Limited Movement Research Articles

Os lunatum reconstruction with autogenous bone graft from the medial condyle of the femur for Kienböck's disease: a case report

This case report outlines the management of a 43-year-old man suffering from chronic wrist pain due to Kienböck's disease. In 2019, the patient underwent os lunatum reconstruction surgery at Hospital of Traumatology and Orthopedics (TOS), utilizing a femur medial condyle autologous bone graft-a rarely reported techinque. Four years postoperatively patient underwent a follow-up visit, the patient exhibited substantial improvements in pain relief and functionality, evidenced by a QuickDASH score of 2 points, indicating minimal disability. Despite these positive outcomes, nuanced limitations in specific wrist movements and a subtle decrease in grip strength were noted. Notably, the patient reported discomfort in the left knee, the donor site for the autologous graft. This case contributes valuable insights into the feasibility and challenges associated with the femur medial condyle autologous bone graft technique for Kienböck's disease. The findings underscore the need for ongoing refinements and long-term monitoring, considering the patient's subjective experiences and the impact on both the wrist and the donor site. The study adds to the limited body of literature on unconventional surgical approaches for Kienböck's disease, guiding future research endeavors and refining the application of femur medial condyle autologous bone grafts in orthopedic practice.

Dynamics and optimal control for a spatial heterogeneity model describing respiratory infectious diseases affected by air pollution

Air pollution has a serious impact on the spread of respiratory infectious diseases. However, the concentration of air pollution is not the same in different places. In order to characterize the spatial heterogeneity and the diffusion of pollutants, this paper proposes a spatial heterogeneity model, where the transmission rate is closely related to air pollution. The dynamics are established in terms of the basic reproduction number R0: if R0≤1, the disease-free equilibrium is globally asymptotically stable; if R0>1, there exists at least one endemic equilibrium and the disease is uniformly persistent. Our findings suggest that spatial heterogeneity, increased pollutants emission, and limited movement of infected individuals will all contribute to the spread of the respiratory infectious diseases. Subsequently, the corresponding strategies are introduced into the model to control the prevalence of the diseases. Under the minimization of the objective function, the necessary condition for the optimal control is acquired with the help of Pontryagin’s maximum principle. Numerical simulations are applied to validate the theoretical results of threshold dynamics and to demonstrate the influences of inflow and clearance rates of pollutants on threshold dynamics and optimal control.

Effectiveness of Frenuloplasty in Ankyloglossia on Speech Quality: A Systematic Review

BACKGROUND: Ankyloglossia, known as tongue-tie, is an inherited anomaly and is caused by a short nonelastic frenulum that causes limited tongue movement. Because of the limitations of tongue movement, it can affect the quality of speech. Ankyloglossia treatment is to divide or separate fibrous bands or frenuloplasty. The purpose of making this systematic review is to systematically review the results of frenulopasty governance in cases of ankyloglossia related to speech quality. AIM: The aim of this systematic review is to explain the original study in patients with Ankiloglosia who underwent a frenectomy procedure on the tongue tie. This study included research evaluating results related to speech quality. METHODS: PubMed, EMBASE, and Cochrane Databases, No restrictions on published studies until September 10, 2021. Studies are included if subjects of all ages have ankyloglossia and performed frenuloplasty procedures. The results assessed were the level of speech quality in the subjects of preoperative ankyloglossia and postoperative frenuloplasty. RESULTS: Overall, 473 abstracts resulted from literature searches; 13 studies met the criteria for data extraction and analysis. Of the 13 studies, eight studies were Randomize control trial studies and 5 case–control studies. Three studies evaluated speech outcomes using Likert scores, 3 studies using questionnaires, and 7 studies using different assessments pre-operative and post-operative speech quality. CONCLUSION: Frenuloplasty in subjects with ankyloglossia mostly gives good results in terms of speech quality. Improvements in articulation and mention of consonant phonation improve after frenuloplasty. Frenuloplasty with the 4 flap Z-Plasty Technique provides better results compared to conventional and horizontal vertical frenuloplasty. A long-term study of the correlation of ankyloglossia and speech difficulties and the effects of frenuloplasty is needed.

