28 research outputs found

    Principles of Hand Fracture Management

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    The hand is essential in humans for physical manipulation of their surrounding environment. Allowing the ability to grasp, and differentiated from other animals by an opposing thumb, the main functions include both fine and gross motor skills as well as being a key tool for sensing and understanding the immediate surroundings of their owner

    Catastrophic failure of tripolar constrained liners due to backside wear: a novel failure mode

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    Constrained acetabular liners have been developed for patients who are at high risk for dislocation or who are undergoing revision surgery for recurrent dislocations. We report on 2 cases of failure of tripolar constrained liners due to severe backside polyethylene wear after dissociation of the outer polyethylene liner without dislocation, a mode of failure not previously reported. The backside of the inserts suffered severe polyethylene deformation, wear, and scratching due to dissociation from the locking mechanism. In patients with tripolar constrained liners, radiographic evidence of eccentric wear should be considered as possible occult dissociation of the polyethylene liner within the shell. Conversion to a modular dual mobility liner appears to be a viable solution in this setting. © 2018 The Author

    A Simple Technique for Protecting Exposed K Wire Ends

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    Image-guided versus palpation-guided injections for the treatment of chronic lateral epicondylopathy: A randomized controlled clinical trial

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    Background There have been several studies published comparing the ultrasound-guided with the blind infiltrations in the shoulder's area. On the contrary, there is only very limited data regarding the necessity of ultrasound guidance in lateral epicondylitis. Materials and Methods A prospective, randomized, blinded at initial and follow-up evaluation, comparative clinical trial was conducted, involving 44 patients with a history of chronic persistent epicondylopathy. The patients were randomly divided into 2 groups of 22 people each. Group A patients underwent three ultrasound-guided betamethazone injections, while group B included those who underwent three blind injections, centered at the palpable point of maximum pain. The evaluation was done before and after (4 and 12 weeks) the injections using the Visual Analogue Scale for pain (VAS, 0-10) and the Roles & Maudsley score. Results There was not any significant statistical difference between the two groups as for mean VAS at 4 weeks (p=0.150, t-test) and mean VAS at 12 weeks (p=0.286, t-test). Furthermore, the final success rate, as measured by the Roles & Maudsley score, was slightly superior in group B (67% of the patients with excellent or good results) when compared with group A (46% of the patients), but without any statistical difference (p=0.161, chi-square). Conclusion Our trial proved that an ultrasound-guided injection is not superior than a palpation-guided injection of corticosteroids in the treatment of lateral epicondylopathy. © 2018 Georg Thieme Verlag KG Stuttgart New York

    Platelet-rich plasma ultrasound-guided injection in the treatment of carpal tunnel syndrome: A placebo-controlled clinical study

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    The purpose of this study is to demonstrate whether and to what extent a single injection of platelet-rich plasma (PRP), under ultrasound guidance, can improve the clinical symptoms of patients with a mild to moderate carpal tunnel syndrome (CTS). We conducted a prospective, randomized, clinical study including 50 patients suffering from mild to moderate CTS for a minimum duration of 3 months. Patients were randomly divided into 2 groups: Group A (26 patients) received an ultrasound-guided PRP injection into the carpal tunnel, whereas Group B (24 patients) was injected with placebo (0.9% normal saline). The short- and mid-term outcomes were determined with the use of the Q-DASH questionnaire and the pain scale VAS administered at 0, 4, and 12 weeks follow-up. The success ratio was determined by the difference in the Q-DASH obtained pre-injection minus the final Q-DASH obtained after 12 weeks follow-up. Success was defined as a difference more than 25%. Group A patients demonstrated a 76.9% success as determined by the difference Q-DASH, whereas Group B patients demonstrated 33.3% success, which was significantly less than Group A (Χ2, p =.011). The findings of this study suggest that a single PRP ultrasound-guided injection has positive effects in patients with CTS. Copyright © 2017 John Wiley & Sons, Ltd
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