Home exercise in the dart-throwing motion plane after distal radius fractures: A pilot randomized controlled trial.

INTRODUCTION: During daily functions, our wrist moves through an oblique plane, named the dart-throwing motion (DTM) plane. This plane is considered a more stable plane because the proximal carpal row remains relatively immobile. However, rehabilitation programs that incorporate exercising in the DTM plane have yet to be explored. PURPOSE OF THE STUDY: The purpose of this study was to evaluate the rehabilitation outcomes after treatment in the DTM plane compared with outcomes after treatment in the sagittal plane after distal radius fracture. STUDY DESIGN: This is a pilot randomized controlled trial. METHODS: Subjects after open reduction internal fixation were assigned into a research group (N = 12; ages 48.7 ± 7.3) and a control group (N = 12; ages 50.8 ± 15). The control group activated the wrist in the sagittal plane, whereas the research group activated the wrist in the DTM plane. Range of motion, pain levels, functional hand motor skills tests, and satisfaction from self-training exercise were measured before and after a 12-session intervention. RESULTS: The outcome measures were similar between the treatment groups. The research group reported significantly higher satisfaction rates than the control group on topics such as general satisfaction (research group: 3.4 ± 0.7, control group: 2. 5 ± 1.2, P = .030), motivation to exert oneself (research group: 2.8 ± 1.0, control group: 2.3 ± 1.2, P = .009), progressed function (research group: 3.4 ± 0.7, control group: 2.4 ± 1.1, P = .012), and self-training contribution to the daily function (research group: 3.4 ± 0.7, control group: 2.5 ± 1.2, P = .030). DISCUSSION AND CONCLUSION: Pilot results do not favor one treatment method over the other. However, exercising in the DTM plane may contribute to the satisfaction of the client and increase self-training motivation.

Comparative analysis of the benefits of autotransfusion of blood by a shed blood collector after total knee replacement.

INTRODUCTION: Joint replacement is associated with massive blood loss. Various techniques have been used to avoid the use of allogeneic blood. One of the techniques used is postoperative salvage and reinfusion of shed blood that was found to reduce the use of banked blood with its potential risk. MATERIALS AND METHODS: We prospectively studied 365 patients who underwent knee joint replacement (TKR) and were divided in two groups. Group A's shed blood (SureTrans System) was collected ( n=194) and reinfused and group B's was not ( n=171, "controls"). Hemoglobin levels before and after the operation were recorded. RESULTS: Allogeneic blood requirement for TKR decreased by 65% in group A compared to group B. The packed cell/patient index dropped from 0.91 to 0.29 in group 2A. Statistical analysis yielded the odds ratio for blood replacement, a "predicting formula" for blood replacement depending on hemoglobin levels, and a cutoff point for a patient's receiving blood replacement. CONCLUSION: We recommend using this system in TKR for decreasing allogeneic blood replacement and potential associated risks. The predicting formula for blood replacement may be a helpful tool when making a decision of whether or not to use the collector system and for whom.