Apparent diffusion coefficient in intrahepatic cholangiocarcinoma diffusion-weighted magnetic resonance imaging noninvasively predicts Ki-67 expression.

Tumor Ki-67 expression reflects prognosis and cancer grade, and biopsy-based preoperative assessment of Ki-67 expression is key to treatment. Apparent diffusion coefficient (ADC) values obtained with this imaging may noninvasively predict Ki-67 by reflecting tumor cell density and limited water molecule movement from irregular alignment. This study aimed to investigate the ability of ADC values to predict Ki-67 expression in intrahepatic cholangiocarcinoma (ICC). We retrospectively analyzed 39 cases of ICC confirmed by surgical pathology. All patients had undergone magnetic resonance imaging, and ADC values (mean, minimum, and maximum) were calculated. Ki-67 expression was assessed by immunohistochemistry, and patients were divided into groups of high (n=18) and low (n=21) Ki-67 expression. To assess the diagnostic performance of the ADC values for Ki-67 expression, we used the receiver operating characteristic curve and compared the areas under the curve (AUC). The mean and minimum ADC values were significantly lower in the group with high Ki-67 expression. For predicting high Ki-67 expression, the AUC values were 0.701 for mean ADC, 0.818 for minimum ADC, and 0.571 for maximum ADC. The diagnostic sensitivity and specificity of the minimum ADC values were 88.9% and 76.2%, respectively. In addition, with ADC values combined, the AUC increased to 0.831. Apparent diffusion coefficient is a useful predictor of Ki-67 expression level in ICC. Apparent diffusion coefficient values, especially minimum ADC values, can noninvasively predict ICC associated with high Ki-67 expression.

Microneedling in the Treatment of Post-burn Hypertrophic Scars.

Post-burn hypertrophic scars are an important cause of physical discomfort, limitation of movements, psychological disorders, low self-esteem and reduced quality of life. Treatment for this condition is complex and involves several options. Microneedling, also known as minimally invasive percutaneous collagen induction,is an affordable minimally invasive option that can be combined with other treatments, including ablative ones. The goal of this study was to present our microneedling approach for the treatment of hypertrophic scars after burns. A prospective study of 15 patients with post-burn hypertrophic scars was conducted between October 2016 and June 2022. All patients were treated with microneedling and drug delivery of triamcinolone. Scars were evaluated using Vancouver Scar Scale (VSS), Burn Scar Assessment Scale (BSAS) and angle measurement for amplitude of movement evaluation of joints. A significant improvement in the VSS score was obtained after microneedling (8.8 ± 0.44 to 4.1 ± 0.98; p = 0.012), especially in the acute group (less than 1 year after burns): 9.3 ± 0.49 to 3.5 ± 1.36; p = 0.041. There was a significant and progressive improvement of the scars throughout the treatment sessions in all criteria evaluated and in the ranges of joint movement (p = 0.012). Our microneedling protocol promoted a significant improvement of post-burn scars, especially in acute hypertrophic scars, and in the amplitude of joint motion. Sequential treatments provided progressive improvement. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effect of Closed Kinetic Chain Exercise to Reduce Pain and Increase Functional Ability in Patient with Osteoarthritis Genu

Background: Osteoarthritis genu is a degenerative disease with symptoms of chronic inflammation of the joint cartilage which causes pain, limited movement and function. Closed kinetic chain exercise is an active movement that involves many joints and muscle groups simultaneously. This study aims to analyze the effect of closed kinetic chain exercise on reducing pain and increasing functional ability in osteoarthritis genu.
 Subjects and Method: Quasi experimental research with a research approach in the form of pretest and posttest with control group design. This study was conducted at RST dr. Soedjono Magelang in May-June 2023. A total of 20 osteoarthritis genu patients were divided into two groups: (1) The intervention group was given closed kinetic chain exercise and (2) The control group was given conventional physiotherapy. Pain level was measured using the Visual Analog Scale (VAS). Functional ability was measured by the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Mean differences between the closed kinetic chain exercise group and the conventional physiotherapy group were analyzed using the independent t-test.
 Results: Providing closed kinetic chain exercise is effective in reducing the level of silent pain (Effect Size = 1.20; p= 0.014), movement pain (Effect Size= 0.99; p= 0.004), movement pain (Effect Size= 1.37; p= 0.023), and increasing functional ability in osteoarthritis genu patients (Effect Size = 0.10; p= 0.023).
 Conclusion: Providing closed kinetic chain exercise can reduce pain and increase functional ability in osteoarthritis genu.
 Keywords: Closed Kinetic Chain Exercise; Painful; Functional Capabilities; Osteoarthritis Genu
 Correspondence: Siti Fadhilah, Bachelor of Physiotherapy, Universitas Muhammadiyah Surakarta, Indonesia. Perumahan Koperasi Putri Tujuh Blok D17 RT 026 Bagan Besar Dumai Riau. Email: j120221270@student.ums.ac.id. Mobile: 081267705503

