combined effect of mobilization technique and therapeutic exercises versus therapeutic exercises in treatment of shoulder impingement syndrome

The objective of our work is to compare between the use of combined effect of mobilization technique and therapeutic exercises versus therapeutic exercises as regard pain functional disability at the shoulder and motion in case pf supraspinatus, impingment syndrome. Thirty patients diagnosed as shoulder impingement syndrome [SIS] due to functional causes [stage II Neer classification] participated in this study. Patients were randomly distributed into two groups. The first group consisted of 15 patients with a mean age 36.47 [ +/- 6.68], they received infrared radiation followed by a program of therapeutic exercises. The second group consisted of 15 patients with a mean age 36.26 [ +/- 6.54], they received infrared radiation followed by a combined program of mobilization techniques and therapeutic exercises. Treatment was given 3 times per week, each other day, for 4 consecutive weeks. Patients were evaluated pretreatment and posttreatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions as well as for the acromiohumeral distance in adduction and abduction using ultrasonography. Both groups of patients showed significant improvement in all the measured variables. There was a significant reduction of both shoulder pain severity and functional disability as well as significant increase of shoulder flexion, abduction and internal rotation motions. In addition to that there was also a significant increase in the acromiohumeral distance in adduction and abduction. However the combination of mobilization and therapeutic exercises was more effective than the therapeutic exercises alone in improving the measured variables. Use of a combined program of mobilization and therapeutic exercises is more significantly effective than therapeutic exercises in treatment of shoulder impingement syndrome

Wrist joint arthodesis seven years experience

Prospective study of 23 cases of painful wrist presented at Elsahel teaching hospital from May 2000 to March 2007. Age ranged from 24- 52 years. 12 cases female and 11 males. 14 wrists were right and 9 wrists were left. All cases were heavy workers. 11 cases were rheumatoid arthritis, 8 cases were post traumatic arthritis, 4 cases were stage 4 kienbock's disease. To evaluate the result of wrist fusion in different aeteological conditions. All patients had preoperative assessment, clinically and radiologically for 1 -3 years. All operations were done under general anesthesia through dorsal approach of the wrist joint. 15 cases excellent, 4 cases good, 2 cases fair and 2 cases poor. Wrist arthrodesis is a good choice for patients with persistent wrist pain and functional disability who are demanding painless stable wrist. Wrist arthrodesis allows pain relief, deformity correction and restoration of function

Arthroscopic surgery for osteoarthritis of the knee [early results]

A retrospective study had been made on a 50 patients with a mean age of 56.6 years [50-72], 16 were male and 34 were female, operated by arthroscopic lavage and debridement for OA knee with symptomatic mechanical derangement not responding to any con servative treatment. All operation was done by me in El Haran hospital Cairo Egypt, the period between 2002-2006. With a minimal follow up of one year, range from 12-20 months of a mean of 14.8 months. The patients selected from plenty of patients had the same procedure, the exclusion criteria was, ligamentuous injury. Fracture of the knee, previous operation, and local or general synovial diseases. The post operative evaluation showing gradual improvement of preoperative symptoms up to 80% of patients at final follow up, improvement of leisure and living activity in 80% of patients despite of early limited results, the mean lysholm score gradually increase by time postoperatively to reach a mean of 78. [55-90] at the final follow up, and the patients needs for NSAID; for symptoms control decrease [10% not receiving, 10% rarely receiving, 60% receiving in case of pain and 20% had a constant medication fortunately alleviating pain]. I conclude that arthroscopic debridement and lavage are effective procedure for symptomatic OA knees to improve symptoms, leisure and living activity, and reduce the daily use of medicine and delay the need for joint arthropathy. Further more the procedure needs long term follow up to evaluate the reality and the durability of its efficacy