Text Size

Ενδιαφέροντα Άρθρα

Παιδικη οσφυαλγια

Η οσφυαλγία στην παιδική και εφηβική ηλικία είναι ένα σχετικά σπάνιο μη ειδικό σύμπτωμα, το οποίο χρήζει ιδιαίτερης προσοχής αφού συνδιάζεται με αξιοσημείωτη παθολογία. Η αιτιολογία του συμπτώματος αυτού είναι πολλές φορές άγνωστη και ο ενδελεχής ...

Cowden syndrome

Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, characterised by both benign and malignant tumours affecting multiple ...

Κα­κω­σεις προ­σθιου χια­στου

Οι ρήξεις του προσθίου χιαστού συνδέσμου (ΠΧΣ) είναι συχνές κακώσεις του γόνατος, οι οποίες αφορούν κυρίως άτομα νεαρής ηλικίας με αυξημένη δραστηριότητα. Το κοινωνικοοικονομικό κόστος που προκαλεί η αντιμετώπιση και ...

Electrical stimulation of wound

Low-intensity currents (LIC) have gained popularity during the last years, and nowadays the majority of electrotherapy units may produce LIC. On wounding, the body produces a current, the current of ...

Συνδρομο απιοειδους μυος

Το σύνδρομο του απιοειδούς μυός (ΣΑM) χαρακτηρίζεται από παγίδευση του ισχιακού νεύρου με αντίστοιχη συμπτωματολογία, παραμένει δε μέχρι σήμερα μια αμφιλεγόμενη, δύσκολη έως και αβέβαιη διάγνωση. Με την παρούσα σύντομη βιβλιογραφική ανασκόπηση ...

News Image

Παιδικη οσφυαλγια

Η οσφυαλγία στην παιδική και εφηβική ηλικία είναι ένα σχετικά σπάνιο μη ειδικό σύμπτωμα, το οποίο χρ...

News Image

Cowden syndrome

Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, characterised by both...

News Image

Κα­κω­σεις προ­σθιου χια­στου

Οι ρήξεις του προσθίου χιαστού συνδέσμου (ΠΧΣ) είναι συχνές κακώσεις του γόνατος, οι οποίες αφορούν ...

News Image

Electrical stimulation of wound

Low-intensity currents (LIC) have gained popularity during the last years, and nowadays the majority...

News Image

Συνδρομο απιοειδους μυος

Το σύνδρομο του απιοειδούς μυός (ΣΑM) χαρακτηρίζεται από παγίδευση του ισχιακού νεύρου με αντίστοιχη...

 

Thanasas C, Kontakis G, Angoules A, Limb D, Giannoudis P.

Clinical Trauma Fellow, Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds.

HYPOTHESIS: Locking plates with special configuration for the anatomic region of the proximal humerus have been introduced recently to address the difficulties of stabilizing proximal humeral fractures. The purpose of this study was to carry out a systematic review of the literature on the efficacy and early to medium term functional results of locking plates for stabilization of proximal humeral fractures. METHODS: Using the PubMed database, a systematic review of the English and German literature was carried out in order to assess the efficacy and complications related to the use of these plates and the patients' functional outcome, using the key words "locking plates proximal humeral fractures," "angular stability plates proximal humeral fractures," "PHILOS plate," and "LPHP plate." Our criteria for eligibility were clinical studies with more than ten cases followed-up, adult patients, and adequate data provided at least in terms of implant related complications. Articles written in English and German language were included. Exclusion criteria were: studies dealing exclusively with 2-part fractures (since this category has a more favorable outcome); experimental studies; case reports; and, literature other than English or German. Each one of the articles was evaluated for quality of the study using the Structured Effectiveness Quality Evaluation Scale (SEQES). RESULTS: Twelve studies including 791 patients met the inclusion criteria. Patients in these studies continued to improve up to one year, achieving a mean Constant score of 74.3. The incidence of the reported complications was: avascular necrosis 7.9%, screw cut-out 11.6% and re-operation rate 13.7%. DISCUSSION: The high incidence of cut-out may be secondary to the rigidity of the implant in combination with medial inadequate support, in cases compromised by severe underlying osteoporotic bone. Definition of indications for the use of locking plates and attention on technical aspects of applying them would help optimization of the results. LEVEL OF EVIDENCE: Systematic Review.