Aggregation‐Induced Emission (AIE) of Au(I)‐GSH Complexes is Activated by Optical Manipulation and Exhibits Surprising 780 nm Emission

AbstractAn optical manipulation method to activate the aggregation‐induced emission (AIE) of Au(I)‐glutathione (Au(I)‐GSH) complexes is presented. First, the well‐known AIE‐type Au(I)‐GSH complexes with a solid emission wavelength of 570 nm are synthesized. At the beginning of the focusing a 1064 nm continuous‐wave (CW) laser at the interface of Au(I)‐GSH complexes solution, its luminescence is hardly detectable. However, with the extension of the laser irradiation time, aggregate appears and rapidly grows, and strong luminescence is shown, indicating the activation of AIE of Au(I)‐GSH complexes through optical manipulation. Surprisingly, the emission peak is at 780 nm and no blue‐shift is observed with the emission intensity increases. The activated AIE emission wavelength by optical manipulation is longer than reported previously, which means that optical manipulation activates AIE in a unique manner. The switching on/off of the activation of AIE is arbitrarily controlled by changing the laser power. In this paper, the luminescence phenomenon and mechanism of AIE are discussed from the perspective of the movement limitation of Au(I)‐GSH complexes under optical manipulation. It is of significant importance for further insights into the luminescence of Au(I)‐GSH complexes and their future development.

The anatomy and feeding mechanism of the Japanese giant salamander (Andrias japonicus).

The fully aquatic Japanese giant salamander (Andrias japonicus) is a member of the Cryptobranchidae, and is currently distributed in western Japan, with other members of this group restricted to China and North America. Their feeding behaviour is characterized by a form of suction feeding that includes asymmetric movements of the jaw and hyobranchial apparatus. Previous studies on the North American species, Cryptobranchus alleganiensis, have suggested that this specialized jaw movement is produced by a flexible quadrate-articular joint combined with a loosely connected lower jaw symphysis including two small fibrocartilaginous pads. However, little is known about this feeding behaviour in the Asian species, nor have the three-dimensional asymmetric jaw movements been fully investigated in any member of Cryptobranchidae. In this study, we explore the asymmetric jaw movements in A. japonicus using three methods: (1) dissection of musculoskeletal structures; (2) filming of feeding behaviour to understand in which situations asymmetric feeding is used; (3) analysis of 3D movement of jaws and skull. In the third component, fresh (from frozen) specimens of A. japonicus were manipulated to replicate asymmetric and symmetric jaw movements, with the specimens CT scanned after each step to obtain the 3D morphology of the jaws at different positions. These positions were combined and their Euler angles from resting (closed) jaw position were calculated for asymmetric or symmetric jaw positions. Our filming revealed that asymmetric jaw movements are linked to the position of the prey in relation to the snout, with the jaw closest to the prey opening asymmetrically. Moreover, this action allows the salamander to simultaneously grasp prey in one side of the mouth while ejecting water on the other side, if the first suction attempt fails. The asymmetric jaw movements are performed mainly by rotation of the mandible about its long axis, with very limited lateral jaw movements. During asymmetric and symmetric jaw movements, the posterior ends of the maxilla and quadrate move slightly. The asymmetric jaw movements are permitted by a mobile quadrate-articular joint formed by wide, round cartilages, and by two small fibrocartilage pads within the jaw symphysis that act as cushions during jaw rotation. Some of these soft tissue structures leave traces on the jaws and skull, allowing feeding mode to be reconstructed in fossil taxa. Understanding cryptobranchid asymmetric jaw movement thus requires a comprehensive assessment of not only the symphysial morphology but also that of other cranial and hyobranchial elements.

