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Journal articles on the topic 'Orthopedic traction'
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Gautam, Sapana, and Dinesh Kumar Thapa. "Knowledge and Practice among Nurses of Traction in Patients: In a Tertiary Care Center." Eastern Green Neurosurgery 2, no. 1 (January 29, 2020): 47–51. http://dx.doi.org/10.3126/egn.v2i1.27463.
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Background and purpose: The role of nursing care among the traction patients is vital and they should be competent, experienced and educated well about the traction devices used and care to minimize the traction associated complications and infections. This study was designed to access the knowledge and practice regarding care and management of the patients with traction in orthopedic trauma by Nurses.
Material and method: A cross sectional descriptive study was conducted on 100 eligible nursing staffs from Kathmandu Medical College Teaching Hospital. Non-probability purposive sampling technique and a self administered structured questionnaire were used to collect data. The statistical analysis was done by using the SPSS version 16. The association between the demographic factors was analyzed by using chi square test.
Result: The working area and traction training has significant relation to knowledge and other, such as age, education, work experience, worked in orthopedic ward has no significance. There is adequate knowledge as the percentage value is 88 and practice regarding care of the patient on traction is 98%.
Conclusion: The knowledge regarding traction care seems sufficient in this study and every orthopedic nursing should be master in traction knowledge, application and nursing care to acquire early patient recovery without significant deformity and complications.
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Solano-Mendoza, B., A. Iglesias-Linares, RM Yañez-Vico, A. Mendoza-Mendoza, JJ Alió-Sanz, and E. Solano-Reina. "Maxillary Protraction at Early Ages. The Revolution of New Bone Anchorage Appliances." Journal of Clinical Pediatric Dentistry 37, no. 2 (December 1, 2012): 219–29. http://dx.doi.org/10.17796/jcpd.37.2.q0k770403v443053.
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Purpose: An update is provided on the different types of early treatment for class III malocclusions of maxillary origin. There is an increasing tendency to prescribe maxillary orthopedic treatment with skeletal an-chorage, with the purpose of enhancing the skeletal and reducing the dentoalveolar effects - offering a management option for children with important deformations that otherwise would have to wait until adult age to receive surgical treatment. Method: A literature review has been made of maxillary bone orthopedic traction appliances in growing children with class III malocclusions. A Medline (PubMed) search was made using the following MeSH terms: Cephalometric, Child, Malocclusion class III / therapy, Extraoral traction appliances, Palatal expansion, Bone plates, Skeletal anchorage, Orthodontic anchorage. Results: Many articles show that the greatest maxillary advances are obtained at very early ages, though with a greater tendency towards relapse. However, skeletal anchorage has been seen to afford a lesser relapse rate and greater dentofacial orthopedic efficiency due to its low dentoalveolar impact. In any case, further randomized clinical studies are needed to firmly establish the quantifiable differences in terms of maxillary advance, optimum traction age, optimum traction appliance and potential side effects. At present, the incorporation of surgically inserted bone anchorage appliances (miniplates and miniscrews) offers a purely orthopedic approach to treatment, with minimization of the undesirable side effects of traditional dentofacial orthopedic compensation based on dentoalveolar anchorage. Nevertheless, further studies are needed to consolidate the supporting scientific evidence in this field.
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Melamed, Eitan, Amir Blumenfeld, Boaz Kalmovich, Yona Kosashvili, Guy Lin, Amir Korngreen, Igal Mirowsky, Rami Mosheiff, Dror Robinson, and Moshe Salai. "Prehospital Care of Orthopedic Injuries." Prehospital and Disaster Medicine 22, no. 1 (February 2007): 22–25. http://dx.doi.org/10.1017/s1049023x00004295.
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AbstractOrthopedic injuries are predominant among combat casualties, and carry the potential for significant morbidity. An expert consensus process (Prehospital care of military orthopedic trauma: A consensus meeting, Israel Defense Forces Medical Corps, May 2003) was used to create guidelines for the treatment of these injuries by military prehospital providers. The consensus treatment guidelines developed by experienced orthopedic trauma personnel from leading trauma centers in Israel are presented in this paper.For victims with open fractures, the first priority is hemorrhage control. Splinting, irrigation, and wound care should be performed while waiting for transport, or, in any scenario, in the case of an isolated limb injury. The use of traction splints was advocated for both the rapid transport scenario (up to one hour from the time of injury to arrival at the hospital) and the delayed transport scenario. In the urban setting, traction splints may not be necessary. Any victim experiencing pelvic pain following a high-energy mechanism of injury should be presumed to have an unstable pelvic fracture, and a sheet should be tied around the pelvis. The panel agreed that field-reduction of dislocations should be avoided by the medical officer unless it is anticipated that the patient will need to go through a long evacuation chain and the medical officer is familiar with specific reduction techniques.
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Shmyrev, V. I., А. I. Romanov, К. L. Kinlein, Т. S. Rakova, and О. V. Balakireva. "The results of the implementation of the therapeutic system "detensor" in the complex of rehabilitation measures in patients with a neurological profile." Neurology Bulletin XXVIII, no. 3-4 (December 15, 1996): 38–40. http://dx.doi.org/10.17816/nb79654.
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The therapeutic system "Detensor" was created in 1980 by prof. K.A. Kinlein (Germany) and is successfully used in clinics of therapeutic and orthopedic profile abroad for long-term traction of the spinal column.
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Bezabeh, Bahiru, Biruk L. Wamisho, and Maxime JM Coles. "Treatment of Adult Femoral Shaft Fractures Using the Perkins Traction at Addis Ababa Tikur Anbessa University Hospital: The Ethiopian Experience." International Surgery 97, no. 1 (January 1, 2012): 78–85. http://dx.doi.org/10.9738/cc48.1.
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Abstract This is a prospective study to evaluate the efficacy of the Perkins traction in the treatment of adult femoral shaft fractures from October 1, 2007, to the present at the Black Lion Hospital in Addis Ababa University Hospital in Ethiopia. All femur fractures admitted to the hospital were reviewed and evaluated for treatment. Black Lion Hospital (Tikur Anbessa) is the university hospital in Addis Ababa and the highest tertiary teaching hospital in a country of 85 million inhabitants. A 67-bed orthopedic department offers the main ground for teaching to the undergraduate medical students. The hospital is also the pivotal center for the formation of the orthopedic residents. Patients from different parts of the country are referred to this institution for orthopedic care. A total of 68 adult (older than 16 years) patients with 69 femoral shaft fractures were considered for treatment during the study period. Consent was obtained and prospective treatment initiated. A standard Perkins traction was applied by an orthopedic team composed of consultants, orthopedic residents, physical therapists, and nurses. A protocol was developed for patients undergoing such traction. The physiotherapists will supervise all individual or group therapy sessions. Progressive knee range of motion to facilitate quadriceps and hamstring muscle strengthening exercises were implemented four times a day and recorded. Demographic information, fracture patterns, duration of traction, thigh circumference leg length discrepancy, and pin sites were routinely monitored and charted. Data were computerized and analyzed weekly, and appropriate adjustments were made accordingly. Clinical evidence of a competent callus and confirmation by radiographic studies will influence the cessation of traction to allow gait training with toe-touch crutch ambulation. Progress will be monitored during the following outpatient visits in the fracture clinic. A total of 68 consecutive patients with 69 femoral shaft fractures were treated with the Perkins traction. There were 60 men (88.2%) and only 8 women (11.8%), for a ratio of 8 men to 1 woman. The age of the cohort patient varied between 18 and 28 years. The mechanisms of injury for most of the fractures were motor vehicle accidents, resulting in an isolated femoral shaft fracture in 49.2% of the patients. Half of the fractures were by means of closed injury (n = 44; 64.7%). One patient with a bilateral femoral shaft fracture was also added to the study. The right side was more often involved, with 41 fractures (60%), than the left, with 28 fractures (40%). Most of the fractures involved the proximal third of the femur (n = 34; 50%), but the most common fracture pattern was transverse (n = 29; 42.6%), followed by a comminuted pattern (n = 18; 26.5%). Three segmental fractures were also encountered. The mean hospital stay was 45 days (33 patients; 48.5%), with the length of time in traction varying from 30 to 40 days. Only 2 patients remained in traction for a period of 60 days. At the end of the traction period, 8 patients (11.8%) showed a decrease in the quadriceps mass, and 7 patients (10.3%) showed stiffness of the knee with a range of motion limited to 0° to 90°. Most patients were discharged after about 8 months of treatment. One patient suffered a nonunion, and one was malunited. Superficial pin care infections were noted in 8 patients (11.8%) and treated appropriately. The conservative treatment of 69 femoral shaft fractures using the Perkins traction at Black Lion University Hospital in Addis Ababa, Ethiopia, has been proven to be a safe and effective method. It should be encouraged in countries like ours where it is a luxury to have a C-Arm in the operating room and where the hardware often is not available to perform a stable stabilization of the long bone fractures.
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Vukasinovic, Zoran, Dusko Spasovski, Igor Seslija, Zorica Zivkovic, and Milan Stevanovic. "Conservative treatment of Malgaigne fracture in young female - case report." Srpski arhiv za celokupno lekarstvo 141, no. 11-12 (2013): 819–22. http://dx.doi.org/10.2298/sarh1312819v.
