• 제목/요약/키워드: Orthopaedics

검색결과 188건 처리시간 0.029초

Osteocutaneous Turn-Up Fillet Flaps: A Spare-Parts Orthoplastic Surgery Option for a Functional Posttraumatic Below-Knee Amputation

  • Harry Burton;Alexios Dimitrios Iliadis;Neil Jones;Aaron Saini;Nicola Bystrzonowski;Alexandros Vris;Georgios Pafitanis
    • Archives of Plastic Surgery
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    • 제50권5호
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    • pp.501-506
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    • 2023
  • This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Comparative analysis of proximal humerus fracture management in elderly patients: complications of open reduction and internal fixation by shoulder surgeons and non-shoulder surgeons-a retrospective study

  • Rui Claro;Bianca Barros;Carlos Ferreira;Ana Ribau;Luis Henrique Barros
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.32-38
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    • 2024
  • Background: Open reduction and internal fixation (ORIF) with a locking plate is a popular surgical treatment for proximal humeral fractures (PHF). This study aimed to assess the occurrence of complications in elderly patients with PHF treated surgically using ORIF with a locking plate and to investigate the potential differences between patients treated by shoulder surgeons and non-shoulder surgeons. Methods: A retrospective study was conducted using a single-center database to identify patients aged ≥70 years who underwent ORIF for PHF between January 1, 2011, and December 31, 2021. Data on the Neer classification, follow-up, occurrence of avascular necrosis of the humeral head, implant failure, and revision surgery were also collected. Statistical analyses were performed to calculate the overall frequency of complications according to the Neer classification. Results: The rates of implant failure, avascular osteonecrosis, and revision surgery were 15.7%, 4.8%, and 15.7%, respectively. Complications were more common in patients with Neer three- and four-part fractures. Although the difference between surgeries performed by shoulder surgeons and non-shoulder surgeons did not reach statistical significance, the rate of complications and the need for revision surgery were nearly two-fold higher in the latter group. Conclusions: PHF are highly prevalent in the elderly population. However, the ORIF surgical approach, as demonstrated in this study, is associated with a considerable rate of complications. Surgeries performed by non-shoulder surgeons had a higher rate of complications and a more frequent need for revision surgery. Future studies comparing surgical treatments and their respective complication rates are crucial to determine the optimal therapeutic options. Level of evidence: III.

Does Aging Matter? The Efficacy of Carpal Tunnel Release in the Elderly

  • Fung, Bettina Wai Yan;Tang, Chris Yuk Kwan;Fung, Boris Kwok Keung
    • Archives of Plastic Surgery
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    • 제42권3호
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    • pp.278-281
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    • 2015
  • Open release remains the gold standard in the treatment of carpal tunnel syndrome in cases where conservative treatment fails. However, the efficacy of carpal tunnel release in the elderly has been debated in the literature throughout the years. This review aims to review the current evidence pertaining to the efficacy of carpal tunnel release in the elderly. Based on the current evidence, the outcome of carpal tunnel release is unpredictable in the elderly. Elderly patients are also less satisfied with the operation compared to younger patients. The authors recommend that these messages be conveyed to elderly patients before surgery. Moreover, open carpal tunnel release should be offered in the early stages of treatment whenever operative management is indicated.

주관절의 외측방 회전 불안정성에 대한 외측 척측부인대 재건술-1례보고- (Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow Joint - A Case Report -)

  • 문은선;이승기;박철홍
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.236-241
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    • 1998
  • 본 교실에서는 주관절에 발생한 후외측방 회전 불안정성에 의한 재발성 탈구 환자에 대해 Nestor 술식을 이용한 외측 척측부인대 재건을 1례 치 험하였다. 주관절의 재발성 탈구의 치료에 있어서는 병인중 가장 많은 후외측방 회전 불안정성에 대한 이해가 필요하며 그에 따른 외측 척측부인대 재건등의 수술적 수기와 술후 적절한 재활 치료가 치료결과에 큰 영향을 미치게 된다.

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Where is the Lesion? Glomus Tumours of the Hand

  • Tang, Chris Yuk Kwan;Tipoe, Timothy;Fung, Boris
    • Archives of Plastic Surgery
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    • 제40권5호
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    • pp.492-495
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    • 2013
  • Glomus tumours are vascular hamartomas that are commonly found in the hand, particularly the subungual region. They appear as solitary or multiple tumours, and often present as a bluish discoloration of the nail plate. Different diagnostic tests are outlined, as well as imaging studies such as magnetic resonance imaging and ultrasound. Misdiagnosis and delayed diagnosis of these tumours are common, while a familial tendency is a potential risk factor but not yet proven. Complete surgical excision often results in complete symptomatic relief, while recurrences are largely due to incomplete excision or the growth of a new glomus tumour. This article aims to review the key aspects of glomus tumours and provide a diagnostic algorithm so that the lesion can be recognized and treated earlier.

Treadmill에서의 보행 및 주행 시의 수직 지면반발력 (Vertical ground reaction force in the treadmill walking and running)

  • 양길태;김영호;임송학
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 춘계학술대회
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    • pp.339-342
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    • 1996
  • Vertical ground reaction forces on a treadmill were measured at different walking speeds using two tandem force plates. Comparing vertical ground reaction forces in treadmill walking with those in ground free walking, treadmill walking overestimated the first and second peak forces. With the increase of the walking speed, this phenomenon becomes more significant. In treadmill running, the first peak force reached 210-280% of the body weight. However, the instrumented treadmill showed a great potential to investigate the kinetics for multiple foot-strike measurements.

