THE ROLE OF PASSIVE MOBILIZATION IN THE IMMEDIATE MANAGEMENT OF THE FRACTURED NECK OF HUMERUS
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Mobilization
Conservative Treatment
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Joint mobilization
Objective To elevate the level of diagnosis and conservative management for closed splenic injuries in children.MethodsThe clinical data of 25 cases that had closed spleen injuries were analyzed,summarized and assessed retrospectively.Results22 patients of them underwent conservative management,3 of them could not be maintained stably and were finally carried out splenectomy.All children with splenic injuries were discharged from hospital after recovery,had no complication and death.ConclusionClosed splenic injuries in children are suggested to take mainly conservative measures if there is satisfactory hemodynamic stability.Operative treatment ought to be timely given when general conditions take obviously a turn for the worsen.
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Primary omental torsion is a rare cause of acute abdomen with no definite consensus for the best management. We report a young male who was successfully managed using a conservative approach. Conservative management should be the first line of management. Laparoscopic resection is indicated after failure of conservative management.
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The treatment of multidirectional instability of the shoulder is complex. The surgeon should have a clear understanding of the role of hiperlaxity, anatomical variations, muscle misbalance and possible traumatic incidents in each patient.A review of the relevant literature was performed including indexed journals in English and Spanish. The review was focused in both surgical and conservative management of multidirectional shoulder instability.Most patients with multidirectional instability will be best served with a period of conservative management with physical therapy; this should focus in restoring strength and balance of the dynamic stabilizers of the shoulder. The presence of a significant traumatic incident, anatomic alterations and psychological problems are widely considered to be poor prognostic factors for conservative treatment. Patients who do not show a favorable response after 3 months of conservative treatment seem to get no benefit from further physical therapy. When conservative treatment fails, a surgical intervention is warranted. Both open capsular shift and arthroscopic capsular plication are considered to be the treatment of choice in these patients and have similar outcomes. Thermal or laser capsuloraphy is no longer recommended.Multidirectional instability is a complex problem. Conservative management with focus on strengthening and balancing of the dynamic shoulder stabilizers is the first alternative. Some patients will fare poorly and require either open or arthroscopic capsular plication.
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Injuries to the craniovertebral junction (CVJ) are not uncommon, and are among the few skeletal injuries that carry a high mortality rate. Successful management of these injuries depends on familiarity with the normal anatomic relationships of this region, as well as prudent decision making regarding surgical versus conservative management alternatives.The purpose of this study was to analyze the indications for conservative treatment of CVJ trauma and to analyze the outcomes.Eighty-eight patients admitted with CVJ injuries were managed conservatively. More than half were nearly neurologically intact on admission; 91% improved whereas 80% (excluding deaths/lost to follow) ultimately achieved bony union without surgical intervention.This study documents that conservative management of CVJ injuries in a select population can yield good clinical results.
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Fecal Incontinence
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Treatment of choice of ovarian cysts diagnosed in the neonatal period has been until nowadays mainly surgical. Another possibility is a conservative approach, since these cysts have a natural tendency to spontaneous regression. We present 9 cases treated in our hospital in the last 8 years. 6 of them were treated surgically, while in 3 a conservative attitude was used, with sera ultrasound follow-up and disappearance of the cysts in 2 months in 2 cases and in 12 in the other. In cysts smaller than 5 cm we adopt a conservative management, leaving surgery only for those bigger or complicated.
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In infants and children, the fingertip injuries occur frequently by accident which result causing infliction which ranges from a little cut to a fracture and also the finger amputation thus requires an immediate treatment intervention to avoid deformities. Different therapeutic approaches have been used involving surgical or conservative treatment. The conservative treatment is considered to be superior choice for management of these injuries so this research was designed to evaluate the functional and aesthetic outcomes of conservative approaches for treating fingertip injuries. Methods: This research consists of 30 children admitted to Ziaudin Hospital, Karachi with Allen's type II and III of fingertip injuries divided into three groups based on the treatment approach including Platelet Gel treatment group (group I), Fucidic acid treatment group (group II), Hyaluronic acid treatment group (group III). Results: All the conservative treatment approaches showed promising improvement regarding the range of motion, healing time, aesthetic and sensory outcome, complications, and subjective satisfaction. However, the platelet gel group exhibits significantly short healing time (p=0.003) in comparison to Fucidic acid and Hyaluronic acid treatment group Conclusion: It was concluded that conservative treatment is one of the effective approach in management of fingertip injuries in paediatric population providing better functional, sensory and aesthetic outcomes. Keywords: Fingertip injuries, Conservative treatment, Outcomes
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Background: The liver is one of the most frequently damaged organs when abdominal trauma occurs. Currently, a conservative management constitutes the treatment of choice in patients with hemodynamic stability. The aim of this study is to evaluate the results of an operative and conservative management of 143 patients with liver injury treated in a single institution. Methods: A retrospective study of the patients admitted with the diagnosis of liver trauma was performed from 1992-2008. The patients were classified according to the intention to treatment: Group I, operative management; Group II, conservative management. Variables analyzed included demographic data, injury classification, associated lesions, surgical treatment, transfusions, morbi-mortality, and hospital stay. We established two periods (1992-1999; 2000-2008) in order to compare diagnosis and management. Results: A total of 143 patients were analyzed. Thirty-one percent correspond to severe injuries. Conservative treatment was followed in 60.8 % with surgery undertaken in 14.9 % of patients from this group due to failure of conservative treatment. Immediate surgery was carried out in 38.2 %. Total mortality was 14 %. Morbidity (35.7-38.5 %) in the group of immediate surgery and failure of conservative management is similar, but not in mortality (28.6-15.4 %). In the second group (2000-2008) there are more patients with conservative treatment, with a low percentage of failure of this treatment and morbi-mortality. Conclusions: Conservative treatment is an adequate treatment in a great number of patients. Failure of conservative treatment did not show a higher incidence of complications or mortality but it should be performed in centers with experienced surgeons. Gastroenterol Res. 2010;3(1):9-18 doi: https://doi.org/10.4021/gr2010.02.165w
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Canine hip dysplasia (CHD) is a common cause of hind limb lameness in dogs, and may be managed either conservatively or surgically. There is no single treatment option that is appropriate for every dog. This article looks at the evidence for the usefulness of conservative management, and discusses the different options within conservative management: optimisation of body weight; modulation of exercise; physiotherapy; and medical management, including use of analgesics, the prostaglandin receptor antagonist grapiprant, and various supplements. Conservative management should be multimodal, employing various of these options in combination as appropriate for the individual patient.
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objective of this review is to determine the effects of conservative (non‐surgical, non‐pharmacological) management of nocturia in adults. The following hypotheses will be tested: 1. A conservative management is better than no intervention or a placebo/sham intervention 2. One conservative management is better than another conservative management 3. A conservative management is better than treatment with a drug
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