Percentage Of Good Results Research Articles

Results of different methods of ankle arthrodesis in patients with osteoarthritis

Introduction. Despite the large number of ankle arthrodesis operations performed, to date, no unified approaches to the algorithm for selecting surgical treatment tactics, orthopedic implants, and postoperative management of patients have been developed. The debate over the choice of surgical technique is still ongoing. Objective of the investigation — to carry out a comparative analysis of the treatment results of patients with posttraumatic osteoarthritis of the ankle joint depending on the performed arthrodesis technique. Material and methods. 90 patients aged 30-65 years (mean age 52+6.2 years) with posttraumatic cirrhosis of stages III-IV (according to Kellgren & Lawrence) were under observation. The outcome of surgical treatment was assessed using the AOFAS scale. Depending on the tactics of surgical treatment, the patients were divided into 2 groups: 1) arthrodesis was performed using arthroscopic technique, open operations with the Ilizarov apparatus and locking rods (retrospective, 62 patients); 2) arthrodesis was performed using advanced techniques and devices (prospective, 28 patients). Results and Discussion. Complete bone ankylosis was detected in 88,9% of cases depending on the choice of surgical technique. The use of modern methods of treatment resulted in the high percentage of good results — 92,8%. According to the literature, the use of effective modern fixators and arthrodesis methods enables to achieve 93% of good clinical results. Our data are comparable to the scientific sources. The use of an arthrodesis pin was especially effective (100% positive results). Conclusion. Taking into account the wider spread of minimally invasive techniques, further study of long-term results of treatment in patients treated with these techniques is required.

Наш опыт лечения застарелых вывихов головки лучевой кости у детей

Objective Improve the effectiveness of pediatric treatment of chronic radial head dislocations (CRHD). Material and methods The review included 100 pediatric patients aged 2–18 years treated for CRHD between 2005 and 2019. Patients underwent physical examination, radiological (conventional radiography, US, MRI, MSCT) evaluation and statistical analysis was performed. Patients were divided into two groups. A major group consisted of 33 (33%) patients who were treated with new bone and plasty procedures including open reduction of the radial head (ORRH), plasty of the annular ligament with m. anconeus flap and fixation with the plaster cast; osteotomy of the proximal ulna and ulnar realignment with the Ilizarov external fixation. Outcomes were retrospectively compared with 67 (67.0 %) control patients treated with different classical techniques including ORRH, radial head fixation with wires, polyethyleneterephthalate band or the remnants of the annular ligament, with/without ulnar osteotomy. Anatomical and functional results of treatment were evaluated at a short (up to one year) and long term (over one year) after frame removal using modified Mattis-Lyuboshitz-Shwarzberg grading scale. Results Comparative analysis of outcomes of surgical management at a short- and long term in both groups showed that the percentage of good results was 1.5 times higher in the major group. A table of differentiated indications to pediatric treatment of CRHD was devised based on the findings. Conclusion Biomechanical articular parameters appear to deteriorate over time following radial head dislocation and can result in radial head deformity, malaligned and shortened ulna. Pediatric treatment is supposed to be differentiated depending on time of injury, patient's age, anatomical and radiological manifestations of the joint. Operative pediatric treatment of CRHD involving bone and plasty procedures can provide good internal fixation preventing recurrence.

Minimally Invasive Repair of Pectus Carinatum in Patients Unsuited to Bracing Therapy.

BackgroundWe used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall.MethodsBetween July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery.ResultsThe mean age of the patients was 24.35±13.20 years (range, 14–57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60–2.31), and 2.22±0.19 (range, 1.87–2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5–15 days). Only one patient experienced postoperative complications.ConclusionMinimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.

Comparison of abduction brace and surgical containment in management of Perthes disease

