• Title/Summary/Keyword: orthopaedic

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Arthroscopic Capsular Release for Painful Throwing Shoulder With Posterior Capsular Tightness

  • Yoneda, Minoru;Nakagawa, Shigeto;Mizuno, Naoko;Fukushima, Sunao;Hayashida, Kenji;Mae, Tatsuo;Izawa, Kazutaka
    • 대한관절경학회:학술대회논문집
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    • 2006.11a
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    • pp.35-39
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    • 2006
  • Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically. Because an extensive adhesion between the capsule and the fascia of the external rotators was noted, a capsular release was performed from 6 o'clock to 11 o'clock (in the right shoulder) to completely expose the muscle belly of the external rotators. Of the first 16 consecutive patients, 4 had no concomitant lesions and underwent posterior capsular release alone. With a minimum of 2 years' follow-up, it was ascertained that the throwing pain completely disappeared in 14 patients and improved in 2. In all, 11 patients returned to their preinjury performance level, and 5 returned to a lower level of function. In the 4 patients who had no concomitant lesions, throwing pain completely disappeared, and all were able to return to their preinjury performance level.

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Acute Shortening and Delayed Lengthening in Management of Lower Leg Amputation: A Case Report

  • Kang, Seung Hoon;Jung, Sung Won;Jin, Jin Woo;Kim, Dong Hee;Shin, Sung Jin;Jeong, Min;Eho, Yil Ju
    • Archives of Reconstructive Microsurgery
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    • v.25 no.2
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    • pp.65-68
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    • 2016
  • Acute bone shortening and delayed lengthening by Ilizarov surgery have been used to treat a wide range of soft tissue injuries including open fracture, osteomyelitis of the tibia and lower leg amputation. It has advantages such as bone lengthening as well as minimizing the loss of damaged tissues via tissue expansion. Here, we report a case of 52-year-old male with satisfactory results through acute bone shortening, replantation, and gradual bone lengthening after complete amputation of the ankle with related literature reviews.

Intraneural Ganglion Cyst of the Peroneal Nerve -A Case Report- (비골신경내의 결절종 - 1례 보고-)

  • Yoon, Jung-Ro;Shim, Jae-Ik;Kim, Taek-Seon;Lee, Sung-Jong;Kim, Young-Bae;Kim, Hak-Joon;Lee, Tae-Jin;Ko, Dae-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.106-110
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    • 2002
  • Ganglion cysts occurring within sheaths of peripheral nerves have been documented, but are relatively rare entities. The peroneal nerve at the level of the knee and proximal tibiofibular joint is most commonly involved. We report a case of the intraneural ganglion cyst in the peroneal nerve without neurologic deficit, which was excised sucessfully.

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Primary versus revision total shoulder arthroplasty: comparing relative value and reimbursement trends

  • Carney, John Joseph;Gerlach, Erik;Plantz, Mark;Swiatek, Peter Raymond;Marx, Jeremy;Saltzman, Matthew;Marra, Guido
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.42-48
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    • 2022
  • Background: Total shoulder arthroplasty (TSA) has been demonstrated to be an effective treatment for multiple shoulder pathologies. The purpose of our study was to compare the relative value units (RVUs) per minute of surgical time for primary and revision TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients that underwent primary TSA, one-component revision TSA, and two-component revision TSA between January 1, 2015 and December 31, 2017 using current procedure terminology codes. RVUs were divided by mean operative time for each procedure to determine the amount of revenue generated per minute. Rates were compared between the groups using a one-way analysis of variance with post-hoc Tukey test. Statistical significance was set at p<0.05. Results: When dividing compensation by surgical time, we found that two-component revision generated more compensation per minute compared to primary TSA (0.284±0.114 vs. 0.239±0.278 RVU per minute or $10.25±$4.11 vs. $8.64±$10.05 per minute, respectively; p=0.001). Conclusions: The relative value of revision TSA procedures is weighted to account for the increased technical challenges and time associated with these procedures. This study confirms that reimbursement is higher for revision TSA compared to primary TSA.