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Introduction. Pelvic ring injuries usually result from high?energy trauma, and cranial and abdominal multiple injuries are frequently present. Malgaigne fracture is referred to pelvic ring disruption at two sites, and is often treated surgically for its instability. We present a case of nonoperative treatment of Malgaigne pelvic fracture. Case Outline. A 17?year?old girl sustained a Malgaigne fracture falling off a horse. After ruling out urgent multiple trauma in local hospital, she was then transferred to Pediatric Orthopedic and Trauma Service at the Institute of Orthopedic Surgery ?Banjica? Belgrade, with provisional cutaneous traction of 2 kg applied to her right leg. After the status evaluation, the supracondylar femoral traction was applied for three months, combined with pelvic cradle for first 73 days. Weight of traction was gradually adjusted according to x?ray check?up, ranging from 1?16 kg (1/4 of body weight). Antibiotic prophylaxis was administered for 10 days, and thromboprophylaxis for two months. After the removal of traction, physical therapy was applied and the patient achieved full weight bearing four months after the injury. Treatment outcome was a symmetric and stable pelvic ring, equal leg length, full range of motion in both hip joints and normal walking. Conclusion. Traction therapy, combined with gravitational suspension in pelvic cradle, resulted in excellent clinical result. Although significantly longer and more loaded than usual, normal weight bearing and walking were promptly achieved using intensive physical therapy.
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Gouda, Rania. "Nurses’ Performance for Orthopedic Patients with Traction or Internal Fixatio." Port Said Scientific Journal of Nursing 4, no. 2 (December 1, 2017): 193–2018. http://dx.doi.org/10.21608/pssjn.2017.33082.
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Goldberg, Tyler D., Stefan Kreuzer, Filippo Randelli, and George A. Macheras. "Direct anterior approach total hip arthroplasty with an orthopedic traction table." Operative Orthopädie und Traumatologie 33, no. 4 (August 2021): 331–40. http://dx.doi.org/10.1007/s00064-021-00722-x.
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Marciniak, Tomasz, Maciej Brożyński, and Andrzej Wit. "Ultrasound guided joint space distance changes during manual traction of acromioclavicular joint in young and healthy adults." Advances in Rehabilitation 29, no. 3 (September 1, 2015): 13–19. http://dx.doi.org/10.1515/rehab-2015-0028.
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Abstract Introduction: Manual traction is a commonly used technique in manual therapy. However, depicting changes in joint space distance via real time imaging during traction is seldomly applied. The aims of the study were to identify ACJ joint space distance changes during manual traction and creation of a classification of the techniques upon the largest change in the resultant parameter (l) representing joint space distance. Material and methods: Thirteen healthy volunteers were examined unilaterally. Acromioclavicular joint space distance changes were measured with dynamic ultrasound imaging during followingmanual traction techniques: International Academy of Orthopedic Medicine technique (IAOM AC), Karel Lewit’s Prague School of Manual Medicine & Rehabilitation technique (LAC) and author’s own proposition (B AC). The differences in joint space distance between resting position (RP) and the traction technique position, created three parameters of displacement - horizontal (x), vertical (y) and (l) - the resultant component. Results: Parameters were not coherent with normal distribution. Statistical differences showed significance in the (x) parameter for IAOM AC compared with L AC (p<0,0183) and B AC (p<0,02). All techniques presented a significant increase of the resultant distance (l), compared with RP as the reference value - IAOM AC p<0,0036, L AC and B AC p<0,0000. In few cases L AC decreased the distance in the (x) parameter, but not significantly. Conclusions: 1.Significant changes of (x) parameter did not correspond with the significance of the resultant parameter (l), which prevented authors from creating a classification of the techniques. 2.All traction techniques used in the study increased the joint space distance compared to RP, which confirms traction’s theoretical assumptions. 3.For clinical purpose the change of (x) parameter may prove crucial for therapy’s effectiveness, despite lack of change in the joint space distance in the resultant parameter (l) by itself.
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Jordan, Robert W., Gurdip S. Chahal, and Matthew H. Davies. "Role of Damage Control Orthopedics and Early Total Care in the Multiple Injured Trauma Patients." Clinical Medicine Insights: Trauma and Intensive Medicine 5 (January 2014): CMTIM.S12258. http://dx.doi.org/10.4137/cmtim.s12258.
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The care of multiply injured patients with orthopedic injuries has evolved from prolonged periods in traction to early total care (ETC). ETC is advantageous in ease of nursing care and aiding patient recovery. However, concerns have been raised that this ‘second hit’ of surgery places these severely injured patients at risk of excessive inflammatory responses that can lead to systemic inflammatory response syndrome (SIRS). Damage control was initially used in abdominal trauma but has been adapted for use in orthopedics. The mainstay of treatment involves external fixation of long bone and pelvic fractures which acts to defer definitive fixation until physiologic stability is restored. The indications for implementing each approach are not clear and this article provides a narrative review of the topic.
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Valgadde, Sneha Basaveshwar, and Kishor Chougule. "Early treatment of Class III malocclusion with a tandem traction bow appliance." APOS Trends in Orthodontics 6 (July 15, 2016): 228–31. http://dx.doi.org/10.4103/2321-1407.186439.
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Since Class III malocclusion is progressive in nature, the facial growth of Class III malocclusion worsens with age. Class III malocclusion is associated with a deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficient maxilla, retrognathic mandible, or a combination of both. The early orthopedic treatment of Class III malocclusions, at the end of primary dentition or the beginning of mixed dentition, prior to growth spurt, allows the accomplishment of successful results, providing facial balance, modifying the maxillofacial growth and development, and in many instances, preventing a future surgical treatment by increasing the stability. Many treatment approaches can be found in the literature regarding orthopedic and orthodontic treatment of Class III malocclusion, including intra- and extra-oral appliances. The major problem with extraoral anchorage has been of patient compliance due to its physical appearance. The case report presents an intraoral modified tandem appliance for maxillary protraction that has been used clinically to achieve successful results without relying much on patient co-operation.
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Lara, María Salcedo, Rocío Briones Rodríguez, María Biedma Perea, and Beatriz Solano Mendoza. "Canine transposition as an alternative to trauma of the maxillary incisors: case report." Dental Press Journal of Orthodontics 23, no. 4 (August 2018): 55–63. http://dx.doi.org/10.1590/2177-6709.23.4.055-063.oar.
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ABSTRACT Objective: The present article aims at reporting the clinical case of a patient who suffered trauma at two years of age, causing almost complete apical displacement of the deciduous maxillary left central incisor and of the permanent incisor. Methods: Ectopia secondary to intrusion was minimized by surgical removal of the ectopic tooth, and the left permanent canine was submitted to orthodontic traction to replace the extracted tooth. Results: The treatment period lasted 36 months, resulting in correct occlusion and a good aesthetic outcome. Conclusions: Dental transposition carried out by means of orthopedic traction is a good alternative in cases of a very unfavorable ectopic tooth position.
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Mahmoud, AlHassan, Amira Hassanien, Wafaa Sherief, and Hanan Soliman. "NURSES' KNOWLEDGE REGARDING TRACTION CARE IN ORTHOPEDIC UNIT AT MANSOURA UNIVERSITY HOSPITAL." Mansoura Nursing Journal 3, no. 1 (January 1, 2016): 1–21. http://dx.doi.org/10.21608/mnj.2016.149273.
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Kusuman, Kevin, Kadek Adit Wiryadana, and Su Djie To Rante. "Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review." Intisari Sains Medis 13, no. 1 (April 30, 2022): 158–61. http://dx.doi.org/10.15562/ism.v13i1.1310.
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Introduction. Inferior shoulder dislocation is considered a rare event. Although there is a seemingly low chance of occurrence, this condition should not be prematurely ruled out in the presence of acute shoulder pain. Case. A 45 years old woman complained of pain in her left shoulder and was unable to bring her arm lower than 90° after a car accident. The patient unintentionally put her left arm outstretched above her head to avoid head impact during the crash, causing hyperabduction of the shoulder. She experienced pain, numbness and could not move the ipsilateral hand. Her left arm was locked in hyperabduction (100°), and her elbow was extended. Close inspection showed a loss of left shoulder contour. On palpation, the humeral head was palpable in the axilla. Anteroposterior X-ray view confirmed inferior dislocation of the left shoulder with associated greater tuberosity fracture. A closed reduction under general anesthesia with the traction-counter traction technique was conducted as commonly used in rural settings. After perfect anatomical reduction was obtained and confirmed with X-ray, the patient was immobilized using an arm sling. The shoulder was immobilized for three weeks in adducted position to support soft tissue healing. Physiotherapy was started after three weeks. Conclusion. Inferior shoulder dislocation is a rare orthopedic pathology that should not be easily dismissed in post-traumatic shoulder pain. The mechanism of injury is characterized by downward force or lever mechanism on the hyperabducted arm. Orthopedic surgeons in rural areas could utilize the Traction-countertraction method.
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Almeida, Márcio Rodrigues de, Renato Rodrigues de Almeida, Ana Claúdia de Castro Ferreira Conti, Ricardo de Lima Navarro, Giovani de Oliveira Correa, Cristiane Aparecida de Oliveira, and Paula Vanessa Pedron Oltramari. "Long-term stability of an anterior open-bite malocclusion treated in the mixed dentition: a case report." Journal of Applied Oral Science 14, no. 6 (December 2006): 470–75. http://dx.doi.org/10.1590/s1678-77572006000600015.
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A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment.
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Pelo, Sandro, Roberto Boniello, Giulio Gasparini, and Gianluigi Longobardi. "Maxillary Corticotomy and Extraoral Orthopedic Traction in Mature Teenage Patients: A Case Report." Journal of Contemporary Dental Practice 8, no. 5 (2007): 76–84. http://dx.doi.org/10.5005/jcdp-8-5-76.
