International orthopaedics
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Comparative Study
Minimally invasive percutaneous plate osteosynthesis (MIPPO) technique applied in the treatment of humeral shaft distal fractures through a lateral approach.
The minimally invasive percutaneous plate osteosynthesis (MIPPO) technique through the anterior approach has been successfully used in the treatment of humeral shaft fractures and has gained satisfactory clinical outcome. An anatomical study and a preliminary clinic report were performed to evaluate the feasibility of applying the MIPPO technique in the treatment of humeral shaft distal fractures through the lateral approach. ⋯ The results of this study showed that it is possible to treat humeral shaft distal fractures by using the MIPPO technique through the lateral approach. The results of using the MIPPO technique through the lateral approach in the treatment of humeral shaft fractures in 22 patients were also reviewed.
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This article reports an analysis of 75 consecutive lower limb amputees who developed painful neuroma requiring surgical excision after lower limb amputation following landmine explosions. This retrospective study analyses the results of 75 patients who were treated for painful neuroma after lower limb amputation following landmine explosions between the years 2000 and 2006. The average time period from use of prosthesis to start of symptoms suggesting neuroma was 9.6 months. ⋯ All clinically proven neuromas were surgically resected. In the mean follow-up of 2.8 years, all patients were satisfied with the end results and all were free of any pain symptoms. Painful stump with clinical diagnostic findings of neuroma described above may be regarded as neuroma without requiring any further imaging modalities and is an indication for surgery if conservative measures fail.
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Low back pain (LBP) is currently the most prevalent and costly musculoskeletal problem in modern societies. Screening instruments for the identification of prognostic factors in LBP may help to identify patients with an unfavourable outcome. In this systematic review screening instruments published between 1970 and 2007 were identified by a literature search. ⋯ The strongest predictors for "work status" were psychosocial and occupational structures, whereas for "functional limitation" and "pain" psychological structures were dominating. Psychological and occupational factors show a high reliability for the prognosis of patients with LBP. Screening instruments for the identification of prognostic factors in patients with LBP should include these factors as a minimum core set.
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Despite recent developments in fracture treatment, cases of non-union after long bone fractures are still encountered. This work aims at evaluating the active management of delayed union after the bridge-plate fixation of multifragmentary diaphyseal fractures by a limited surgical interference. Nineteen patients were included. ⋯ Bone grafting was added in nine patients. Union was achieved in all patients 8-16 weeks after re-operation. This work is a message for timely surgical interference in delayed union after bridge-plate fixation by a limited surgical procedure, before complete failure of the fracture stabilisation or non-union.