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PURPOSE: The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) an lateral epicondylitis of the elbow. MATERIALS AND METHODS: Twenty-four patients with refractory lateral epicondylitis were treated with shock waves. The patients were evaluated by assessing of pain using visual analog scale (VAS) and a simple elbow test (SET). Overall clinical outcomes were evaluated using Roles and Maudsley scores at 12 months after ESWT. RESULTS: Significant symptom improvement were observed in 20 (83%) patients at the 12 months follow up according to the Roles and Maudesley scores. Average SET and VAS scores were also significantly improved after ESWT (p<0.05). CONCLUSION: This study suggests that shock waves therapy could be considered as an effective and noninvasive treatment modality for refractory lateral epicondylitis of the elbow.
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Humanos , Cotovelo , Seguimentos , Choque , Cotovelo de Tenista , Tênis , Escala Visual AnalógicaRESUMO
An avulsion fracture of the second metacarpal base by the extensor carpi radialis longus is rare. There have been only 7 reports (in 10 patients) of this injury in the literature. We report upon a case of avulsion fracture of the second metacarpal base, which was treated successfully by open reduction and internal fixation.
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The medial collateral ligament is the most commonly injured ligamentous structure of the knee. The management of the medial collateral ligament injuries were divided into surgical and conservative treatment. More recently, many investigators reported that isolated medial collateral ligament injuries did well under non-operative treatment. So, arthroscopic examination of the knee to rule out other intraarticular pathologic conditions such as cruciate ligament injuries, meniscal tear and osteochondral lesion is essential. From October 1993 to April 1995, we treated 45 cases of Grade III medial collateral ligament injuries and arthroscopic finding for cruciate ligament, meniscus, bony structure were analized in these cases. The result were as follows; 1. Anterior cruciate ligament injury:37.5% in +1 degree, 42.8% in +2 degree, 86.7% in +3 degree 2. Posterior cruciate ligament injury:12.5% in +1 degree, 13.4% in +2 degree, 33.3% in +3 degree 3. Meniscal injury:12.5% in +1 degree, 21.3% in +2 degree, 33.4% in +3 degree 4. Medial capsular ligament injury was more frequent and severe in the meniscofemoral ligament than in the meniscotibial ligament, but that finding was not correlated with degree of medial instability.
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Humanos , Ligamento Cruzado Anterior , Ligamentos Colaterais , Joelho , Ligamentos , Ligamento Cruzado Posterior , Pesquisadores , Ruptura , LágrimasRESUMO
The repair of striated muscle after acute trauma occurs simultaneously by the regeneration of disrupted muscle and formation of connective scar. But, there had been no attention concerning effects of local anesthetics on the degeneration and regeneration process of the injured muscle. The author induced a constant contusion injury on the calf of rats. Lidocaine and/or epinephrine was intramuscularly injected at the site of injury. Morphological and histochemical observation was conducted and the results were as follows: 1. Traumatized striated muscle showed evidences of the healing process for upto 90 days. 2. Morphological and histochemical changes in the traumatized muscle became more severe after the injection of lidocaine and/or epinephrine. 3. Formation of collagenous scar tissue significantly increased after injection of lidocaine and/or epinephrine. Injection of lidocaine or epinephrine developed similar amount of scar after 15 days. 4. Cross section area of the regenerated muscle fibers decreased in the injection groups than in the control groups. Atrophy was significant on day 90 in all types of fiber after injection of the mixture of lidocaine and epinephrine, and in type B after injection of epinephrine. In conclusion, injection of the lidocaine and epinephrine inhibited regeneration of the traumatized striated muscle. Mixture of the drugs showed more inhibitory effect than a single drug.
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Animais , Ratos , Anestésicos Locais , Atrofia , Cicatriz , Colágeno , Contusões , Epinefrina , Lidocaína , Músculo Estriado , RegeneraçãoRESUMO
We report a case of calcific bursitis of the shoulder in four-year-old boy who had severe pain and limitation of motion of the left shoulder joint for three days. Radiographs revealed the oval radiopaque lesion in the subacormial space, and the MR signal intensity of the mass was moderate on T2WI. Histological examination of the mass showed acute necrotizing inflammation with calcification.
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Humanos , Masculino , Bursite , Inflamação , Ombro , Articulação do OmbroRESUMO
No abstract available.
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No abstract available.
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No abstract available.
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A study group composed of 11 shoulders in 10 patients underwent arthroscopic subacromial decompression for impingement syndrome. There were no biceps tendon ruptures, acromioclavicular arthritis or glenohumeral instability. Eight men and two women ranging in age from 17 to 65 years (mean age 38.7) with dominant arm involvement in 9/10 were evaluated for an average follow-up of 19.4 months (range 12-26) postoperatively. Based on the University of California at Los Angeles shoulder rating scale, nine (82%) shoulders had satisfactory results and the remaining two (18%) had unsatisfactory results. This is a preliminary report of our early experience in this rather new method of treatment, but the results are encouragingly good.
