Surveying Colombian Speech-Language Pathologists on their Reported Training & Practices of Auditory-Perceptual Evaluation of Voice

Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.

Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.

Functional Shoulder Evaluation after Osteosynthesis of Greater Tuberosity Fracture: Is There any Influence of Glenohumeral Dislocation? / Avaliação funcional do ombro após osteossíntese da fratura da tuberosidade maior: Há influência da luxação glenoumeral?

Abstract Objective To evaluate the postoperative functional and radiographic outcomes of the shoulder of patients submitted to transosseous suturing of a greater tuberosity fracture (GTF) through an anterolateral route and the influence of the glenohumeral dislocation on these outcomes. Methods We conducted a retrospective study and functional assessment using the Constant-Murley score. The distance between the greater tuberosity and the joint surface of the proximal humerus (in true anteroposterior radiographs) after the union was calculated. We used the Fisher exact test for the categorical independent variables, and the Student t or Mann-Whitney test for the non-categorical variables. Results In total, 26 patients met the inclusion criteria, and 38% of the sample presented an association between glenohumeral dislocation and GTF. The mean Constant-Murley score was of 82.5 + 8.02 points. The presence of an associated dislocation did not alter the functional outcome. The mean distance between the greater tuberosity of the humerus and the joint surface of the humeral head after the union was of 9 + 4.3 mm below the articular line of the humeral head. The dislocation led to a lower level of reduction, but this did not influence the Constant-Murley score. Conclusion The cases of GTF submitted to surgical treatment with transosseous sutures had good functional outcomes. The presence of dislocation made the anatomical reduction of the greater tuberosity difficult. However, it did not influence the Constant-Murley score.

Resumo Objetivo Avaliar os resultados funcional e radiográfico pós-operatórios do ombro, em pacientes submetidos a sutura transóssea de fratura da tuberosidade maior (FTM) por acesso anterolateral, e a influência da luxação glenoumeral nesses resultados. Métodos Realizou-se estudo retrospectivo e avaliação funcional (pela escala de Constant-Murley). Calculou-se a distância entre a tuberosidade maior e a superfície articular do úmero proximal (por meio de radiografia em incidência anteroposterior verdadeira) após a consolidação. Usou-se o teste Exato de Fisher para as variáveis independentes categóricas, e os testes tde Student ou de Mann-Whitney para as não categóricas. Resultados Ao todo, 26 pacientes preencheram os critérios de inclusão. A associação de luxação glenoumeral com FTM foi observada em 38% da amostra. A média da pontuação na escala de Constant-Murley foi de 82,5 + 8,02. A presença de luxação associada não alterou o resultado funcional. A distância média da consolidação da tuberosidade maior do úmero em relação à superfície articular da cabeça umeral foi de 9 + 4,3 mm abaixo da linha articular da cabeça umeral. Pacientes com luxação associada evoluíram com redução menor, mas isso não influenciou na pontuação na escala de Constant-Murley. Conclusão As FTMs submetidas ao tratamento cirúrgico com sutura transóssea evoluíram com bom resultado funcional. A presença de luxação dificultou a redução anatômica da tuberosidade maior. Entretanto, isso não influenciou na pontuação na escala de Constant-Murley.

Shoulder arthroscopic treatment of avulsion fracture of humeral greater tuberosity with double-row suture bridge / 中华创伤骨科杂志

Objective:To evaluate the shoulder arthroscopic treatment of avulsion fracture of humeral greater tuberosity with double-row suture bridge.Methods:Retrospectively analyzed were the 13 avulsion fractures of humeral greater tuberosity which had been treated by shoulder arthroscopic double-row suture bridge at Bone and Joint Department, Guangzhou Liwan District Orthopedic Hospital from March, 2018 to March, 2020. There were 6 males and 7 females, with an average ages of 52.3 years (from 35 to 69 years). According to the Mutch classification, all the fractures of humeral greater tuberosity were attributed to the avulsion type. Of them, 3 were simple avulsion fractures of humeral greater tuberosity and 10 were complicated with shoulder anterior dislocation which was reduced manually before operation. There were 3 obsolete avulsion fractures of humeral greater tuberosity. Regular clinic and X-ray follow-ups were carried out. At the final follow-up, the pain, range of motion (ROM) and stability of the shoulder joint were assessed using visual analogue scale (VAS), American shoulder elbow scores (ASES), and Korean shoulder scores (KSS).Results:All the patients were followed up for an average of 12.3 months (from 10 to 16 months) postoperatively. No infection or shoulder instability was observed. At the final follow-up, the abduction and elevation averaged 164.6° (from 135° to 180°), the lateral external rotation 62.7° (from 40° to 80°), the internal rotation touch back test T10 level (from L2 to T6), the VAS 0.65 (from 0 to 2.5), the ASES 90.5 (from 78 to 100), and the KSS 91.5 (from 84 to 100).Conclusion:Shoulder arthroscopic treatment of avulsion fracture of humeral greater tuberosity with double-row suture bridge is minimally invasive and allows for repair of combined injury, leading to quick postoperative recovery.

Progress in application of suture anchor in rotator cuff injury / 中国医师杂志

Rotator cuff injury is the most important cause of shoulder joint pain and dysfunction. In recent years, the incidence of rotator cuff injuries has gradually increased, reaching 30%-50% in people >50 years old. In the clinical treatment of rotator cuff injuries, suture anchors are widely used to fix the tendon to the bone and keep it in place without loosening or moderate tension until physiological healing is completed. The materials of suture anchors are constantly updated in clinical practice and have undergone the evolution of metal suture anchors, biodegradable suture anchors, biostable suture anchors, biocomposite suture anchors, and all suture anchors.This article reviews the advantages and disadvantages of anchors of various materials reported in domestic and foreign literatures.

