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1.
Orthopedics ; 45(3): e140-e147, 2022.
Article En | MEDLINE | ID: mdl-35112957

Osteoarthritis of the thumb carpometacarpal (CMC) joint is the most common type of arthritis of the hand. The goal of the study was to evaluate clinical results and radiographic changes after arthroscopic partial trapeziectomy combined with ligament shrinkage and K-wire fixation to treat thumb CMC joint arthritis. From February 2013 to March 2014, 24 patients with thumb CMC joint arthritis received this arthroscopic procedure. We investigated the preoperative and postoperative Modified Mayo Wrist Score (MMWS); Disabilities of the Arm, Shoulder and Hand (DASH) score; radiographic changes; and associated complications. Sixteen patients completed 5 years of functional score and radiographic follow-up. Comparison of preoperative and postoperative MMWS and DASH scores showed significant improvement after the arthroscopic procedure. Pre-operative and postoperative evaluation of radiographic changes showed significant differences in the CMC joint distance, scaphoid-metacarpal distance, trapezium-metacarpal distance, and metacarpal prominence distance. This arthroscopic procedure is an effective and less invasive method for the treatment of CMC joint arthritis. This procedure can improve clinical function, preserve the mechanical height of the trapezium, and increase CMC joint space. We report our surgical technique and some pitfalls that required attention during the arthroscopic procedure. [Orthopedics. 2022;45(3):e140-e147.].


Carpometacarpal Joints , Osteoarthritis , Arthroscopy , Carpometacarpal Joints/diagnostic imaging , Carpometacarpal Joints/surgery , Follow-Up Studies , Humans , Osteoarthritis/diagnostic imaging , Osteoarthritis/surgery , Thumb/diagnostic imaging , Thumb/surgery
2.
Int J Mol Sci ; 22(14)2021 Jul 08.
Article En | MEDLINE | ID: mdl-34298988

This study evaluated the biocompatibility and biological performance of novel additive-manufactured bioabsorbable iron-based porous suture anchors (iron_SAs). Two types of bioabsorbable iron_SAs, with double- and triple-helical structures (iron_SA_2_helix and iron_SA_3_helix, respectively), were compared with the synthetic polymer-based bioabsorbable suture anchor (polymer_SAs). An in vitro mechanical test, MTT assay, and scanning electron microscope (SEM) analysis were performed. An in vivo animal study was also performed. The three types of suture anchors were randomly implanted in the outer cortex of the lateral femoral condyle. The ultimate in vitro pullout strength of the iron_SA_3_helix group was significantly higher than the iron_SA_2_helix and polymer_SA groups. The MTT assay findings demonstrated no significant cytotoxicity, and the SEM analysis showed cells attachment on implant surface. The ultimate failure load of the iron_SA_3_helix group was significantly higher than that of the polymer_SA group. The micro-CT analysis indicated the iron_SA_3_helix group showed a higher bone volume fraction (BV/TV) after surgery. Moreover, both iron SAs underwent degradation with time. Iron_SAs with triple-helical threads and a porous structure demonstrated better mechanical strength and high biocompatibility after short-term implantation. The combined advantages of the mechanical superiority of the iron metal and the possibility of absorption after implantation make the iron_SA a suitable candidate for further development.


Absorbable Implants , Biocompatible Materials , Suture Anchors , Alanine Transaminase/blood , Animals , Biocompatible Materials/chemistry , Biocompatible Materials/toxicity , Biomechanical Phenomena , Blood Urea Nitrogen , Calcium Phosphates/chemistry , Calcium Phosphates/toxicity , Calcium Sulfate/administration & dosage , Calcium Sulfate/chemistry , Calcium Sulfate/toxicity , Creatinine/blood , Equipment Design , Femur/diagnostic imaging , Femur/ultrastructure , Iron , Lasers , Materials Testing , Microscopy, Electron, Scanning , Molecular Structure , Osseointegration , Polymers/chemistry , Polymers/toxicity , Porosity , Rabbits , Random Allocation , Tensile Strength , Viscera , X-Ray Microtomography
3.
Indian J Orthop ; 55(Suppl 2): 409-417, 2021 Jul.
Article En | MEDLINE | ID: mdl-34306555

