were noted. One patient had plates breakage due to mechanical fall and one had 35 mm of lateral mechanical axis deviation requiring corrective osteotomy. Conclusion: Pelvic support hip reconstruction with exclusive internal devices is a technique in evolution with encouraging early results. It avoids common complications of external fixators and facilitates quick rehabilitation of joints. Refraining from distal varus can effectively eliminate Trendelenburg gait, albeit with some degree of lateral mechanical axis deviation. Unlike external fixation where there is a possibility of gradual correction, this staged procedure of internal fixation is technically demanding with a learning curve. Clinical significance: Pelvic support hip reconstruction performed by internal implants is a viable alternative to IHR with potential benefits
The impact of chronic depression on acute and long-term outcomes in a randomized trial comparing selective serotonin reuptake inhibitor monotherapy versus each of 2 different antidepressant medication combinations
10.4088/JCP.11m07043Journal of Clinical Psychiatry737967-976JCLP
Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients
Canadian Journal of Psychiatry582113-122CJPS
Concise associated symptoms tracking scale: A brief self-report and clinician rating of symptoms associated with suicidality
10.4088/JCP.11m06840Journal of Clinical Psychiatry726765-774JCLP
Combining Medications to Enhance Depression Outcomes (CO-MED): Acute and long-term outcomes of a single-blind randomized study
10.1176/appi.ajp.2011.10111645American Journal of Psychiatry1687689-701AJPS
Randomized comparison of selective serotonin reuptake inhibitor (escitalopram) monotherapy and antidepressant combination pharmacotherapy for major depressive disorder with melancholic features: A CO-MED report
10.1016/j.jad.2011.04.032Journal of Affective Disorders1333467-476JADI