Pectoralis major tendon injury: reconstruction using bone tunnel and anchors / Lesão do tendão do peitoral maior: reconstrução utilizando túnel ósseo e âncoras

ABSTRACT Objective: This study aims to assess a new technique used for pectoralis major reconstruction using bone tunnel and fixation with metallic anchors in the contralateral cortical bone. Methods: Patients who had undergone post-surgical reconstruction of the pectoralis major at least 24 months before were assessed by the UCLA Shoulder Score and the Simple Shoulder Test and compared with the contralateral side by manual goniometry. Subgroup analysis was also performed between grafted and non-grafted patients. Results: 13 patients fulfilled the inclusion criteria. The average UCLA score was 34.77 ± 0.12, compared with the standard 27 of good and excellent results p < 0.0001. The Simple Shoulder test mean was 11.92 ± 0.08. Grafted and non-grafted subgroups had no statistical differences for UCLA p = 0.58 and Simple Shoulder Test p = 1.00. Long term losses for elevation or external rotation were lower than 5º. No lesions recurred. All patients returned to their physical activities with no restrictions. Conclusion: The pectoralis major reconstruction technique using a bone tunnel and metallic anchors in the contralateral cortical bone was effective. However, its execution needs special care to avoid complications. Level of Evidence IV, Case Series.

RESUMO Objetivo: Avaliar, em uma série de casos, o uso da técnica de reconstrução do músculo peitoral maior através de túnel ósseo na cortical umeral anterior, feito no local de inserção original desse tendão, com fixação tendínea, usando âncoras metálicas na cortical contralateral. Métodos: Foram avaliados pacientes com mais de 24 meses depós-operatório de reconstrução do tendão do peitoral maior através do escore da UCLA, do teste simples de ombro e da goniometria manual comparativa com o lado contralateral. Foram também avaliados e comparados os subgrupos uso de enxerto versus sem enxerto usando os testes de qualidade de vida e goniometria mencionados acima. Resultados: De todos os pacientes operados pelo cirurgião sênior do serviço, 13 alcançaram os critérios de inclusão e foram incluídos nesse trabalho. O escore da UCLA foi de 34,77 ± 0,12, comparado com o padrão 27 de bons e ótimos resultados p < 0,0001. A média para o teste simples de ombro foi de 11,92 ± 0,08. Com relação ao uso de enxerto, não houve diferenças entre os subgrupos com e sem enxerto, p = 0,62 para o escore da UCLA e p = 0,35 para o teste simples de ombro. Não houve perda de elevação ou rotação externa superior a 5º nem relesões. Todos os pacientes retornaram às atividades físicas. Conclusão: A técnica de reconstrução do tendão do peitoral maior com túnel ósseo e fixação na cortical contralateral com âncoras demonstrou-se efetiva, mas sua execução necessita cuidado afim de evitarem-se complicações. Nível de Evidência IV, Série de Casos .

Introducing a Novel Method of Patella Tendon Defunctioning using Suture Anchors after a Tibial Tuberosity Avulsion Repair: Report of Three Cases

@#Tibial tuberosity avulsion injuries are rare and result from direct trauma to the tibial tuberosity or forceful and repetitive contraction of the quadriceps muscles. In this case series, we describe a novel method of defunctioning the patella tendon using a suture anchor after a tibial tuberosity avulsion fracture repair was performed. We present three consecutive patients with tibial tuberosity avulsion fractures who were treated by the same surgeon using the technique described. Pre and post-operative range of motion of the knee joint were then reviewed retrospectively. All patients achieved preinjury range of motion within three months post-operatively. In conclusion, defunctioning the patellar tendon with a suture anchor is a reliable and reproducible technique. The new technique yielded excellent functional outcomes which allowed patients to regain their pre-injury range of motion and the strength of the construct allows early range of motion.

Alinhamento das âncoras de carreira, satisfação no trabalho e danos à saúde dos enfermeiros / Alignment of career anchors, job satisfaction and damage to nurses' health

