RESUMO
PURPOSE: The purpose of this review is to compare the clinical and radiological outcomes between open and closed wedge distal femoral varus osteotomy (DFO). METHODS: A literature search of online databases (MEDLINE, EMBASE, and Cochrane Library database) was made in addition to manual search of major orthopedic journals. Data were searched from the time period of January 1990 to October 2016. A modified Coleman Methodology Score system was used to assess the methodologic quality of the included studies. A total of 20 studies were included in the review. All studies were level IV evidence. RESULTS: Comparative analysis of open and closed wedge DFO did not demonstrate clinical and radiological differences. The survival rates were also similar. Five studies (56%) on open wedge DFO mentioned the need for either bone grafting or substitute for osteotomy gap filling and reported higher incidences of reoperation for plate removal than the closed wedge DFO studies. CONCLUSIONS: The present systematic review showed similar performance between open and closed wedge DFO. Outcomes including survival rates were not statistically significantly different. However, additional bone grafting or substitutes were often needed to prevent delayed union or nonunion for open wedge techniques. Additional operations for plate removal were commonly required due to plate irritation in both techniques.
RESUMO
Diabetes mellitus (DM) is a common disease which usually manifests in the form of polyuria, polydipsia, weight loss, fatigue, weakness, blurry vision, frequent skin infections, and slow healing of skin lesions. Taste disturbances like ageusia, hypogeusia and dysgeusia have been associated with DM. The early diagnosis of DM based on these symptoms is very important to start treatment early and thereby prevent complications. We present an interesting case of a female presenting with altered taste as the first symptom of DM.