PMID: 19748802 [PubMed - as supplied by publisher]

Treatment of proximal humerus fractures with locking plates: A systematic review.

Clinical Trauma Fellow, Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds.

HYPOTHESIS: Locking plates with special configuration for the anatomic region of the proximal humerus have been introduced recently to address the difficulties of stabilizing proximal humeral fractures. The purpose of this study was to carry out a systematic review of the literature on the efficacy and early to medium term functional results of locking plates for stabilization of proximal humeral fractures. METHODS: Using the PubMed database, a systematic review of the English and German literature was carried out in order to assess the efficacy and complications related to the use of these plates and the patients' functional outcome, using the key words "locking plates proximal humeral fractures," "angular stability plates proximal humeral fractures," "PHILOS plate," and "LPHP plate." Our criteria for eligibility were clinical studies with more than ten cases followed-up, adult patients, and adequate data provided at least in terms of implant related complications. Articles written in English and German language were included. Exclusion criteria were: studies dealing exclusively with 2-part fractures (since this category has a more favorable outcome); experimental studies; case reports; and, literature other than English or German. Each one of the articles was evaluated for quality of the study using the Structured Effectiveness Quality Evaluation Scale (SEQES). RESULTS: Twelve studies including 791 patients met the inclusion criteria. Patients in these studies continued to improve up to one year, achieving a mean Constant score of 74.3. The incidence of the reported complications was: avascular necrosis 7.9%, screw cut-out 11.6% and re-operation rate 13.7%. DISCUSSION: The high incidence of cut-out may be secondary to the rigidity of the implant in combination with medial inadequate support, in cases compromised by severe underlying osteoporotic bone. Definition of indications for the use of locking plates and attention on technical aspects of applying them would help optimization of the results. LEVEL OF EVIDENCE: Systematic Review.

PMID: 19748802 [PubMed - as supplied by publisher]

 

Necrotising fasciitis of upper and lower limb: a systematic review.

Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, UK.

Necrotising fasciitis is a rapidly progressive, life threatening soft tissue infection. In a significant proportion of patients, the extremities are involved as a result of trauma, needle puncture or extravasation of drugs, often leading to limb loss and devastating disability. In this systematic review of necrotising fasciitis of the upper and lower extremities, we report on the clinical characteristics, the predisposing factors, the associated diseases, the pathogenic bacteria, the surgical treatment and the final outcome in terms of limb loss and mortality. Data for a total of 451 patients were analysed for each parameter of interest. A percentage of 22.3% of the reviewed patients underwent amputation or disarticulation of a limb following failure of multiple debridements to control infection and the mortality rate was estimated as high as 21.9%.

PMID: 18048033 [PubMed - indexed for MEDLINE]

 

  

Cowden syndrome. Managing multiple skeletal metastases of different origin: a case report.

Academic Orthopaedic Unit, Leeds General Infirmary, Leeds School of Medicine, Leeds, LS1 3EX, UK. This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

ABSTRACT: BACKGROUND: Cowden Syndrome is a rare autosomal dominant multiple hamartomatous condition, characterised by both benign and malignant tumours affecting multiple systems. CASE PRESENTATION: We present a 47-year-old female patient with thigh pain that was diagnosed with Cowden syndrome 20 years ago and developed multiple and different skeletal metastases which became resistant to radio-chemotherapy. A percutaneous plate fixation of the distal femur with an intralesional excision and cementoplasty of the metastasis was performed initially. This was combined with a cemented total hip arthroplasty using an Exeter long revision stem and a cementoplasty of the femoral canal for the proximal lesions. CONCLUSION: A meticulous approach to her complex metastatic disease resulted in successful palliative prophylactic reconstructive surgery that improved her quality of life, allowing her independent pain free walking for 12 months.

PMID: 18947411 [PubMed - in process]

PMCID: PMC2584651

 

Effectiveness of electromyographic biofeedback in the treatment of musculoskeletal pain.