Acute acquired comitant esotropia: Current understanding of its etiological classification and treatment strategies

Abstract: Acute acquired comitant esotropia (AACE) is characterized by acute onset of esotropia without limitation of eye movements in children and adults. AACE has been considered relatively rare, and most previous reports were small case series. However, recently, there has been great interest in this disease because of the rapid increase in the number of cases speculated to be related to the use of digital devices. In a growing number of studies, disputes remain regarding its etiology, clinical features, management, and classification. Herein, we review the literature on the history, clinical features, possible etiologic classifications, and treatment strategies for AACE to provide a comprehensive and updated understanding of the disease.

Framing seascape connectivity modeling to prioritize marine conservation effort in China’s coastal sea

Anthropogenic disturbances and climate change are projected to become leading drivers of biodiversity loss and ecological connectivity degradation in marine ecosystems. However, the lack of quantitative understanding for seascape connectivity modeling hinders our ability in providing large-scale marine conservation guidance. By applying well-established theories and tools in landscape connectivity study and marine-specific indicators, we proposed a framework to evaluate the resistance-based seascape connectivity among marine habitats and Marine Protected Areas (MPAs) across China’s coastal sea. The spatial vulnerability of marine habitats was further assessed to prioritize conservation effort. Our results showed that 82% of China’s coastal seas were covered with middle to high level of resistance for migratory marine species, mainly due to concentrated inshore anthropogenic disturbances such as ship traffic and ocean pollution. With the modeled migration distances of different species guilds from short-range (25 km) to long-range (100 km), the area percentage of connected corridors increased from 12.02% to 44.68% in the study area. Vulnerable areas were identified as high resistance (high exposure) and abundant threatened species (high sensitivity) but with small number of connected corridors (low adaptive capacity), primarily distributed in offshore regions of Yellow Sea and East China Sea. Collectively, inshore regions with high anthropogenic disturbances warrant regulation and mitigation in major coastal cities and ports. While the lack of interconnected networks for offshore regions prioritized efforts to enhance seascape connectivity through the establishment of MPA network. Sensitive species groups require more attention in future marine conservation, including threatened populations, climate refugees of marine species, and species with limited movement ranges. This study highlights the potential of developing seascape connectivity model based on landscape theories, and the importance of seascape connectivity study in guiding evidence-based marine conservation strategies.

The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design

The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design Abstract: Background: Most patients in acute care hospitals experience movement limitations due to surgery or a general deterioration of their condition. Therefore, nurses need a high level of competence in movement promotion. Aim: The aim of this study was to evaluate the feasibility of a three-day advanced kinaesthetics training course followed by six months of practical support to promote kinaesthetic competence in inpatient acute care and the competence development achieved as a result. Methods: The evaluation of the nurses' effectiveness was conducted using a pre- and post-measurement of kinaesthetic competence through a self-assessment questionnaire and an observation protocol. The evaluation of feasibility was done through a semi-structured questionnaire. Results: Eight nurses rated their kinaesthetics competence as good before (mean: 10,8 on a scale of 4-16) and very good after the intervention (mean: 13,2). The kinaesthetics trainer assessed the competence before as sufficient (mean: 9,4 on a scale of 4-16) and very good (mean: 14,5) after the practical support. The need to make practical support more flexible is highlighted in the qualitative data. Conclusion: The results demonstrate that a three-day training followed by six months of practical support has a positive impact on nurses' kinaesthetic competence.

