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1.
Int Orthop ; 46(8): 1855-1862, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35678843

RESUMO

PURPOSE: The aim of the study was to evaluate the antegrade intramedullary locking nail osteosynthesis for the treatment of the proximal and middle thirds of humeral shaft fractures. METHODS: A retrospective study was made on 218 patients diagnosed with humeral diaphysis fractures who undergo surgery with antegrade intramedullary locking nail between January 2017 and December 2021. The clinical follow-up started two days after surgery and continued at one month, three months, six months and one year. The functional recovery evaluation was performed using visual analogue scale (VAS) score, Rating Scale of American Shoulder and Elbow Surgeons Form (ASES), Mayo Elbow Performance Score System (MEPS) and rate of complications. RESULTS: Low intra-operative blood loss, short operation time, short hospitalisation, early mobilisation of the patient and high union rate imposed intramedullary nailing as a standard procedure for the treatment of proximal and middle thirds of humeral diaphyseal fractures in the past years, and the union rate was 99.5%. VAS score evaluated at one month, three months and six months indicated a very good overall post-operative experience. The ASES and MEPS score were evaluated at six months and one year and showed excellent results. All the patients (except 1 case) were able to return to their previous jobs within six months. CONCLUSION: Humeral nailing is associated with early return to function of the upper limb, with very good clinical and functional outcomes of the shoulder and elbow. This method could be considered the best surgical option for the management of proximal middle humeral fractures.


Assuntos
Fixação Intramedular de Fraturas , Fraturas do Úmero , Fraturas do Ombro , Pinos Ortopédicos , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/métodos , Humanos , Fraturas do Úmero/cirurgia , Úmero , Estudos Retrospectivos , Fraturas do Ombro/cirurgia , Resultado do Tratamento
2.
Int Orthop ; 46(9): 1963-1970, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35711003

RESUMO

PURPOSE: The study wants to evaluate the incidence, the clinical evolution, and treatment of common peroneal nerve (CPN) palsy after primary total hip arthroplasty. METHODS: Our clinical prospective study was made between January 2016 and December 2020. The study group comprised 1240 total hip replacements over a period of five years. Six cases were diagnosed with CPN palsy (0.48%). Five were women and one man, aged from 52 to 71 years old. The common peroneal nerve lesion was diagnosed clinically and by electromyography. RESULTS: The follow-up period was at least 24 months post-operatively. In all six cases, there was a complete common peroneal nerve palsy, documented by electromyography. The poorest results were obtained in the older patients and those who had the highest body mass index, which at two years post-operatively achieved only a partial sensory rehabilitation, with complete motor deficit. All patients can walk unassisted, without support, with one case having complete rehabilitation achieved 18 months postoperatively and three with partial rehabilitation. CONCLUSION: CPN palsy after primary THA is a very serious complication with poor functional outcome. There is no consensus regarding the treatment. The age and the intensity of the rehabilitation program are the only significant factors for the medical rehabilitation after this debilitating post-operative complication.


Assuntos
Artroplastia de Quadril , Neuropatias Fibulares , Idoso , Artroplastia de Quadril/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paralisia/epidemiologia , Paralisia/etiologia , Nervo Fibular/cirurgia , Neuropatias Fibulares/diagnóstico , Neuropatias Fibulares/epidemiologia , Neuropatias Fibulares/etiologia , Estudos Prospectivos
3.
J Clin Med ; 13(5)2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38592012

RESUMO

Background: Cancer rehabilitation represents a series of measures adopted for the recovery of psychological, emotional, social, and financial functioning in the case of cancer patients. The purpose of this study is to identify the main elements of therapeutic management in the field of medical rehabilitation, as well as integrative, complementary medicine and holistic approaches that can be performed on the oncological patient. Methods: This systematic literature review follows the methodology outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" ("PRISMA") statement, which is an internationally recognized and widely accepted standard. Results: Active rehabilitative therapies offer therapeutic options for improving the functioning and quality of life of oncological patients; these therapies comprehensively address both the physical and psychological aspects of the disease. This review also includes the latest novelties and nanotechnologies applied in oncological rehabilitation, for example, drugs (or supplements) inspired by nature. Conclusions: Physical and rehabilitation medicine, mostly using stimulating therapeutic methods, was recently added to the list of contraindications in the management of oncological patients, both as an approach to the pathological concept itself and as an approach to the main clinical consequences and functional aspects of oncological therapies. Integrative, complementary medicine presents an important therapeutic resource in the case of oncological patients. Advanced studies are needed in the future to further ascertain the role of these therapies.