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Abstract Aim The authors’ propose to combine the reverse pull headgear with a Delaire type face mask and a maxillary corticotomy to treat a Class III non-growing patient with maxillary retrusion. The aim of this report is to present two cases in which this treatment strategy was successful. Background Several studies suggest the majority of Class III dento-skeletal malocclusions have components of maxillary retrusion. Early treatment of these patients with maxillary protraction devices have shown promising results. Facemask therapy has some important limits. Most important is the optimal timing of treatment between the ages of six to ten years. Closure of the maxillary suture occurs as a child ages which results in an increase of maxillary resistance to protraction. Report A proposed therapy carried out in orthodontic and surgical phases was used in the treatment of two young patients. They were both beyond the optimal age range for the application of the orthopedic device (a girl 15 years old and a boy 16 years old), however, they had not reached the necessary skeletal maturity for orthognathic surgery. Summary The described technique has the advantage of being quick and easy to perform with a low surgical risk yielding satisfactory results after 15-20 days of therapy instead of the six to nine months associated with traditional procedures. Citation Pelo S, Boniello R, Gasparini G, Longobardi G. Maxillary Corticotomy and Extraoral Orthopedic Traction in Mature Teenage Patients: A Case Report. J Contemp Dent Pract 2007 July;(8)5:076-084.
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de Souza, Ricardo Alves, Gregório Bonfim Dourado, Isa Mara Andrade Oliveira Farias, Matheus Melo Pithon, José Rino Neto, and João Batista de Paiva. "Miniscrews as an alternative for orthopedic traction of the maxilla: A case report." APOS Trends in Orthodontics 10 (June 30, 2020): 132–38. http://dx.doi.org/10.25259/apos_16_2020.
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The aim of this study was to report the case of a Class III prepuberal patient treated by a maxillary protraction using four miniscrews. The screws were installed between maxillary first molars and second premolars and between mandibular canines and first premolars. A 1/4˝ intermaxillary elastics were used in both sides, ligating the upper-lower screws to perform a maxillary protraction and correction of the Class III malocclusion. A bite plate made by resin flow was made on lingual surfaces of the mandibular incisors to eliminate occlusal interference. After 16 months of treatment, it was possible to see a significant improvement of patient’s facial profile, with overcorrection in overjet and preservation of the tissues and integrity of dental roots.
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Goldberg, Tyler D., Stefan Kreuzer, Filippo Randelli, and George A. Macheras. "Erratum to: Direct anterior approach total hip arthroplasty with an orthopedic traction table." Operative Orthopädie und Traumatologie 33, no. 6 (September 30, 2021): 556. http://dx.doi.org/10.1007/s00064-021-00739-2.
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Alexiades, Nikita G., Belinda Shao, Bruno P. Braga, Christopher M. Bonfield, Douglas L. Brockmeyer, Samuel R. Browd, Michael DiLuna, et al. "Development of best practices in the utilization and implementation of pediatric cervical spine traction: a modified Delphi study." Journal of Neurosurgery: Pediatrics 27, no. 6 (June 2021): 649–60. http://dx.doi.org/10.3171/2020.10.peds20778.
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OBJECTIVE Cervical traction in pediatric patients is an uncommon but invaluable technique in the management of cervical trauma and deformity. Despite its utility, little empirical evidence exists to guide its implementation, with most practitioners employing custom or modified adult protocols. Expert-based best practices may improve the care of children undergoing cervical traction. In this study, the authors aimed to build consensus and establish best practices for the use of pediatric cervical traction in order to enhance its utilization, safety, and efficacy. METHODS A modified Delphi method was employed to try to identify areas of consensus regarding the utilization and implementation of pediatric cervical spine traction. A literature review of pediatric cervical traction was distributed electronically along with a survey of current practices to a group of 20 board-certified pediatric neurosurgeons and orthopedic surgeons with expertise in the pediatric cervical spine. Sixty statements were then formulated and distributed to the group. The results of the second survey were discussed during an in-person meeting leading to further consensus. Consensus was defined as ≥ 80% agreement on a 4-point Likert scale (strongly agree, agree, disagree, strongly disagree). RESULTS After the initial round, consensus was achieved with 40 statements regarding the following topics: goals, indications, and contraindications of traction (12), pretraction imaging (6), practical application and initiation of various traction techniques (8), protocols in trauma and deformity patients (8), and management of traction-related complications (6). Following the second round, an additional 9 statements reached consensus related to goals/indications/contraindications of traction (4), related to initiation of traction (4), and related to complication management (1). All participants were willing to incorporate the consensus statements into their practice. CONCLUSIONS In an attempt to improve and standardize the use of cervical traction in pediatric patients, the authors have identified 49 best-practice recommendations, which were generated by reaching consensus among a multidisciplinary group of pediatric spine experts using a modified Delphi technique. Further study is required to determine if implementation of these practices can lead to reduced complications and improved outcomes for children.
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Nascimento, Maria Augusta Back, Anna Carolina Coelho Nogueira, Carlos Daniel Cândido de Castro Filho, André Vitor Kerber Cavalcante Lemos, Mário Sérgio Paulillo de Cillo, and Cíntia Kelly Bittar. "Metatarsophalangeal arthroscopy of the hallux." Scientific Journal of the Foot & Ankle 13, no. 2 (May 3, 2019): 119–23. http://dx.doi.org/10.30795/scijfootankle.2019.v13.917.
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Objective: This study sought to describe a modified arthroscopic technique in which a traction device with a horizontal vector and nylon mesh are used to allow continuous and uniform distraction without requiring an assistant surgeon to perform manual traction. Methods: Nine patients (seven females and two males; mean age 31.8 [30-52] years) with an indication for treatment of this joint who had been diagnosed with different pathologies, including synovitis, hallux vagus, and hallux rigidus, were selected and underwent arthroscopy of the first metatarsophalangeal joint using this modified technique. Results: Patient evaluations determined using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale were recorded before and after surgery. The mean scores before and after the procedure were 43.66 (32-55) and 95.22 (90-8), respectively. No scars or joint complications were observed at a six-month follow-up, and all subjects experienced rapid recovery and quickly returned to daily functions. Conclusion: Similarly to conventional arthroscopy of the metatarsophalangeal joint, the modified technique produced satisfactory surgical outcomes; moreover, this technique reduced surgical time and improved the surgeon’s autonomy by obviating the need for an assistant surgeon to perform traction. Level of Evidence IV; Therapeutic Studies; Case Series.
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Achouri, Sihem, Bachir Redjel, and Mounira Bourebia. "Effect of Size and Volume on the Breaking Properties of Fragile Materials: The Case of Laminate for Orthopedic Acrylic Glass-Perlon Use." Revue des composites et des matériaux avancés 32, no. 2 (April 30, 2022): 61–68. http://dx.doi.org/10.18280/rcma.320202.
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The stresses at break of fragile materials like acrylic resin and composite material for orthopedic use measured in bending are higher than those measured in direct traction. Tests on a composite material for orthopedic use laminated with 6 glass-perlon-acrylic layers (PV-2P-VP) for orthopedic use made it possible to identify its mechanical characteristics and to highlight the influence of the direction of cutting of the samples. The mechanical properties of this material indicate dispersion in the direction of the orientation of the molding which shows values of stress at break and of the Young's modulus which are reduced compared to the values measured in the perpendicular direction. The choice motivates the statistical approach which leads us to apply the Weibull model to assess the dangerousness of a stress in terms of probability of failure. The theoretical predictions are in good agreement with the experimental values. The morphological study of the fracture facies makes it possible to draw up an inventory of the various mechanisms at the origin of the damage and the rupture of these materials and thus to locate the most dominant.
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De Lira, Ana de Lourdes Sá, and Igo Rafael Costa Araújo. "Analysis of orthopedic treatment of skeletal Class III malocclusion with Rapid Palatal Expansion and Face Mask therapy." Brazilian Dental Science 22, no. 4 (October 31, 2019): 467–74. http://dx.doi.org/10.14295/bds.2019.v22i4.1794.
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Aim: To demonstrate the main effects on maxillary and facial profile after treatment with expansion and face mask therapy in patients pattern III Class III. Material and Method: A cross-sectional study of maxillary expansion and reverse traction performed in 4 patients with maxillary deficiency, in the pre-peak pubertal growth stage and in the mixed dentition, with cephalograms before and after treatment, using angular measurements (SNA, SNENA, ANL and 1NA) and linear (S’-ENA, S’-A, 1-NA, OVERJET, S-LS and S-LI) and plot overlays. Results: Improvement in overjet was observed, going from negative to positive in all cases treated with incisor uncrossing, although it was not statistically significant. The upper and lower labial posture with respect to the base of the nose and the ment improved significantly, represented by the measurements S-LS and S-LI, with a change from the concave profile to slightly convex. Conclusion: Class III malocclusion with maxillary deficiency treated with rapid maxillary disjunction and reverse traction with facial mask was effective in both groups, with maxillary protraction and shifting in the concave to slightly convex profile.KeywordsFacial Mask; Rapid maxillary expansion; Class III.
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Levytskyi, A. F., V. A. Rogozinskyi, and M. M. Dolianytskyi. "Halo-gravity traction in the treatment of complex (>100°) scoliotic deformities of the spine in children: a review of clinical cases." Paediatric Surgery. Ukraine, no. 4(69) (December 30, 2020): 67–71. http://dx.doi.org/10.15574/ps.2020.69.67.