Athens University Medical School, 4 Christovassili St, 15451, Neo Psychikon, Athens, Greece.

1: Orthopedics. 2008 Oct;31(10). pii: orthosupersite.com/view.asp?rID=32085.Links

Electromyographic biofeedback is a therapeutic modality used along with other interventions in the treatment of pain. This article presents a brief review of the effectiveness of electromyographic biofeedback in treating musculoskeletal pain. Electromyographic biofeedback may provide pain relief for chronic musculoskeletal pain due to cumulative trauma, and may be proposed as an additional intervention to exercise in patellofemoral pain syndrome and acute sciatic pain. Electromyographic biofeedback is comparable to cognitive behavioral treatment and relaxation techniques. When added to an exercise program in patients with patellofemoral pain or acute sciatic pain, no further pain reduction is achieved. Electromyographic biofeedback promotes active participation and thus may motivate patients to adopt an active role in establishing and reaching goals in rehabilitation. Further research is required to investigate its effect on musculoskeletal pain.

PMID: 19226020 [PubMed - in process]

 

 

Low-intensity Electrical Stimulation in Wound Healing: Review of the Efficacy of Externally Applied Currents Resembling the Current of Injury.

Objective: Low-intensity currents (LIC) have gained popularity during the last years, and nowadays the majority of electrotherapy units may produce LIC. On wounding, the body produces a current, the current of injury, which promotes healing. Still, this current may gradually decrease resulting occasionally to delayed or limited wound healing. Thus, by applying the same LIC externally, healing may be accelerated by sustaining the LIC throughout the healing phases. The first review of research studies on the effect of LIC on wound healing is attempted, which can be considered useful for the practicing clinician, to provide an overview of current evidence on the effectiveness of LIC and provide protocols of treatment. Methods: Comprehensive review of randomized-controlled trials investigating the effect of LIC on wound healing. Results: The review revealed that LIC promote wound healing and appear to be effective in the range of 200-800 muA. The direct current may be continuous or pulsed and polarity may or may not be reversed. Conclusion: Research available indicates that LIC accelerate wound healing. Further research is required to clarify the healing effects of LIC on wounds.

PMID: 18552975 [PubMed - in process]

PMCID: PMC2396465

 

Prevalence and current concepts of management of farmyard injuries.

Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, United Kingdom.

Farmyard injuries in young adults and the elderly usually result from machinery accidents, whereas children tend to be injured by runovers and motor vehicle collisions. A variety of farmyard injuries secondary to environmental and human factors may cause permanent disability or even death. Common injuries include lacerations, hand injuries, amputations, farm animal bites, fractures and dislocations. Special considerations should be taken into account when treating these injuries, focusing on their noteworthy bacterial load in order to minimise the risk of chronic morbidity.

PMID: 18045599 [PubMed - indexed for MEDLINE]

 


Treatment and Outcomes of Pelvic Malunions and Nonunions: A Systematic Review.
                                                                           Clin Orthop Relat Res. 2009 Jan 30. [Epub ahead of print]Click here to read Links

Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospital, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon Wing, Level A, Great George Street, Leeds, LS1 3EX, UK.

Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic implications. We analyzed the factors predisposing a pelvic injury to develop malunion/nonunion, the clinical presentation of these complications, and the efficacy of the reported operative protocols in 437 malunions/nonunions of 25 clinical studies. Treatment of these demanding complications appeared effective in the majority of the cases: overall union rates averaged 86.1%, pain relief as much as 93%, patient satisfaction 79%, and return to a preinjury level of activities 50%. Nevertheless, the patient should be informed about the incidence of perioperative complications, including neurologic injury (5.3%), symptomatic vein thrombosis (5.0%), pulmonary embolism (1.9%), and deep wound infection (1.6%). For a successful outcome, a thorough preoperative plan and methodical operative intervention are essential. In establishing effective evidence-based future clinical practice, the introduction of multicenter networks of pelvic trauma management appears a necessity. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

PMID: 19184260 [PubMed - as supplied by publisher]