Study of Prevalence of Temporomandibular Disorders among Undergraduate Students

Temporo-mandibular joint function has been extensively studied for more despite extensive investigation, the complicated etiology of TMJ dysfunction has remained a mystery for more than a century. Temporomandibular disorder (TMD) is a sub - class of painful orofacial conditions characterized by complaints of pain in the region of the temporomandibular joint (TMJ), difficulty concentrating craniocervicofacial muscles, especially mastication muscles, limitations of mandibular movement, and the presence of articular clicking. Emotional stress, occlusal interferences, tooth loss, postural deviation, muscles of mastication neuromuscular both internal and external dysfunction anomalies in Temporo-mandibular joint anatomy, and the multiple interrelationships between these factors all contribute to the complicated etiology of TMD.Aim: Determine the prevalence of temporomandibular joint disorder between college students. The sample for this sectional potential study consisted of 691 college students (339 male and 352 female). Self-reported questionnaires were used to determine the incidence and severity of TMJ disorders. By virtue of the quantity and frequency of notable replies, the rankings were upgraded to an intensity ranking. Results:56.6% of students reported some level of TMD, including 39.7% with mild TMD, 12.2% with moderate TMD, and 4.6% with severe TMD. Historically, no significant correlation between gender and TMD severity was observed.Conclusion: This student population exhibited a high prevalence of TMD; however, the majority of cases were mild. The statistical significance of the association between TMD severity and gender is no longer proven. Despite having TMD. The students had little knowledge of their conditions.

Nutritional Risk, Depression, and Physical Function in Older People Living Alone.

This study investigated depression and physical function as factors associated with nutritional risk in older adults living alone. The study included 2896 people 65 years or older who lived alone. Data were collected in South Korea between September and November 2020. Descriptive statistics, a chi-squared test, independent samples t-test, weighted multiple regression analysis, and binary logistic regression analysis were performed using IBM SPSS for Windows ver. 23.0. In this study, 44.8% of participants were in the nutritional risk group. Furthermore, 60.9% of those at risk for depression, 75.1% of those with instrumental activities of daily living (IADLs) dependency, and 59.1% of those with chewing limitations were at nutritional risk. The factors that increased nutritional risk in the weighted multiple regression analysis were depression (β = 0.27, p < 0.001), chewing limitations (β = 0.12, p < 0.001), IADL dependency (β = 0.09, p < 0.001), and basic physical movement (β = 0.04, p = 0.020). Binary logistic regression analysis showed that those with IADL dependency had a 2.59 times higher nutritional risk than those with IADL non-dependency (p < 0.001). The nutritional risk group had a higher risk of depression (2.01 times higher [p < 0.001]), chewing limitations (1.76 times higher [p < 0.001]), and basic physical movement limitations (1.35 times higher [p = 0.009]) than the good nutritional group. Therefore, nutritional screening is required of older individuals living alone. To mitigate nutritional risks, it is necessary to assess depression and physical function, including IADL dependency.

Implications of exposure route for the bioaccumulation potential of nanopolystyrene particles

Microplastics and nanoplastics are found in marine biota across a wide range of trophic levels and environments. While a large portion of the information about plastic exposure comes from gastrointestinal (GI) data, the relevance of particle accumulation from an oral exposure compared with other types of exposure (e.g. dermal, respiratory) is unknown. To address this gap in knowledge, larval zebrafish (7 days post fertilization) were exposed to two different sizes of nanoplastics through either oral gavage or a waterborne exposure. Larvae were tracked for 48 h post exposure (hpe) to assess the migration and elimination of plastics. Larvae eliminated orally gavaged nanoplastics within 48 hpe. Oral gavage showed limited particle movement from the GI tract into other tissues. In contrast, waterborne nanoplastic-exposed larvae displayed notable fluorescence in tissues outside of the GI tract. The 50 nm waterborne-exposed larvae retained the particles past 48 hpe, and showed accumulation with neuromasts. For both sizes of plastic particles, the nanoplastics were eliminated from non-GI tract tissues by 24 hpe. Our results suggest that waterborne exposure leads to greater accumulation of plastic in comparison to oral exposure, suggesting that plastic accumulation in certain tissues is greater via routes of exposure other than oral consumption.

Psyllids in Natural Habitats as Alternative Resources for Key Natural Enemies of the Pear Psyllids (Hemiptera: Psylloidea).