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Relevance. The definition of «complex spinal deformity» remains rather vague, but in most publications mark it as a deformation, which on average exceeds 100 degrees. Modern surgical practice of one-stage correction of complex spinal deformities includes performing osteotomies of the spine, which significantly improves the possibility of deformity correction, but also increases the risk of neurological complications and the volume of intraoperative blood loss. The aim. To improve the results of surgical treatment of patients with complex spinal deformities through the preliminary use of halogravitational traction and to establish an effective and safe algorithm for the treatment of complex spinal deformities in children. Materials and methods. During the period from 2008 to 2018, the Orthopedic and Traumatology Department of the National Children’s Specialized Hospital «OKHMATDYT» treated 48 children with complex spinal deformities (>100°) using halo-gravity traction. Of these, 32 are boys and 16 are girls. The average age of the patients was 12.9 years. The average Risser score was 4.2 (P>0.01). 27.1% of patients had type 1 deformity according to Lenke, type 2 – 54.1%, type 3 – 8.3%, type 4 – 6.4%, type 5 – 4.1%. Results and discussion. Using of halo- gravity traction for the preoperative reduction of spinal deformity and prevention of neurological disorders, the average duration of spinal traction application was 46 (P>0.01) days. A weight of 40–50% of the patient’s body weight was used. After the stage of halo-gravity traction, the spine was stabilized with a polysigmentary construction. Conclusion. Halo-gravity traction as a first stage of severe scoliotic spinal deformations treatment allows to increase the mobility of the vertebral column and to adjust spinal cord step by step for the next correction treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: spinal deformity, halo-gravity traction, surgical treatment.
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Mo, Zhuomao, Dong Li, Renwen Zhang, Minmin Chang, Binbin Yang, and Shujie Tang. "Comparisons of the Effectiveness and Safety of Tuina, Acupuncture, Traction, and Chinese Herbs for Lumbar Disc Herniation: A Systematic Review and Network Meta-Analysis." Evidence-Based Complementary and Alternative Medicine 2019 (March 20, 2019): 1–10. http://dx.doi.org/10.1155/2019/6821310.
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Background. Tuina, acupuncture, traction, and Chinese herbs play an important role in the treatment of lumbar disc herniation. However, the comparative effectiveness and safety of the four commonly utilized treatment modalities are still unclear. Objective. To compare the effectiveness and safety of the four interventions for lumbar disc herniation. Methods. Randomized controlled trials comparing any two of the four interventions in the treatment of lumbar disc herniation were identified using the following databases: PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data, and network meta-analysis was performed using STATA 14.0. Results. One hundred and twenty-one studies involving a total of 13075 patients were included. In all the outcome measurements, traction demonstrated a worst effectiveness, and Tuina and acupuncture demonstrated a best effectiveness, but no significant differences were found between Tuina and acupuncture. Compared with Tuina or acupuncture, Chinese herbs showed a similar effectiveness in Visual Analogue Score and Japanese Orthopedic Association Scores, but an inferior effectiveness in invalid rate and cure rate. Conclusions. In the treatment of lumbar disc herniation, Tuina and acupuncture were superior to traction or Chinese herbs, and the effectiveness of traction was the worst. However, considering the limitations of this review, more high-quality trials, especially those comparing Chinese herbs with the other three interventions, should be carried out in the future to further confirm the current findings.
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Derakhshan, Ali, Nima Derakhshan, Hamid Namazi, and Fariborz Ghaffarpasand. "Effect of immobilization on urine calcium excretion in orthopedic patients with pelvic fracture treated by skin traction." Archivio Italiano di Urologia e Andrologia 87, no. 1 (March 31, 2015): 62. http://dx.doi.org/10.4081/aiua.2015.1.62.
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Objectives: To determine the effects on urine calcium excretion of immobilization by skin traction in patients with pelvic fracture. Methods: In a prospective study, a consecutive series of patients with pelvic fracture treated by skin traction were enrolled. Serum (calcium, phosphorous, alkaline phosphatase, sodium, potassium, uric acid, BUN, creatinine) and fasting urine calcium, creatinine, sodium, potassium and uric acid were checked within 48 hours of hospitalization and at 7, 14 and 21 days of immobilization and then after 3 months of mobilization. Trends in changes of variables were recorded. Results: Fifty five patients were enrolled in this study; they were 45 (81.8%) males and 10 (18.2%) females with a mean age 19.4 ± 12.7 years. We found that serum levels of calcium (p = 0.004), phosphorous (p = 0.047) and alkaline phosphatase (p = 0.001) increased significantly during the 3 weeks of immobilization. In the same way, urine calcium/ urine creatinine ratio increased significantly in the study period (p = 0.004). No symptomatic renal stone formation was observed during the study period. Conclusions: Immobilization even in short term causes hypercalciuria in orthopedic patients. Although it is transient and improves with subsequent mobilization, it is needed to be considered specifically by the team caring for this group of patients.
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Vibhute, PavankumarJanardan, Usha Shenoy, Punit Fulzele, and Rohan Bhede. "Open-coil orthopedic traction spring: An innovative approach for force delivery with face-mask therapy." International Journal of Health & Allied Sciences 2, no. 2 (2013): 122. http://dx.doi.org/10.4103/2278-344x.115689.
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De Clerck, Hugo J., Marie A. Cornelis, Lucia H. Cevidanes, Gavin C. Heymann, and Camilla J. F. Tulloch. "Orthopedic Traction of the Maxilla With Miniplates: A New Perspective for Treatment of Midface Deficiency." Journal of Oral and Maxillofacial Surgery 67, no. 10 (October 2009): 2123–29. http://dx.doi.org/10.1016/j.joms.2009.03.007.
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Young, Ian A., Lori A. Michener, Joshua A. Cleland, Arnold J. Aguilera, and Alison R. Snyder. "Manual Therapy, Exercise, and Traction for Patients With Cervical Radiculopathy: A Randomized Clinical Trial." Physical Therapy 89, no. 7 (July 1, 2009): 632–42. http://dx.doi.org/10.2522/ptj.20080283.
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Background To date, optimal strategies for the management of patients with cervical radiculopathy remain elusive. Preliminary evidence suggests that a multimodal treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy. However, limited evidence exists to support the use of mechanical cervical traction in patients with cervical radiculopathy. Objective The purpose of this study was to examine the effects of manual therapy and exercise, with or without the addition of cervical traction, on pain, function, and disability in patients with cervical radiculopathy. Design This study was a multicenter randomized clinical trial. Setting The study was conducted in orthopedic physical therapy clinics. Patients Patients diagnosed with cervical radiculopathy (N=81) were randomly assigned to 1 of 2 groups: a group that received manual therapy, exercise, and intermittent cervical traction (MTEXTraction group) and a group that received manual therapy, exercise, and sham intermittent cervical traction (MTEX group). Intervention Patients were treated, on average, 2 times per week for an average of 4.2 weeks. Measurements Outcome measurements were collected at baseline and at 2 weeks and 4 weeks using the Numeric Pain Rating Scale (NPRS), the Patient-Specific Functional Scale (PSFS), and the Neck Disability Index (NDI). Results There were no significant differences between the groups for any of the primary or secondary outcome measures at 2 weeks or 4 weeks. The effect size between groups for each of the primary outcomes was small (NDI=1.5, 95% confidence interval [CI]=−6.8 to 3.8; PSFS=0.29, 95% CI=−1.8 to 1.2; and NPRS=0.52, 95% CI=−1.8 to 1.2). Limitations The use of a nonvalidated clinical prediction rule to diagnose cervical radiculopathy and the lack of a control group without treatment were limitations of this study. Conclusions The results suggest that the addition of mechanical cervical traction to a multimodal treatment program of manual therapy and exercise yields no significant additional benefit to pain, function, or disability in patients with cervical radiculopathy.
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Teicher, Carrie Lee, Kathryn Alberti, Klaudia Porten, Greg Elder, Emannuel Baron, and Patrick Herard. "Médecins Sans Frontières Experience in Orthopedic Surgery in Postearthquake Haiti in 2010." Prehospital and Disaster Medicine 29, no. 1 (January 15, 2014): 21–26. http://dx.doi.org/10.1017/s1049023x13009278.
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AbstractIntroductionDuring January 2010, a 7.0 magnitude earthquake struck Haiti, resulting in death and destruction for hundreds of thousands of people. This study describes the types of orthopedic procedures performed, the options for patient follow-up, and limitations in obtaining outcomes data in an emergency setting.ProblemThere is not a large body of data that describes larger orthopedic cohorts, especially those focusing on internal fixation surgeries in resource-poor settings in postdisaster regions. This article describes 248 injuries and over 300 procedures carried out in the Médecins Sans Frontières-Orthopedic Centre Paris orthopedic program.MethodsSurgeries described in this report were limited to orthopedic procedures carried out under general anesthesia for all surgical patients. Exclusion factors included simple fracture reduction, debridement, dressing changes, and removal of hardware. This data was collected using both prospective and retrospective methods; prospective inpatient data were collected using a data collection form designed promptly after the earthquake and retrospective data collection was performed in October 2010.ResultsOf the 264 fractures, 204 were fractures of the major long bones (humerus, radius, femur, tibia). Of these 204 fractures of the major long bones, 34 (16.7%) were upper limb fractures and 170 (83.3%) were lower limb fractures. This cohort demonstrated a large number of open fractures of the lower limb and closed fractures of the upper limb. Fractures were treated according to their location and type. Of the 194 long bone fractures, the most common intervention was external fixation (36.5%) followed by traction (16.7%), nailing (15.1%), amputation (14.6%), and plating (9.9%).ConclusionThe number of fractures described in this report represents one of the larger orthopedic cohorts of patients treated in a single center in the aftermath of the 2010 earthquake in Haiti. The emergent surgical care described was carried out in difficult conditions, both in the hospital and the greater community. While outcome and complication data were limited, the proportion of patients attending follow-up most likely exceeded expectations and may reflect the importance of the rehabilitation center. This data demonstrates the ability of surgical teams to perform highly-specialized surgeries in a disaster zone, and also reiterates the need for access to essential and emergency surgical programs, which are an essential part of public health in low- and medium-resource settings.TeicherCL, AlbertiK, PortenK, ElderG, BaronE, HerardP. Médecins Sans Frontières experience in orthopedic surgery in postearthquake Haiti in 2010. Prehosp Disaster Med. 2014;29(1):1-6.
