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Veroniek M van Praag, Magdalena Lysenko, Barbara Harvey, Rosanna Yankanah, James G Wright
BACKGROUND: Up to 40% of patients with idiopathic clubfoot who are treated with the Ponseti method experience recurrence of deformity. Many of these patients receive surgery (e.g., anterior tibial tendon transfer). An alternative approach for recurrent clubfoot is repeat Ponseti casting. The purpose of this study was to evaluate the outcome of repeat Ponseti casting in the treatment of recurrent clubfoot. METHODS: Patients with recurrent idiopathic clubfoot who were treated at our hospital, between 2004 and 2012, with repeat serial casting and bracing (the recurrent group) were eligible for inclusion in the study...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Andrew Loftus, Harvey Pynn, Paul Parker
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell , and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives...
June 15, 2018: Emergency Medicine Journal: EMJ
Benjamin Hon Kei Yip, Xue Li, Christine Hiu Yan Leung, Ting Gao, Vincent Chi Ho Chung, Fiona Wai Ping Yu, Tsz Ping Lam, Jack Chun Yiu Cheng, Samuel Yeung Shan Wong
INTRODUCTION: Adolescent idiopathic scoliosis (AIS) is the most prevalent deforming orthopaedic condition; it causes significant disability when spinal curves progress beyond 45deg. Bracing is the primary treatment prescribed for adolescents with an immature skeleton who have spinal curves between 25 and 45deg. New evidence suggests that compliance with bracing significantly decreases the progression of high-risk curves to the threshold for surgery. Nonetheless, bracing is a stressful experience...
June 12, 2018: Journal of Physiotherapy
Junsheng Gao, Lu Zhang, Zhiang Liu, Shuaihui Yao, Songming Gao
Objective: To analyze the correlation between the polymorphism on interleukin 6 (IL-6) gene promoter region-174 locus and adolescent idiopathic scoliosis (AIS), including the susceptibility, the bracing effectiveness, and the possible mechanism. Methods: The 182 AIS patients and 210 healthy controls who met the inclusion criteria between January 2013 and January 2016 were collected as research objects. The genotype of IL-6 gene promoter region-174 locus, the serum IL-6, the bone mineral density (BMD) of femoral neck and vertebrae (L 1-4 ), and the bone metabolism parameters, including bone alkaline phosphatase (BALP), bone gla protein (BGP), tartrate resistant acid phosphatase 5b (TRACP-5b), urine Ca, and urine Ca/Cr, were detected...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Piyush Mahapatra, Saman Horriat, Bobby S Anand
BACKGROUND: This article provides a detailed narrative review on the history and current concepts surrounding ligamentous repair techniques in athletic patients. In particular, we will focus on the anterior cruciate ligament (ACL) as a case study in ligament injury and ligamentous repair techniques. PubMed (MEDLINE), EMBASE and Cochrane Library databases for papers relating to primary anterior cruciate ligament reconstruction were searched by all participating authors. All relevant historical papers were included for analysis...
June 15, 2018: Journal of Experimental Orthopaedics
C van den Berg, T Haak, N L Weil, J M Hoogendoorn
BACKGROUND: In general, stable type B ankle fractures are treated conservatively with cast immobilization or a walking boot during six weeks. Some disadvantages of casting are joint stiffness, muscle wasting and lack of comfort. This study was designed to evaluate whether functional treatment with a removable brace is a safe and more comfortable alternative. MATERIAL AND METHODS: Randomized controlled trial. In the period March 2013 - May 2015, 44 patients visiting the emergency department due to a stable type B ankle fracture were included...
June 4, 2018: Injury
Harry M Lightsey, Margaret L Wright, David P Trofa, Charles A Popkin, Lauren H Redler
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is an increasingly utilized surgical option for recurrent patellar instability. Recent studies have highlighted the potential benefits of accelerated functional rehabilitation; however, no validated MPFL rehabilitation guidelines currently exist. OBJECTIVE: To assess the variability of MPFL reconstruction rehabilitation protocols published online by academic orthopaedic programs. METHODS: Online MPFL rehabilitation protocols from U...