Melatonin protects endothelial progenitor cells against AGE-induced apoptosis via autophagy flux stimulation and promotes wound healing in diabetic mice

  • Jin, Haiming;Zhang, Zengjie;Wang, Chengui;Tang, Qian;Wang, Jianle;Bai, Xueqin;Wang, Qingqing;Nisar, Majid;Tian, Naifeng;Wang, Quan;Mao, Cong;Zhang, Xiaolei;Wang, Xiangyang
    • Experimental and Molecular Medicine
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    • v.50 no.11
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    • pp.13.1-13.15
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    • 2018
  • Wound healing is delayed in diabetic patients. Increased apoptosis and endothelial progenitor cell (EPC) dysfunction are implicated in delayed diabetic wound healing. Melatonin, a major secretory product of the pineal gland, promotes diabetic wound healing; however, its mechanism of action remains unclear. Here, EPCs were isolated from the bone marrow of mice. Treatment of EPCs with melatonin alleviated advanced glycation end product (AGE)-induced apoptosis and cellular dysfunction. We further examined autophagy flux after melatonin treatment and found increased light chain 3 (LC3) and p62 protein levels in AGE-treated EPCs. However, lysosome-associated membrane protein 2 expression was decreased, indicating that autophagy flux was impaired in EPCs treated with AGEs. We then evaluated autophagy flux after melatonin treatment and found that melatonin increased the LC3 levels, but attenuated the accumulation of p62, suggesting a stimulatory effect of melatonin on autophagy flux. Blockage of autophagy flux by chloroquine partially abolished the protective effects of melatonin, indicating that autophagy flux is involved in the protective effects of melatonin. Furthermore, we found that the AMPK/mTOR signaling pathway is involved in autophagy flux stimulation by melatonin. An in vivo study also illustrated that melatonin treatment ameliorated impaired wound healing in a streptozotocin-induced diabetic wound healing model. Thus, our study shows that melatonin protects EPCs against apoptosis and dysfunction via autophagy flux stimulation and ameliorates impaired wound healing in vivo, providing insight into its mechanism of action in diabetic wound healing.

Assessing the Necessity of Extra Reduction Aides in Intramedullary Nailing of Intertrochanteric Hip Fractures

  • John W. Yurek;Nikki A. Doerr;Alex Tang;Adam S. Kohring;Frank A. Liporace;Richard S. Yoon
    • Hip & pelvis
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    • v.35 no.3
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    • pp.183-192
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    • 2023
  • Purpose: This study aims to determine which intertrochanteric (IT) hip fracture and patient characteristics predict the necessity for adjunct reduction aides prior to prep and drape aiming for a more efficient surgery. Materials and Methods: Institutional fracture registries from two academic medical centers from 2017-2022 were analyzed. Data on patient demographics, comorbidities, fracture patterns identified on radiographs including displacement of the lesser trochanter (LT), thin lateral wall (LW), reverse obliquity (RO), subtrochanteric extension (STE), and number of fracture parts were collected, and the need for additional aides following traction on fracture table were collected. Fractures were classified using the AO/OTA classification. Regression analyses identified significant risk factors for needing extra reduction aides. Results: Of the 166 patients included, the average age was 80.84±12.7 years and BMI was 24.37±5.3 kg/m2. Univariate regression revealed increased irreducibility risk associated with RO (odds ratio [OR] 27.917, P≤0.001), LW (OR 24.882, P<0.001), and STE (OR 5.255, P=0.005). Multivariate analysis significantly correlated RO (OR 120.74, P<0.001) and thin LW (OR 131.14, P<0.001) with increased risk. However, STE (P=0.36) and LT displacement (P=0.77) weren't significant. Fracture types 2.2, 3.2, and 3.3 displayed elevated risk (P<0.001), while no other factors increased risk. Conclusion: Elderly patients with IT fractures with RO and/or thin LW are at higher risk of irreducibility, necessitating adjunct reduction aides. Other parameters showed no significant association, suggesting most fracture patterns can be achieved with traction manipulation alone.