Abstract The approach in management of Perthes disease attempts to prevent the femoral head from bearing forces across the acetabular margin by either preventing or reversing extrusion of the femoral head. Once the diagnosis is established, the primary aim of treatment of Legg-Calve-Perthes disease is containment of femoral head within the acetabulum. Containment can be achieved either conservatively or surgically. If this is achieved, the femoral head can reform in a concentric manner by what Salter has termed as “biological plasticity”. Thirty-six patients with Perthes disease were thoroughly evaluated both clinically and radiologically following admission and were divided into 2 groups in a randomized trial. Eighteen patients in group I received conservative treatment with a weight-relieving caliper, a modification of ambulation-abduction brace designed in our institute. Equal number of patients in group II were treated by surgical methods to bring the subluxated head inside the acetabulum for containment. Of the 18 patients in group II, 9 patients were undergone Axer's osteotomy and another 9 patients were treated by trochanteric bifurcation osteotomy with lateral advancement of trochanter and the bifurcation is maintained by autogenous ipsilateral fibular graft. The follow-up period is 2 years. We lost follow-up of 1 patient in group I, 1 from Axer's osteotomy, and 3 from trochanteric advancement group. Another 5 patients in group III were not treated but followed up similar to groups I and II in this study. It is evident from the overall result of different groups that 64% of good results were observed in group I, followed by group II (50%) and group III (20%). Fair results were observed at 50% in group II, followed by group III (40%) and group I (18%). There was no evidence of poor results in group II, whereas it was 40% in group III and 20% in group I. Our maximum percentage of good results was observed in the conservative group and in the untreated group the percentage of good results is as low as 20%. Fair results were almost the same in all 3 groups, irrespective of type of treatment. Clinical and radiological outcome in both conservative and surgical containment group is similar, although the Axer's osteotomy group has an extra burden of shortening and limping, and requires a second surgery for plate removal.

Le fratture prossimali dell’omero. Complicanze neurologiche: diagnosi e trattamento

Peripheral nerve damage in proximal humeral head fractures is not rare. It is more frequent in 2-part of the surgical neck, 3- and 4-part fractures and in fracture-dislocations involving the axillary nerve. It is possible to cause a iatrogenic nerve lesion while performing reduction and synthesis of the fracture. We have to evaluate movement and sensibility after the trauma, before and after the treatment of the fracture. More than 90% of these peripheral nerve lesions have a spontaneous recovery. If there isn’t clinical and EMG recovery after 4–6 months, there is the indication to surgical revision and reconstruction by 2 or 3 autologous sural grafts, with a percentage of good results of 74% (deltoid in M4- M5).

Extremitätenerhaltende Amputations- und Resektionstechniken am Fuß

The main causes for amputations on the lower extremities are dysvascular disease and/or diabetes mellitus. Especially in diabetics tissue preserving surgical techniques should be performed. Due to multimorbidity and high risk of an amputation on the other extremity, the so called "major amputations" ("transtibial" or "transfemoral") should be reduced. Especially in diabetics tissue preserving amputations on the foot or resection techniques on the foot are of importance to prevent major disabilities or handicaps on the patients. For this the surgeon has to have knowledge on all amputation levels on the foot as well as knowledge about prosthetic fitting or shoe techniques. With this a high percentage of good results will prevent the patient from major amputations.

Resultados a largo plazo del tratamiento endoscópico del reflujo vesicoureteral: Consideraciones al respecto

To analize results and late complications in patients with vesicoureteral reflux, treated by endoscopic treatment and with several substances. In a long bibliographic review we analize results, recurrences and late complications with this treatment using different substances. In spite of the prescribed substance, VUR may recur several years after treatment. These cases are of low grade and most disappear after a new session of ET VUR can also appear in the other side, not knowing in fact why this happens. Grade IV -V reflux, and also VUR secondary to organic and functional pathology, can be resolved by endoscopic treatment, although the percentage of good results is lower. Parents have to be informed, in detail, of the three therapeutic options for reflux, (medical, endoscopic, and open surgery), and participate in the final decision. Parents use to prefer ET. According to the number of patients treated by ET and the number of follow-up years that possible side effects have been observed, most authors consider that ET is a safe treatment, and it is currently the treatment of choice for patients with reflux.

Significance of patients’ satisfaction with an ambulatory treatment: Experience with sclerotherapy of hemorrhoids

We studied the patentssatisfaction with the ambulatory treatment of second degree symptomatic hemorrhoids by means of injection therapy and the degree of agreement between clinicians and patients satisfaction. 80 patients were revisited by the same surgeon who performed the sclerotherapy. Later they underwent a questionnaire purposely prepared by psychologists for evaluating their perception of possible changes in functioning and well being after the therapy. The same percentage of good results are reported by the surgeon and patients, but in individual cases the correlation between subjective and objective results does appear weak. When disagreement is reported, the surgeon seems to overtreat the patients regardless of how they feel about their disease.

Significance of patients’ satisfaction with an ambulatory treatment: Experience with sclerotherapy of hemorrhoids

We studied the patentssatisfaction with the ambulatory treatment of second degree symptomatic hemorrhoids by means of injection therapy and the degree of agreement between clinicians and patients satisfaction. 80 patients were revisited by the same surgeon who performed the sclerotherapy. Later they underwent a questionnaire purposely prepared by psychologists for evaluating their perception of possible changes in functioning and well being after the therapy. The same percentage of good results are reported by the surgeon and patients, but in individual cases the correlation between subjective and objective results does appear weak. When disagreement is reported, the surgeon seems to overtreat the patients regardless of how they feel about their disease.

