ABSTRACT
Background: The objectives of this study were to investigate whether severity of clubfoot, age, and weight of the patients at initial manipulation and casting influence the total number of castings required. Methods: This prospective study was conducted on 38 idiopathic clubfoot patients undergoing weekly manipulation and casting using the method recommended by Ponseti. The patients’ age, weight, and foot Pirani score at the start of manipulation and casting were analysed against the total number of castings required to achieve correction to 60° abduction. Results: Simple linear regression analysis on the influence of weight, age, and Pirani score at the time of cast initiation showed that the Pirani score was the only significant predictor for the total number of castings required. Conclusion: The total number of castings required to treat clubfoot was determined by the severity of clubfoot but not by the weight and age of patients.
ABSTRACT
Uno de los pilares fundamentales en el tratamiento conservador de las fracturas diafisarias del húmero ha sido el uso del yeso colgante como método de inmovilización, por lo que se decició aplicar dicho tratamiento en un paciente después de haber realizado el diagnóstico de dicha afección. Se evaluó la eficacia del método empleado a través del seguimiento periódico de la evolución clínica e imaginológica de la lesión, obteniéndose la consolidación de la fractura sin que se apreciara complicación alguna, resultado que concuerda con la literatura mundial, la cual refiere la importancia y resultados positivos del método empleado. Teniendo en cuenta lo práctico, económico y útil que resulta el mismo los autores consideraron oportuno presentar esta experiencia con el objetivo de promover la extensión práctica del tratamiento conservador de la fractura diafisaria del húmero.
One of the main pillars of the humerus dyaphisial fracture conservative treatment has been the usage of the hanging plaster cast as an immobilization method, so we decided to use that treatment in a patient after diagnosing that condition. We evaluated the efficacy of the used method periodically following the clinical and imaging evolution of the lesion, obtaining the consolidation of the fracture without any complication, result agree with the international literature that refers the importance and positive outcomes of the used method. Taking into account its suitability, effectiveness, and usefulness we considered it opportune to present this experience with the objective of promoting the practical extension of the humerus dyaphisial fracture conservative treatment.
Subject(s)
Humans , Adult , Female , Humeral Fractures , Humeral Fractures/therapy , Calcium Sulfate/therapeutic use , Case ReportsABSTRACT
OBJETIVO: o objetivo dos autores desse estudo foi comparar o método de análise de dentição mista que utiliza tomografia computadorizada de feixe cônico para avaliar os diâmetros dos dentes intraósseos com os métodos de Moyers, Tanaka-Johnston e radiografias oblíquas em 45º. MÉTODOS: foram realizadas medidas, na arcada inferior, dos diâmetros mesiodistais dos incisivos permanentes irrompidos, nos modelos de gesso com auxílio de paquímetro digital e estimativa do tamanho de pré-molares e caninos permanentes ainda não irrompidos utilizando-se a tabela de Moyers e a fórmula de predição de Tanaka-Johnston. Nas radiografias oblíquas em 45º, caninos e pré-molares foram medidos utilizando-se o mesmo instrumento. Nas tomografias, as mesmas unidades dentárias foram aferidas por meio de ferramentas do programa Dolphin. RESULTADOS: a análise estatística revelou elevada concordância entre o método tomográfico e o radiográfico, e baixa concordância entre o tomográfico e os demais avaliados. CONCLUSÃO: a tomografia computadorizada de feixe cônico mostrou-se confiável para análise da dentição mista e apresenta algumas vantagens em relação aos métodos comparados: a observação e mensuração dos dentes intraósseos individualmente, com a possibilidade, contudo, de visualizá-los sob diferentes perspectivas e sem superposição de estruturas anatômicas.
