Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
-
Comparative Study
The complement of the load-sharing classification for the thoracolumbar injury classification system in managing thoracolumbar burst fractures.
The classification and therapeutic strategy for thoracolumbar burst fractures are controversial. The load-sharing classification (LSC) and thoracolumbar injury classification system (TLICS) are both quantitative evaluation systems for thoracolumbar burst fractures. We hypothesized that their combination would be helpful not only for surgical indications but also for deciding on the surgical approach. However, no reports have evaluated the relationship between them. The purpose of this study was to clarify the relationship between the LSC and TLICS and investigate the clinical usefulness of their combination. ⋯ Although the TLICS scores correlated with the LSC scores, a single application of TLICS might not be sufficient to identify those patients who have a TLICS score of 3 or less and an LSC score of 7 or more as surgically indicated. However, an additional LSC evaluation avoided deviations as the two classifications complemented each other, and it was useful in determining the best treatment options for thoracolumbar burst fractures.
-
Comparative Study
Infra-isthmal fracture is a risk factor for nonunion after femoral nailing: a case-control study.
The rates of nonunion after femoral nailing are currently reported to be 4.1-12.5 %. The purpose of this study was to identify the risk factors of noninfected nonunion after femoral nailing, focusing in particular on the effects of the length of the distal main fragment. ⋯ The elucidated risk factors of nonunion after femoral nailing were identified as open fracture, infra-isthmal femoral fracture, breakage of locking screw, and inappropriate dynamization. We believe that the surgeon should be consciously aware of the need for additional surgical fixation for the distal fragment when performing femoral nailing of infra-isthmal femoral fractures.
-
Multicenter Study Comparative Study
Validity, reliability and responsiveness of the Japanese version of the Neck Disability Index.
The Neck Disability Index (NDI) is one of the most widely used questionnaires for neck pain. The purpose of this study was to validate the Japanese NDI. ⋯ We demonstrated the validity, reliability and responsiveness of the Japanese NDI. The modified NDI was more strongly correlated with numbness and mental health-related QOL.
-
Comparative Study
Percutaneous iliosacral screwing in pelvic ring injury using three-dimensional fluoroscopy.
Iliosacral screw fixation is a popular technique for treatment of unstable pelvic injuries involving the posterior ring. However, screw malposition may result in dangerous complications involving injury to adjacent neurovascular structures. This study was conducted in order to evaluate the results and efficacy of using three-dimensional fluoroscopy in the performance of iliosacral screw fixation. ⋯ When performing percutaneous iliosacral screw fixation in a patient with an unstable pelvic ring injury, use of three-dimensional fluoroscopy may allow for accurate location of the screw and result in fewer complications.
-
Comparative Study
Different analgesic effects of adenosine between postoperative and neuropathic pain.
Adenosine is an endogenous neuromodulator in both the peripheral and central nervous systems. Adenosine inhibits pain signals by hyperpolarizing neuronal membrane. ⋯ These results suggest that adenosine effectively inhibits pain signals in neuropathic pain but is less effective in postoperative pain because of the decrease in adenosine A1 receptors.