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Physiotherapy fracture clinic

Helen Hg Handoll, Joanne Elliott, Zipporah Iheozor-Ejiofor, James Hunter, Alexia Karantana
BACKGROUND: Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and other usually displaced fractures. There is considerable variation in practice, such as the extent of immobilisation for buckle fractures and use of surgery for seriously displaced fractures. OBJECTIVES: To assess the effects (benefits and harms) of interventions for common distal radius fractures in children, including skeletally immature adolescents...
December 19, 2018: Cochrane Database of Systematic Reviews
L Willinger, A B Imhoff, A Schmitt, P Forkel
OBJECTIVE: Anatomical reduction of bony avulsions of the posterior cruciate ligament (PCL) by a suture-bridge™ (Arthrex, Naples, FL, USA) technique to restore posterior knee stability. INDICATIONS: Acute bony tibial avulsions of the PCL and multifragmentary fractures. CONTRAINDICATIONS: Chronic condition of avulsion fractures or posterior instability, advanced knee osteoarthritis, high-grade soft tissue injury, infection. SURGICAL TECHNIQUE: Prone position, minimally invasive posterior medial approach, exposure and reduction of the bony fragment, positioning of the proximal suture-anchor (interfragment), suturing the PCL and knotting to achieve repositioning of the anterior part of the fragment, tighten both ends of the tape by two suture anchors distally to the PCL insertion to fix the posterior part of the fragment...
February 2019: Operative Orthopädie und Traumatologie
Jerra Stemmle, Alex Marzel, Patricia O Chocano-Bedoya, E John Orav, Bess Dawson-Hughes, Gregor Freystaetter, Andreas Egli, Robert Theiler, Hannes B Staehelin, Heike A Bischoff-Ferrari
OBJECTIVES: To evaluate 2 simple strategies, vitamin D3 and a home exercise program, in functional recovery during the first year after hip fracture. DESIGN: Secondary analysis of a factorial clinical trial. Patients were randomly allocated to 800 IU (standard of care) or 2000 IU vitamin D3 and a daily instruction of a simple home exercise program (SHEP) or standard physiotherapy alone during acute care. SETTING AND PARTICIPANTS: Acute hip fracture patients aged ≥65 years, after hip fracture surgery, admitted to a large hospital in Zurich, Switzerland...
December 11, 2018: Journal of the American Medical Directors Association
Sophia Stasi, George Papathanasiou, Efstathios Chronopoulos, Antonios Galanos, Nikolaos A Papaioannou, Ioannis K Triantafyllopoulos
OBJECTIVES: To explore associations between abductor strength and functionality in hip-fracture patients. METHODS: Ninety-six participants (70-84 years) followed a 12-week physiotherapy programme emphasizing hip abductor strengthening. The abductor's isometric strength, the hip strength asymmetry (HSA), expressing the ratio of abductor strength in the fractured versus the contralateral hip, and the patients' functional level were recorded 3 months post-intervention...
December 1, 2018: Journal of Musculoskeletal & Neuronal Interactions
Jason L Martin, Paraskevi A Vlachou
History A 58-year-old woman was seen in the rheumatology clinic for bilateral wrist and knee pain that was unresponsive to physiotherapy and intra-articular steroid injections. Remote fracture of the left tibia from a motor vehicle collision was reported and was previously treated with conservative management. Serologic work-up for inflammatory disease was negative. The patient reported no prior surgical or medical history. Social history revealed remote immigration from Malaysia. Radiographs of the hands and knees were obtained ( Figs 1 - 4 )...
November 2018: Radiology
Alex Kocheta, Yuvraj Agrawal
Effective anesthesia of the hand and wrist has many uses inside and outside the operating room. In the emergency department or fracture clinic, a wrist block may be used for closed reductions of dislocations and fractures or for effective inspection and treatment of wounds. In the operating room, surgery may be carried out under a wrist block alone or a wrist block may be used as an adjunct to general anesthesia as the block is an opiate-sparing option to facilitate outpatient surgery and to provide many hours of postoperative analgesia, particularly if administered prior to the commencement of surgery...
