The impact of Yoga on patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The objective of this review is to conduct a comprehensive and systematic assessment of the efficacy of Yoga as an intervention for knee osteoarthritis (KOA). METHODS: We searched PubMed, Cochrane Library, Embase, Web of Science, and PEDro as of January 3, 2024. Retrieved a total of 200 articles. Standardised mean differences (SMDs) and 95% confidence intervals (CI) were calculated. RESULTS: The study included a total of 8 trials and involved 756 KOA patients. The results indicated that compared to the control group, Yoga exercise showed significant improvements in alleviating pain (SMD = -0.92; 95% CI = -1.64 ~ - 0.20; P = 0.01, I2 = 94%), stiffness (SMD = -0.51; 95% CI = -0.91 ~ -0.12; P = 0.01; I2 = 66%) and physical function (SMD = -0.53; 95% CI = -0.89 ~ -0.17; P = 0.004; I2 = 59%) among KOA patients. However, there was no significant improvement observed in terms of activities of activity of daily living (ADL) (SMD = 1.03; 95% CI = -0.01 ~ 2.07; P = 0.05; I2 = 84%), and quality of life (QOL) (SMD = 0.21; 95% CI = -0.33 ~ 0.74; P = 0.44; I2 = 83%) with the practice of Yoga. CONCLUSIONS: In general, Yoga has been found to be effective in reducing pain and stiffness in KOA patients, it can also improve the physical function of patients. However, there is limited evidence to suggest significant improvements in terms of ADL and QOL.

[Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion].

Objective: To investigate the effectiveness of transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion. Methods: Between January 2007 and May 2015, 23 patients with thumb nerve avulsion were treated by transferring the ulnaris proper digital nerve of index finger and its dorsal branch. There were 17 males and 6 females with an average age of 32 years (range, 16-63 years). The injuries were caused by machine twist in 10 cases, electric saw in 8 cases, and sharp article prick in 5 cases. And thumb rotational avulsion amputation happened in 8 cases, thumb incomplete amputation in 2 cases, laceration of thumb palmaris with the thumb nerve avulsion of both sides in 13 caese (7 cases with tendon rupture). The time from injury to operation was 1.0-3.5 hours (mean, 2.2 hours). Results: All incisions healed by first intention. Ten cases of thumb reimplantation were successful. All the patients were followed up for 5 months to 2 years and 8 months, with an average of 1 year and 4 months. Two-point discrimination was 3-9 mm (mean, 6.8 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the sensory of the thumb was rated as S 4 in 18 cases and S3+ in 5 cases; the sensory at donor sites recovered to S3. Conclusion Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp. Conclusion: Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.

[Repair of degloving injury of fingertip with vascular pedicled cross finger flap].

OBJECTIVE: To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip. METHODS: Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm x 2.3 cm to 4.2 cm x 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft. RESULTS: Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%. CONCLUSION: The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.

[Application of the island flap at the dorsum of the middle phalange with the pedicel of the digital proper artery].

OBJECTIVE: To explore a method for the treatment of the skin defects at the distal phalanges of 2-5th fingers. METHODS: The island flap at the dorsum of the middle phalange was designed with the pedicle of dorsal branches from the digital proper artery. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. From Feb. 2005 to May. 2010, 54 cases with skin defects at the distal phalanges of 61 fingers were treated with the flap, including 35 defects at finger pulp and 26 defects at finger tip. RESULTS: The maximum size of defects and flaps was 2.2 cm x 2.5 cm and 2.4 cm x 2.7 cm, respectively. 61 flaps survived completely. Blister was happened in 3 flaps 2 days after operation, which healed spontaneously without necrosis. 54 cases were followed up for 5 to 22 months (average, 11 months). The flaps had good texture and color match with normal sensation (grade S4). The 2-point discrimination distance was 6-9 mm. The interphalangeal joint had normal movement. CONCLUSIONS: The island flap at the dorsum of the middle phalange is an ideal method for the skin defect at the distal phalange of finger.

External fixation and bone grafting for collapsed and comminuted distal radius fracture.

OBJECTIVE: To study the therapeutic effect of collapsed and comminuted distal radius fracture. METHODS: Twenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius. RESULTS: All 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient's radius. The average volar tilt was 6 to 15 degrees and the average ulnar tilt was 18 to 25 degrees. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good. CONCLUSIONS: The method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.