Triangular fibrocartilage complex injury treated with prolotherapy

Triangular fibrokartilaj kompleks el bileğinin stabilitesinde ve fonksiyonel çalışmasında önemli rolü olan bir yapıdır. Travmatik ya da dejeneratif olarak hasarlanması ulnar taraf el bileği ağrısının en yaygın nedenlerindendir. Kronik triangular fibrokartilaj kompleks hasarında artroskopik cerrahi tedavi önerilmektedir. Sol el bileği ulnar tarafta ağrı yakınmasıyla gelen 19 yaşında erkek hastada MR görüntüleme ile triangular fibrokartilaj kompleks hasarı saptandı. Daha önce aldığı medikal tedaviden fayda görmeyen hastaya üç seans proloterapi uygulandı. Tedavi sonrasında hastanın ağrısında azalma görüldü ve hasta el bileğini daha rahat kullanabildiğini bildirdi. Bu vakada triangular fibrokartilaj kompleks hasarında artroskopik tedaviye gerek kalmadan proloterapi ile klinik fayda sağlandı. Proloterapinin triangular fibrokartilaj kompleks hasarı tedavisindeki yerini daha iyi göstermek için gelecekte yapılacak klinik çalışmalara ihtiyaç duyulmaktadır.Triangular fibrocartilage complex has a crucial role in stability and functionality of the wrist. Traumatic or degenerative injury of the triangular fibrocartilage complex is a common cause of ulnar side wrist pain. Arthroscopic treatment has been offered in chronic triangular fibrocartilage complex injury. A 19-year old male patient presented with pain at ulnar side of the wrist. He was diagnosed as having triangular fibrocartilage complex injury after assessment with MR imaging. The patients who did not benefit from drugs underwent prolotherapy three times. After treatment, he had pain relief and reported that he could use his wrist better. In this case, triangular fibrocartilage complex injury improved with prolotherapy and arthroscopic treatment was not required. Further clinical trials are needed to show better the role of prolotherapy in the treatment of triangular fibrocartilage complex injury

Effect of prolotherapy on hemiplegic shoulder pain due to rotator cuff tendinopathy: a pilot study

omuz ağrısı bulunan inmeli hastalarda proloterapi uygulamasının ağrı ve omuz eklem hareket açıklığı üzerine etkisini araştırmak. Gereç ve Yöntem: En az 6 ay önce inme geçirmiş hemiplejik omuz ağrısına yönelik proloterapi uygulanan 10 hastanın (ortalama yaş, 64.2±11.6 yıl) verileri retrospektif olarak toplandı. Tedavide rotator manşon tendonuna yönelik 3 seans dekstroz proloterapi enjeksiyonu içermekteydi. Hastaların tedavi öncesi ve tedavi bitiminden iki hafta sonraki vizüel analog skala omuz ağrısı skorları ve omuz eklem hareket açıklıkları değerlendirildi. Bulgular: Hastaların proloterapi öncesi vizüel analog skala omuz ağrısı değerleri (8.2±1.1 cm) proloterapi sonrası kontrolde (4.8±1.9 cm) istatistiksel olarak anlamlı derecede azaldı. Omuz fleksiyonu ve abduksiyonu derecelerinde tedavi sonrası görülen artış istatistiksel olarak anlamlı bulundu.. Sonuç: Bu pilot çalışmada elde edilen ilk bulgular hemiplejik omuz ağrısı tedavisinde proloterapinin faydalı etkisi olduğunu önermektedir.Purpose: To investigate the effect of prolotherapy on pain and shoulder range of motion in stroke patients with hemiplegic shoulder pain due to rotator cuff tendinopathy. Material and Methods: The data of 10 patients (mean age, 64.2±11.6 years) who had a history stroke of more than six months and underwent prolotherapy treatment were collected retrospectively. The treatment included 3 sessions of dextrose prolotherapy injections applied to rotator cuff tendon. Visual analogue scale pain scores and shoulder range of motions measured at baseline and two weeks later after end of the treatment were assessed. Results: Visual analogue scale shoulder pain scores of the patients decreased from 8.2±1.1 at baseline to 4.8±1.9 after prolotherapy. The degrees of shoulder flexion and abduction increased significantly after the treatment . Conclusion: Preliminary results in this pilot study suggested the beneficial effect of proloterapi in the treatment of hemiplegic shoulder pain

