To investigate the impact of the body mass index (BMI) change on risk of falling in postmenopausal women with osteopenia or osteoporosis. Also, we aimed to evaluate and associate the individuals' functionality, mobility and balance with the risk of falling.This one-year prospective observational study assessed 498 postmenopausal Greek women over the 50th year of age suffering from either osteoporosis or osteopenia. Parameters such as the height, weight and BMI were documented. Furthermore, the subjects were asked whether they experienced a fall the preceding year. Balance was evaluated using the Berg Balance Scale, the Timed-Up-And-Go test, and the 30 Seconds Sit-to-Stand test. Hand-grip strength was assessed with the Jamar Hydraulic Hand Dynamometer.The observed one-year BMI change was associated with falls in postmenopausal osteopenic and osteoporotic women over the age of 70. Additionally, there were statistically significant changes in the BBS, TUG, 30CST and the hand-grip strength on both hands at the one-year follow-up but there were not associated with an increased fall risk.The one-year change in BMI was associated with the risk of falling in postmenopausal osteopenic and osteoporotic women over the 70th year of age. Whereas, the one-year change in balance, mobility and grip strength were not linked to an increased risk of falling.
Background To investigate the new theory of hydroneurolysis and hydrodissection in the treatment of carpal tunnel syndrome (CTS). Independently of the fluid hydrodissolution works due to mechanical forces and it may have some positive effects in patients with ischemic damage caused by scar tissue pressure at the nerve9s surface. Methods A prospective blind clinical study of 31 patients suffering from carpal tunnel syndrome, established by nerve conduction studies and clinical tests. 14 patients (out of 29), who refused to undergo an open operation as a treatment to their disease at this point of time, were treated with a simple ultrasound-guided injection at the proximal carpal tunnel. In order to exclude the biochemical influence of the fluid in the treating disease we choosed to infiltrate 3 cc. of normal saline 0,9%. In the follow-up period our group was asked to answer to a new Q-DASH score and visual analogue scale (VAS) 100/100 in 2, 4 and 8 weeks. Results At the end of the second month we found only 2 out of 14 patients of the infiltration9s group with clinical improvement. As far as the control group (17 patients), there was just one patient with recovery of the symptoms at the end of the second month who avoided operation. The rest 16 patients experienced insistence or worsening of CTS while they were waiting to be operated (mean time till operation in our department9s waiting list: 2 months) and underwent a surgical decompression of the median nerve. Comparing the two groups in Q-DASH score, VAS 100/100 and ultrasound cross sectional area measurements we found no statistical difference between the two groups at the endpoint of our follow-up period. Conclusion As far as nerve entrapment syndromes we proved that normal saline hydrodissolution appears to be non effective as a conservative treatment. The mechanical way of action seems to have only very short term effects. Level of Evidence II
Reconstruction of the central band of the interosseous membrane is an emerging procedure implemented in the treatment of longitudinal radioulnar dissociation (LRUD), usually in its chronic setting, after Essex-Lopresti injuries of the forearm.There are no sufficient clinical data to support reconstruction of the central band of the interosseous membrane in acute LRUD injuries.Clinical and cadaveric studies comparing autografts (palmaris longus, flexor carpi radialis and bone-patellar-bone), allografts (Achilles tendon) and synthetic ligaments have not shown superiority of one technique versus another; however, they have shown special concerns with respect to the use of synthetic grafts.Latrogenic fracture, decrease of rotational range of movement, iatrogenic nerve injury (superficial radial and median nerve), donor site morbidity with autografts and recurrent instability are the complications reported in literature after interosseous membrane reconstruction. Cite this article: EFORT Open Rev 2019;4:143-150. DOI: 10.1302/2058-5241.4.180072.
Crowned dens syndrome (CDS) is a rare clinical entity characterized by acute neck pain due to calcification around the odontoid process of the axis in “crown-like” configuration. The disease can cause neurological symptoms, due to spinal cord compression but also it may lead to chronic neck pain or be asymptomatic. We present a case of a 73-year-old patient who, after a fall of a height of approximately 2 m, sustained a cervical spine injury and his clinical examination revealed an incomplete quadriplegia. Surprisingly, the only finding after the diagnostic imaging, including radiographs, CT scan and MRI, was periodontoid calcification, indicative of CDS. After a few days of hospital admission, a full neurological recovery was spontaneously achieved and the patient, after a 6-week use of cervical orthosis, was free of pain. We perform a brief review of the literature to shed light onto this rare clinical entity. J Med Cases. 2015;6(4):167-169 doi: https://doi.org/10.14740/jmc1837e
BackgroundThe economic crisis has significantly altered the quality of life in Greece. The obvious negative impact on the offered social and health services has been adequately analysed. We aimed to determine whether the economic crisis has influenced the quantity and quality of Orthopaedic research in Greece, as mirrored from the papers presented at the annual meetings of Hellenic Association of Orthopaedic Surgery between the years 2008–2014.MethodsThe abstracts of the papers (oral and posters) presented in these meetings have been examined. Details regarding the department of origin were registered. We determined the level of evidence (according to the AAOS classification system), found the amount of papers that were published in PubMed journal and noted if a department of another country participated.ResultsThrough the years 2008–2014 the papers concerning clinical and basic orthopaedic research that were presented were 146, 207, 304, 331, 318, 234 and 191 respectively. The percentage of those that we...
Retrospective study.Spinal cord stimulation has been mainly used for the management of postsurgical persistent neuropathic. The purpose of the study was to evaluate the rate and causes for reoperation following spinal cord stimulation, and to identify risk factors for reoperation.A retrospective study was conducted including patients who underwent surgical implantation of spinal cord stimulators within a 10-year period. The medical records of the included patients were reviewed for reoperations, demographics and certain clinical parameters. Demographics and clinical parameters were compared between patients with and without reoperations, and between patients with and without surgical site infections.Overall, 1014 index procedures and 175 reoperations were performed within the study period. At least 1 reoperation was performed in 97 (9.5%) cases. The most common cause for revision was lead migration or lead misplacement (n = 31, 3.0%). In 31 (3.1%) cases the stimulator was removed due to no pain relief. Surgical site infection that required reoperation developed in 30 cases (2.9%). Younger age was associated with a need for reoperation (Odds Ratio [OR]: .97,95% Confidence Interval [CI]:0.95-.99, P = .005), while higher Body Mass index and diabetes were associated with development of infection (OR: 1.05, 95% CI: 1.00-1.11, P = .036 and OR: 2.42, 95% CI: 1.05-5.47, P = .033 respectively).The results of this study indicate that certain measures could improve the overall reoperation rate after spinal cord stimulation, such as accurate positioning of the spinal cord stimulators and design of smaller generators. Moreover, preoperative optimization of patients could result in lower complication rate, lower reoperations rate, and subsequently better clinical outcomes.
Osteoid osteomas of the talus are rarely seen. They can easily be misdiagnosed. In this case report, we present a 21-year-old man with an osteoid osteoma in the talar neck whose pain onset coincided with an ankle injury. The latter was deemed a misleading factor when making a diagnosis. Eventually, the patient was treated with surgical excision of the osteoid osteoma. The gap that resulted after the excision was filled with an autologous bone graft. A year after his operation, the patient returned to his daily activities and remained pain-free. A high index of suspicion and an appropriate imaging examination are mandated for the early diagnosis of such entities.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
