Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Dec 2012
Comparative StudyTrends in the surgical treatment of proximal humeral fractures - a nationwide 23-year study in Finland.
Proximal humeral fractures are common osteoporotic fractures. Most proximal humeral fractures are treated non-surgically, although surgical treatment has gained popularity. The purpose of this study was to determine changes in the surgical treatment of proximal humeral fractures in Finland between 1987 and 2009. ⋯ An increase in the incidence of the surgical treatment of proximal humeral fractures was seen in Finland in 1987-2009. Fracture plating became increasingly popular since 2002. As optimal indications for each surgical treatment modality in the treatment of proximal humeral fractures are not known, critical evaluation of each individual treatment method is needed.
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Bmc Musculoskel Dis · Dec 2012
ReviewThe role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature.
A number of factors have been identified as influencing total knee arthroplasty outcomes, including patient factors such as gender and medical comorbidity, technical factors such as alignment of the prosthesis, and provider factors such as hospital and surgeon procedure volumes. Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of total joint arthroplasty to higher volume centers, and adoption of volume standards. To contribute to the discussions concerning the optimization of provider factors and proposals to regionalize total knee arthroplasty practices, we undertook a systematic review to investigate the association between surgeon volume and primary total knee arthroplasty outcomes. ⋯ Findings suggest a trend towards better outcomes for higher volume surgeons, but results must be interpreted with caution.
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Bmc Musculoskel Dis · Dec 2012
Randomized Controlled TrialEffectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial.
Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. ⋯ This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome.
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Bmc Musculoskel Dis · Dec 2012
Normal inter-limb differences during the straight leg raise neurodynamic test: a cross sectional study.
The straight leg raise (SLR) neurodynamic test is commonly used to examine the sensitivity of the lower quarter nervous system to movement. Range of motion during the SLR varies considerably, due to factors such as age, sex and activity level. Knowing intra-individual, inter-limb differences may provide a normative measure that is not influenced by such demographic characteristics. This study aimed to determine normal asymmetries between limbs in healthy, asymptomatic individuals during SLR testing and the relationship of various demographic characteristics. ⋯ Overall range of motion during SLR was related to sex, weight, BMI and activity level, which is likely reflected in the high variability documented. We can be 95% confident that inter-limb differences during SLR neurodynamic testing fall below 11 degrees in 90% of the general population of healthy individuals. In addition, inter-limb differences were not affected by demographic factors and thus may be a more valuable comparison for test interpretation.