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Kim, Kyung A., Kyung Won Seo, Seong-Hun Kim, Kyu-Rhim Chung, and Gerald Nelson. "Modification Protocol for an Early Class III Treatment Using 3 Miniplates for Bone-Anchored Maxillary Orthopedic Traction." Journal of Craniofacial Surgery 25, no. 5 (September 2014): e440-e442. http://dx.doi.org/10.1097/scs.0000000000000953.
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Railean, Silvia, Ghenadie Ababii, Cristina Postaru, and Victor Bobeico. "Orthopedic and surgical rehabilitation children with unilateral cleft/palat." Bulletin of the Academy of Sciences of Moldova. Medical Sciences, no. 2(73) (November 2022): 48–53. http://dx.doi.org/10.52692/1857-0011.2022.2-73.06.
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Introduction. Maxillofacial fissures are the most common form of congenital malformations of the face and the maxillofacial region. These forms of malformations may vary from simple shapes to particularly non-specific forms. The cleft lip and palate are characterized by anatomical and functional disorders. In unilateral total splits, anatomical disorders are characterized by bone deformities. The upper jaw is divided into two segments by the fissure that passes on the upper lip, alveolar and hard palatal process and soft palatal region. The clinical manifestations of these forms of malformations appear with severe aesthetic facial deformities and functional disorders that can lead to a chain of clinical diseases that endagers even the vital functions of the child.Background. During the years of research in order to find a better optimal way to treat the cleft palate, there was described a lot of controversary methods and steps to reduce the dimension of the cleft, using prenasoalveolar molding appliances and different types of surgical methods(one or 2 steps plasty of the palate).Materials and methods. Six patients with total palatal splitting were examined. There were done impression and obtained study gypsum models during preoperative to the primary stage of plasty and postoperatively to the secondary stage of plasty of the hard palate.Results. According to the measurements and calculations, we came to the conclusion that the two-stage plasty, only with passive therapy of separation of the nasal cavity from the oral cavity with the help of palatal plates, has a displace-ment efficiency of the splitting segments of 46%, while one-stage palatal plasty with active preoperative nasal-alveolar molding with intermaxillary traction has a closure value of 76% (after Elcin).Conclusion. One-stage cleft palate surgery, which preoperatively undergoes orthodontic nasal-alveolar molding ther-apy, is more effective in closing the cleft at the level of the alveolar processes than two-stage plastic surgery without preoperative nasal-alveolar orthodontic therapy.
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Shakya, Akash, Ghanshyam Kakadiya, Yogesh Soni, and Vinayak Garje. "A comparative study of the management of pediatric femoral shaft fractures treated conservatively with traction or spica casting." International Journal of Research in Orthopaedics 6, no. 4 (June 23, 2020): 793. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20202687.
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<p class="abstract"><strong>Background:</strong> Femoral shaft fractures, though not very common, are of major concern for orthopedic surgeons. the management for infants and older children is generally universal but the young patients still offer a management dilemma.</p><p class="abstract"><strong>Methods:</strong> We present a prospective study conducted at a tertiary care hospital in India of 37 children between 1 year and 6 years to compare the two conservative methods most commonly used i.e. spica casting and traction application.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that though both the methods are similar in the time for union, shortening was better controlled with traction and angulation with spica casting. The frequency of other complications was also comparable.</p><p class="abstract"><strong>Conclusions:</strong> Both the methods give acceptable results and given the feasibility of such procedures in developing countries, both may be recommended. However, the choice thus depends on the surgeon treating the patient keeping in mind the drawbacks and limitations of each.</p>
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Prado, Vivian C. M., Maria Cristina F. N. S. Hage, and Renata G. S. Dória. "Welfare and locomotor system disorders in active draft horses (cart horses)." Pesquisa Veterinária Brasileira 39, no. 12 (December 2019): 942–48. http://dx.doi.org/10.1590/1678-5150-pvb-6388.
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ABSTRACT: Horses performing tasks is a common scene in urban centers, evidenced by the significant number of animals pulling carts along the streets (cart horses). Despite the rising concern of the population for animal welfare, as well as the creation of laws that prohibit traction activity in several Brazilian municipalities, these attitudes must be based on the impact of such activity on equine health. Locomotor system disorders are commonly observed in animals of this species, and become even more frequent when they are submitted to unhealthy working conditions. In this context, we conducted a survey on locomotor system disorders in 11 active draft horses. To this end, we performed lameness assessments and radiographic and ultrasound examinations. Information on management regarding the horses’ hooves, type of harness used, and type of work performed was also obtained through the application of questionnaires to the owners. The collected data showed that, although most of the animals in the study presented critical orthopedic conditions, they were not treated and the horses did not rest for adequate time. We observed that the disorders, which are often chronic, may be directly associated with incorrect management of the animals. We emphasize the importance to disseminate information that values the welfare of traction animals in order to tackle mistreatment.
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Tajima, Kosuke, Yusho Nishida, Chikako Shimizu, and Shingo Hori. "Double traction method-an easy and safe reduction method for anterior shoulder dislocations, even for non-orthopedic surgeons." Acute Medicine & Surgery 3, no. 3 (December 9, 2015): 272–75. http://dx.doi.org/10.1002/ams2.179.
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Baindurashvili, Alexei G., Sergei V. Vissarionov, Ivan V. Pavlov, Dmitriy N. Kokushin, and Grigoriy A. Lein. "Conservative treatment of children with vertebral compression fractures of the thoracic and lumbar spine in the Russian Federation: a literature review." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 4, no. 1 (March 15, 2016): 48–56. http://dx.doi.org/10.17816/ptors4148-56.
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Various options for medical treatment of children with compression fractures of the thoracic and lumbar spine include unloading of damaged segments by simultaneous or gradual reclination (e.g., functional traction and reclination of the spine); measures aimed at building and strengthening the muscular “corset” of the back; and the use of orthotic devices of various designs (e.g., fixating-discharging, fixating-correcting corsets, orthoses on a modular basis). Questions regarding the early and late use of orthotics in patients with compression fractures of the vertebral bodies are discussed. Literature analysis, considering different methods used in the treatment of these patients in terms of their effectiveness to restore the height and shape of the damaged spinal segment revealed the absence of a differentiated approach for choosing treatment and selection criteria for orthopedic management.
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Martin, Kevin D., Alicia Unangst, and Jaime Chisholm. "Fracture Immobilization in an Austere Environment: A Comparative Study of Military Special Operations Medical Personnel using a SAM Splint vs a One-Step Spray on Foam." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0029. http://dx.doi.org/10.1177/2473011419s00297.
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Category: Trauma Introduction/Purpose: Improved body-armor and mine resistant vehicles have improved battlefield survivability, but now nearly 50% of casualties have a musculoskeletal extremity injury. The purpose of the current study was to evaluate current SAM splint techniques utilized for a distal Tib/Fib fracture verse a new one-step spray on foam immobilization technique. Methods: A cadaveric model with a distal third combined tibia-fibula fracture was used for testing. The specimens were placed in an austere environment and participants immobilized the injury with standard equipment (SAM splint, 6in Ace wrap). The test group immobilized the injury with a one-step in-situ spray on foam splint. Results: Twenty-one military Joint Special Operations Command (JSOC) medical personnel (11 Medics, 4 PAs, 6 Physicians) participated with an average of 7.7 years as a provider and 25.4 months deployed in a combat theater. Each participant was observed and scored by a single orthopedic foot and ankle surgeon using a Likert scale based on 10 splinting criteria. Standard SAM splinting resulted in an average score of 32.2 (range, 5-50), with significant deficiencies in fracture traction (1/5), fracture motion (2.9/5), protection of neurovascular structures (3/5), and soft tissue manipulation (3/5). The average time to completion was (203 sec), with one splint failure. The spray on foam splinting technique yielded a significantly higher score of 48.5 while completing the task significantly faster at 68 sec with no failures. Conclusion: JSOC medical personnel demonstrated overwhelming success in immobilizing a complex extremity fracture with a SAM splint. Testing demonstrated the inherent inability of the SAM splint to provide longitudinal traction while simultaneously allowing excessive fracture motion and potential injury to the soft tissues. In addition, our spray-on foam proof of concept technique eliminated motion and provided traction by allowing in-situ application with adequate rigidity.
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Bayir, A., U. Kaldirim, S. Ardic, Y. E. Eyi, I. Arziman, and M. Durusu. "(P2-62) An Infrequent Case of Orthopedic Emergencies – Open Dorsal Dislocation of the Proximal Interphalangeal (PIP) Joint Dislocation." Prehospital and Disaster Medicine 26, S1 (May 2011): s155—s156. http://dx.doi.org/10.1017/s1049023x11005061.