June 9, 2018: Physician and Sportsmedicine
Austin E Sanders, Lindsay M Andras, Stephanie E Iantorno, Anita Hamilton, Paul D Choi, David L Skaggs
STUDY DESIGN: Prospective study of 92 patients. OBJECTIVES: To determine if the incidence of clinically significant psychological and emotional distress in adolescent idiopathic scoliosis (AIS) patients is higher than the general population and if this correlates with deformity severity. SUMMARY OF BACKGROUND DATA: Adolescents with scoliosis may exhibit a less positive outlook on life, suffer from lower self-esteem, and have more difficulty connecting with peers; however, there is conflicting evidence whether different stages of treatment prompt different psychological problems and the long-term psychological effect of scoliosis...
July 2018: Spine Deformity
Joshua J Thomas, Anthony A Stans, Todd A Milbrandt, Vickie M Treder, Hilal Maradit Kremers, William J Shaughnessy, A Noelle Larson
BACKGROUND: With new data supporting the efficacy of bracing, the role of school screening for early detection of moderate scoliosis curves has been revisited. Because of a high rate of false-positive screening and cost concerns, a comprehensive county-wide school screening program was discontinued in 2004. We aim to determine the impact of a comprehensive school screening program on curve magnitude at presentation and initial scoliosis treatment for all local county patients presenting to a pediatric orthopedic clinic from all referral sources...
July 2018: Spine Deformity
Cole M Dovey, Jonathan Diep, Bradley P Clarke, Andrew T Hale, Dan E McNamara, Hongyan Guo, Nathaniel W Brown, Jennifer Yinuo Cao, Christy R Grace, Peter J Gough, John Bertin, Scott J Dixon, Dorothea Fiedler, Edward S Mocarski, William J Kaiser, Tudor Moldoveanu, John D York, Jan E Carette
Necroptosis is an important form of lytic cell death triggered by injury and infection, but whether mixed lineage kinase domain-like (MLKL) is sufficient to execute this pathway is unknown. In a genetic selection for human cell mutants defective for MLKL-dependent necroptosis, we identified mutations in IPMK and ITPK1, which encode inositol phosphate (IP) kinases that regulate the IP code of soluble molecules. We show that IP kinases are essential for necroptosis triggered by death receptor activation, herpesvirus infection, or a pro-necrotic MLKL mutant...
June 7, 2018: Molecular Cell
H J Christiaan Swellengrebel, David Saper, Paul Yi, Alexander A Weening, David Ring, Andrew Jawa
Diaphyseal fractures of the distal humerus have a high rate of union when treated with a functional brace or an above-elbow cast (AEC). This study compares alignment of the humerus and motion of the elbow after functional brace or AEC treatment. One-hundred and five consecutive patients with a closed, extra-articular fracture of the distal humeral diaphysis were identified in the orthopedic trauma databases of 3 hospitals between 2003 and 2012. Seventy-five patients with a follow-up of at least 6 months or with radiographic and clinical evidence of fracture union were included (51 treated with functional bracing and 24 treated with an AEC)...
May 2018: American Journal of Orthopedics
Andrey V Dovzhenko, Vera D Kuroedova, Lyudmila B Halych
OBJECTIVE: Introduction: Tooth loosening is divided into physiological and pathological one, but there is tooth loosening that occurs during orthodontic treatment (OT) and depends on the tissues of parodontium and strength of orthodontic apparatus. The aim of the research is to evaluate teeth loosening of the upper jaw during adaptive period in patients with permanent bite who were treated by braces. PATIENTS AND METHODS: Materials and methods: Periostometry (device «Periotest») of teeth to 30 patients who are from 14 to 27 years old with the pathology of the first type based Angle's classification...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Cheng-Li Lin, Po-Hsin Chou, Jing-Jing Fang, Kuo-Yuan Huang, Ruey-Mo Lin
Objective We assessed our results of short-segment decompression and fixation for osteoporotic thoracolumbar fractures with neurological deficits. Methods We evaluated 20 elderly patients (age, 60-89 years; mean, 73.2 years) with osteoporotic thoracolumbar fractures and neurological deficits. They underwent short-segment decompression and fixation and followed up for 40.6 (range, 24-68) months. A visual analog scale (VAS) and the Oswestry Disability Index (ODI) were used to measure back pain and disability...
