Background: The objectives of this comprehensive quantitative review of the treatment of calcific supraspinatus tendinitis were to investigate if there is a sustainable positive effect on outcomes after treatment with extracorporeal shockwave therapy (ESWT) or ultrasound (US)-guided needling and to compare these results with those of treatment with arthroscopic surgery. Method: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to conduct this review. A systematic literature search was conducted in December 2019 to identify relevant clinical articles in peer-reviewed journals with at least 3 months' follow-up. Each article was scored using the Coleman Methodology Score. The primary endpoints were functional outcome and radiologic change in the size of the calcific deposit. Results: Twenty-four studies were included (1,509 shoulders). The mean Coleman Methodology Score for the included studies was 77.1± 9.1. Overall, good to excellent clinical outcomes were achieved after treatment with either ESWT, US-guided needling, or arthroscopic surgery, with an improvement in the Constant-Murley score ranging between 26.3 and 41.5 points after 1 year. No severe side effects or long-term complications were encountered. Conclusions: Patients can achieve good to excellent clinical outcomes after ESWT, US-guided needling, and arthroscopy for calcific tendinopathy of the shoulder. Side effects and posttreatment complications should be taken into account when a decision is being made for each individual patient. Physicians should consider ESWT and US-guided needling as minimally invasive treatment options when primary conservative treatment fails. Arthroscopy can safely be used as a very effective but more invasive secondary option, although the extent of deposit removal and the additional benefit of subacromial decompression remain unclear.
Simulation and analysis of a turbulent free jet flame erupting into still air are done using computational fluid dynamics (CFD). Using 2D axisymmetric numerical modeling in ANSYS-Fluent 14.5. Three distinct kinds of gaseous fuels are used: methane, carbon monoxide, and Biogas (50 % CH4 and 50 % CO2). The effects of thermal radiation modeling utilizing the P-1 radiation model on the behavior of a free jet flame are investigated, and the impacts of air temperature and fuel velocity on the flame length are also provided. The findings demonstrated that the radiation modeling did not affect the temperature distribution and flame length for CO and Biogas (i.e., lower heating value fuels). Nevertheless, the air temperature and fuel kind considerably impact the flame behavior. While the fuel inlet velocity (i.e., burner power) does not affect the flame length. Additionally, free jet flame velocity and length numerical correlations considering radiation modeling are predicted and presented with allowable errors. A comparison with earlier experimental correlation proved successful, with a maximum error of ?9.4%.
Despite the relative prevalence of intra-articular calcaneal fractures, definitive management is controversial. The goal of this study is to evaluate the clinical and radiological outcome of percutaneous reduction and fixation of 20 patients with intraarticular calcaneal fractures Sanders type II, III or IV by k wires, Steinmann pins or cannulated screws subjectively and objectively over 8 months . Twenty-two ( 22) percutaneous fixation of calcaneal fractures in 20 patients were included in this study. This study included closed intra-articular calcaneal fractures type II , III and IV in adult patients and excluded open, extra-articular, type I fractures. The American Orthopaedic Foot and Ankle Score (AOFAS) was used for evaluation. The excellent and good results were considered satisfactory while the poor and fair results were considered unsatisfactory. The results at the end of this study were satisfactory in 86.3% of patients (AOFAS score more than 75 in 19 fractures) and unsatisfactory in 13.6% of patients (AOFAS score less than 75 in 3 fractures). All patients included in this study showed normal range of motion of the ankle joint (active dorsiflexion and planter flexion) with variable decrease in the subtalar range of motion (active inversion and eversion) when compared with the normal side. .Percutaneous reduction and fixation had been found to be satisfactory in reduction of Böhler's angle, Gissane angle and Sarrafian angle with avoiding open reduction surgical and postoprtative complications and avoiding conservative management bad functional outcome.
Background: Fractures of scaphoid are prevalent, and many times are difficult to identify and heal. Fracture scaphoid may cause extended morbidity and absences from work in young adult in which they are most prevalent. Non displaced fractures of the scaphoid waist were handled with immobilization as conventional therapy, with possibly resulting reduction of wrist motion . include extended cast immobility, and constitute a severe economical hardship. Immobilization may be required for up to 3 months, and patient compliance is therefore generally poor, particularly in the presence of low symptom levels, when plasters may be removed early, resulting in delayed union or nonunion. For nonoperative therapy of acute scaphoid waist fractures, numerous forms of casts are utilized in normal practice. These include Colles' cast with wrist in flexion or extension; scaphoid cast below or above elbow; scaphoid cast including or omitting the thumb. This research aims at examining the efficiency of percutaneous cannulated Herbert's screw repair of new scaphoid fractures in providing good result. Methods: Fifteen patients with new scaphoid fractures repaired with percutaneous Herbert screw were included in this investigation. This research was done at Banha university hospital and Kafr El-Sheikh general hospital between October 2019 and August 2020. These patients were followed up for an average of 10 months (8-12 months) post-operatively. This research covered non-displaced or mildly displaced complete waist fractures (B2) according to Herbert's classification. We utilized volar technique in all situations. Results: The clinical findings were assessed as outstanding in 12 patients (80 percent ) and good in 3 individuals (20 percent ). (20 percent ). By the conclusion of the follow up period 12 patients (80 percent ) had no pain at all, and 3 patients (20 percent ) experienced minor intermittent discomfort. Twelve patients (80 percent ) restored wrist range of motion with flexion & extension higher than 120 degrees, two patients (13.3 percent ) regained mobility between 119 to 110 degree, and one patient (6.7 percent ) regained motion between 90 to 99 degrees. Thirteen patients (86.7 percent ) have 90 percent to 100 percent grip strength compared to the normal side, two (13.3 percent ) patients has 75 percent to 89 percent grip strength compared to the normal side. Comparing the functional end outcomes with smoking, no significant association was identified. (P>0.05 statistically insignificant). Significant association was established between central location of the screw and the functional end outcomes, (P<0.05 statistically significant). The fixation group contained 11 and the cast group 14 patients. The cast group was immobilized in a long cast for 6 weeks, followed by a short cast until union was attained, which was verified clinically and radiographically. The fixation group was immobilized with a brief cast for 10 days and a detachable splint till union. All patients were followed up for 25 months, and all fractures attaine...
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