Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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The present study evaluated the importance of visualizing both sides of the triangular fibrocartilage complex (TFCC) when diagnosing ulnar wrist pain. ⋯ Adding DRUJ arthroscopy to RCJ arthroscopy enables more accurate diagnosis of TFCC pathology because the proximal aspect of the articular disk and the foveal insertion of the distal radioulnar ligament can be visualized.
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Randomized Controlled Trial
Does an ulnar styloid fracture interfere with the results of a distal radius fracture?
The ulnar styloid is a supportive structure for the capsular ligament complex of the distal radioulnar joint. The relation between fractures of the ulna and distal radius is not clear, especially in regard to whether ulnar fractures predict worse outcomes for distal radius fractures. The objective of this study was to analyze the influence of ulnar styloid fractures in patients with reducible and unstable distal radius fractures. ⋯ Ulnar styloid fracture may be a predictive factor of worse functional outcome for distal radius fracture. Pinning and above-the-elbow casting, used to treat ulnar styloid fractures, led to better function than fixation.
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Instrumentation and fusion to the sacrum/pelvis has been a mainstay in the surgical treatment of scoliosis in patients with Duchenne muscular dystrophy since the development of the intrailiac post. It is recommended for correcting pelvic obliquity. However, caudal extent of instrumentation and fusion has remained a matter of considerable debate. This study was performed to determine the efficacy and safety of stopping segmental pedicle screw constructs at L5 during surgical treatment of scoliosis associated with Duchenne muscular dystrophy (DMD). ⋯ Segmental pedicle screw instrumentation and fusion only to L5 is safe and effective in patients with DMD scoliosis of <85 degrees and pelvic obliquity of <15 degrees . Good sagittal plane alignment was achieved and maintained. All patients benefited from surgery in terms of improved quality of life. There was no major complication.
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Hip fractures following falls by the elderly, which increase with age, are increasing in number annually. The incidence of refracture (second hip fractures) has been reported to be 5%-10% in Japan and is expected to increase with the aging of the population in the future. Therefore, through a retrospective cohort study, we attempted to clarify the risk factors associated with second hip fractures. ⋯ In this study, 85.7% of refractures occurred within 3 years of the first fracture, with dementia and respiratory disease being the complicating factors that influenced refracture.
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From 1979 to 2005, a total of 279 hips in 249 patients with advanced and/or terminal-stage osteoarthritis of the hip underwent valgus osteotomy. Among them, we reviewed 256 hips in 229 patients (91.8%) with a minimum follow-up of 1 year. We reviewed the clinical and radiological results and analyzed prognostic factors that may have affected the postoperative outcome. ⋯ Valgus osteotomy is effective joint-preserving surgery for advanced or terminal-stage osteoarthritis of the hip in middle-aged patients, and it is acceptable for clinical and radiological evaluation. If the AHI is <60%, valgus osteotomy should be combined with Chiari's pelvic osteotomy.