Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use. ⋯ The usefulness of this new system will have to be proven in future studies investigating inter- and intraobserver reliability, as well as long-term outcome studies for operative and nonoperative treatment methods.
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Long-term application of an external fixator to treat leg-length discrepancy and short stature often causes complications, such as pin-tract infection or loss of range of motion at the knee or ankle (or both). Prolonged fixator use also interferes with the activities of daily living. To minimize such problems, we have combined intramedullary nailing with external fixation. Using this technique, the external fixator can be removed more quickly after completing the lengthening. ⋯ A combination of intramedullary nailing and external fixation produces callus formation as good as that obtained by the standard Ilizarov method of lengthening. Furthermore, this combined procedure decreases the external fixation time and is associated with fewer complications.
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Comparative Study
Quality of life assessment before and after lumbar disc surgery.
Although operative treatment for lumbar disc herniation is a commonly performed neurosurgical procedure, no reports have described whether health-related quality of life before surgery affects the operative treatment outcome. This prospective study assessed health-related quality of life before and after surgery and evaluated the predictor variables affecting outcomes. ⋯ Surgery for lumbar disc herniation improved health-related quality of life. Patients <50 years old with a <60 score in social functioning on SF-36 were considered good candidates.
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Previous reports have described magnetic resonance imaging (MRI) findings alleged to be specific for vertebral fractures caused by malignant lesions. Using such findings for differential diagnosis is often difficult, especially during the early phase of the fracture. With the relative inaccuracy of any single imaging finding, a validated scoring system based on a combination of imaging findings might lead to enhanced diagnostic accuracy. The purpose of this study was to establish a diagnostic scoring system for discriminating osteoporotic vertebral fractures from those caused by malignant tumors on the basis of MRI and computed tomography (CT) findings. ⋯ By combining the findings common to MRI and CT scans of vertebral fractures, a simple scoring system was devised. This scoring system was found to enhance the accuracy of imaging diagnosis of fractures caused by benign or malignant spinal lesions.
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The Disability of the Arm, Shoulder and Hand (DASH) questionnaire is a region-specific self-administered questionnaire that consists of a disability/symptom (DASH-DS) scale, and two optional modules, the work (DASH-W) and the sport/music (DASH-SM) modules. The DASH was cross-culturally adapted and developed by the Impairment Evaluation Committee, Japanese Society for Surgery of the Hand. The purpose of this study was to test the reliability, validity, and responsiveness of the Japanese version of DASH (DASH-JSSH). ⋯ The DASH-DS and DASH-W Japanese version have evaluation capacities equivalent to those of the original and other language versions of the DASH.