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Fe3O4 magnetic nanoparticles provide a novel alternative strategy for Staphylococcus aureus bone infection

  • Youliang, Ren;Jin, Yang;Jinghui, Zhang;Xiao, Yang;Lei, Shi;Dajing, Guo;Yuanyi, Zheng;Haitao, Ran;Zhongliang, Deng;Lei, Chu
    • Advances in nano research
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    • 제13권6호
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    • pp.575-585
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    • 2022
  • Due to its biofilm formation and colonization of the osteocyte-lacuno canalicular network (OLCN), Staphylococcus aureus (S.aureus) implant-associated bone infection (SIABI) is difficult to cure thoroughly, and may occur recurrently subsequently after a long period dormant. It is essential to explore an alternative therapeutic strategy that can eradicate the pathogens in the infected foci. To address this, the polymethylmethacrylate (PMMA) bone cement and Fe3O4 nanoparticles compound cylinder were developed as implants based on their size and mechanical properties for the alternative magnetic field (AMF) induced thermal ablation, The PMMA mixed with optimized 2% Fe3O4 nanoparticles showed an excellent antibacterial efficacy in vitro. It was evaluated by the CFU, CT scan and histopathological staining on a rabbit 1-stage transtibial screw model. The results showed that on week 7, the CFU of infected soft tissue and implants, and the white blood cells (WBCs) of the PMMA+2% Fe3O4+AMF group decreased significantly from their controls (p<0.05). PMMA+2% Fe3O4+AMF group did not observe bone resorption, periosteal reaction, and infectious reactive bone formation by CT images. Further histopathological H&E and Gram Staining confirmed there was no obvious inflammatory cell infiltration, neither pathogens residue nor noticeably burn damage around the infected screw channel in the PMMA+2% Fe3O4+AMF group. Further investigation of nanoparticle distributions in bone marrow medullary and vital organs of heart, liver, spleen, lung, and kidney. There were no significantly extra Fe3O4 nanoparticles were observed in the medullary cavity and all vital organs either. In the current study, PMMA+2% Fe3O4+AMF shows promising therapeutic potential for SIABI by providing excellent mechanical support, and promising efficacy of eradicating the residual pathogenic bacteria in bone infected lesions.

Bilateral anterior dislocation in the hips: a case report

  • Dheeraj Makkar;Ravi Sauhta
    • Journal of Trauma and Injury
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    • 제36권1호
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    • pp.70-73
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    • 2023
  • The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

Quercetin Enhances Cisplatin Sensitivity of Human Osteosarcoma Cells by Modulating microRNA-217-KRAS Axis

  • Zhang, Xian;Guo, Qinggong;Chen, Jingtao;Chen, Zhaohui
    • Molecules and Cells
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    • 제38권7호
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    • pp.638-642
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    • 2015
  • Quercetin can suppress osteosarcoma cell growth and metastasis. However, other effects of quercetin on osteosarcoma remain largely unknown. This research aims to evaluate the effects of quercetin in combination with cisplatin as treatment for osteosarcoma and investigate its regulatory mechanism. Cell viability and apoptosis in 143B cell line were determined after treatment with quercetin and/or cisplatin. RT-PCR and Western blot analysis were performed to determine the RNA or protein expression levels. Moreover, transwell assay was used to evaluate metastasis. Furthermore, rescue experiments were performed to investigate the potential regulatory mechanism of the treatment. Results showed that quercetin with concentration that was equal to or greater than $10{\mu}M$ inhibited 143B proliferation, while $5{\mu}M$ quercetin enhanced the cisplatin sensitivity of 143B cells. Expression of miR-217 was upregulated after quercetin and/or cisplatin treatment, while its target KRAS was downregulated both at mRNA and protein levels. MiR-217 knockdown led to the loss of enhanced cisplatin sensitivity while miR-217 overexpression showed the opposite effects, indicating that quercetin regulated cisplatin sensitivity by modulating the miR-217-KRAS axis. In conclusion, $5{\mu}M$ quercetin enhanced the cisplatin sensitivity by modulating the miR-217-KRAS axis. This finding suggests that quercetin may be administered with cisplatin to improve the treatment for osteosarcoma.

신규 생약 복합추출물에 의한 Prostaglandin $E_2$ 활성억제, 염증성 Cytokine 생성 저해 및 진통 작용에 관한 연구 (Analgesic Effect and Inhibition of Prostaglandin $E_2$ Activity and Pro-inflammatory Cytokines Production by Ethyl Alcohol Extract from New Herbal Formula)

  • 권순용;이화성;이순혁;임군일;김시나;김희석;황성완;황성연
    • 생약학회지
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    • 제37권3호
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    • pp.136-142
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    • 2006
  • New herbal formula (NHF) is the ethanol extract mixture of Puerariae radix, Artemisia capillaries and Perilla frutescens. We have Investigated the effects on anti-inflammation by NHF and attempted acetic acid induced writhing to verify the analgesic effect. Macrophages and chondrocytes were obtained from mouse and rabbit. Inflammation was induced bγ interleukin-1, tumor necrosis $factor-{\alpha}$, $interferon-{\gamma}$, and lipopolysaccharide. NHF showed strong inhibitory efficacy against cytokine-induced proteoglycan degradation, $PGE_2$ production, NO production, and MMP-9 expression in rabbit articular chondrocyte. In the writhing test, NHF exhibited a dose-dependent inhibition of writhing. Futhermore, NHF increased the activity of SOD. NHF have anti-inflammatory and analgesic activities, and could be a good herbal medicine candidate for curing of osteoarthritis.