Objetivos: identificar os tipos de âncora de carreira, o nível de satisfação no trabalho e os danos à saúde dos enfermeiros de um hospital universitário do Rio de Janeiro; Descrever a relação das âncoras de carreira com a satisfação no trabalho e o adoecimento dos enfermeiros. Metodologia: pesquisa do tipo descritiva com delineamento transversal, realizada em um hospital universitário localizado no município do Rio de Janeiro, através de censo com 135 enfermeiros que trabalhavam no hospital universitário. Utilizou-se como instrumento de coleta de dados: Questionário com história pessoal e profissional dos enfermeiros, Escala de Âncoras de Carreira, Escala de Satisfação no Trabalho (EST) e Escala de Avaliação dos Danos Relacionados ao Trabalho (EADRT). Foram obedecidas em todas as etapas do estudo as exigências da Resolução 466/2012 do Conselho Nacional de Saúde. Perfil sociodemográfico e profissional: Eram 86,7% do sexo feminino, 64,4% viviam com o companheiro (a), 48,9% brancos, e tinham em média 39 anos. Observou-se que 31,3% eram técnicos de enfermagem antes da graduação, 56% prestaram o vestibular apenas uma vez, e destes, 49,6% prestaram somente para a enfermagem. Dos que escolheram outros cursos, 40,1% tentaram para área das ciências biológicas e da saúde, 5,1% para área contábil e social/humanas. Sendo que 7,4% fizeram outra graduação antes da enfermagem e 68,9% tinham especialização. No que se refere às áreas de atuação, 63,2% atuavam na área hospitalar. Sobre os que mudaram de emprego, 66,7%, foi por concurso e 60,8% indicaram vontade de mudar de profissão. Também se observou que 59,3% eram estatutários, 32,8% tinham mais de um vínculo, 50,4% tinham uma carga horária de 30 horas, seguidos de 49,6% acima de 30 horas e 58,5% trabalhavam em plantões; 12,1% tinham cargo de chefia na instituição e tempo médio de formado foi de 14,68 anos, 13,4 anos de atuação como enfermeiro, 6,08 anos de atuação na instituição e 3,84 de atuação nos setores. Resultados: Sobre a âncora de carreira, a mais frequente foi a Segurança e Estabilidade (26,29%), e a maioria dos enfermeiros era pertencentes à Geração X. Pode-se observar que 63,7% dos enfermeiros não estavam alinhados com a sua âncora de carreira. No que diz respeito à satisfação no trabalho, 50,4% estavam insatisfeitos nas dimensões "Satisfação com o salário", "Satisfação com a natureza do trabalho" e "Satisfação com as promoções". Sobre os danos à saúde relacionados ao trabalho, no fator Danos psicológicos e Danos sociais foram considerados como não adoecimento. E o fator Danos Físicos como adoecimento. Nas associações entre "alinhamento e satisfação", "alinhamento e adoecimento" não houve p valor significativo, apenas na associação entre satisfação e adoecimento houve diferença significativa (p < 0,05). Conclusões: Pode-se concluir que os resultados ampliaram o conhecimento sobre a perspectiva da teoria de âncoras de carreira na área da enfermagem e saúde do trabalhador, mas é importante sobressaltar que a hipótese proposta foi refutada. Não existiu uma associação significativa entre o alinhamento das âncoras de carreira dos enfermeiros com a satisfação no trabalho e adoecimento ocasionado pelo trabalho.

Objectives: To identify the types of career anchor, the level of job satisfaction and the health damage of nurses at a university hospital in Rio de Janeiro; Describe the relationship of career anchors with job satisfaction and illness of nurses. Methodology: cross-sectional descriptive research, conducted in a university hospital located in the city of Rio de Janeiro, through a census of 135 nurses who worked in the university hospital. The following data collection instruments were used: Questionnaire with personal and professional history of nurses, Career Anchor Scale, Job Satisfaction Scale (EST) and Work Related Damage Assessment Scale (EADRT). The requirements of Resolution 466/2012 of the National Health Council were complied with at all stages of the study. Sociodemographic and professional profile: 86.7% were female, 64.4% lived with a partner, 48.9 % of the white race, and were on average 39 years old. It was observed that 31.3% were nursing technicians before graduation, 56% provided the entrance exam only once, and of these, 49.6% provided only for nursing. Of those who chose other courses, 40.1% tried for biological sciences and health, 5.1% for accounting and social / human. 7.4% had another degree before nursing and 68.9% had specialization. Regarding the areas of expertise, 63.2% worked in the hospital area. Of those who changed jobs, 66.7% were by competition and 60.8% indicated willingness to change jobs. It was also observed that 59.3% were civil servants, 32.8% had more than one bond, 50.4% had a workload of 30 hours, followed by 49.6% over 30 hours and 58.5% worked in shifts; 12.1% had the position of head of the institution and average time of graduation was 14.68 years, 13.4 years working as a nurse, 6.08 years working in the institution and 3.84 years in the sectors. Results: Regarding the career anchor, the most frequent was Security and Stability (26.29%), and most nurses were from Generation X. It can be observed that 63.7% of nurses were not aligned with your career anchor. Regarding job satisfaction, 50.4% were dissatisfied in the dimensions "Satisfaction with salary", "Satisfaction with the nature of work" and "Satisfaction with promotions". Regarding work-related health damage, the factor Psychological damages and social damages were considered as non-illness. And the factor Physical Damage as illness. In the associations between "alignment and satisfaction", "alignment and illness" there was no significant p value, only in the association between satisfaction and illness there was a significant difference (p <0.05). Conclusions: It can be concluded that the results broadened the knowledge about the perspective of career anchor theory in the area of nursing and occupational health, but it is important to highlight that the proposed hypothesis was refuted. There was no significant association between the alignment of nurses' career anchors with job satisfaction and work-related illness.