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IntroductionReducible open dorsal dislocation of the single finger's PIP joint is an infrequent case of orthopedic emergencies. The severity of this injury may be underestimated. These injuries are associated with long-term complications such as synovitis, stiffness, degenerative arthrosis, septic arthritis, and loss of the digit if suboptimally treated.CaseA 90-year-old male came to the emergency department with an open dorsal PIP dislocation due to a fall on his right hand. There was a transverse skin laceration just proximal to the PIP flexion crease of his small and ring fingers. The condyles of his small finger's proximal phalanx protruded through the wound. X-rays showed a dorsal dislocation of the PIP joint without fracture. There was no neurovascular injury determined. The proximal phalanx was hyperextended slightly with gentle axial traction. After irrigation, the skin wound was closed primarily without repair of damaged structures, and systemic antibiotherapy was performed for a week. The PIP joint was immobilized for three weeks by applying the splint dorsally with the joint in 20 degrees of flexion. Active range of motion exercises were then implemented, and the patient regained full digital flexion with only a 10 degree loss of extension within eight weeks.DiscussionForced hyperextension with axial compression causes a dorsal dislocation of the PIP joint. Dorsal PIP dislocations are more common than volar IP dislocation. Open dorsal dislocation of the PIP joint is an infrequent case of orthopedic emergencies. Such injuries can be treated safely in the emergency department by closed reduction and extensor splinting until a definite treatment plan is made by an orthopedic hand surgeon. The complications must be taken into consideration. Early active motion leads to significantly superior results in the range of motion than static splinting, because prolonged immobilization may result in flexion contracture.
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Anghelescu, Aurelian, Florin Bica, Ionut Colibeaseanu, Raluca Poganceanu, and Gelu Onose. "Our experience regarding rehabilitative, orthopedic integrative interdisciplinary approach in patients with disabling neurological posttraumatic sequelae. Case series and some related literature pointing." Balneo Research Journal 10, no. 10.2 (May 20, 2019): 74–81. http://dx.doi.org/10.12680/balneo.2019.243.
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Abstract Introduction Traumatic brain injury (TBI) and / or spinal cord injury (SCI) usually occur in a polytraumatic context, and may produce catastrophic central nervous system (CNS) damages and secondarily extensive dysfunctional biomechanical alterations. This study aims to illustrate the interdisciplinary collaboration between neurorehabilitation and orthopedic clinics in our hospital, focusing on the results of surgical interventions intended to correct the fixed-flexion deformity of knees, in patients with disabling sequelae after CNS severe lesions. Material and methods Between 2005-2018, in the Neuromuscular Rehabilitation Clinic of Teaching Emergency Hospital "Bagdasar-Arseni", 13 young patients (mean age 37.4 +/- 12.6; median 31; limits 26-43) with multiple articular stiffness and joint deposturing sequelae after severe CNS trauma have been transferred from other medical units. Twelve had bilateral knee flexion contractures, two associated additional elbow stiffness, and in three patients ectopic ossifications of the hips, with ankylosis in extension or painful flexion were found. Patients were subsequently transferred for iterative orthopedic interventions: hamstring lengthening (pes anserinus and femoral biceps tendon transpositions) in 12 cases, associated with posterior knee capsulotomy, traction and/or resection of neurogenic heterotopic ossification around the knee or hip joints and casting in 8 of them. All orthopedic interventions were followed by progressive rehabilitation programs. Spasticity was assessed with modified Ashworth scale (mAS). In pre-/ and post orthopedic surgery, all patients were assessed using an adaptation for adults of the Gross Motor Function Classification Scale, Expanded and Revised (GMFCS – E&R). Results Twelve patients had knee joint stiffness and chronic flexion contracture: 77% were severely limited in their walking ability, depending on wheelchair (GMFCS – E&R level IV), respectively 23% were bedridden, non-ambulate and totally dependent in all aspects of care (GMFCS – E&R level V). Knee orthopedic serial interventions were followed by iterative, individualized rehabilitation treatments, and 50% subjects have regain their capacity to walk independently (GMFCS – E&R level II), respectively 50% succeeded to walked with assistive devices (GMFCS – E&R level III). Discussion Both neuro-muscular system deficits and joint disorders can produce locomotor system abnormalities, joint complications and limb dysfunctional problems. These disturbances represent targets and therapeutic objectives for rehabilitation. Chronic knee flexion contracture, stiff elbows and/or hips, periarticular neurogenic heterotopic ossification: all represents major challenges in the complex management of patients with sequelae after CNS severe traumatic events. Posterior capsulotomy addressed to a stiffed, distorted knee joint, corrects the limb axis and expands the range of motion (through the angle gained by the eliminated flexion contracture), and sometimes restores the patient's ability to walk. Serial orthopedic interventions, followed by sustained postoperative rehabilitation, had a decisive influence on obtaining good functional results. Conclusions Comprehensive, multiprofessional approach and collaboration between neurorehabilitation and orthopedic teams are essential for the therapeutic management of patients with severe contractures post neuraxial lesions. Proper evaluation and goal setting are mandatory for rehabilitative management, pre-/ and post orthopedic corrective surgery. Harmonized timing for iterative interventions, followed by postoperative structured, sustained (often for life-time) rehabilitation are essential for obtaining functional results. Adequate prophylaxis of complications represents a main therapeutic objective, as well. Key words: traumatic brain injury (TBI), spinal cord injury (SCI), vegetative status, spasticity, contracture, capsulotomy, orthopaedic surgery, neurorehabilitation
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Tindlund, Rolf S., Per Rygh, and Olav E. Bøe. "Orthopedic Protraction of the Upper Jaw in Cleft Lip and Palate Patients during the Deciduous and Mixed Dentition Periods in Comparison with Normal Growth and Development." Cleft Palate-Craniofacial Journal 30, no. 2 (March 1993): 182–94. http://dx.doi.org/10.1597/1545-1569_1993_030_0182_opotuj_2.3.co_2.
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Cleft lip and palate (CLP) patients often develop maxillary retrusion after cleft repair. Since 1977, a group of 98 cases with negative overjet (anterior crossbite) during the period of deciduous dentition has been treated by the Bergen CLP team. The purpose of treatment has been to achieve favorable occlusion with positive overjet and overbite by means of anterior orthopedic traction (protraction). The average age at start of treatment was 6 years 11 months, and mean treatment duration was 13 months. The protraction force was 700 g. The serial lateral cephalograms of the treated CLP group were compared with those of a noncleft group with normal growth. Normalization of the sagittal maxillomandibular relationship (ANB angle) was achieved. Significant changes were a more anterior position of the upper jaw, and a more posterior position of the lower jaw, due to mandibular clockwise rotation. The variation was considerable. This paper reports the overall changes in the whole CLP group (ALL-C group).
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Meadows, Molly, Brian Vuong, Hunter Storaci, Kaysie Tam, and Kevin Shea. "BIOMECHANICAL SIMULATION OF RADIAL HEAD SUBLUXATION IN CADAVERIC PEDIATRIC ELBOWS." Orthopaedic Journal of Sports Medicine 9, no. 7_suppl3 (July 1, 2021): 2325967121S0015. http://dx.doi.org/10.1177/2325967121s00158.
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Background: Radial head subluxation, known as pulled elbow or Nursemaid’s elbow, is a common pediatric condition that occurs when a longitudinal traction force is applied to an elbow that is pronated and extended. Although the stability of the proximal radioulnar joint has been previously examined in cadaveric models, there are no current studies quantifying the biomechanics of nursemaid’s elbow. The purpose of our study was to demonstrate and quantify the axial traction force required to produce a nursemaid’s elbow in a pediatric cadaver specimen. Methods: Two fresh-frozen cadaveric elbows from a single 3 year-old male donor were dissected by a fellowship-trained orthopedic surgeon. An Instron 5944 testing machine with a 2 kN load cell was used to perform uniaxial testing. The radius and humerus were mounted to the Instron machine, and loaded in the axial direction with the elbow in full extension. Loading occurred at a rate of 10 mm/sec for 4 seconds, during which the force and actuator displacement were continuously recorded. The local instantaneous load and extension displacement at the time of subluxation were recorded, and data was synced with high-frame-rate video footage used to confirm the annular ligament subluxation. Results: The load to failure required to produce the nursemaid’s elbow injury in the first elbow was 31N, with a failure displacement of 4.6mm. The second elbow demonstrated a load to failure of 26N, with a failure displacement of 4.6mm. After subluxation, we reduced the annular ligament from the first specimen. The elbow was then re-tested and demonstrated a load to failure of 20N, with a failure displacement of 2.6mm. Conclusion: Axial traction applied to a pediatric cadaver specimen results in subluxation of the annular ligament into the radiocapitellar joint. The mean load to failure is 28.5N, and a lower load to failure was required to produce a recurrent subluxation in a previously injured specimen. Lower load for a recurrent subluxation may be attributed to damage on the annular ligament due to the first subluxation. [Figure: see text]
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Evnevich, Kirill A. "Comparative analysis of dental micromobility at the stages of orthodontic dental protrusion treatment in patients with healthy periodontium and generalized periodontitis of moderate severity." Russian Journal of Dentistry 25, no. 5 (July 1, 2022): 415–21. http://dx.doi.org/10.17816/1728-2802-2021-25-5-415-421.
