Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Evaluate the cost effectiveness of combined CTPA and indirect CTV for evaluation of patients with intermediate to high probability for pulmonary embolism using Wells criteria. ⋯ For 96 cases with intermediate to high probability of PE, the authors needed to spend 70,909 baht more per case for the extra-investigation (combined CTPA and indirect CTV) for early detection of DVT. By comparison of two workup strategies, combined CTPA and indirect CTV of the lower extremities and CTPA with direct CTV of the lower extremities, the expense for detecting DVT in patients who also have PE will be 31,200 baht per case. Clinicians can use this value to judge between the cost effectiveness of this investigation and the expense of longer hospitalization and medical expense for late complication of DVT which was frequently found in patients with PE. In additional, indirect CTV can increase diagnosis of deep vein thrombosis in non-PE case up to 30% in the present study.
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The authors conducted study to analyze results of peri-articular steroid injection in the treatment of chronic pain from soft tissue inflammation after total knee arthroplasty (TKA). ⋯ Local steroid injection is a safe and effective choice for treatment of pain from chronic soft tissue inflammation after TKA.
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Management of displaced femoral neck fracture is crucial and vulnerable to develop complications. The present study was performed to evaluate the clinical outcome of delayed reduction with multiple screw fixations in young patients who had displaced femoral neck fracture. ⋯ Within 30-day delayed reduction and screw fixation for the treatment of displaced femoral neck fracture in the young is still good alternative treatment to preserve the femoral head with low rate of avascular necrosis.
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Randomized Controlled Trial Comparative Study
The effect of preoperative quadriceps exercise on functional outcome after total knee arthroplasty.
To compare the level of pain scores, range of motion, quadriceps strength and quality of life after TKA patients between preoperative quadriceps exercise group and usual care group. ⋯ Preoperative quadriceps exercise at least three weeks prior total knee replacement result in short-term benefit such as decreased pain, improved quadriceps strength and improved quality of life after elective TKA.
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Flexor tendon injury is a potential complication after volar plating of distal radius fracture. This article reports a case of flexor pollicis longus tendon rupture after corrective osteotomy of a distal radius malunion with volar fixed-angle plating. Thirty-three cases of flexor tendon injuries after fixed-angle volar plating and eleven cases of flexor tendon injuries after non-fixed-angle volar plating were also reviewed. The clinical presentation, injured tendons, type of the plate, causes of the injuries and preventions of this complication were discussed.