Objetivos: identificar los tipos de anclaje profesional, el nivel de satisfacción laboral y el daño a la salud de las enfermeras en un hospital universitario en Río de Janeiro; Describa la relación de los anclajes profesionales con la satisfacción laboral y la enfermedad de las enfermeras. Metodología: investigación descriptiva transversal, realizada en un hospital universitario ubicado en la ciudad de Río de Janeiro, a través de un censo de 135 enfermeras que trabajaban en el hospital universitario. Se utilizaron los siguientes instrumentos de recolección de datos: Cuestionario con historial personal y profesional de enfermeras, Escala de anclaje profesional, Escala de satisfacción laboral (EST) y Escala de evaluación de daños relacionados con el trabajo (EADRT). Se cumplieron los requisitos de la Resolución 466/2012 del Consejo Nacional de Salud en todas las etapas del estudio Perfil sociodemográfico y profesional: 86.7% eran mujeres, 64.4% vivían con una pareja, 48.9 % de la raza blanca, y tenían en promedio 39 años. Se observó que el 31.3% eran técnicos de enfermería antes de la graduación, el 56% proporcionó el examen de ingreso solo una vez, y de estos, el 49.6% proveyó solo para enfermería. De aquellos que eligieron otros cursos, el 40.1% lo hizo para ciencias biológicas y salud, el 5.1% para contabilidad y social / humano. El 7,4% tenía otro grado antes de enfermería y el 68,9% tenía especialización. En cuanto a las áreas de especialización, el 63.2% trabajó en el área hospitalaria. De aquellos que cambiaron de trabajo, 66.7% fueron por competencia y 60.8% indicaron disposición para cambiar de trabajo. También se observó que el 59.3% eran funcionarios, el 32.8% tenía más de una fianza, el 50.4% tenía una carga de trabajo de 30 horas, seguido por el 49.6% durante 30 horas y el 58.5% trabajaba en turnos; El 12.1% tenía el cargo de jefe de la institución y el tiempo promedio de graduación fue de 14.68 años, 13.4 años trabajando como enfermera, 6.08 años trabajando en la institución y 3.84 años en los sectores. Resultados: en cuanto al anclaje profesional, el más frecuente fue Seguridad y Estabilidad (26.29%), y la mayoría de las enfermeras eran de la Generación X. Se puede observar que el 63.7% de las enfermeras no estaban alineadas con el ancla de tu carrera En cuanto a la satisfacción laboral, el 50,4% no estaba satisfecho en las dimensiones "Satisfacción con el salario", "Satisfacción con la naturaleza del trabajo" y "Satisfacción con las promociones". Con respecto al daño a la salud relacionado con el trabajo, el factor Daños psicológicos y daños sociales se consideraron como no enfermedad. Y el factor Daño físico como enfermedad. En las asociaciones entre "alineación y satisfacción", "alineación y enfermedad" no hubo un valor p significativo, solo en la asociación entre satisfacción y enfermedad hubo una diferencia significativa (p <0.05). Conclusiones: Se puede concluir que los resultados ampliaron el conocimiento sobre la perspectiva de la teoría del ancla profesional en el área de enfermería y salud ocupacional, pero es importante resaltar que la hipótesis propuesta fue refutada. No hubo una asociación significativa entre la alineación de los anclajes profesionales de las enfermeras con la satisfacción laboral y las enfermedades relacionadas con el trabajo.

Arthroscopic simplified double-pulley double row suture technique to fix the bigger glenoid anterior edge fracture / 中华骨科杂志

Objective To investigate the clinical results of arthroscopic double-pulley double row suture technique for the treatment of bigger Ideberg Ⅰa glenoid fracture.Methods From January 2014 to July 2017,data of patients with Ideberg Ⅰa glenoid fracture who were treated by arthroscopic double-pulley double row suture technique were retrospectively analyzed.Totally 24 patients were enrolled of whom 13 were males and 11 were females.The mean age was 50.14±10.60 years (range,34-67).In those patients,there were 8 cases of glenoid fracture alone,4 cases of glenoid fracture associated with greater tuberosity fracture,5 cases of glenoid fracture with rotator cuff tear,4 cases of glenoid fracture with shoulder anterior dislocation and greater tuberosity fracture,2 cases of glenoid fracture with shoulder anterior dislocation and rotator cuff tear,and 1 case of shoulder anterior dislocation with ipsilateral distal radius fracture.The fragment accounts for 28.91±5.35％ (range,25.1％-38.5％) of the glenoid articular surface.According to the size of the fragment,one medial row anchor was used to implant at the medial edge of the fracture bed of the anterior edge of the glenoid;two to four lateral row suture anchors were used to implant at the margin of the glenoid joint surface sequentially from low level to higher level,and simplified double-pulley technique was finally used to fix the fragment.The situation of fracture reduction and healing and the post-operative complications were evaluated.The Constant-Murley,DASH and VAS were also recorded.Results Satisfactory fracture reduction and fixation were achieved in all 24 patients.The mean followup time was 19.5 months (range,12-36).Mean VAS was 0.8±0.8 (range,0-2).The range of motion at the latest follow-up was:anterior flexion 145°-180° (mean,161.00°±5.77°),external rotation at the side 35°-60° (mean,46.43°±6.63°),internal rotation L3-T10 level.The mean Constant-Murley score was 88.1±3.7 (range,81-93),and mean DASH score was 8.4±4.7 (range,0-40.4).All cases except one showed no dislocation or disability of the shoulder.The CT scans showed:19 cases of which the step-off of articular surface was less than 2 mm;4 cases of which the step-off was between 2 mm to 4 mm and 1 case of which the step-off was more than 4 mm.No severe osteoarthritis was identified at the latest follow-up,and only 1 patient at the age of 67 showed slight osteoarthritis.Two patients with shoulder anterior dislocation and rotator cuff tear committed significant restricted shoulder range of motion.Conclusion The arthroscopic simplified double-pulley double row suture technique was identified safe,effective and reliable for treating the bigger Ideberg Ⅰa glenoid fracture.The technique is able to provide clear visulization of the fracture and achieve excellent clinical results.

