ABSTRACT
A variety of cystic lesions are encountered around the knee joint. Particularly, the prepatellar region is the site of soft tissue lesions including mainly bursal fluid collections, joint synovial herniation and tendons ganglia. We report here the case of an exceptional prepatellar posttraumatic epidermal inclusion cyst mistaken for a prepatellar bursitis. With this case report, orthopedic surgeons should widen the array of the differential diagnosis in patients presenting with a post-traumatic prepatellar slow growing soft tissue mass, making epidermoid inclusion cyst a valid possibility to consider
ABSTRACT
Background: Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear
Material and methods: This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis. Evaluation was done using the Constant score, visual analog scale for satisfaction and quality of life
Results: Twenty patients met the inclusion criteria. Three patients were lost to follow-up. The remaining [9 males and 8 females] had a mean follow-up period of 40.5 months. The mean age at surgery was 61.3 years. Thirty-five percent of patients were involved in heavy labor while the lesions affected the dominant side in 70% of the cases. Mean preoperative Constant score was 40.8 and increased to 78.8 [p < 0.05] with a difference of + 38 points on the raw Constant score and an improvement rate of 64%. The greatest improvement involved essentially pain and quality of life [improvement rate of 82%] [p < 0.05]. Eighty-nine percent of patients have good and excellent self-reported results
Conclusion: More than just a salvage procedure, deltoid muscle flap seems to be an adequate option in terms of appropriate pain relief, function recovery as well as patient satisfaction
ABSTRACT
This retrospective study evaluates the results of wireless tension band wire [WTBW] which is a modified technique of tension band wires [TBW] for Mayo type II A and III A olecranon fractures. In this technique the K-wires of the TBW are replaced by a cerclage wire while keeping the figure of eight wiring
Material and Methods: We reviewed retrospectively our WTBW cases done between 2000 and 2015 where we replaced the K-wires by a cerclage wire. In this technique no hardware migration is possible. Patients were evaluated clinically, radiographicaly and a DASH score was measured
Results: Seventeen patients were reviewed with a mean age of 58.5 years. The mean follow-up period was 58.5 months. The mean DASH score was 12 with 7 patients having a DASH score of zero. Joint mobility was near normal compared to the other side with loss of a mean of 4[degree sign] in elbow extension and a mean of 3[degree sign] in elbow flexion. In comparison with other series, in addition to good results, hardware removal for medical reasons was the lowest in our technique. It was needed in three patients for pain on elbow contact and in one with ulnar nerve irritation. This represents a rate of 23.5%
Conclusion: Undesirable events related to the use of K-wires in standard tension band wiring, such as wire migration, wire protrusion through the skin and wire impingement, are absent in the wireless tension band wiring. The high rate of patient satisfaction, good clinical results as well as low rate of needed hardware removal make this technique preferable for fixing Mayo Type II A olecranon fractures
ABSTRACT
The aim of the study is to identify risk factors that can worsen the disability in chronic hemodialysis patients. A transversal study was conducted on a total of 210 patients. Data was collected using a 42-item questionnaire, and univariate and multivariate statistical analyses were conducted. Univariate analysis reveals that male sex, advanced age, small stature, low weight, unemployment, lifestyle, lack of sport, hypertension or diabetes, co-morbid conditions, polysulfane filter, time on dialysis, diffuse and chronic pain with high analog visual score are all aggravating disability. Multivariate study confirms advanced age, male sex, hemiplegia, cardiac failure and high analog visual scale as factors aggravating handicap in hemodialysis patients. Modifiable and non modifiable factors can be identified in the disability of dialysis patients. The approach for such patients should be targeted and multifactorial with emphasis on the role of physical rehabilitation and exercises