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Acrômio/diagnóstico por imagem , Artroscopia , Estudo de Avaliação , Pessoa de Meia-Idade , Movimento , Dor , Período Pós-Operatório , Estudos Retrospectivos , Ombro/fisiopatologiaRESUMO
No abstract available.
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In this abstract we report a case of Albright's syndrome associated with hypophosphatemic rickets and hyperthyroidism in a six-year-old girl. She had suffered from repeated fractures of her long bones owing to multiple locations of radiolucent areas and generalized skeletal demineralization. The biopsy in the lucent area revealed histologic appearance of fibrous dysplasia.
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Criança , Feminino , Humanos , Fraturas do Fêmur/etiologia , Displasia Fibrosa Poliostótica/complicações , Hipertireoidismo/complicações , Fosfatos/sangue , Raquitismo/complicaçõesRESUMO
It is often difficult to achieve bony union and eradicate infection in treating infected non-unions of the fractured long bones. Authors carried out a clinical analysis of the 35 infected non-union cases, all aged 21 years or older, treated and followed for 6 months to 6 years from July 1979 to July 1988 in order to determine the possible factors which might influence the time required for attaining union. The results were as follows: l. In 22 of the 35 infected non-unions, the primary fracture site was open (62.9%). The remaining 13 cases (37.1% ) were the closed fractures associated with postoperative infection. 2. The sites of infected non-union were tibia in 19 (54.3%), femur in 13 (37.1%), and upper extremity in 3 (8.6%) cases. Tibia was more often involved in open fractures (63.6%). Femur, on the other hand, was more involved in closed fractures (61.5%). 3. After an average of 3.3 times of bony procedures, primary fixation was left in place in 15 (42.9%), external fixation was required in 11 (31.4%), and internal fixation was performed in 9 (25.7%). Bone graft was performed in 26 cases (74.3%). 4. Time required for achieving union was 7.1 month with stable primary fixation and 21.7 months with unstable primary fixation. Femur and tibia united at 10.5 (mean; ranged from 4 to 29) and 7.0 (mean; ranged from 3 to 19) months, respectively. 5. Bony union was delayed as the number of prior surgical procedures before successful treatment increased; the time for union was significantly shorter when either stable primary fixation or external fixation was combined with bone grafting. 6. Firmer bony union was achieved after performing Osteoperiosteal decortication with autogenous cancellous bone graft even in the presence of remaining infection at the non-union site.
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Transplante Ósseo , Fêmur , Fraturas Fechadas , Fraturas Expostas , Mãos , Tíbia , Transplantes , Extremidade SuperiorRESUMO
Since 1952, Ilizarov external fixator has been developed and used for more than 30 years in Russia and world-wide interest on it has been prevalent during last 2-3 years. The fixation of the tension applied thin wires to the metal frame resist flexional and translational deformity just like other extenal fixators. But, it allows cyclic axial micro-motion at the fracture site without loss of reduction so that it can provide good environment for the fracture healing biologically and biomechanically. Another advantage of Ilizarov external fixator is that it permits mobilization of the adjacent joints and weight bearing of the fractured limb during the application of it and shortens the duration of administration. Since 1988, We applied the Ilizarov external fixator for the treatment of diffcult tibial fractures (open comminuted, segmented and comminuted fractures, nonunion, maunion) and obtained good results in 7 cases. So we report our results even if we had limited cases and experiences.
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Anormalidades Congênitas , Fixadores Externos , Extremidades , Consolidação da Fratura , Fraturas Cominutivas , Articulações , Federação Russa , Tíbia , Fraturas da Tíbia , Suporte de CargaRESUMO
The back pain is increasingly becoming a major problem in the elderly people. The cause of back pain in the elderly patient is quite different from in the young subject. And relationship of the occurrence of osteoporosis with the incidence of fractures in general is currently regarded as a major factor. The authors performed clinical observation on 194 elderly patients who were treated for back pain during 5 years period from April, 1983 to April, 1988 at the Department of Orthopaedic Surgery, Severance Hospital and relationship between osteoporosis and compression fracture of spine was reviewed. The results were as follows : l. Among the 194 cases of back pain(28.3% of total admission cases), whose age were over 50: 142 cases were female and 52 cases were male, being more common in female. 2. Most common cause of back pain was the compression fracture of spine : 86 cases(44.3 %). Osteoporosis was associated with 66 cases(76.7%) out of 86 cases. 3. The number of compression fracture in same patient was more frequent in osteoporotic patient and thoracolumber junction (T12, Ll) was the major site of fracture (45.6%). Compression fracture of spine caused by osteoporosis occured at multiple level in 60.6%. 4. Twenty three cases(34.8%) of compression fracture of spine with osteoporosis were found to have previous history of fractures of spine and/or extremities by radiological examination. Regarding this results, compression fractures of spine was not infrequent cause of back pain in the elderly. It was thought that re-fracture of spine should be prevented by vigorous approach against osteoporosis along with the treatment of presenting fracture in these patients.