BACKGROUND: In female badminton players, certain landings are associated with injury to the anterior cruciate ligament (ACL). However, the kinematic and kinetic changes of the landing leg and the effects of risky posture on ACL injuries among female vs male badminton players are still unknown. We hypothesized that female players land with a significantly higher knee valgus angle and moment compared to male players during single-leg landings in badminton. METHODS: Ten male and ten female badminton players were enrolled in this study. In the laboratory, these subjects performed back-stepping to the backhand side with a concurrent overhead stroke, a single-leg landing on the force plate, and a return to the starting position. The kinematic data in the stance phase were normalized ranging from 0% as initial contact to 100% as toe-off; and 0% as initial contact to 100% as maximum knee flexion in the impact phase. RESULTS: The knee valgus angle in female players was significantly higher in initial contact (5.06° ± 6.83° vs - 5.10° ± 4.30, p = .001) and maximal knee valgus angle (7.58° ± 9.54° vs - 3.93° ± 4.22°, p = .004) compared to male players. The knee valgus moment was significantly higher in male players than female players ( - 0.09 ± 0.12 vs 0.03 ± 0.10 N∙m/kg, p = .032) in initial contact during the impact phase. During landings, female badminton players had lower hip flexion angles, greater knee valgus angles, and greater ankle dorsiflexion angles. CONCLUSION: Female badminton players presented higher knee valgus angles but smaller knee valgus moments compared with male players during backward single-leg landings. The concomitant kinematic and kinetic changes of the hip, knee, and ankle joints also can play an important role in the higher incidence of ACL injury in female athletes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43465-021-00421-6.

4.
J Emerg Med ; 56(2): 201-204, 2019 Feb.
Article En | MEDLINE | ID: mdl-30527562

BACKGROUND: Anterior dislocation of the glenohumeral joint is a common upper extremity injury in orthopedic and emergency medicine. The aim of this study was to introduce a novel reduction technique, "elbow technique," for anterior shoulder dislocations. DISCUSSION: This study included 26 patients with anterior shoulder dislocation who were treated using the elbow technique in our hospital's emergency department between October 2014 and December 2015. One orthopedic physician performed the reduction maneuver and the vast majority of the patients were sedated. Patients who presented with posterior shoulder dislocation, remained dislocated for more than 7 days, who had Neer three or four parts proximal humerus fractures, and who had received previous shoulder surgery were excluded from this study. Twenty-one dislocations (80% of the patients) were primary. Six patients (23% of the dislocations) had associated fractures of the greater tuberosity. All of the patients were successfully reduced with the elbow technique. Mean time for reduction was 5 s (range 3-69 s). No iatrogenic fractures or neurovascular injuries were noted after the reductions. CONCLUSIONS: The elbow technique involves traction, leverage, pulsion, and can be performed by a single operator. The elbow technique is a safe, elegant, simple, effective, fast, and gentle reduction procedure for anterior shoulder dislocations in the emergency department.


Manipulation, Orthopedic/methods , Shoulder Dislocation/therapy , Adult , Aged , Aged, 80 and over , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Male , Manipulation, Orthopedic/standards , Middle Aged , Range of Motion, Articular/physiology , Shoulder Injuries , Shoulder Joint/abnormalities , Time Factors
5.
J Am Podiatr Med Assoc ; 103(3): 236-40, 2013.
Article En | MEDLINE | ID: mdl-23697731

Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint was reduced successfully through the closed method, but multiple attempts at closed reduction under local anesthesia failed to reduce the dislocated second and third metatarsophalangeal joints. We performed a dorsal incision between the second and third metatarsals, and the metatarsal heads were found to be entrapped under the plantar plate. Dislocation reduction was performed without damage to the plantar plate, and one Kirschner wire was used to fix the fourth metatarsal head fracture. The pin was removed 8 weeks after surgery, and the patient regained normal gait and returned to work and his previous physical activity level without recurrent dislocation.


Fracture Fixation/methods , Fractures, Bone/surgery , Joint Dislocations/surgery , Metatarsal Bones/injuries , Metatarsophalangeal Joint/injuries , Toes/injuries , Adult , Fractures, Bone/complications , Humans , Joint Dislocations/complications , Male , Metatarsal Bones/surgery , Metatarsophalangeal Joint/surgery , Toes/surgery
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