OBJECTIVE: The aim of this study was to evaluate the method for mixed-dentition analysis using Cone-Beam Computed Tomography for assessing the diameter of intra-osseous teeth and compare the results with those obtained by Moyers, Tanaka-Johnston, and 45-degree oblique radiographs. METHODS: Measurements of mesial-distal diameters of erupted lower permanent incisors were made on plaster cast models by using a digital calliper, whereas assessment of the size of non-erupted permanent pre-molars and canines was performed by using Moyer's table and Tanaka-Johnston's prediction formula. For 45-degree oblique radiographs, both canines and pre-molars were measured by using the same instrument. For tomographs, the same dental units were gauged by means of Dolphin software resources. RESULTS: Statistic analysis revealed high agreement between tomographic and radiographic methods, and low agreement between tomographs and other methods being evaluated. CONCLUSION: Cone-Beam Computed Tomography was accurate for mixed-dentition analysis in addition to presenting some advantages over compared measurement methods: observation and measurement of intra-osseous teeth individually with the possibility, however, to view them from different prospects and without superimposition of anatomical structures.
Subject(s)
Humans , Male , Female , Casts, Surgical , Cone-Beam Computed Tomography , Dentition, Mixed , Radiography, Dental, Digital , Cuspid , Dental Arch , Diagnostic Imaging , Incisor , MolarABSTRACT
The impact of low intensity, pulsed ultrasound on fracture healing is controversial. This review summarizes the authors' research on therapeutic ultrasound in fracture management. Our survey of orthopaedic surgeons and senior physiotherapy students found that use of therapeutic ultrasound is rare, due primarily to a perceived lack of evidence and lack of availability. There is evidence from randomized trials that low intensity ultrasound may significantly reduce the time to fracture healing, particularity in those fractures treated nonoperatively. The benefit of ultrasound following operativelymanaged fractures remains uncertain. Our economic analysis suggests that, from both governmental and societal perspectives, reamed intramedullary nailing is the treatment of choice for closed and open grade I tibial shaft fractures; however, there is evidence from a societal perspective that treatment of low energy tibial fractures with therapeutic ultrasound and casting may also be an economically-sound intervention. Larger trials are needed to resolve the role of therapeutic ultrasound in fracture healing
La relevancia que tiene un tratamiento con pulsos de ultrasonido de baja intensidad para la consolidación de las fracturas es controvertida. Esta revisión resume la investigación de los autores acerca de la terapia ultrasónica en el manejo de las fracturas. Nuestra encuesta de las creencias y las conductas de los cirujanos ortopedistas y de los estudiantes avanzados de fisioterapia encontró que la terapia ultrasónica es utilizada rara vez, debido fundamentalmente a que es vista como carente de pruebas en cuanto a sus beneficios y a que no es fácilmente accesible. Existen datos sugestivos tomados de ensayos aleatorizados de que el ultrasonido de baja intensidad podría reducir considerablemente el tiempo de consolidación de las fracturas, particularmente en el caso de aquellas tratadas incruentamente. Los beneficios del ultrasonido aplicado a las fracturas tratadas quirúrgicamente son aún inciertos. Nuestro análisis económico sugiere que, tanto desde la perspectiva gubernamental como desde la social, el enclavado endomedular fresado es el tratamiento de elección para las fracturas diafisarias de la tibia, tanto cerradas como expuestas tipo I; sin embargo, existen además hechos indicativos de que desde la perspectiva de la sociedad, el tratamiento de las fracturas tibiales de baja intensidad con reducción incruenta e inmovilización con yeso, en combinación con terapia ultrasónica, podría también ser una intervención económicamente beneficiosa. Se necesitan ensayos más grandes para dilucidar al papel que la terapia ultrasónica tiene en la consolidación de las fracturas
Subject(s)
Ultrasonics , Fracture Healing , Fractures, Bone , Ultrasonic Waves , Fracture Fixation, Intramedullary , ImmobilizationABSTRACT
Object of treatment of long bone fracture is the reduction of fracture and maintenance of good alignment. Recently operative treatment has been attempted increasingly, but conservative treatment is considered important also. The authors have employed the multiple splint method that is modified from triangular splint method for humerus shaft fracrure originally having designed and reported by ourselves. In our experience of multiple splint method for long bone fracture and ligament injuries, some merits were noticed such as easiness of application, simplicity of removal and reapplication. We report this method with review of literature.