Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Sep 2004
Comparative Study Clinical Trial Controlled Clinical Trial[Effectiveness of interscalene plexus block for open subacromion decompression].
The aim of this study was to assess the influence of interscalene brachial plexus blocks on the functional outcome, subjective pain appraisal and patient satisfaction after open shoulder surgery. These results were compared with patients treated by conventional analgesic measures. ⋯ By implementing ISB sufficient analgesia in the early postoperative period after open shoulder surgery is attained, allowing for early physiotherapy. This positively influences convalescence and the outcome of the surgical procedure. Furthermore, patients are visibly more satisfied with the postoperative pain management.
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Z Orthop Ihre Grenzgeb · Jul 2004
Case Reports[Intramuscular application of diclofenac--case report and critical consideration of a therapeutic measure].
Diclofenac is a non-steroidal anti-inflammatory drug of the phenylacetic class. It is frequently given as an intramuscular injection. ⋯ Based on a short case report about a fatal complication in the context of the i.m. administration of diclofenac, the arguments for and against the intramuscular injection of the drug are critically discussed. As a result, the administration of diclofenac as an intramuscular injection should be critically reviewed and alternatives -- as suppositories are available -- should be taken into account.
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Z Orthop Ihre Grenzgeb · Jul 2004
Practice Guideline Guideline[Guidelines for the assessment of pain. Version 8.3 from 9.7.2004].
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In several prospective studies it has been demonstrated that psychological factors are better predictors of low back pain than biographical or medical factors. The most elaborate model for the development of chronic low back pain is the model of fear avoidance. The essential feature of this model is that exaggerated negative orientations towards pain ("pain catastrophizing") lead to fear of movements and the belief that movements will lead to more pain. ⋯ On the other hand, reduction of uncertainty via adequate information about the non-serious nature of back pain disorders may lead to an adequate confrontative pain behavior, less emotional arousal and more useful coping mechanisms. In particular, the uncritical use of widespread back schools has to be looked upon carefully for pronouncing avoidance learning. For chronic pain, therapy must include mechanisms from the treatment of phobias in which pain behavior is looked upon as the result of a phobic process.
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Z Orthop Ihre Grenzgeb · Jan 2004
Review Case Reports[Posteromedial bowing of the lower leg and neuroblastoma with possible neurofibromatosis type I: a case report and literature review].
The posteromedial bowing of the tibia is a rare condition that is not yet known to be related to neurofibromatosis. The case of a three month-old boy with the tentative diagnosis of neurofibromatosis is described. He developed paraplegia due to an abdominal neuroblastoma at the age of 9 months. This led us to a review of the literature. ⋯ The posteromedial bowing of the lower leg seems to affect more boys as well as the left side. As far as described in all but one case it was the first delivery. Regularly, a limb shortening and pes calcaneovalgus is to be found. 99 children were treated conservatively, 21 got an operation of the affected side. In 19 performed osteotomies no pseudarthrosis occurred. One case of a fracture due to an adequate trauma without healing problems is described.