Radiography still remains as the first screening tool in acute traumatic wrist injuries and MDCT is complementary to it and used as a problem-solving tool or for preoperative planning.
Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. Keywords Arthrocentesis; Anterior repositioning splint; TMD; Internal derangement; Anterior disc displacement; Mandibular range of motion.
Background: Fractures of the clavicle account for 44% of injuries around the shoulder girdle, several techniques of fixation have been described in literature, including the use of plates, Kirschner wires, Steinman pins, external fixators and even plaster constructs. Objective: The purpose of this prospective cohort study was to compare the outcomes of intra-medullary fixation and plating in the treatment of mid-shaft clavicle fractures. Patients and Methods: In this study, 24 patients ranging in age from 18 to 60 were enrolled. They were split into two groups and given intra-medullary nailing or plating as their treatment options. Comparison of the two groups' outcomes and complications was done. Results:The nail group's union time was markedly reduced. In terms of the functional outcome, as measured by the Quick DASH Score, there was no significant difference between groups. A higher rate of infection and nonunion was found in those who used plates, although there was no statistically significant difference between the groups. The nail group had much more skin irritation (hardware prominence) than the control group. When compared to the plate group, patient dissatisfaction was much higher due to scar development. Conclusion:It is possible to employ intra-medullary fixation in the treatment of mid-shaft clavicle fractures as a viable alternative to plate fixation since it is a minimally invasive procedure with fewer risks, faster healing, and better cosmetic and functional outcomes.
Background: Our hypothesis was that the mini-anterior approach gives adequate exposure with satisfactory result in patients with developmental dysplasia of the hip. Methods: Twenty-three hips in 20 patients who had developmental dysplasia of the hip (18 girls and two boys) underwent surgical reduction using the mini-anterior approach. The incision extended from a point about 1 cm below and medial to the anterior iliac superior spine obliquely to a point about 1 cm lateral to the femoral pulsation. The average patient age at the time of surgery was 15 mo. Results: Clinical results were evaluated according to the modified McKay criteria and the cosmetic appearance of the wound. Excellent wound cosmetic appearance was present in all patients. Twenty-two hips (95.7%) were rated clinically as excellent to good, whereas only one hip was rated as fair. According to radiographic Severin grading, 20 hips (86.4%) were rated as excellent to good and only three hips (13.6%) were rated as fair. Conclusions: The mini-anterior approach can be used safely in patients with dysplasia of the hip who are younger than 20 mo with adequate exposure and minimal soft-tissue dissection. Level of Evidence: Level IV.
Background: Anterior glenohumeral dislocation is a widespread problem among young athletic populations. Objective: This study was aimed to evaluate the clinical and the radiological results of patients with recurrent traumatic anterior shoulder instability treated with Latarjet procedure. Patients and Methods: A clinical trial study was conducted on 18 patients with recurrent traumatic anterior shoulder instability treated at the Department of Orthopedic, Faculty of Medicine, Zagazig University Hospitals. Pre-and postoperative clinical evaluation and radiological assessment was applied. Results: The average glenoid bone loss was (24.1±2.3 %) ranging from 20 to 27. All cases showed postoperative union and most of them (94.4%) had bony union and only (5.6%) had a fibrous union. Regarding range of motion and the shoulder functional evaluation there was a highly statistically significant improvement in all examined items (p-value<0.001). 123.0 % improvement postoperatively with a highly statistically significant increase in the constant score from (48.1±6.2) to (91.4±3.7) (p-value<0.001). 93.6 % improvement postoperatively with a highly statistically significant increase in the ULCA score from (14.6±2.9) to (31.3±1.8) (p-value<0.001). Most of the studied group (16 cases, 88.8%) didn't have any postoperative complications, one case had a hematoma (5.6%) and one case had a superficial infection (5.6%). Conclusion: It could be concluded that the open Latarjet procedure has confirmed to be an effective and efficient procedure for shoulder stabilization.
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