Õlavarreluu proksimaalse osa murdude operatiivne ravi

Analüüsitud on õlavarreluu proksimaalse osa murdude ravi tulemusi, kus osteosünteesiks on kasutatud uut Targon-tüüpi lukustuvat naela. Jälgimisel oli 21 opereeritud haiget vanuses 52–87 aastat. Murde liigitasime AO/ASIF klassifi katsiooni järgi. Ravitulemust hindasime röntgenoloogiliselt (2, 4 ja 12 kuud pärast operatsiooni) ning spetsiaalse küsimustiku – constant shoulder score – abil. Meie kogemuse põhjal on proksimaalse õlavarreluu naela kasutamine näidustatud õla varreluu A2–C1 tüüpi murdude raviks. Operatsioonil kasutatud miniinvasiivne juurdepääs võimaldab täielikult säästa õlavarreluu pea verevarustust ja innervatsiooni, mis soodustab kiiret paranemist ja funktsiooni taastumist. Eriti on vajalik märkida, et osteopeenia ja osteoporoos ei ole vastunäidustuseks naela kasutamisel, kuna see meetod võimaldab nurkstabiilse murru fikseerimist ning jäse ei vaja lisaimmobilisatsiooni, mistõttu võib kohe alustada taastusravi. Eesti Arst 2009; 88(Lisa3):16−2

Range of motion and pain intensity of the first metatarsophalangeal joint in women with hallux valgus deformation after two-month home exercise programme

Hallux Valgus (HV) (also Hallux abducto valgus) is a common deformity of the foot, which causes pain, inflammation and decreased joint mobility in the big toe. There are no universally accepted protocols for treating advanced phase HV, corrective surgery seems to be the most common direction of curing advanced HV deformation. The purpose of this study was to assess the effects of two-month home exercise programme (HEP) on joint mobility and pain of the first metatarsophalangeal joint (MTP-joint) in women with advanced phase HV deformation. Seven women with mean age 55.6±2.9 years with advanced phase HV deformation (first MTP-joint angle more than 20 degrees) participated in the study. Foot pain in different conditions was assessed with modified Foot Function Index's (FFI) pain subscale before and after HEP. Passive range of motion (PROM) of flexion and extension of the first MTP-joint was measured before and after HEP using a standard mechanical goniometer. A significant increase (p<0.001) in the passive extension of the first MTP-joint was noted after HEP compared with the joint mobility before HEP, also passive flexion increased considerably but no significant difference was noted (p>0.05). Foot pain score decreased significantly (p<0.05) after HEP. In conclusion, in advanced phase HV two-month HEP was an effective therapeutic approach for increasing first MTP-joint mobility and reducing foot pain

Rod-Through-Plate Fixator for Long Bone Fractures:A Morphological Study on Rabbits

We study the effect of a new fixator for treatment of diaphyseal bone fractures of small animal. The experiments  were performed on 12 New Zealand White rabbits. Transverse osteotomy was made in the central  third of the diaphysis of the rabbit’s femur and a rod-through-plate fixator was used to treat the bone fracture.  The regeneration of the bone tissue was studied by means of radiography and histomorphology at  postoperative weeks 2, 4 and 8. The rod-through-plate fixator gives stable fixation and early mobilisation  of the limb. Radiographic images showed that the fractures had repaired well. Morphologically, all the parts  of the callus had a typical structure. An immunohistochemical examination showed elevated levels of extracellular  matrix proteins collagen type II, osteocalcin and osteopontin in the callus area. The new fixation  method gives strong fixation of bone fragments with minimal traumatization of soft tissue during the operation.  The construction of the rod-through-plate fixator allows one to reduce pressure in the area of the  fracture and the dynamic fixation given by intramedullary rods allows micromotions stimulating callus formation  and avoiding implant-induced osteoporosis. The fixator has a simple construction and its use  expands the treatment possibilities for diaphyseal fractures of long bones. The rod-through-plate fixator use  does not require special training for the surgeon.

Altered mitochondrial apparent affinity for ADP and impaired function of mitochondrial creatine kinase in gluteus medius of patients with hip osteoarthritis.

International audienceThe cellular energy metabolism in human musculus gluteus medius (MGM) under normal conditions and hip osteoarthritis (OA) was explored. The functions of oxidative phosphorylation and energy transport systems were analyzed in permeabilized (skinned) muscle fibers by oxygraphy, in relation to myosin heavy chain (MHC) isoform distribution profile analyzed by SDS-PAGE, and to creatine kinase (CK) and adenylate kinase (AK) activities measured spectrophotometrically in the intact muscle. The results revealed high apparent Km for ADP in regulation of respiration that decreased after addition of creatine in MGM of traumatic patients (controls). OA was associated with increased sensitivity of mitochondrial respiration to ADP, decreased total activities of AK and CK with major reduction in mi-CK fraction, and attenuated effect of creatine on apparent Km for ADP compared with control group. It also included a complete loss of type II fibers in a subgroup of patients with the severest disease grade. It is concluded that energy metabolism in MGM cells is organized into functional complexes of mitochondria and ATPases. It is suggested that because of degenerative remodeling occurring during development of OA, these complexes become structurally and functionally impaired, which results in increased access of exogenous ADP to mitochondria and dysfunction of CK-phosphotransfer system