Arthroscopic simplified double-pulley double row suture technique to fix the bigger glenoid anterior edge fracture / 中华骨科杂志

Objective@#To investigate the clinical results of arthroscopic double-pulley double row suture technique for the treatment of bigger Ideberg Ia glenoid fracture.@*Methods@#From January 2014 to July 2017, data of patients with Ideberg Ia glenoid fracture who were treated by arthroscopic double-pulley double row suture technique were retrospectively analyzed. Totally 24 patients were enrolled of whom 13 were males and 11 were females. The mean age was 50.14±10.60 years (range, 34-67). In those patients, there were 8 cases of glenoid fracture alone, 4 cases of glenoid fracture associated with greater tuberosity fracture, 5 cases of glenoid fracture with rotator cuff tear, 4 cases of glenoid fracture with shoulder anterior dislocation and greater tuberosity fracture, 2 cases of glenoid fracture with shoulder anterior dislocation and rotator cuff tear, and 1 case of shoulder anterior dislocation with ipsilateral distal radius fracture. The fragment accounts for 28.91±5.35% (range, 25.1%-38.5%) of the glenoid articular surface. According to the size of the fragment, one medial row anchor was used to implant at the medial edge of the fracture bed of the anterior edge of the glenoid; two to four lateral row suture anchors were used to implant at the margin of the glenoid joint surface sequentially from low level to higher level, and simplified double-pulley technique was finally used to fix the fragment. The situation of fracture reduction and healing and the post-operative complications were evaluated. The Constant-Murley, DASH and VAS were also recorded.@*Results@#Satisfactory fracture reduction and fixation were achieved in all 24 patients. The mean follow-up time was 19.5 months (range, 12-36). Mean VAS was 0.8±0.8 (range, 0-2). The range of motion at the latest follow-up was: anterior flexion 145°-180° (mean, 161.00°±5.77°), external rotation at the side 35°-60° (mean, 46.43°±6.63°), internal rotation L3-T10 level. The mean Constant-Murley score was 88.1±3.7 (range, 81-93), and mean DASH score was 8.4±4.7 (range, 0-40.4). All cases except one showed no dislocation or disability of the shoulder. The CT scans showed: 19 cases of which the step-off of articular surface was less than 2 mm; 4 cases of which the step-off was between 2 mm to 4 mm and 1 case of which the step-off was more than 4 mm. No severe osteoarthritis was identified at the latest follow-up, and only 1 patient at the age of 67 showed slight osteoarthritis. Two patients with shoulder anterior dislocation and rotator cuff tear committed significant restricted shoulder range of motion.@*Conclusion@#The arthroscopic simplified double-pulley double row suture technique was identified safe, effective and reliable for treating the bigger Ideberg Ia glenoid fracture. The technique is able to provide clear visulization of the fracture and achieve excellent clinical results.

Absorbable suture anchors for treating femoroacetabular impingement syndrome combined with acetabular labral tears / 中国组织工程研究

BACKGROUND: Metal anchors are not easily accepted by patients as permanent foreign bodies, so bioabsorbable anchors have been gradually applied in orthopedics in recent years. OBJECTIVE: To evaluate the effectiveness of absorbable suture anchors for repairing femoroacetabular impingement syndrome combined with acetabular labral tears. METHODS: Eighty patients with femoroacetabular impingement syndrome combined with acetabular labral tears admitted in Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2014 to February 2016 were selected, and all were treated by absorbable suture anchors under arthroscopy. The Harris hip score, and the Visual Analogue Scale score at baseline, postoperative 1 and 3 months were recorded and compared to assess the effectiveness. The complications and material-host reaction were recorded. The treatment satisfaction was evaluated. The study was approved by the Ethical Committee of Beijing Shijitan Hospital and all patients and their families signed the informed consents. RESULTS AND CONCLUSION: (1) The Harris hip scores at 1 and 3 years postoperatively in 80 patients with femoroacetabular impingement syndrome combined with acetabular labral tears were significantly higher than those at baseline, and the Visual Analogue Scale scores were significantly lower than those at baseline (P 0. 05). (3) None appeared with anchor drop off, cartilage injury or material-host reaction. In summary, the method of absorbable suture anchors under arthroscopy has the advantages of minimal invasion, reliable fixation, simple operation, no metal implants, and significant clinical effect to treat femoroacetabular impingement syndrome combined with acetabular labral tears.

Functional and Radiological Outcomes of the Surgical Treatment of Acute Acromioclavicular Dislocation with Anchors Associated with Clavicle and Scapula Fixation / Resultados funcionais e radiológicos do tratamento cirúrgico da luxação acromioclavicular aguda com âncoras e fixação clavículo-escapular

Abstract Objective To evaluate the clinical, radiological and functional results of the surgical treatment of acute acromioclavicular dislocation using a coracoclavicular fixation technique (syndesmopexy) with two metallic anchors, temporary clavicle and scapula fixation, and transfer of the coracoacromial ligament. Methods Longitudinal observational study of 30 patients with diagnoses of acute acromioclavicular dislocation, who were submitted to surgical treatment with a minimum follow-up of six months, and who were evaluated clinically, radiologically, and by the University of California at Los Angeles (UCLA), the Disabilities of the Arm, Shoulder and Hand (DASH) and the Constant-Murley functional scores. Results The mean values of the scores were: UCLA = 32; DASH = 11.21; and Constant-Murley = 86.93, with satisfactory results higher than 80%. The unsatisfactory results were associated with acromioclavicular pain on palpation, positive subacromial impingement tests, and older age group, presenting statistical significance (p < 0.05). Radiologically, higher values on account of the coracoclavicular distance ratio from the operated shoulder compared to the normal shoulder were related to worse outcomes, but with no statistically significant difference. No associations were found between the results of the functional scores and the variables degree of the injury, coracoacromial ligament transfer, clinical impression of loss of reduction and scapulothoracic dyskinesis. Conclusion The technique used provides an efficient fixation, with a high level of satisfaction according to the UCLA, Constant-Murley and DASH scores; moreover, it has a low complication rate, despite the high rate of residual radiological acromioclavicular subluxation.