The pear psyllids (Cacopsylla spp.; Psylloidea) comprise ~24 species of sap-feeding insects distributed in Europe, temperate Asia, and (as introductions) in the Americas. These pear-specialized insects are among the most damaging and difficult to control pests in orchards. Biological control increasingly is being used to replace or partially replace insecticidal management of pear psyllids. Many key natural enemies of pear psyllids regularly occur in non-orchard habitats on native plants. The presence of beneficial species both in orchard and non-orchard habitats (here referred to as "spillover") has prompted suggestions that native plants and their associated psyllids should be conserved as alternative resources for natural enemies of pear psyllids. The expectation is that the natural enemies will move from those habitats into psyllid-infested orchards. This review shows that psyllids in native habitats are important resources for several key predators and parasitoids of pear psyllids. These resources are critical enough that some beneficials exhibit an almost nomadic existence as they move between plant species, tracking the seasonal appearance and disappearance of psyllid species. In contrast, other natural enemies show minimal or no spillover between orchard and non-orchard habitats, which likely is evidence that they exhibit limited movement at best between orchard and non-orchard habitats. To show conclusively that spillover also indicates that a beneficial species disperses between native habitats and orchards requires difficult research on insect movement. This review concludes with a brief discussion of these difficulties and possible solutions.

The Impact of Covid-19 On the Economic Growth of Sacu Countries

The objective of this research was to appraise the influence of COVID-19 on the economic expansion of the Southern African Customs Union (SACU) countries, using yearly averages from the period 2010 to 2021. Prior research has focused on the effect of COVID-19 on the global economy, with limited studies conducted on the economic consequences of the pandemic in the SACU region. The economies of the SACU member states depend on international trade. A panel data random of fixed effects analysis was employed. The results showed a significant negative impact of the lockdown period on GDP per capita, suggesting that the COVID-19 pandemic had a substantial negative impact on the economic growth of SACU countries. As a result, the study recommends that there be an improvement in economic activities during any pandemic that may arise in the future. Moreover, there should be a reduction in import and export levies as so to improve trade. Finally, governments should increase their expenditure to bolster consumer demand during economic downturns caused by pandemics as well as, strengthen digital trade infrastructure and e-commerce capabilities to facilitate trade continuity during periods of limited physical movement.

Critical Needs for Integrated Surveillance: Wastewater-Based and Clinical Epidemiology in Evolving Scenarios with Lessons Learned from SARS-CoV-2

During the COVID-19 pandemic, wastewater-based epidemiology (WBE) and clinical surveillance have been used as tools for analyzing the circulation of SARS-CoV-2 in the community, but both approaches can be strongly influenced by some sources of variability. From the challenging perspective of integrating environmental and clinical data, we performed a correlation analysis between SARS-CoV-2 concentrations in raw sewage and incident COVID-19 cases in areas served by medium-size wastewater treatment plants (WWTPs) from 2021 to 2023. To this aim, both datasets were adjusted for several sources of variability: WBE data were adjusted for factors including the analytical protocol, sewage flow, and population size, while clinical data adjustments considered the demographic composition of the served population. Then, we addressed the impact on the correlation of differences among sewerage networks and variations in the frequency and type of swab tests due to changes in political and regulatory scenarios. Wastewater and clinical data were significantly correlated when restrictive containment measures and limited movements were in effect (ρ = 0.50) and when COVID-19 cases were confirmed exclusively through molecular testing (ρ = 0.49). Moreover, a positive (although weak) correlation arose for WWTPs located in densely populated areas (ρ = 0.37) and with shorter sewerage lengths (ρ = 0.28). This study provides methodological approaches for interpreting WBE and clinical surveillance data, which could also be useful for other infections. Data adjustments and evaluation of possible sources of bias need to be carefully considered from the perspective of integrated environmental and clinical surveillance of infections.