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BACKGROUND: Literature data revealed that the prevalence of periodontal diseases in all age groups is high, at 90%95%. The inflammatory processes in the periodontal tissues have a multifactorial nature. The application of a small force while correcting dentofacial anomalies and deformities is necessary to achieve the desired results and to preserve physiological processes in the periodontium in case of bone resorption and alveolar process bone formation at the stages of correction.
AIM: To assess dental mobility dynamics according to periotestometry data in patients with chronic generalized periodontitis of moderate severity and protrusion of the anterior teeth at the stages of orthodontic treatment.
MATERIAL AND METHODS: A total of 70 patients aged 3544 years with generalized periodontitis of moderate severity, complete dentition, absence of orthopedic structures, and protrusion of incisors without general somatic diseases were examined and treated. Dental micromobility was assessed using the periotest apparatus prior to orthodontic treatment, at the stage of eliminating gaps and after removing the bracket system.
RESULTS: The dental micromobility increased after the application of the braces, but in group 2 with generalized periodontitis of moderate severity, it was by 2.67 times higher. Anterior teeth position stabilization lead to a gradual decrease (stabilization) in periotestometry indicators. In group 2 b using a low-force traction, this process was more intensive.
CONCLUSION: The dynamics of periotestometry indicators at the stages of orthodontic treatment of dental protrusion in the presence of generalized periodontitis of moderate severity indicates the formation of favorable conditions in the periodontium for the mobility of the teeth using low-force traction.
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Cilliers, Louise, and François Retief. "Orthopedics in the Graeco - Roman era." Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie 28, no. 2 (September 6, 2009): 87–100. http://dx.doi.org/10.4102/satnt.v28i2.63.
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In this study the evolutionary development of orthopedics (management of diseases of bones and joints), which commenced in early Mesopotamia and Egypt, is followed through Classical times.The Greek infl uence probably commenced in the 6thcentury BC with Democedes of Croton who cured the Persian king’s dislocated ankle. The Corpus Hippocraticum laid the foundation of orthopedic practice in antiquity. Although knowledge of anatomy was limited, its four books on orthopedics (The Nature of Bones, Mochlicon, On Fractures, On Joints) count amongst the outstanding contributions of Hippocratic writers. In systematic manner the general recognition and management of fractures and dislocations are covered, followed by the handling of individual lesions. Hippocrates differentiated between closed and open fractures (with overlaying skin wounds). Closed fractures were reduced to as normal a position as possible – manually where possible, but with large bones and in the presence of formidable muscle mass, mechanical traction was often employed (e.g. the Hippocratic bench and the bizarre succusion ladder for spinal deformities). There is no mention of the use of analgetic drugs. After application of cerate (mixture of olive oil, soda and pitch) to the skin, the fracture was immobilized by a combination of plasters and compresses (often fi rmed up with gum-mixtures) – but never very fi rmly. On the 3rd, 6/7th, 9thand 12th days the bandaging was removed, the lesion inspected and if considered necessary, re-aligned, A variety of splints were then applied. Strict bed rest was enforced, as well as a light diet (no wine or meat for 10 days). It was believed that fractures of the feet, clavicle, ribs and jaw healed after 20 days, of the forearm after 30 days, and fractures of the upper arm and leg after 40 days. Open fractures were considered very serious injuries, and reduced very carefully. Protruding bone fragments were removed (sawn off if necessary) and the wound was covered with black cerate, compresses and light bandages. Pressure and heavy splints were thought to induce infection and gangrene and thus avoided. Dislocations were reduced as soon and as effectively as possible, before muscle spasm set in. As with fractures manual reduction was, where necessary, complemented by mechanical traction. After extensive washing of the joint area with warm water, cerate was applied to the wound and specialised bandaging (even splints) ensured immobilization. Open dislocations like open fractures were considered very serious and reduction was not attempted. Again all pressure bandaging was avoided. A non-functional joint was commonly the end result. The management of 18 specifi c fractures is described in detail. Jaw fractures were fi xed by the binding of contiguous teeth. Fractures of the spinal column clearly presented a major problem. Although knowledge of spinal anatomy was surprisingly good, the diagnosis of fractures was very difficult and its association with spinal curvatures presented almost insurmountable problems of management. It was recognized that rib fractures could cause serious damage to the lung and pleura. Complex problems caused by arm fractures involving the elbow or shoulder joints, and combined radius and ulna fractures, are addressed. Femur fractures presented major problems and permanent leg deformity was very common. Open femur fractures were extremely serious and Hippocrates even stated that a physician who could ethically avoid becoming involved in treating such an injury, should do so. Fractures of femur necks were not recognised. The Hippocratic work, Wounds of the head, dealing with fractures of the skull, is not covered in this study.Management of the major joints are individually described. Seven different techniques of reducing a dislocated shoulder joint are mentioned The original description of the management of the dislocation of the wrist and hand is lost. Proper reduction of hip-dislocation was essential to avoid muscle atrophy and life-long limping, and was achieved by intricate mechanical suspension. Strangely enough, lateral dislocation of the knee was a common occurrence and not seen as a serious problem. Congenital club feet were effectively treated by prolonged fi xation in the correct position by way of tight bandaging with compresses stiffened in glue-mixtures.There is abundant skeletal evidence of osteo-arthritis in Neolithic man, but no clear description of it in the Corpus Hippocraticum. Gout is repeatedly mentioned in the Corpus but without detailed descriptions of the disease. In the Roman era authors like Heliodorus, Antyllus and Celsus in particular, wrote authoritatively on orthopedic subjects, Osteo-archaeological evidence is that fractures were treated expertly in the Roman army. Conditions consistent with degenerative osteoarthritis and true gout (as podagra and chiragra) were described by Celsus and Aretaeus of Cappadocia. Soranus, Rufus of Ephesus and Galen also wrote on orthopedic subjects. We will today differ from many statements made in the Corpus Hippocraticum, but it is clear that the orthopedic basis laid by those documents was not seriously challenged for 1 000 years.
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Maharjan, Rajram, Rishi Bisht, and Dipesh Pariyar. "Outcome of Titanium Elastic Nailing in the Surgical Management of Femoral-Shaft Fracture in Children." Journal of KIST Medical College 2, no. 2 (July 31, 2020): 61–66. http://dx.doi.org/10.3126/jkistmc.v2i2.33755.
Full textAbstract:
Introduction: Femoral shaft fracture is one of the most common orthopedic injuries of the children. These fractures treated non-operatively by traction followed by hip spica require prolonged hospitalization causing undue physical and psychological stress for patient and patient family. Loss of reduction is also commonly seen with hip spica that leads to unacceptable complications like angular deformities and limb length discrepancies. Titanium Elastic Nailing (TEN) is becoming widely accepted treatment for femoral shaft fractures in children due to its simplicity and physeal protective stable load sharing construct that allows early mobilization. The purpose of this study was to see the outcome of operative treatment of femoral shaft fracture in children by TEN.
Methods: A retrospective observational study was carried out in the Department of Orthopedics in National Academy of Medical Sciences, National Trauma Center from February 2017 to January 2019. Study was undertaken in 22 children between the age group of 5-14 years with femoral shaft fractures. Fixation with TEN was done for all fractures within nine days of injury. Patients were assessed radiologically as well as clinically until fractures healed. The results were evaluated using Flynn scoring criteria.
Results: Radiological union was seen in all cases between 6–12 weeks after surgery. The mean operating time was 58 (48-115) minute and mean hospital stay after surgery was 9 (6-15) days. Results were excellent in 14 patients (63.63%), satisfactory in 6 patients (27.37%) & poor in 2 patients (9%). Six patients had skin irritation at nail insertion site which resolved after removal of nails. Functional range of motion in both hip and knee joints of affected limb was preserved in all cases after the removal of nails.
Conclusion: TEN is an effective and safe treatment of femoral shaft fractures in children of 5-14 years of age group.
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Carrasco-Uribarren, Andoni, Jacobo Rodríguez-Sanz, Miguel Malo-Urriés, César Hidalgo-García, José Miguel Tricás-Moreno, David Balboa-López, and Sara Cabanillas-Barea. "Short-term effects of an upper cervical spine traction-manipulation program in patients with cervicogenic dizziness: A case series study." Journal of Back and Musculoskeletal Rehabilitation 33, no. 6 (November 11, 2020): 961–67. http://dx.doi.org/10.3233/bmr-181479.
Full textAbstract:
BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p< 0.001), decreased intensity of dizziness (p< 0.001) and intensity of pain (p< 0.001). Functional capacity also improved after the intervention (p< 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness.
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Levytskyi, A. F., V. O. Rogozinskyi, M. M. Dolianytskyi, and L. V. Duda. "Halo-gravity traction in the treatment of complex spinal deformities in children with respiratory dysfunctions." Paediatric Surgery. Ukraine, no. 3(72) (September 29, 2021): 10–14. http://dx.doi.org/10.15574/ps.2021.72.10.
