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Functional Bracing

Chetan Gohal, Ajaykumar Shanmugaraj, Patrick Tate, Nolan S Horner, Asheesh Bedi, Anthony Adili, Moin Khan
CONTEXT: Knee osteoarthritis affects 9.3 million adults over age 45 years in the United States. There is significant disability associated with this condition. Given the potential complications and the significant cost to the health care system with the dramatic increase in total knee arthroplasties performed for this condition, assessment of the efficacy of nonoperative modalities, such as offloading knee braces, is essential as part of optimizing nonoperative treatment for this condition...
March 1, 2018: Sports Health
Molly K Lewis, Omar Ramos-Williams, Hasan M Syed, Theodore K Gregorius
CASE: A 9-year-old boy sustained intrasubstance tears of the rotator cuff and periscapular muscles due to a fall, resulting in scapular winging and severely decreased shoulder range of motion. Treatment consisted of a modified thoracolumbosacral orthosis (TLSO) with a shoulder immobilizer attachment (to reduce the scapula to the thoracic wall and hold the arm in 10° of abduction). The brace was worn for 8 weeks. The patient recovered full, pain-free shoulder function and range of motion, and returned to high-level athletics...
March 14, 2018: JBJS Case Connector
Klaus Bsl Batista, Badri Thiruvenkatachari, Jayne E Harrison, Kevin D O'Brien
BACKGROUND: Prominent upper front teeth are a common problem affecting about a quarter of 12-year-old children in the UK. The condition develops when permanent teeth erupt. These teeth are more likely to be injured and their appearance can cause significant distress. Children are often referred to an orthodontist for treatment with dental braces to reduce the prominence of their teeth. If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait and provide treatment in adolescence...
March 13, 2018: Cochrane Database of Systematic Reviews
Megan H M Kuba, Byron H Izuka
BACKGROUND: Previous studies have showed the efficacy of removable brace treatment for distal radius buckle fractures in children, whereas others have independently suggested that these injuries do not require additional radiographic imaging. However, no study has sought to collectively determine whether treating pediatric distal radius buckle fractures with a removable brace and no follow-up visit or imaging after the initial visit is a safe and satisfactory protocol. METHODS: In total, 42 consecutive patients with a distal forearm buckle fracture seen by a single fellowship trained pediatric orthopaedic surgeon were eligible to participate...
March 9, 2018: Journal of Pediatric Orthopedics
Edward P Washabaugh, Chandramouli Krishnan
BACKGROUND: Robotic-resisted treadmill walking is a form of task-specific training that has been used to improve gait function in individuals with neurological injury, such as stroke, spinal cord injury, or cerebral palsy. Traditionally, these devices use active elements (e.g., motors or actuators) to provide resistance during walking, making them bulky, expensive, and less suitable for overground or in-home rehabilitation. We recently developed a low-cost, wearable robotic brace that generates resistive torques across the knee joint using a simple magnetic brake...
2018: Restorative Neurology and Neuroscience
Sydney C Karnovsky, Bridget Desandis, Andrea K Papson, Quinn O'Malley, Robert DiGiacomo, Martin J O'Malley, Taylor N Cabe, Mark C Drakos
BACKGROUND: Tibialis anterior tendon ruptures are rare and can cause significant dysfunction. Often, conservative measures are prescribed because of the morbidity of a tendon transfer as an operative solution. We present a novel reconstruction technique using hamstring autograft, which may obviate the need for local tendon transfer and long-term bracing. METHODS: Patients who underwent tibialis anterior reconstruction with hamstring autograft between 2011 and 2015 were screened for inclusion...
March 1, 2018: Foot & Ankle International
Koichiro Sota, Yuki Uchiyama, Mitsuhiro Ochi, Shuji Matsumoto, Kenji Hachisuka, Kazuhisa Domen
BACKGROUND: Functional electrical stimulation (FES) for patients with stroke and foot drop is an alternative to ankle foot orthoses. Characteristics of FES responders and non-responders have not been clarified. OBJECTIVES: 1. To investigate the effects of treatment with FES on patients with stroke and foot drop. 2. To determine which factors may relate to responders and non-responders. DESIGN: Multicenter, non-randomized, prospective study...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Soliman Oushy, Lucas P Carlstrom, William E Krauss
BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness...
March 5, 2018: Neurosurgery
Aakash Chauhan, Alan Slipak, Mark C Miller, Daniel T Altman, Gregory T Altman
INTRODUCTION: The use of a postoperative brace may be beneficial after open reduction and internal fixation of tibial plateau fractures. However, bracing has potential drawbacks related to cost, fitting, wound complications, and compliance. We hypothesized that no difference will be found between patients with and without bracing after open reduction and internal fixation of tibial plateau fractures. METHODS: In this prospective, comparative trial, patients were randomized to 6 weeks of bracing or no bracing after open reduction and internal fixation of tibial plateau fractures...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Gwendolyn Vuurberg, Alexander Hoorntje, Lauren M Wink, Brent F W van der Doelen, Michel P van den Bekerom, Rienk Dekker, C Niek van Dijk, Rover Krips, Masja C M Loogman, Milan L Ridderikhof, Frank F Smithuis, Sjoerd A S Stufkens, Evert A L M Verhagen, Rob A de Bie, Gino M M J Kerkhoffs
This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury...
March 7, 2018: British Journal of Sports Medicine
L G Hvid, P Aagaard, N Ørtenblad, M Kjaer, C Suetta
While short-term disuse negatively affects mechanical muscle function (e.g. isometric muscle strength) little is known of the relative contribution of adaptions in central neural drive and peripheral muscle contractility. The present study investigated the relative contribution of adaptations in central neural drive and peripheral muscle contractility on changes in isometric muscle strength following short-term unilateral disuse (4 days, knee brace) and subsequent active recovery (7 days, one session of resistance training) in young (n = 11, 24 yrs) and old healthy men (n = 11, 67 yrs)...