Resumo Objetivo Avaliar os resultados clínicos, radiológicos, e funcionais do tratamento cirúrgico da luxação acromioclavicular aguda, utilizando a técnica de sindesmopexia coracoclavicular com duas âncoras metálicas, fixação temporária clavículo-escapular, e transferência do ligamento coracoacromial. Métodos Estudo observacional longitudinal com trinta pacientes com diagnóstico de luxação acromioclavicular aguda submetidos à cirurgia, com seguimento mínimo de seis meses, avaliados clínica, radiograficamente, e pelos escores de University of California at Los Angeles (UCLA), Disabilities of the Arm, Shoulder and Hand (DASH) e Constant-Murley. Resultados Os valores médios dos escores foram: UCLA = 32; DASH = 11,21; e Constant-Murley = 86,93, com resultados satisfatórios acima de 80%. Os resultados insatisfatórios foram relacionados à dor acromioclavicular, a testes de impacto subacromial positivos, e aos pacientes de faixa etária mais elevada (p < 0,05). Radiologicamente, valores maiores em razão da distância coracoclavicular do ombro operado, comparado com o ombro normal, foram relacionados a piores resultados, embora sem significância estatística. Não foi observada associação entre os resultados dos escores funcionais e as variáveis grau da lesão, transferência do ligamento coracoacromial, impressão clínica de perda de redução, e discinesia escapulo-torácica. Conclusão A técnica utilizada propicia uma fixação eficiente, com alto índice de satisfação segundo os escores de UCLA, Constant-Murley e DASH. Observou-se baixo índice de complicações apesar da frequência elevada de subluxação acromioclavicular radiológica residual.

Minimally invasive facial rejuvenation combining thread lifting with liposuction: A clinical comparison with thread lifting alone

BACKGROUND: Barbed thread lifting is known to be a minimally invasive procedure compared with standard incisional surgery for facial rejuvenation. However, some studies have pointed out that the effects of thread lifting do not last long and disappear after several months. Therefore, the aim of this study was to evaluate the efficiency and duration of anchoring-type absorbable thread lifting combined with liposuction for facial rejuvenation. METHODS: A retrospective review of 27 cosmetic patients who underwent absorbable barbed thread lifting with liposuction between July 2013 and December 2015 was undertaken. The efficiency of facial rejuvenation was evaluated through a patient satisfaction score and the global aesthetic improvement scale (GAIS). RESULTS: Subjects were divided into two groups: thread lifting only and thread lifting combined with liposuction. The mean follow-up period of each group was 8.5 and 9.3 months, respectively. In the thread lifting-only group, the average patient satisfaction score was 2.36 (1=unsatisfied to 4=very satisfied), and the average GAIS score was 2.54 (1=very much improved to 5=worsen). In the thread lifting with liposuction group, the average patient satisfaction score was 3.06, and the average GAIS score was 1.85. CONCLUSIONS: Thread lifting combined with liposuction showed better patient satisfaction and GAIS results than thread lifting alone, even over a long follow-up period.

Curative effect of micro-strip line anchors combined with posterior capsulorrhaphy in the treatment of first metacarpophalangeal joint dislocation in rheumatoid arthritis / 中国综合临床

Objective To study the short-term and medium-term effects of mini- strip anchor and capsulotomy in the treatment of first metacarpophalangeal joint dislocation in rheumatoid arthritis (RA). Methods From January 2015 to December 2016,fifty-eight RA patients with first metacarpophalangeal joint dislocation were randomly divided into study group (20 cases),joint replacement group (19 cases) and non-operation group (19 cases). Postoperative evaluation indexes: the wound healing was observed in accordance with ＂trial standard of functional evaluation of upper limbs of Chinese Medical Association Hand Surgery Society＂. The surgical outcomes of the three groups were compared. The hand function and quality of life were assessed by Michiga Hand Outcomes Questionnaire ( MHQ ) and arthritis impact measurement scale 2 (AIMS2) before treatment, 6 months after treatment and 12 months after treatment. Results All the patients in the study group and the joint replacement group healed by first intention without any early complications. According to the criteria of upper extremity functional evaluation of Chinese Medical Association,the curative effect of the operation was evaluated. In the study group,15 cases were excellent,3 cases were good,2 cases were poor,the excellent and good rate was 90. 0%. In the joint replacement group, 15 cases were excellent,3 cases were good,1 case was poor,and the excellent and good rate was 94. 7%. After treatment for 6months, the MHQ scores were improved significantly in the three groups (( 48. 36 ±8. 24) vs. (73. 06±10. 55); (47. 56±7. 75) vs. (81. 42±8. 54); (48. 75±8. 85) vs. (65. 91±8. 26)) (F＝33. 19,35. 12,28. 42, P＜0. 05). The MHQ scores of study group ( (73. 06±10. 55)points) and joint replacement group ( ( 81. 42 ± 8. 54) points) were significantly higher than those of non-operation group ((65. 91± 8. 26) points) ( P＜0. 05), and the MHQ scores of joint replacement group were significantly higher than those of study group (P＜0. 05). At 12 months after treatment,there was no significant difference in MHQ score between the study group ((82. 45±7. 18)points) and the arthroplasty group ((84. 36±6. 33) points) (P＞0. 05) . At 6 and 12 months after treatment, AIMS2 scores of each group were significantly improved,but AIMS2 scores of study group (( 216. 51 ± 35. 28) points, ( 230. 28 ± 23. 51) points) and arthroplasty group ((221. 45±31. 63) points,(234. 15±21. 42) points) were significantly higher than those of non-operation group ((192.69±41.31) points,(200.43 ±28.42) points) (P＜0.05).At 6 and 12 months after treatment,there was no significant difference in AIMS2 scores between the study group and the arthroplasty group ( P ＞ 0. 05 ) . Conclusion Micro-strip line anchors combined with posterior capsulorrhaphy in the treatment of first metacarpophalangeal joint dislocation in rheumatoid arthritis can achieve good stability of articular reduction,significantly improve the joint function and quality of life and have ideal short-term and mid-term effect.