Hip arthroplasty : Operation preliminary to the prosthetic surgery

At a time when prosthetic hip surgery becomes more widespread with the use of cementless prostheses, of hydroxyapatite or of metal-metal or alumina-alumina bearings, it is important to recall that prosthetic hip surgery makes it possible to obtain a high percentage of good results whose longevity depends on good indications.The Pauwels inter-trochanteric osteotomy allows one to increase the weight bearing surface. Shelf operations and pelvic osteotomies, allow one to reconstruct a receptive acetabular cavity.One should bear in mind that this surgery cannot be definitive. It will lead in the long term to the hip replacement. It must therefore endeavour to reconstruct the anatomy and avoid creating problematic deformities for the subsequent arthroplasty.

The laser treatment of port wine stains: a survey by the French Society of Medical Lasers (SFLM)

Lasers have been used in dermatology for several years. The unique and powerful photocoagulation obtained by lasers has proved to be highly valuable in the treatment of port wine stains (PWS). Different lasers such as Argon, CO2, Copper Vapour, Continuous Wave and Pulsed Dye as well as different techniques have been described as suitable for this purpose in the literature. However, little information is available on the number of dermatologists using lasers for the treatment of PWS or on their techniques and their results. The aim of this survey, sponsored by the French Society of Medical Lasers was the evaluation of the usage of lasers by dermatologists in France, Belgium and Switzerland. Questionnaires were sent to 81 dermatologists of whom 55 replied. Analysing their answers shows that the percentage of good results obtained is slightly lower than that reported in the literature and appears to be related to the experience of the dermatologist. Pre-treatment characterization of PWS and better control of light dosimetry were the two main factors requiring further improvement.

The Use of Fibrin Glue in Repair of Peripheral Nerves

Gluing of nerves with histocompatible and resorbable materials offers a distinct advantage on suturing alone because results in clinical surgery are similar and often better. This method, when applied properly, allows a considerable gain of operative time, which we estimate to be 3-fold (ie, instead of taking 1 hour for grafting one nerve trunk, it takes 20 minutes). It does not represent a breakthrough in peripheral nerve surgery because it does not guarantee that each nerve fiber will be aligned with its own stump. Gross evaluation shows that the percentage of good results is increased by approximately 15 per cent. It must be stressed, however, that a portion of this improvement, difficult to evaluate, may be caused not by the method but by the experience we have gained over the years practicing nerve repair. The commercial fibrin glue is not yet released in the United States by the Food and Drug Administration; however, it seems, at the time of this writing, that this will be done by the first months of 1988.

Factors influencing outcome in patients with postoperative biliary strictures

We reviewed our experience from 1955 to 1979 with benign postoperative biliary strictures to determine which factors were associated with a favorable outcome. Patients operated on from 1970 to 1979 were significantly more likely (p <0.01) to achieve a good result (86 percent) than were patients undergoing surgery between 1955 and 1969 (68 percent). An inverse correlation (r = −0.96, p <0.05) was present between the number of previous repairs and the percentage of good results. Patients referred without a previous repair were most likely to achieve a good result (86 percent). Roux-Y jejunal reconstructions were associated with the best results (p < 0.01). In recent years Silastic transhepatic stents were used in 20 patients with hilar strictures; 18 (90 percent) achieved good results. Patients stented for the shortest period (less than 1 month) were less likely to achieve a good outcome than those stented for longer periods (p <0.025). Patients with difficult hilar strictures who were stented for more than 9 months were more likely to have a good result if a changeable Silastic transhepatic stent was employed (p <0.01). This analysis suggests that early referral, Roux-Y jejunal reconstruction, judicious use of Silastic transhepatic stents, and prolonged stenting of hilar strictures will improve the outlook in patients with postoperative biliary strictures.

Legg-Calvé-Perthes Disease: Treatment and Prognosis

Our experience in the treatment of Legg-Perthes disease using non-containment, containment, and surgical treatment supports the concept that containment is a key factor in the treatment of Legg-Perthes disease. Patients without excessive lateral extrusion or other signs of "head at risk" and half or more of the femoral head involved probably can be treated for short periods of time in an abduction orthosis. If less than half the femoral head is involved but lateral extrusion is minimal, a period of traction to obtain range of motion and decrease the synovitis may be sufficient treatment. In the more severely involved heads that show the poor prognostic signs of excessive lateral extrusion, bed rest in addition to abduction may statistically offer the best chances for a good result. For patients with severe involvement and excessive lateral extrusion of the femoral head, intertrochanteric osteotomy gave us a better percentage of good results than treatment with abduction and weight bearing. Our intertrochanteric osteotomy series results were comparable to those in the Katz and Brotherton and McKibbin patients treated by abduction and nonweight bearing. Regardless of the method of treatment chosen for a specific patient, it is essential that a good range of motion be obtained and maintained throughout the course of treatment. If this is successfully done, regardless of other factors, the outcome should be satisfactory.