4.
Ortop Traumatol Rehabil ; 25(3): 131-141, 2023 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38078354

RESUMO

BACKGROUND: The aim of the study was to evaluate total hip arthroplasty in terms of clinical and functional outcomes, rate of complications and hospitalization, as a treatment of choice for displaced femoral neck fractures. MATERIALS AND METHODS: We retrospectively reviewed the data of 526 patients with THA operated on in our department between January 2017 and December 2021. Clinical examinations, functional outcome assessment and radiographic evaluation were performed during follow-up. Patients were evaluated at the following time points: postoperatively at 3 days, 6 weeks, 12 weeks and 1 year, and we recorded surgery related data, complications, Visual Analogue Scale pain score, Harris Hip Score, the Western Ontario McMaster Osteoarthritis Index, and range of motion. RESULTS: Low intraoperative blood loss, short surgical time, short hospitalization, early mobilization of the patient and a good range of motion testify that the modified direct lateral approach is a valuable procedure for the patients with THA. A VAS score evaluated at 3 days and 6 weeks indicated a very good overall postoperative experience. The HHS and Womac scores were evaluated at 6 weeks, 12 weeks and 1 year and showed excellent results. CONCLUSION: THA for active patients with a displaced fracture of the femoral neck is an excellent treatment option which provides lasting pain relief, a high level of function and very low rates of reoperation.


Assuntos
Artroplastia de Quadril , Fraturas do Colo Femoral , Humanos , Idoso , Artroplastia de Quadril/métodos , Estudos Retrospectivos , Resultado do Tratamento , Fraturas do Colo Femoral/cirurgia , Dor
5.
Exp Ther Med ; 22(4): 1192, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34475982

RESUMO

The aim of the present study conducted on the lumbar spine was to confirm that the pronounced decrease in resistance in the system is a phenomenon that can be eminently affected by the adaptive changes that occur at the level of the intervertebral disc at axial mechanical stresses. The biomechanical trial was carried out on 11 lumbar segments L1-L5, gathered from adult human cadavers. The dissection considered the complete keeping of all bone, disc, articulated and ligamentous components in their anatomical position. All 11 samples were frozen 24 h prior to the performance of the biomechanical measurement. The specimens were placed in the testing device, their placement being conditioned by the estimated dimensional values. Thus, to calculate the load and axial resistance, the models were placed vertically, central between the test machine ferries. The testing was carried out by applying variable forces and displacement supervision. The displacement interval was represented by a segment of 0-10 mm with surveillance every 2 mm. Mobility in the sagittal plane (flexion earlier in our case) was much higher than that in the frontal plane, obviously limiting mobility via the intervertebral disc and articular complex through the presence of arches. Statistical analysis demonstrated the lack of any correlation values between the two types of movements (R2=0.005507), underlining the absence of any prediction elements. A noteworthy aspect is that the correlations appeared low, statistically insignificant, even within the same movement in the sagittal plane between the two levels, L1-L3 and L3-L5 (R2=0.610427), which may lead to the possibility of the emergence of significant differences in mobility between respective levels. The behavior type of the monitored specimens and the results obtained allowed the mapping of objective parallelism between the values obtained and the behavior in vivo of the lumbar vertebral segment.

6.
J Int Med Res ; 46(8): 3480-3486, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30058420

RESUMO

Necrotizing fasciitis (NF) is a severe infection involving the superficial fascial layers, subcutaneous cellular tissue, and possibly skin. It usually has a fulminant evolution, rapidly leading to death in the absence of early diagnosis and aggressive surgical treatment. We herein report a rare case of NF secondary to a traumatized occipital psoriatic plaque in an alcoholic 47-year-old woman and compare this case with the published literature. The NF extended to the entire scalp, right face, and posterior and lateral cervical region. Despite the initially guarded prognosis, the patient's survival emphasizes the importance of aggressive surgical treatment with wide excision of all necrotic structures without any aesthetic compromise.


Assuntos
Antibacterianos/uso terapêutico , Traumatismos Craniocerebrais/complicações , Fasciite Necrosante/cirurgia , Psoríase/complicações , Alcoolismo/complicações , Desbridamento , Face , Fasciite Necrosante/tratamento farmacológico , Fasciite Necrosante/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pescoço , Prognóstico , Reoperação , Couro Cabeludo , Músculos Superficiais do Dorso/transplante , Retalhos Cirúrgicos
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