February 21, 2018: Experimental Gerontology
Ewa Misterska, Jakub Głowacki, Maciej Głowacki, Adam Okręt
We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group...
2018: PloS One
Zhi-Wei Zhao, Wen-Jing Liu, Zhu-Qing Zha, Yan-Feng Li, Hui-Jun Fan
OBJECTIVE: To investigate the effect of tibial composite saphenous nerve tissue flap in repairing traumatic bone-skin defect of leg. METHODS: From February 2009 to May 2015, 23 patients with focile skin defect caused by trauma were treated, including 18 males and 5 females, aged from 8 to 59 years old with an average age of 35.6 years old. Length of tibia bone cortex defect ranged from 4 to 12 cm, width ranged from 2 to 2.5cm, skin defect ranged from 8 cm× 3 cm to 18 cm× 11 cm, all the wound surfaces had purulent exudation...
December 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Katherine A Davies, Maria C Tanzer, Michael D W Griffin, Yee Foong Mok, Samuel N Young, Rui Qin, Emma J Petrie, Peter E Czabotar, John Silke, James M Murphy
The programmed cell death pathway, necroptosis, relies on the pseudokinase, Mixed Lineage Kinase domain-Like (MLKL), for cellular execution downstream of death receptor or Toll-like receptor ligation. Receptor-interacting protein kinase-3 (RIPK3)-mediated phosphorylation of MLKL's pseudokinase domain leads to MLKL switching from an inert to activated state, where exposure of the N-terminal four-helix bundle (4HB) 'executioner' domain leads to cell death. The precise molecular details of MLKL activation, including the stoichiometry of oligomer assemblies, mechanisms of membrane translocation and permeabilisation, remain a matter of debate...
February 14, 2018: Cell Death and Differentiation
Stefano Negrini, Sabrina Donzelli, Angelo Gabriele Aulisa, Dariusz Czaprowski, Sanja Schreiber, Jean Claude de Mauroy, Helmut Diers, Theodoros B Grivas, Patrick Knott, Tomasz Kotwicki, Andrea Lebel, Cindy Marti, Toru Maruyama, Joe O'Brien, Nigel Price, Eric Parent, Manuel Rigo, Michele Romano, Luke Stikeleather, James Wynne, Fabio Zaina
Background: The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS)...
2018: Scoliosis and Spinal Disorders
Kazuhide Miyamoto, Ayumi Yamashita, Kazuki Saito
Cross-brace structural motifs are required as a scaffold to design artificial RING fingers (ARFs) that function as ubiquitin ligase (E3) in ubiquitination and have specific ubiquitin-conjugating enzyme (E2)-binding capabilities. The Simple Modular Architecture Research Tool database predicted the amino acid sequence 131-190 (KIAA1045ZF) of the human KIAA1045 protein as an unidentified structural region. Herein, the stoichiometry of zinc ions estimated spectrophotometrically by the metallochromic indicator revealed that the KIAA1045ZF motif binds to two zinc atoms...
February 12, 2018: Protein Science: a Publication of the Protein Society
Rajdeep Singh Bagga, Arvind B Goregaonkar, Aditya Anand Dahapute, Saurabh R Muni, Sandeep Gokhale, Jitesh Manghwani
Aim: To study the functional and radiological outcomes in cases managed conservatively for single-level traumatic thoracolumbar spine fractures without neurological deficit. Materials and Methods: In this prospective study design, thirty patients who presented to tertiary care hospital and diagnosed with posttraumatic thoracolumbar vertebral fracture without any neurodeficit were recruited. All the patients were managed conservatively as per the protocol which included bed rest, spinal braces, and physiotherapy...
October 2017: Journal of Craniovertebral Junction and Spine
Declan T Millett, Susan J Cunningham, Kevin D O'Brien, Philip E Benson, Cesar M de Oliveira
BACKGROUND: A Class II division 2 malocclusion is characterised by upper front teeth that are retroclined (tilted toward the roof of the mouth) and an increased overbite (deep overbite), which can cause oral problems and may affect appearance.This problem can be corrected by the use of special dental braces (functional appliances) that move the upper front teeth forward and change the growth of the upper or lower jaws, or both. Most types of functional appliances are removable and this treatment approach does not usually require extraction of any permanent teeth...
February 1, 2018: Cochrane Database of Systematic Reviews
Nelly Morellet, Xianghong Li, Silke A Wieninger, Jennifer L Taylor, Julien Bischerour, Séverine Moriau, Ewen Lescop, Benjamin Bardiaux, Nathalie Mathy, Nadine Assrir, Mireille Bétermier, Michael Nilges, Alison B Hickman, Fred Dyda, Nancy L Craig, Eric Guittet
The piggyBac transposase (PB) is distinguished by its activity and utility in genome engineering, especially in humans where it has highly promising therapeutic potential. Little is known, however, about the structure-function relationships of the different domains of PB. Here, we demonstrate in vitro and in vivo that its C-terminal Cysteine-Rich Domain (CRD) is essential for DNA breakage, joining and transposition and that it binds to specific DNA sequences in the left and right transposon ends, and to an additional unexpectedly internal site at the left end...
January 27, 2018: Nucleic Acids Research
Sarah Walton, Emily Schaeffer, Kishore Mulpuri, Peter Cundy, Nicole Williams
INTRODUCTION: Developmental dysplasia of the hip (DDH) affects 4-6 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction...
January 29, 2018: BMJ Open
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