March 28, 2018: JBJS Essential Surgical Techniques
Tobias M Kraus, Charlotte Abele, Thomas Freude, Atesch Ateschrang, Ulrich Stöckle, Fabian M Stuby, Steffen Schröter
BACKGROUND: Tibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture. METHODS: 39 consecutive patients (ages 20-61 years) were retrospectively included in the study and were clinically examined at a minimum of 14 month postoperatively...
August 7, 2018: BMC Musculoskeletal Disorders
Fu-Hui Dong
The miminally-invasive techniques of traditional Chinese medicine(TCM) uses different types of acupuncture needles to treat diseased locations with special techniques. These techniques include different methods of insertion and closed incision (press cutting, sliding cutting, scrape cutting, etc.). This needling technique is based on the traditional Chinese medicine theories of Pi Bu (cutaneous), Jing Jin (sinew), Jing Luo (meridian), Wu Ti (five body structure components) and Zang Fu (organ system). Commonly used needles include: needle Dao , needle with edge, Pi needle, Shui needle, Ren needle, Gou needle, Chang Yuan needle, Bo needle and so on...
June 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Redouane Hani, Idriss Jeddi, Mohamed Saleh Berrada
BACKGROUND: Divergent carpometacarpal joint dislocations of the fingers are very rare. Due to severe swelling and overlapping of bones on a radiograph of the wrist and hand, dislocations are missed. The purpose of this clinical case report is to highlight this unusual injury to avoid missing diagnosis. CASE PRESENTATION: We report a case of a 24-year-old Moroccan man, an athlete, who presented divergent carpometacarpal joint fracture-dislocations of the ulnar four fingers after a fall during a national cycling competition...
June 7, 2018: Journal of Medical Case Reports
S Rammelt, E Manke
BACKGROUND: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy due to an extensive range of diagnostic techniques and therapeutic options. OBJECTIVE: The aim of this review is to summarize the current knowledge on syndesmotic instability and to present some recommendations for the clinical practice for acute an chronic injuries. MATERIAL AND METHODS: Analysis of the current literature concerning the anatomy, etiology, diagnostics and treatment of syndesmosis injuries...
September 2018: Der Unfallchirurg
Luke Farrow, Andrew Hall, Adrian D Wood, Rik Smith, Kate James, Graeme Holt, James Hutchison, Phyo K Myint
BACKGROUND: Optimizing the perioperative care of patients with a hip fracture is a key health-care priority. We aimed to determine whether adherence to the Scottish Standards of Care for Hip Fracture Patients (SSCHFP) was associated with improved patient outcomes. METHODS: In this retrospective cohort study of prospectively collected data from the Scottish National Hip Fracture Audit, we assessed adherence to the SSCHFP in 21 Scottish hospitals over a 9-month period in 2014 and examined the effect of the guidelines on 30 and 120-day mortality, length of hospital stay, and discharge destination...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
A Notarnicola, G Maccagnano, M F Gallone, L Mastromauro, F Rifino, V Pesce, I Covelli, B Moretti
The physiotherapy treatment of low back pain (LBP) with physical stimulation offers different possibilities of application. Until now, the physical therapies used in LBP are laser therapy, ultrasonotherapy and currents. We conducted a clinical trial in order to verify whether shockwave therapy, which is very effective in treating tendinopathies and fracture consolidation delays, leads to clinical and electromyographic improvement in patients affected by LBP. We randomized thirty patients affected by LBP treated with shock waves (shockwave group) or a standard protocol characterized by rehabilitative exercises (control group)...
March 2018: Journal of Biological Regulators and Homeostatic Agents
Ali Rabatsky, John D Lockenour
Objective: The purpose of this case report was to describe the management of a tibial plateau fracture in a patient who had undergone anterior cruciate ligament (ACL) reconstruction 3.5 years earlier. Clinical Features: A 36-year-old man presented with pain and edema following a fall from a height of approximately 2 m while skateboarding. The patient reported having undergone arthroscopic ACL reconstruction with allograft and bioabsorbable screws 3.5 years earlier...