Surgical treatment of peri-implant femoral fractures - case report and literature review

Introduction. Peri-implant femoral fractures (PIFF) are defined as fractures of the femur with the presence of previously implanted non-prosthetic osteosynthetic material. A review of available literature revealed that there are several proposed classifications and sets of guidelines for surgical treatment of PIFF. Case outline. A 49-year-old patient was injured from a fall on the same level, the day before admission to the hospital. The anamnesis at admission showed that six months earlier, he had sustained a pertrochanteric fracture of the left femur, which had been treated surgically with a short cephalomedullary nail. Two years prior to hospital admission, the patient had sustained a tibial plateau fracture of the same leg, which was treated non-surgically with above the knee cast immobilization. After the fracture had healed, paresis of the peroneal nerve was diagnosed, while subsequent follow-up revealed secondary post-traumatic arthrosis of the knee joint. Reduction and fixation of the fracture was performed on a surgical extension table, with the use of fluoroscopy. Previously implanted osteosynthetic material was removed, a short cephalomedullary nail, and fixation of the fracture was carried out with a long cephalomedullary nail. Six months after the operation, the patient can ambulate independently, without assistance. He reports no pain in the left groin and upper leg but reports pain and limitation of movement in the left knee joint. Conclusion. By reviewing the available literature, we found that the patient was cared for in our hospital in keeping with all current recommendations for surgical treatment of this type of fracture.

Risk factors for burn contractures in a lower income country: Four illustrative cases.

Burns are most prevalent in low- and middle-income countries but the risk factors for burn contractures in these settings are poorly understood. There is some evidence from low- and middle-income country studies to suggest that non-medical factors such as socio-economic and health system issues may be as, or possibly more, important than biomedical factors in the development of post-burn contractures. Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a cross-sectional study which examined risk factors for contracture in Bangladesh. The two cases had similar burns but different standards of care for socio-economic reasons, leading to very different contracture outcomes The two cases both had access to specialist care but had very different contracture outcomes for non-medical reasons. The risk factors and contracture outcomes in each case are documented and compared. The impact of non-biomedical factors in contracture development after burns in low- and middle-income countries is highlighted and discussed. Burns are common in low- and middle-income countries (LMICs) but the risk factors for burn contractures in these settings are poorly understood. Burn contractures are formed when scarring from a burn injury is near or over a joint and results in limited movement. There is some evidence from LMIC studies which suggests that non-medical factors such as socio-economic (e.g., household income, level of education) and health system issues (e.g., whether specialist burn care could be accessed) may be as, or possibly more, important than non-medical factors (such as the type and depth of burn and the treatments received) in the development of contractures following burn injuries.Four cases are presented to illustrate the impact of non-biomedical factors on contracture outcomes in a low-income setting. The cases were drawn from participants in a larger study which examined risk factors for contracture in Bangladesh. Two cases had similar burns but different standards of care and different outcomes. Two cases had similar access to specialist care but very different outcomes for non-medical reasons. The risk factors present and contractures outcomes in each case are documented and compared.The importance of non-biomedical factors in contracture development after burns in LMICs is highlighted and discussed.

Social Life After Hip Fracture: A Qualitative Study.

The return to social life after a hip fracture is a major concern for patients and a determinant factor in their recovery. However, patients' perceptions of social life after hip fracture are variable and context-dependent. By identifying these perceptions and strategies of patients, interventions can be strengthened and modified. The aim of this study was to identify patients' perceptions of their social life after hip fracture. This qualitative study used inductive content analysis. Twenty patients with hip fractures who were referred to Tehran University of Medical Sciences hospitals were purposefully selected and included in the study. Data were collected through individual, face-to-face, in-depth, semi-structured interviews conducted by a researcher experienced in carrying out such interviews. The interviews were recorded, immediately transcribed verbatim, and analyzed in MAXQDA-10. The interviewing process continued until data saturation was reached. The data analysis led to the extraction of three categories: Disruption of normal social life, Minimal social life, and Social isolation. The results indicated that the social life of these patients is influenced by physical conditions and contextual factors and progresses over time. All patients experienced meaningful disruption of their social life after experiencing hip fractures and movement limitations. The interdisciplinary perspectives provided by these findings can increase awareness of patients' post-fracture social life perceptions and conditions. These findings can also be used to design future programs for interdisciplinary interventions (involving sociology and medical sciences) to improve social life and increase the ability to return to a normal social life. Recovery management for patients with hip fractures should be preventive and organized by an all-around team (involving medicine, psychology, and sociology) based on patient-centered, community-based, and modern care strategies.