Purpose: to compare the effect of diclofenac sodium phonophoresis (DSPH) with conventional therapeutic ultrasound (TUS) on knee OA. Subjects and methods: Fifty patients (two groups) participated in this study. Group (A); consists of 25 patients (5 males, 20 females), with mean age 57 years, treated with TUS plus exercises. Group (B); consists of 25 patients (8 males, 17 females), with mean age 54 years, treated with DSPH plus exercises. Each patient was assessed for knee pain intensity level and physical function using the WOMAC score and knee flexion ROM using the digital inclinometer pretreatment, posttreatment and follow up one month after treatment. Results: There were non-significant differences among group (A) for WOMAC score, and significant only at posttreatment and follow up compared to pretreatment for group (B) (P-value <0.003 * ). Significant differences between posttreatment compared to pretreatment and follow up among group (A) for knee flexion ROM (P-value <0.03 * ), and significant only between post and pretreatment for group (B) (P-value = 0.000 * ). However, there was no significant difference between groups neither at posttreatment nor at follow up. Conclusion: DSPH had improvement but not significant in pain intensity level, physical function, and knee flexion ROM posttreatment but it had no superior effect on TUS. Knee flexion ROM improved significantly posttreatment in both groups, but only in PH the improvement sustained for one month after treatment. PH had long term effect than TUS.
Purpose
To assess the reliability of sequential examination under anaesthesia (EUA) to determine pelvic instability and to evaluate radiological and functional outcomes in unstable lateral compression (LC) injuries.
Methods
A prospective case series study was conducted from 2020 to 2022 at a university hospital on 43 cases with LC injuries that met the inclusion criteria. Sequential EUA was carried out in three steps. Posterior-only fixation or anterior–posterior fixation was done according to the algorithm. Each patient was followed up for at least 12 months, both radiologically and functionally.
Results
Forty cases proved unstable and were fixed. None showed secondary displacement in the anterior–posterior fixation group. However, five cases (19.2%) of the posterior-only fixation group showed secondary displacement with a mean of 5.9 mm. Four cases of them had tetra-ramic injuries. There is a high tendency for secondary displacement at 14.5 mm or more preoperative displacement of the rami. Patients with secondary displacement showed comparable functional outcome scores to patients without secondary displacement. Posterior-only fixation showed shorter operative time, lesser radiological exposure, blood loss and iatrogenic nerve injury than anterior–posterior fixation.
Conclusion
EUA is a reliable method to determine pelvic instability and management plan for LC fractures with unilateral anterior ring injury. Anterior–posterior fixation is needed if there is a tetra-ramic fracture or initial anterior ring displacement of 14.5 mm or more, irrespective of EUA.
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