Treatment of painful neuromas of sensory nerves in the hand: A comparison of traditional and newer methods

The results of treatment of 348 painful neuromas of sensory nerves of the hand in 172 patients were evaluated. Three hundred and sixteen were treated by simple excisional neurectomy and these results may be used for comparison with other methods. Sixty-five percent had an excellent or satisfactory result from a single such procedure. A repeated neurectomy improved the results to 78 percent. The use of silicone rubber caps as a secondary procedure over the nerve stump in 32 cases did not improve the results. A technique of funicular resection with epineurial ligation in 45 patients with neuromas achieved about the same percentage of good results as did simple excisional neurectomy. The ideal treatment is not at hand yet, but at the present time it is recommended that treatment should consist of excisional neurectomy, repeated at least one if necessary.

The use of cautery in external dacryocystorhinostomy.

MANY ophthalmologists prefer not to perform external dacryocystorhinostomy, and some others perform the procedure so infrequently that the percentage of good results is discouraging. The purpose of this paper is to describe a simple diathermy technique which will increase the cure rate following this difficult operation. External dacryocystorhinostomy, performed in the routine manner, is more effective when the mucosal flaps are fashioned differently and cautery is used to enlarge the membranous anastomosis. Technique After a large amount of the bone which separates the lacrimal sac from the nasal mucosa has been removed, fashion flaps of the lacrimal sac mucosa and of the nasal mucosa so that they are hinged anteriorly and later can be sutured together. (In adults, the osseous anastomosis should be approximately 15 mm in diameter.) To enlarge the membranous anastomosis between the lacrimal sac and the nasal cavity, apply diathermy (high frequency voltage) (beginning about 2 mm

AN EVALUATION OF AN EXTERNAL SPLINT FOR IDIOPATHIC STRUCTURAL SCOLIOSIS IN INFANCY

1. The records of forty-nine patients with idiopathic structural scoliosis in infancy treated by a combination of splinting and physiotherapy have been reviewed. 2. Nine curves (18·3 per cent) failed to respond to treatment and five of these progressed. 3. The percentage of good results (81·7 per cent) shows no improvement on the natural course of the condition.

METHOXYFLURANE IN DENTAL ANAESTHESIA: A BLIND TRIAL

Anaesthesia with nitrous oxide and oxygen, alone or supplemented with methoxyflurane or halothane, was administered for dental extractions in 256 patients (204 children and 52 antenatal women). Anaesthesia was regarded as good in 69 per cent of patients with methoxyflurane and 75 per cent with halothane, but only 50 per cent with unsupplemented nitrous oxide and oxygen. A further trial was carried out in 144 children and 8 antenatal women, nitrous oxide and oxygen being supplemented in all cases with methoxyflurane or halothane. There were 59 per cent good results with methoxyflurane and 76 per cent with halothane. Methoxyflurane was found to be considerably cheaper than halothane. The shortcomings of purely inhalational anaesthesia for dental extractions was shown by the finding that in no series was the percentage of good results as high as 80.

Intramedullary Wire Fixation of Mallet-Finger

The modification of Pratt's technique used by the author appears to give a high percentage of good results its fresh ruptures and to provide a useful finger, occasionally even a normal finger, in older ruptures. It will probably give better results than open operation in the older ruptures, unless the surgeon is especially skilled and experienced in the treatment of this condition.

Selection of patients for mitral commissurotomy in relation to clinical results.

SURGICAL separation of the cohered leaflets of the stenotic mitral valve has become established as a satisfactory operation.* As an application of a new principle, it has from the earliest reports by Bailey † provided a relatively constant and high proportion of good clinical results. Aside from minor variations, some of which are undoubtedly improvements, there has been little change in the technical aspects of mitral commissurotomy. Although, with greater experience, the safety and the anatomical thoroughness of the procedure have improved, there has been little real change in the percentage of good results. This, however, has not been a matter of wide dissatisfaction because of the continuous, rather high proportion of good results and because of the realization that certain aspects of the disease process prevent more accurate preoperative prediction of what commissurotomy will do for individual patients. Selection of patients as it is generally done cannot fully cover