March 2018: Journal of Chiropractic Medicine
Michelle Fitzgerald, Catherine Blake, David Askin, John Quinlan, Tara Coughlan, Caitriona Cunningham
OBJECTIVE: Better patient outcomes and more efficient healthcare could be achieved by predicting post hip fracture function at an early stage. This study aimed to identify independent predictors of mobility outcome one week post hip fracture surgery. METHODS: All hip fracture inpatients (n=77) were included in this 6 month prospective observational cohort study. Predictor variables were obtained on the first postoperative day and included premorbid function using the New Mobility Score (NMS)...
May 2018: International Journal of Orthopaedic and Trauma Nursing
Lisa Gamsjaeger, Munashe Chigerwe
OBJECTIVE To characterize indications for and clinical outcomes of limb amputation in goats and sheep. DESIGN Retrospective case series and observational study. ANIMALS Goats (n = 15) and sheep (7) that underwent partial or complete limb amputation at the University of California-Davis Veterinary Medical Teaching Hospital from January 1, 1985, through December 31, 2015. PROCEDURES Medical records of qualifying goats and sheep were reviewed and data extracted regarding signalment, use of animal, characteristics of the amputated limb, duration of hospitalization, outcome, and surgery-associated complications...
April 1, 2018: Journal of the American Veterinary Medical Association
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
Duccio Conti, Piercarlo Ballo, Laura Salucci, Enrico Benvenuti, Lorena Metrangolo, Riccardo Barucci, Chiara Giulietti, Sante Giardini, Rossana Boccalini, Giovanni Maria Santoro, Armando Sarti
BACKGROUND: Strategies aimed at favouring functional recovery after surgery for hip fracture may be of clinical importance. AIMS: To test the clinical utility of a recovery room (RR) in terms of postoperative walking performance in an elderly population submitted to hip fracture surgery. METHODS: Postoperative walking performance at rollator was assessed in 242 consecutive orthogeriatric patients able to follow the institutional physiotherapy protocol starting on day 1 after hip surgery...
August 2018: Aging Clinical and Experimental Research
Stuart A Bullock, Georgina M Allen, Marion S Watson, David J Wilson
BACKGROUND: Sprained ankles are common and when there are no signs or evidence of a fracture, conventional management is conservative. At present, there are no clinical markers to identify those that may develop persisting instability and disability that would require rehabilitation or surgery. OBJECTIVES: To investigate the nature and extent of soft tissue ankle injuries, and to consider whether the anatomical severity of injury can predict functional outcome. METHODS: Patients attending a local Accident and Emergency Department in Oxford with an acute ankle injury with no clinical requirement for radiographs, or where radiographs were normal, were invited into the study...
January 2018: British Journal of Radiology
Christa Babst, Alexander Brunner, Reto Babst
BACKGROUND: Treatment recommendations for isolated radial neck delayed union/nonunion are sparse, but include mainly conservative treatment, electro-stimulation, bone grafting, open reduction and internal fixation (ORIF) and radial head resection. The purpose of this study was to perform a literature review on isolated delayed union/nonunion of radial neck fractures and to evaluate the reported outcomes of proposed treatment strategies. Furthermore, we aimed to generate data-based recommendations for this rare pathology...
February 2018: Archives of Orthopaedic and Trauma Surgery
Fraser John Gould
Injuries occurring in the remote environment present particular challenges to healthcare professionals, and decisions need to be carefully made on an individual basis. This report describes the successful management of a patella fracture sustained on the Subantarctic island of South Georgia. A 36-year-old boating officer presented to the island surgery after sustaining an isolated closed injury to his left knee. On physical examination there was a large effusion palpable within the joint, and on subsequent radiography an undisplaced transverse fracture of the patella was apparent...
2017: International Maritime Health
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