Evaluation of functional outcome and patient satisfaction after arthroscopic elbow arthrolysis

Arthroscopic arthrolysis is indicated for stiffness and pain caused by intrinsic stiffness and early arthritis of the elbow joint. Previous studies have demonstrated the benefits in relieving pain and improving motion, but none have reported the specific functional recovery. To understand the functional outcome and patient satisfaction, 26 patients were reviewed at a mean follow-up of 25 months. All were manual workers or strength athletes. Pre- and post-operative evaluation included the Elbow Functional Assessment score, patient satisfaction and return to work and sports. Function improved significantly in 87% and the overall Elbow Functional Assessment score raised from a preoperative 48 to a postoperative 84. Arthroscopic arthrolysis not only improved pain and the range of motion, but also restored the elbow function and returned patients to their desired level of activity

Best practice statement : use of ankle-foot orthoses following stroke

NHS Quality Improvement Scotland (NHSQIS) leads the use of knowledge to promote improvement in the quality of health care for the people of Scotland and performs three key functions. It provides advice and guidance on effective clinical practice, including setting standards; drives and supports implementation of improvements in quality, and assessing the performance of the NHS, reporting and publishing findings

Rehabilitation interventions for foot drop in neuromuscular disease

"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases

The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions.

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture

Dupuytren's disease in bosnia and herzegovina. An epidemiological study

BACKGROUND: It is generally held that Dupuytren's disease is more common in northern than in southern Europe, but there are very few studies from southern European countries. METHODS: We examined the hands of 1207 men and women over the age of 50 years in Bosnia and Herzegovina. RESULTS: The prevalence of Dupuytren's disease was highly age-dependent, ranging from 17% for men between 50–59 years to 60% in the oldest men. The prevalence among women was lower. The great majority only had palmar changes without contracture of the digit. The prevalence was significantly lower among Bosnian Muslim men than among Bosnian Croat and Serbian men and significantly increased among diabetics. No association could be detected between Dupuytren's disease and smoking, alcohol consumption or living in rural or urban areas. CONCLUSION: We conclude that, contrary to previous opinion, Dupuytren's disease is common in Bosnia and Herzegovina

Low-level finite state control of knee joint in paraplegic standing

Low-level finite state (locked-unlocked) control is compared with open-loop stimulation of the knee extensor muscles in functional electrical stimulation (FES) induced paraplegic standing. The parameters were: duration of standing, relative torque loss in knee extensor muscles, knee angle stability, average stimulus output and average arm effort during standing. To investigate the impact of external mechanical conditions on controller performance, experiments were performed both under the condition of a freely moving ankle joint and of a mechanically stabilized ankle joint. Finite state control resulted in a 2.5 to 12 times increase of standing duration or in a 1.5 to 5 times decrease of relative torque loss in comparison with open-loop stimulation. Finite state control induced a limit cycle oscillation in the knee joint. Average maximum knee flexion was 6.2° without ankle bracing, and half that value with ankle bracing. Average arm support was 13.9 and 7.5% of the body weight without and with ankle bracing respectively

Fibromatosis of the Plantar Fascia: Diagnosis and Indications For Surgical Treatment

Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results indicate that recurrence of plantar fibromatosis after surgical resection can be reduced by aggressive initial surgical resection

Post-traumatic flexion contractures of the elbow: Operative treatment via the limited lateral approach

Varying surgical techniques, patient groups and results have been described regards the surgical treatment of post traumatic flexion contracture of the elbow. We present our experience using the limited lateral approach on patients with carefully defined contracture types.Surgical release of post-traumatic flexion contracture of the elbow was performed in 23 patients via a limited lateral approach. All patients had an established flexion contracture with significant functional deficit. Contracture types were classified as either extrinsic if the contracture was not associated with damage to the joint surface or as intrinsic if it was.Overall, the mean pre-operative deformity was 55 degrees (95%CI 48-61) which was corrected at the time of surgery to 17 degrees (95%CI 12-22). At short-term follow-up (7.5 months) the mean residual deformity was 25 degrees (95%CI 19-30) and at medium-term follow-up (43 months) it was 32 degrees (95%CI 25-39). This deformity correction was significant (p < 0.01). One patient suffered a post-operative complication with transient dysaesthesia in the distribution of the ulnar nerve, which had resolved at six weeks. Sixteen patients had an extrinsic contracture and seven an intrinsic. Although all patients were satisfied with the results of their surgery, patients with an extrinsic contracture had significantly (p = 0.02) better results than those with an intrinsic contracture. (28 degrees compared to 48 degrees at medium term follow up). Surgical release of post-traumatic flexion contracture of the elbow via a limited lateral approach is a safe technique, which reliably improves extension especially for extrinsic contractures. In this series all patients with an extrinsic contracture regained a functional range of movement and were satisfied with their surgery