Case-control study on single locking plate and locking plate with suture anchors for the treatment of unstable distal clavicle fractures / 中国骨伤

OBJECTIVE@#To compare therapeutic effects of single locking plates and locking plates with suture anchors in treating type Neer IIb distal clavicle fractures.@*METHODS@#From January 2013 to January 2015, 40 distal clavicle fractures patients with Neer IIb were treated by retrospectively analyzed and divided into single locking plates (control group) and locking plates with suture anchors(observation group) according to methods of operation. There were 20 patients in control group treated by single locking plates, including 16 males and 4 females aged from 26 to 64 years old with an average of(40.60±12.64) years old; while there were 20 patients in observation group treated by locking plates with suture anchors, including 15 males and 5 females aged from 20 to 57 years old with an average of(37.30±10.56) years old. Length of incisions, operation time, blood loss, hospital stays, fracture healing observed by X-ray, position of internal fixation, and changes of coracoclavicular distance were compared, Constant-Murley score was used to evaluate shoulder joint function.@*RESULTS@#All patients were followed up from 22 to 42 months with an average of (30.08±6.72) months. There was no statistical significance in length of incisions, operation time, blood loss, hospital stays and fracture healing time (>0.05). Constant-Murley score in control group was 83.10±5.81, and lower than that of observation group (92.30±6.05)(<0.05) at final following-up. Coracoclavicular distance in control group (11.22±3.85) mm, was longer than that of observation group (8.71±2.14) mm(<0.05).@*CONCLUSIONS@#Compared with locking plates, locking plates with suture anchors for type Neer IIb distal clavicle fractures has better shoulder joint, shorter coracoclavicular distance. It showed coracoclavicular ligament is an effectiveness method for treating Neer IIb distal clavicle fractures.

Study on the morphology of micro-implant-bone interface cells and bone histomorphology under different implantation / Estudio sobre la morfología de las células de la interfaz microscópica implante-hueso y la histomorfología ósea bajo diferentes implantaciones

SUMMARY: Micro-implant stability has always been the focus of orthodontic clinical research.In the experiment, the morphological changes of bone tissue around the micro-implants in self-tapping and assisting implantation were investigated to explore the effect of different implantation on the osseointegration of micro-implants in order to provide some theoretical basis for clinical practice. Six adult male Beagle dogs were selected,three implants were implanted into the left and right maxillary bone of Beagle dogs at the 0th, 4th and 6th week, respectively. One side to self-tapping implantation, the opposite side to assisting implantation. At the 8th week of the experiment, the animals were sacrificed and the micro-implant-bone tissue specimens with the healing time of 8w, 4w and 2w were obtained.The specimens were stained with Toluidine Blue (TB) and photographed under 100X, 200X microscope. Morphology of microimplant- bone interface cells was observed under light microscope. In self-tapping group, there were some fibrous tissues surrounding the micro-implants at the 2th week, the formation of osteoblasts and osteoid was observed at the 4th week, the wavy and lamellar bone tissues were seen at the 8th week.In assisting group,more collagen fibers were deposited around the micro-implant at the 2th week, there were a large number of osteoid-like cells, and the collagen was gradually replaced by the bone tissue at the 4th week, the osteoblasts were active and the osteoblasts were linear arrange and form a laminate bone at the 8th week.Whether implanted self-tapping or assisted implantation, micro-implant-bone interface reconstruction can occur. If the clinical need for early loading force, micro-implant try to choose selftapping implantation. By appropriately prolonging the healing time, the initial stability of the micro-implant under assistive implantation can be improved.

RESUMEN: La estabilidad del microimplante siempre ha sido el foco de la investigación clínica en ortodoncia. En este trabajo se investigaron los cambios morfológicos del tejido óseo alrededor de los microimplantes autorroscantes y se ayudó a la implantación para explorar el efecto de diferentes implantes en la osteointegración de microimplantes con el fin de proporcionar alguna base teórica para la práctica clínica. Se seleccionaron seis perros Beagle machos adultos, y se colocaron tres implantes en los huesos maxilares izquierdo y derecho en la 0ª, 4ª y 6ª semana, respectivamente. De un lado se colocó el implante autorroscante, y del otro lado el implante asistido. En la octava semana, se sacrificaron los animales y se obtuvieron las muestras de microimplante-hueso con el tiempo de cicatrización de 8, 4 y 2 semanas. Las muestras fueron teñidas con azul de toluidina (TB) y fotografiadas bajo aumento de 100X, y microscopio de 200X. La morfología de las células de la interfaz microimplante-hueso se observó bajo microscopio óptico. En el grupo autorroscante, había tejido fibroso que rodeaba los microimplantes a la 2ª semana, se observó la formación de osteoblastos y osteoide a la 4ª semana y de tejido óseo ondulado y lamelar a la 8ª semana. En el grupo asistido, se depositaron más fibras de colágeno alrededor del microimplante en la 2ª semana, hubo un gran número de células similares a osteoide, y el colágeno fue reemplazado gradualmente por el tejido óseo en la 4ª semana; los osteoblastos estaban activos y se ubicaron linealmente formando un hueso laminado en la 8ª semana. Ya sea que el implante sea con autoasistencia o con implantación asistida, puede ocurrir la reconstrucción de la interfaz microimplante-hueso. Si existe la necesidad clínica de una fuerza de carga temprana, el microimplante de elección sería la implantación autorroscante. Al prolongar apropiadamente el tiempo de curación, se puede mejorar la estabilidad inicial del microimplante bajo implantación asistida.