Full textAbstract:
HGT is a safe technique as the world literature describes complications in the form of loosening of the pins or superficial infections of the skin around the pins, which are not significant and do not pose a threat to the patient’s life. Purpose – to improve the results of the ventilation function of the lungs in patients with complex spinal deformities through the preliminary use of halo gravity traction and to introduce an effective and safe method for the treatment of complex spinal deformities in children with respiratory dysfunctions. Materials and methods. 64 children with complex spinal deformities (>100°) were treated in the orthopedic and traumatology department of the Okhmatdet NSPU using halo gravity traction during the period from 2003 until 2018. Of these, 38 are boys and 26 are girls. The average age of the patients was 11.6 years. The average Risser score was 3.8 (P>0.01). Results. According to the data of spirography performed, 46% of patients had moderate ventilation disorders and 54% – severe ventilation disorders (FVC<60% – grade 3 and 4 of ventilation failure). Mixed type disorders were recorded in 83% of patients, and restrictive type disorders in 17% (8/48) of children. After HGT, there was an improvement in pulmonary function indicators: an increase in FVC from 63.19% to 71.77% and FEV1 from 54.71% to 65.46%, Tiffeneau-Pinelli index – from 74.59% to 85.33%. Compared with the initial level of indicators, the improvement in FVC was 13.6% after HGT and 14.6% in dynamics during the year, and FEV1 – 19.6% and 21.6%, respectively. The results obtained indicate a significant improvement in the ventilation function of the lungs, especially due to the degree of FEV1 increase, which correlates with the degree of improvement in performance, mortality and life prognosis. Conclusions. The use of HGT makes it possible to improve the results of the final correction of spinal deformity, which in turn significantly improves the ventilation function of the lungs, which in turn helps to reduce the risks of mortality due to pulmonary insufficiency in adulthood. The choice of the appropriate methods of surgical correction for complex deformity of the spine is a prerequisite for successful treatment and the achievement of three-dimensional correction of the spine to maximally approximate its parameters to the physiological norm. The indication for halo gravity traction is a rigid scoliotic deformity of the spine with a deformity angle (>100°). This study was conducted in accordance with the principles of the Helsinki Declaration. The research protocol was approved by the Local Ethics Committee of the institutions mentioned in the work. Informed parental agreement was obtained for the research. No conflict of interests was declared by the authors. Key words: spinal deformity, respiratory dysfunctions, halo-gravity traction.
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Kruglov, Igor Y., Nicolai Y. Rumyantsev, Gamzat G. Omarov, Natalia N. Rumyantseva, and Ilya M. Kagantsov. "Congenital dislocation of the knee in combination with Meyer-Gorlin syndrome: A case report." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 9, no. 4 (December 15, 2021): 447–54. http://dx.doi.org/10.17816/ptors62569.
Full textAbstract:
BACKGROUND: Meyer-Gorlin syndrome is a rare genetic and autosomal recessive disease that is characterized by the classical triad, including, microtia, very small size or complete patellar absence, and nanism.
CLINICAL CASE: Herein, presented the first clinical case description of a Russian patient with Meyer-Gorlin syndrome in combination with congenital anterior shin dislocation. The main clinical disease manifestations are characterized by a combination of microtia, patellar pathology, and dwarfism.
DISCUSSION: In the practice of pediatric orthopedic surgeons, cases of congenital knee dislocations are extremely rare, especially as part of any syndromes, which cause interest in the presented clinical case publication. Our patient analysis, as well as the patients described in the literature, showed the presence of typical clinical manifestations, which allowed us to suspect the presence of Meyer-Gorlin syndrome during a clinical examination.
CONCLUSIONS: This report is the first case of combined congenital knee dislocation and Meyer-Gorlin syndrome with a diagnostic triad (short stature, microtia, and patellar aplasia) in the Russian Federation. Conservative treatment with constant traction and flexion must be carefully performed to avoid complications. Without the effect of conservative therapy, surgical treatment is indicated.
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Raeker-Jordan, Elisha, Miguel Martinez, and Kenji Shimada. "3D Printing of Customizable Phantoms to Replace Cadaveric Models in Upper Extremity Surgical Residency Training." Materials 15, no. 2 (January 17, 2022): 694. http://dx.doi.org/10.3390/ma15020694.
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Medical phantoms are commonly used for training and skill demonstration of surgical procedures without exposing a patient to unnecessary risk. The discrimination of these tissues is critical to the ability of young orthopedic surgical trainees to identify patient injuries and properly manipulate surrounding tissues into healing-compliant positions. Most commercial phantoms lack anatomical specificity and use materials that inadequately attempt to mimic human tissue characteristics. This paper covers the manufacturing methods used to create novel, higher fidelity surgical training phantoms. We utilize medical scans and 3D printing techniques to create upper extremity phantoms that replicate both osseous and synovial geometries. These phantoms are undergoing validation through OSATS training of surgical residents under the guidance of attendings and chief residents. Twenty upper extremity phantoms with distal radius fracture were placed into traction and reduced by first- and second-year surgical residency students as part of their upper extremity triage training. Trainees reported uniform support for the training, enjoying the active learning exercise and expressing willingness for participation in future trials. Trainees successfully completed the reduction procedure utilizing tactile stimuli and prior lecture knowledge, showing the viability of synthetic phantoms to be used in lieu of traditional cadaveric models.
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Soto-Juárez, Ignacio, and Ricardo Martínez-Pérez. "Traumatic bilateral posterior hip dislocation in children. A 12 years follow up case report." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 8, no. 2 (July 1, 2020): 213–16. http://dx.doi.org/10.17816/ptors16543.
Full textAbstract:
Background. Bilateral traumatic hip dislocation in children is a very rare orthopedic emergency. Few case reports are available in literature.
Clinical case. A 4-year-old male child case with a trivial mechanism of injury is presented. Closed reduction in emergency department was achieved after 24 hours of injury, he was placed on Bucks skin traction for 4 days and during 4 weeks in a spica cast. There was not either clinical sign nor images of early or late complications during follow up until he reached skeletal maturity.
Discussion. Hip dislocation in children is a rare emergency with an incidence of 0.8 cases per million per year, its treatment should not be delayed to minimize late complications such as osteonecrosis, recurrent dislocations, osteoarthritis, neurological lesions, coxa magna and heterotopic ossification. The reported incidence for hip osteonecrosis is 36.4% for late (6 hours) and 8.2% after early (6 hours) reduction. After 12 years of follow up no complication was found although the reduction was made 24 hours later.
Conclusions. After immediate reduction a 4 to 6 weeks immobilization period is an effective treatment. Close monitoring to timely identify and treat any further complication is mandatory.
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Rehman, Riaz Ur, Muhammad Shaheer Akhtar, and Amna Bibi. "Anterior transcervical release with posterior atlantoaxial fixation for neglected malunited type II odontoid fractures." Surgical Neurology International 13 (April 8, 2022): 132. http://dx.doi.org/10.25259/sni_237_2022.
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Background: Type 2 odontoid fractures are associated with a high rate of nonunion without surgical treatment. If neglected, they may become fixed in an abnormal position, causing progressive myelopathy. Conventionally, odontoidectomy or transoral release is performed to relieve symptoms in such cases. Here, were report our experience with a transcervical approach for odontoid release (i.e., of a chronically fractured dens) followed by a posterior C1–C2 fusion. Methods: The 11 patients (2017–2021) retrospectively included; in this study, all had a history of remote trauma and the radiological appearance of an old odontoid fracture that was displaced and could not be reduced with traction. There were eight males and three females who averaged 52.6 years of age. Results: All 11 patients underwent anterior retropharyngeal release with a C4–C5 level incision followed by a posterior C1–C2 fusion. The mean Japanese orthopedic association on presentation was 9.9 ± 2.7 which improved to 13.8 ± 2.7 on final follow-up (P < 0.01). Patients were followed an average of 9.6 months ± 4.4 (mean ± SD) postoperatively during which time they all clinically improved. Conclusion: Anterior release through a retropharyngeal approach coupled with posterior C1–C2 instrumentation proved to be an effective alternative to the traditional transoral approach to treat a chronic malunited odontoid fracture.
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Rudenko, A. "Features of the physical rehabilitation program of preschool children with the consequences of hip joint dysplasia." Scientific Journal of National Pedagogical Dragomanov University. Series 15. Scientific and pedagogical problems of physical culture (physical culture and sports), no. 4(124) (September 4, 2020): 79–85. http://dx.doi.org/10.31392/npu-nc.series15.2020.4(124).16.
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The physical rehabilitation program was developed based on the previous clinical and instrumental screening of functional disorders of the hip joints, formed as a result of dysplasia in preschool children. This program included preventive and rehabilitation blocks. The first block was used during the year and included: morning hygienic gymnastics, exercise minutes and pauses, awakening gymnastics, self-massage, hardening procedures (water procedures, walking barefoot, air and sun baths), psycho-emotional unloading. The second block included therapeutic gymnastics (fitballs, roles Zelart Grid elastic band Thera-band, balancing platform (hemisphere) BOSU, balance discs, traverse walls Traverse, step platforms), hydrokinesiotherapy, moving games, therapeutic massage (local, general, hydromassage), physiotherapy, orthopedic facilities. The developed program provides for the implementation of a comprehensive approach to restoring the physical and functional state of the preschool ORA through the use of game, simulation, traction, relaxation, stretching, special power, breathing, corrective and various coordination exercises. There are a lot of features and benefits of the proposed program, such as many different types of physical exercises for the development of motor skills and motor training, conducting physical exercises in an imitation way, strict dosing and exercise control, purposefully load weakened muscle groups, which depend on the correction of physiological curves of the spine and other segments of the torso and limbs, to diversify each exercise and give it a playful color, stimulate the cardiorespiratory system, using static and dynamic breathing exercises in combination with swinging movements, increase the elasticity and flexibility of the joints of the spine and limbs, through traction exercises and exercises with full range of motion, to form a stereotype of the correct posture, actively using the positive psycho-emotional state of the child, to harmonize the state of the nervous system (processes of excitation and inhibition) due to the alternation of emotional game exercises, strength exercises with overcoming resistance and relaxation exercises, to motivate children to actively and systematically perform special physical exercises.