RESUMO
PURPOSE: We undertook to evaluate the efficacy of C-reactive protein (CRP) determination as a screening test for the detection of malig-nancy in compression fracture patients by comparing simple compression fractures and malignant metastatic compression fractures of spine. MATERIALS AND METHODS: From January 1998 to March 2001, fifty-one patients who had compression fracture of spine with chronic back pain were analysed for CRP levels. The thirty-six patients had simple compression fractures of the spine and fifteen patients malignant metastatic compression fractures. The sensitivity, specificity and positive predictive value of CRP in the screening of benign simple compression fractures were calculated. RESULTS: CRP levels in malignant metastatic compression fracture were significantly higher than in simple compression fracture. The sensitivity of CRP in simple compression fractures was 97%, its specificity 80% and its positive predictive value 92%. CONCLUSION: We consider CRP titer to be a useful screening test for the detection of malignant metastatic compression fractures. In old age, a high titer of CRP needs more precise clinical definition for the detection of malignancy in compression fracture.
Assuntos
Humanos , Dor nas Costas , Proteína C-Reativa , Fraturas por Compressão , Programas de Rastreamento , Sensibilidade e Especificidade , Coluna VertebralRESUMO
PURPOSE: To evaluate the usefulness of plain lateral radiographs processed by the Wintopo(R) program (SoftSoft.netTM, version 1.11, USA)for a picture archiving communication system (PACS) for the diagnosis of bursting fracture. MATERIALS AND METHODS: From January 2001 to April 2002, 24 cases of thoracic and lumbar spine fractures with available computed tomographs were evaluated. Lateral plain radiographs were reviewed by five orthopedic residents, and then were saved as bmp files in a picture archiving communication system. The borderline posterior body in the lateral plain radiographs was defined using the vector image in the Wintopo(R) program. After processing, radiographs were re-evaluated. RESULTS: In all participants, the sensitivity of the diagnosis of bursting fracture was significantly improved after Wintopo(R) program processing. Although the specificity and positive predictive value were improved by processing, this was not statistically significant. CONCLUSION: Wintopo(R) program processing of plain lateral radiographs of the spine could improve the sensitivity of diagnosis for bursting fracture in acute spinal injury.
Assuntos
Diagnóstico , Ortopedia , Sensibilidade e Especificidade , Traumatismos da Coluna Vertebral , Coluna VertebralRESUMO
PURPOSE: We studied to analyse the results of Wolter plate fixation for the treatment of complete acromioclavicular joint dislocation. MATERIALS AND METHODS: From September 1999 to August 2000, 20 patients with complete dislocation of the acromioclavicular joint were treated by Wolter plate fixation. The radiologic and clinical outcomes were evaluated by UCLA scoring. The mean duration of follow up was fifteen months. RESULTS: Functional outcomes at the last follow up were excellent in eleven (55%), good in seven (35%) and poor in two cases (10%). The mean preoperative coracoclavicular interval on the injured side was 200% versus the normal side, and after operation this was 15%. In one case of an elderly patient, the plate was removed at 6 weeks due to loss of fixation. CONCLUSION: The Wolter plate fixation for complete acromioclavicular joint dislocation was considered as one of the effective method. But careful attention should be taken to prevent possible acromial fracture in the elderly.
Assuntos
Idoso , Humanos , Articulação Acromioclavicular , Luxações Articulares , Seguimentos , ArticulaçõesRESUMO
PURPOSE: The purpose of this study was to find a method of proving cold discomfort in patients who complain during the winter seasons, after receiving an internal fixation with a metal plate, and to determine the different in the developments of cold discomfort according to the type of metal plate used. MATERIALS AND METHODS: Among 26 cases of lateral malleolar fracture, 16 stainless-steel plates and 10 titanium plates were compared. Discomfort was induced by placing ice over both lateral malleoli (ice provocation test), and the side on which discomfort was induced first was recorded. RESULTS: Ten patients who felt discomfort in the winter, among which 8 cases stainless-steel plate and 2 cases titanium plate. The degree of pain was rated as 3.6 on average (ranging 2-4) on the VAS (visual analogue scale). CONCLUSION: Cold discomfort during the winter season can be confirmed by using the ice provocation test (p=0.0004). The frequency of discomfort during the winter season was higher (p=0.126) in cases filted with stainless-steel plate (50%) than in those with a titanium plate (20%).