Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Sep 2017
Median nerve movement in the carpal tunnel before and after carpal tunnel release using transverse ultrasound.
We aimed to compare the movement of the median nerve within the carpal tunnel during wrist and finger motions between before and after carpal tunnel release (CTR) using transverse ultrasound in carpal tunnel syndrome (CTS) patients and to evaluate the biomechanical efficacy of CTR for CTS. ⋯ The current study demonstrated the movement patterns of the median nerve in the carpal tunnel during wrist and finger motions compared before and after CTR using transverse ultrasound in CTS patients. The findings suggested that as the median nerve shifted greatly palmarly away from the tendons after CTR, the nerve avoids compression or shearing stress from the tendons. This ultrasound information could offer further understanding of the pathomechanics of CTS and provide a more accurate diagnosis of CTS and better treatment by CTR.
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J Orthop Surg (Hong Kong) · Sep 2017
Comparative StudyInvestigation of efficacy of treatment in spinal cord injury: Erythropoietin versus methylprednisolone.
Investigation of the expression of platelet-derived growth factor (PDGF)-β and glial fibrillary acidic protein (GFAP) in rats with spinal cord injury as a marker of neurologic recovery between groups treated with erythropoietin (EPO) and methylprednisolone (MP). ⋯ EPO seems to better increase the expression of PDGF-β, thus produce better results in locomotor functions when compared to MP.
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J Orthop Surg (Hong Kong) · May 2017
Randomized Controlled TrialEffect of intraoperative autologous transfusion techniques on perioperative hemoglobin level in idiopathic scoliosis patients undergoing posterior spinal fusion: A prospective randomized trial.
Massive blood loss during posterior spinal fusion for adolescent idiopathic scoliosis remains a significant risk for patients. There is no consensus on the benefit of acute normovolemic hemodilution (ANH) or intraoperative cell salvage (ICS) in scoliosis surgery. ⋯ The addition of ANH to ICS in posterior spinal fusion surgery for AIS resulted in a similar decrease in hemoglobin levels between preoperative values and at 24 h postoperatively.
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J Orthop Surg (Hong Kong) · May 2017
Prospective study of surgical fixation of radial head fractures using cannulated headless compression screws for simple and complex radial head fractures.
Fixing the two-part Mason II radial head fracture using screws is becoming a popular practice. However, the screw fixation efficacy for three-part Mason III and IV fractures is controversial. The purpose of this study is to determine the effectiveness of using a uniform technique of headless compression screw fixation in simple, isolated Mason II and complex three-part Mason III and IV radial head fractures in terms of functional outcome, treatment efficiency and assessment of complications with the procedure. ⋯ Overall clinical and functional outcomes of this technique are satisfactory in both simple and complex fracture groups, with simple Mason II fracture group doing better than the complex three-part Mason III and IV fractures in terms of Mayo Elbow Score and range of motion. Screw fixation has the advantage of less periosteal stripping and less impingement compared to other fixation methods and also allows for flexible fixation in constrained areas. Headless compression screw fixation can be considered as a method of fracture fixation for both simple and complex three-part radial head fractures.
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J Orthop Surg (Hong Kong) · May 2017
Comparative StudyCircular external fixation and cemented PMMA spacers for the treatment of complex tibial fractures and infected nonunions with segmental bone loss.
The purpose of this study was to compare the outcome of combined circular external fixation and cemented polymethylmethacrylate (PMMA) spacer application between a cohort of patients with grade 3 open fractures and infected tibial nonunions and concomitant segmental bone loss. ⋯ The findings of this study suggest that patients were treated for infected nonunion with segmental bone loss using circular external fixation, distraction osteogenesis, and antibiotic-impregnated PMMA spacers, and the spacers may not offer any advantage over a conventional approach using the principles of osteogenesis only. In contrast, antibiotic-impregnated spacers for open tibial trauma were advantageous and reduced the EFI considerably.