ABSTRACT
INTRODUCTION: To avoid the DRUJ surgical procedures disadvantages, a new intraosseous distal radioulnar prosthesis designed on Sauvé-Kapandji procedure has been introduced. Stability of the prosthesis and biomechanics are to be evaluated in this article. MATERIALS AND METHODS: On a cadaveric study, during placement of the prosthesis, biometry of the bones, prosthesis stability (in axial and lateral tractions, wrist pronation and supination, and squeeze test), wrist range of motion before and after implantation, and radiographic evaluation were done on 16 cadavers. RESULTS: Range of motion of the wrist joint before and after the insertion of the prosthesis, had no significant difference in all six directions. Stability of the prosthesis, when rotational pronation force was exerted, was greater than when rotational supination force was exerted. The prosthesis showed significant stability against longitudinal traction forces in a way that no prosthesis dislocation was observed up to 150N forces. Stability of the prosthesis was investigated when lateral force was applied to different wrist positions. The most stable position of the prosthesis was in the case of lateral traction forces in supination where no case of dislocation was observed. CONCLUSIONS: The intraosseous distal radioulnar prosthesis demonstrated stable structure with no effect on wrist range of motion. LEVEL OF EVIDENCE: IV.
Subject(s)
Artificial Limbs , Joint Prosthesis , Humans , Range of Motion, Articular , Supination , Wrist Joint/diagnostic imaging , Wrist Joint/surgeryABSTRACT
BACKGROUND: The association between ulnar styloid fracture and distal radius fracture is common while the necessity of ulnar styloid fixation is still controversial. We have aimed to elucidate the effect of ulnar styloid fracture fixation on final outcome of distal radius fracture treatment. METHODS: In a two-arm randomized clinical trial, patients with Fernandez type I distal radius fracture associated with ulnar styloid fracture in the base were divided into two groups of fixed (group A) and unfixed (group B) ulnar styloid fracture. They were followed up for 12 months using pain visual analogue scale (VAS), quick form of the Disabilities of the Arm, Shoulder, and Hand (DASH) score questionnaire, and Mayo performance score as well as wrist range of motion and grip strength evaluation. RESULTS: Quick DASH score was 35.4±14.0 in group A and 30.5±5.82 in group B (P=0.027) at 3-month follow-up and 29.8±18.2 in group A and 18.3±8.40 in group B At 6-month follow-up (P= 0.001). VAS score for pain was declined 4.46±2.17 and 3.64±0.96 after 6 months (P= 0.339) and 4.00±1.73 and 2.50±0.81 after 12 months (P= 0.352) in groups A and B, respectively. The mean Mayo wrist scores were measured as 59.3 and 57.8 in group A and B three months after the fracture, respectively (P= 0.504). We found no significant difference in the wrist range of motion and grip strength between two groups after three months (P>0.05). CONCLUSION: According to our findings, ulnar styloid fixation using pin and wire have an adverse effect on distal radius fixation outcomes.
ABSTRACT
BACKGROUND: Of the pharmacological modalities for knee osteoarthritis (OA), intra-articular injections including ozone (O3) and hyaluronic acid (HA) are commonly used for reducing pain and improving function. In this systematic review and meta-analysis, we aimed to compare the effect of O3 versus HA in reducing pain and increasing function in patients with knee OA. METHODS: After searching databases, we included 6 randomized controlled trials on patients with knee OA that compared the effects of intra-articular injection of ozone versus HA. The primary outcome was visual analogue scale (VAS) of pain. The secondary outcome was Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. RESULTS: There was a total of 237 patients in the HA group and 230 patients in the Ozone group. Of 6 studies, 4 were in English, 1 was in Persian, and 1 was in German language. The overall Standardized Mean Difference (SMD) for VAS pain did not show a significant difference between the groups although it favored HA injection (1.27 [95%CI: (-0.12)-2.66]). Total WOMAC score showed a significant difference over the time favoring HA injection (4.5 [95%CI: 1.1-8]). However, no single time point showed any significant difference between groups. CONCLUSION: This meta-analysis showed no significant difference between HA and ozone in reducing pain and improving function in patients with knee OA, although the overall results favored HA over ozone. Since previous studies have shown comparable results between HA and placebo, ozone seems to fall in the same category with more placebo effect rather than a real disease-modifier.