Pregnancy Associated Osteoporosis Leading to Vertebral Compression Fracture

To describe a patient with low back pain developed in the postpartum period and diagnosed as having vertebral compression fracture due to pregnancy and lactation associated osteoporosis. A 28-year old woman presented with complaints of low back pain started two months after her first delivery. Laboratory tests including bone mineral density (BMD), biochemical evaluation and lomber spinal magnetic resonance imaging (MRI) was evaluated. Lomber spine BMD was extremely decreased: L2-4: 0,685 g/cm2, T-score -3.9, Z-score -3.9. MRI revealed a compression fracture of T12 vertebra. The patient was investigated in terms of all possible risk factors and hormonal pathology causing osteoporosis and no abnormality was found. So she was diagnosed as having pregnancy and associated osteoporosis. Cease of the lactation and the treatment with teriparatide were recommended to the patient but she refused both of them. Clinicians should take into account of pregnancy and lactation associated osteoporosis, when evaluating patients with low back pain in early postpartum period

Epidemiologic data of trauma-related lower limb amputees: A single center 10-year experience

WOS: 000396914100021PubMed ID: 28038786Objective: The aim of this study is three fold: 1) to introduce epidemiologic data of patients with traumarelated amputations as a 10-year experience of a rehabitation center; 2) to determine comorbidities and secondary conditions of lower limb loss; 3) to determine the rehospitalization reasons for lower limb amputee patients. Materials and methods: This retrospective study was conducted in a tertiary rehabilitation center in Turkey. Clinical and demographic data of amputees including sex, age, employment status, time since amputation, time after amputation to first hospitalization, length of hospitalization, how many times the patient was hospitalized, reason for hospitalization, stump complications, comorbid conditions, amputation level and K classifacation were documented. Results: Three hundred ninetynine patients with a mean age of 23,48 + 6,04 (4-74) years were included in this study. Mean duration after amputation was 119,71 +/- 68,86 months. Patients were 3,43 +/- 2,53 times hospitalized. Landmine explosion was the most common etiology of amputation with 370 patients (92.7%). Below knee amputation was the most common amputation level with 230 (50,77%) amputations. 399 patients were hospitalized 1369 times and the most common hospitalization reason were stump complications (356 times, 26,00%). Spur formation (202 times) was the most common stump complications. Pyscologic disorders were the most common comorbidity with 68 patient (37,56%). Conclusion: Patients with traumatic limb amputations are likely to experience several complications and comorbidities. Prevention of secondary conditions affecting those living with the loss of a limb is an important part of amputee rehabilitation and may prevent rehospitalization

Effects of two different degrees of lateral-wedge insoles on unilateral lower extremity load-bearing line in patients with medial knee osteoarthritis

Objective: The aim of this study is to assess the effect of 5 and 10° lateral-wedge insoles on unilateral lower extremity load carrying line in patients with medial knee osteoarthritis using the L.A.S.A.R. posture alignment system. Patients and methods: Twenty subjects (10 females and 10 males, mean age 67.7 ± 5.4 years (range: 58–78) with bilateral medial knee osteoarthritis were included in the study. The laser line projected on the person by the L.A.S.A.R. posture alignment system showed joint load carrying line. The location of the joint load carrying line in static standing with one foot on the force plate was assessed with barefoot, and 5° and 10° lateral-wedge insoles. Displacement of the load carrying line was measured using a ruler placed tangentially to the patella at the level of joint line. Results: The load carrying lines measured with 5° and 10° lateral-wedge insoles were significantly laterally located compared to that without wearing insole (p < 0.001). 10° lateral-wedge insole caused a significant more lateral shifting of the load carrying line than 5° lateral-wedge insole (p < 0.001). Conclusion: Both wedge insoles was effective in moving of the unilateral lower extremity load carrying line to the lateral. Lateral wedged insoles are biomechanically effective and reduce loading of the medial compartment in patients with medial knee osteoarthritis. Keywords: Lateral-wedge insoles, Osteoarthritis, Knee biomechanics, L.A.S.A.R. postur