January 1, 2018: Journal of International Medical Research
Nicholas A Trasolini, George F Rick Hatch
Treatment of posterior cruciate ligament injuries remains controversial, particularly in the case of partial or incomplete tears in the context of a multiple ligament-injured knee. Suture augmentation, or internal bracing, has been shown in other ligament and tendon repairs or reconstructions to provide stable biomechanics and facilitate early return to activity. In the knee, suture augmentation has previously been used for the treatment of medial collateral ligament tears and in the support of anterior cruciate ligament reconstructions...
March 2018: Arthroscopy Techniques
Paul Gagnet, Kent Kern, Kyle Andrews, Hossein Elgafy, Nabil Ebraheim
Spondylolysis is a common diagnosis with a high prevalence in children and adolescents complaining of low back pain. It may be caused by either a defect or fracture of the pars interarticularis due to mechanical stress. Depending on the severity of the spondylolysis and symptoms associated it may be treated either conservatively or surgically, both of which have shown significant success. Conservative treatments such as bracing and decreased activity have been shown to be most effective with patients who have early diagnosis and treatment...
June 2018: Journal of Orthopaedics
Mania Kaveh, Kobra Tahermanesh, Soheil Hanjani, Seyedeh Mehr Abed
Uterine atony is the most common cause of postpartum hemorrhage and can lead to maternal mortality and morbidity [1]. When conservative management fails, surgical intervention is necessary. In 1997, Christopher B-Lynch pioneered the use of a brace-like suturing technique that mechanically compresses the uterus in cases of uterine atony. Subsequently, others have modified the procedure to increase its effectiveness This article is protected by copyright. All rights reserved.
June 7, 2018: International Journal of Gynaecology and Obstetrics
Annika Blomkvist, Kristina Olsson, Meta N Eek
BACKGROUND: Scoliosis is common in children with neuromuscular deficits. It is often associated with an asymmetric sitting position and with poor balance. Many children with neuromuscular scoliosis spend most of their day sitting. OBJECTIVES: To describe how sitting function is affected by treatment with a modified custom-moulded Boston brace in children with neuromuscular scoliosis. STUDY DESIGN: Retrospective review of medical records. METHODS: A review of medical records from children fitted with scoliosis braces, including analysis of sitting, using a pressure-mapping system...
June 1, 2018: Prosthetics and Orthotics International
Zhifeng Xiao, Fengwu Tang, Yannan Zhao, Guang Han, Na Yin, Xing Li, Bing Chen, Sufang Han, Xianfeng Jiang, Chen Yun, Changyu Zhao, Shixiang Cheng, Sai Zhang, Jianwu Dai
Stem cells and biomaterials transplantation hold a promising treatment for functional recovery in spinal cord injury (SCI) animal models. However, the functional recovery of complete SCI patients was still a huge challenge in clinic. Additionally, there is no clinical standard procedure available to diagnose precisely an acute patient as complete SCI. Here, two acute SCI patients, with injury at thoracic 11 (T11) and cervical 4 (C4) level respectively, were judged as complete injury by a stricter method combined with American Spinal Injury Association (ASIA) Impairment Scale, magnetic resonance imaging (MRI) and nerve electrophysiology...
January 1, 2018: Cell Transplantation
Christina Valle, Anja Hirschmüller, Marcus Schmitt-Sody, Bernhard Haller, Matthias Keller, Wolfgang Schoch, Helmut Hoffman, Philipp Minzlaff
INTRODUCTION:  Rehabilitation protocols following anterior cruciate ligament (ACL) reconstruction often differ among orthopaedic surgeons. The primary aim of this study was to investigate which follow-up treatment is recommended by "AGA instructors" certified by the German-speaking Association for Arthroscopic and Open Joint Surgery (AGA). The secondary aim was to compare these findings with the current literature. MATERIAL AND METHODS:  A structured anonymous online survey was performed with "AGA instructors" specialised in knee or ACL surgery...
June 2018: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
Aaron Michael Gipsman, Nicholas Trasolini, George F Rick Hatch
Although anterior cruciate ligament (ACL) reconstruction remains the gold standard for the treatment of ACL tears, repair is regaining popularity as a treatment option for proximal or distal ACL avulsions. Historically, ACL repairs had poor outcomes. To remedy this, techniques were developed using graft-based augmentation but never gained widespread popularity. Recently, there has been a renewed interest in primary ligament repairs, with newer techniques incorporating modern synthetic materials to augment the repair site...
April 2018: Arthroscopy Techniques
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