Delayed Lateral Row Anchor Failure in Suture Bridge Rotator Cuff Repair: A Report of 3 Cases

Compared to single row repair, use of lateral row anchors in suture bridge rotator cuff repair enhances repair strength and increases footprint contact area. If a lateral knotless anchor (push-in design) is inserted into osteoporotic bone, pull-out of the lateral row anchor can developed. However, failures of lateral row anchors have been reported at several months after surgery. In our cases, even though complete cuff healing occurred, delayed pull-out of the lateral row anchor in the suture bridge repair occurred. In comparison to a conventional medial anchor, further biomechanical evaluation of the pull-out force, design, and insertion angle of the lateral anchor is needed in future studies. We report three cases with delayed pull-out of lateral row anchor in suture bridge rotator cuff repair with a literature review.

Comparision between Syndesmotic Screw Fixation and Knotless Tightrope® Fixation on Ankle Fractures with Distal Tibiofibular Syndesmosis Injury / 대한족부족관절학회지

PURPOSE: A distal tibiofibular syndesmosis injury with an ankle fracture is usually fixed with syndesmotic screws. Knotless Tightrope® has been used as an alternative procedure because of the fewer reported complications. Therefore, this study compared the two surgeries. MATERIALS AND METHODS: Forty-two patients, who underwent syndesmotic screw fixation, and 34 patients, who underwent Knotless Tightrope® fixation for distal tibiofibular syndesmosis injury from February 2014 to February 2016, were analyzed retrospectively. The visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, range of motion of ankle at 1 year after surgery, tibiofibular clear space, and tibiofibular interval at preoperative, postoperative and 1 year after surgery were investigated. RESULTS: The VAS score, AOFAS score and radiographs were similar in the two groups. Knotless Tightrope® showed better results in complications and plantarflexion. CONCLUSION: Knotless Tightrope® fixation is a useful treatment that does not show a difference in fixation strength and clinical outcome. Knotless Tightrope® fixation also has an advantage in the range of motion and complications.

Volar plate avulsion fracture alone or concomitant with collateral ligament rupture of the proximal interphalangeal joint: A comparison of surgical outcomes

BACKGROUND: Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. METHODS: A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. RESULTS: The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P < 0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. CONCLUSIONS: Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

Targeted suture anchor repair technique for deltoid ligament rupture / 中华骨科杂志

Objective To summarize the characteristics of deltoid ligament rupture and explore the feasibility and shortterm clinical outcomes of targeted suture anchor repair technique according to the rupture site.Methods From May 2011 to October 2014,19 cases of complete deltoid ligament rupture (17 males and 2 females) were recruited in this study,with an average age of 34.15± 1.23 years (ranged from 15 to 60 years).According to Lauge-Hansen classification,there were 7 cases of pronation external rotation grade ⅣV injury,including 3 cases of Maisonnuve fracture;1 case of pronation abduction type Ⅲ degree injury,1 case of pronation abduction grade ⅣV injury;and 10 cases of supination external rotation grade ⅣV injury.According to AO / OTA classification,there were 9 cases of 43B type injury and 10 cases of 43C type injury.According to the rupture site of deltoid ligament,the targeted suture anchor repair surgery was operated respectively.Early mobilization with the help of hinged ankle brace was encouraged.The evaluation at last follow-up was based on the American Orthopedic and Ankle Association (AOFAS) criteria of ankle and hindfoot,and the visual analogue scale (VAS) scoring system.Results Nineteen patients were all followed up for 24 to 48 months,with an average of 30.42±5.11 months.Fourteen cases (73.7％,14/19) with talus end avulsion were treated by double suture anchor in the talus,with continuous locking suture of the avulsed end.Four cases (21.1％,4/19) with middle part rupture were treated by double suture anchor in the talus,with the sutures crossing three bone tunnels at the medial malleolus.One case (5.3％,1/19) with medial malleolus end avulsion was treated by single suture anchor at the medial malleolus,with continuous locking suture of the avulsed end.At the last follow-up,the AOFAS score was ranged from 70 points to 96 points,with an average of 90.53 points,and excellent in 16 cases,good in 2 cases,fair in 1 case,excellent and good rate was 94.7％.The VAS score was ranged from 0 to 2 points,with an average of 0.42 point.No wide medical clear space was detected.But traumatic arthritis was happened in 2 patients.Conclusion The targeted suture anchor repair technique according to the rupture site was a save technique in treating deltoid ligament rupture,which is conducive to early postoperative functional exercise,with excellent short-term clinical outcomes and few complications.