Prevention Of Stiffness Research Articles (Page 1)

This study aimed to evaluate the stability of bimalleolar ankle fracture fixation techniques (bicortical and unicortical lag screw) in simulated progressive rehabilitation with a walking boot. Five matched pairs of lower extremities underwent simulated bimalleolar ankle fracture and were randomly assigned into these 2 repair groups. Each specimen was tested under an axial compression cyclic load test for 10000 cycles at a rate of 1 Hz while the ankle was held in 30° inclination. Radiographic assessments (screw attached lengths [length from screw head to far cortex], fracture gap, and joint clear space [medial, superior, and lateral]) by 3 examiners were performed at 0th, 5000th, and 10000th cycles. Three repeated measurements by each examiner. The overall level of intra-rater reliability for all 3 raters and all measurements were found to be within "moderate" to "excellent" agreement. For radiographic screw loosening and fracture displacement, evaluation found that at no time point did either the bicortical group or the unicortical group meet the minimal threshold of clinical failure which defined as 2-mm of screw displacement or 2-mm of fracture displacement. Both bicortical and traditional unicortical lag screw fixation techniques provide equivalent stability for medial malleolar fractures in a bimalleolar ankle fracture during simulated progressive rehabilitation with a walking boot. This could potentially have clinical benefits in patient care with earlier return to function, prevention of stiffness and loss of range of motion, and decreased muscle atrophy during the postoperative rehabilitation period.Level of Evidence: Level V: bench top testing.

Introduction: Operative treatment of displaced intra-articular distal humerus fractures is still the gold standard in the management of these challenging injuries. Triceps damaging approaches, as well as bulky or numerous implants, are often associated with complications leading to the development of moderate to severe elbow stiffness. The shortened pre-operation time, the use of approaches preserving the integrity of m. triceps brachii, and the use of optimal osteosynthesis implants to achieve maximum stability with minimal soft tissue damage suggests early elbow mobilization and prevention of stiffness and contracture. Materials and Methods: Eleven patients after surgical treatment for intra-articular distal humerus fractures (AO type 13C and 13B) were included in the study. A posterior paratriceps approach was used. Soft immobilization was applied postoperatively. Patients were followed up in the postoperative period on the 14th, 30th, and 45th day. Rehabilitation and physical therapy courses were conducted, function was assessed, and a questionnaire, the Mayo Elbow Performance Score (MEPS), was filled out. Results: The results achieved in the flexion-extension arch were as follows: 14th day—24° ± 4.5°, 30th day—50°±5.5°, and 45 day—110.5°±8°. Pronosupination for the same periods was 75° ± 8°, 133°±6°, and 156° ± 4°, and MEPS—34±7p, 62±9p, and 90±5p. Conclusion: Surgical reconstruction of intra-articular fractures of the distal humerus through the Alonso-Llames paratriceps approach with stable fracture fixation allowed for early physical therapy and rehabilitation, which is a prerequisite for excellent functional result.

The article presents an analysis of influencing factors on the formation of architecture for the elderly. Factors are conventionally grouped into external and internal. The characteristic methods of forming the architecture of institutions for the elderly are substantiated, as a certain response to the factors impact. Techniques are proposed to be considered in the following categories: structural-functional, volumetric-spatial and architectural-planning. Individual positions in each category are illustrated with architectural examples.External factors represent the environmental envelope under which the architectural object is formed, they include: socio-economic factor, urban planning factor, medical factor, etc. A powerful group of external influencing factors is the socio-economic component. The influence of this group of factors is particularly noticeable in the following aspects: socio-demographic aspect; socio-professional; socio-territorial aspect; socio-ethnic; economic aspects - the aging of the population creates problems for the economies of countries, and the health of the elderly is a concern. Internal factors include: characteristics of the contingent of residents in terms of motor activity, degree of self-care, etc.; the way of life of disabled categories; the nature of the processes that determine the functional blocks of the premises and their relationship; socio-psychological impact of the organization of the interior space of the house for coziness and comfort. Techniques for forming the architecture of institutions for the elderly are conditioned by the influence of external and internal factors and are a certain answer, a reaction to their action. Architecture for the elderly demonstrates a number of solutions, among which you can single out techniques that can be called general, but there are also those that claim certain uniqueness. It is proposed to analyze such methods in the following categories: structural-functional, volumetric-spatial and architectural-planning. Architecture for the elderly is currently becoming a much more powerful typological link than it was before. On the one hand, this is due to the progressive ageing of the population, and, as a result, increases in the share of elderly people in society, on the other hand, a change in the attitude towards such people, and now also a change in the concepts of creating an appropriate architectural product. Modern views — preserving the quality of life and encouraging active physical and mental actions — are formed into architectural concepts and offer new high-quality architecture under the influence of external and internal factors. Several methods defined in the article are already concrete means of creating an artificial space for the elderly, where almost every one of them is not a purely technical design, but has a certain philosophical basis and takes into account the specifics of the existence of the elderly in society at the moment, as well as long-term preservation of physical and mental health, encouragement to move, prevention of stiffness in one's condition.

Olecranon fractures are relatively common injuries, accounting for approximately 10% of upper extremity fractures in adults [26]. These fractures may result from a direct blow to the proximal ulna, or indirectly, via the forceful contraction of the triceps against resistance (typically, during a fall onto an outstretched hand). Less commonly, the olecranon may fracture when the elbow is hyperextended, as the bone is impacted against the olecranon fossa of the distal humerus. For unstable injuries, operative fixation typically is required. Even after recovery, loss of ROM is not uncommon. This article provides an overview of olecranon fractures in adults; therefore, discussion of olecranon fractures in skeletally immature patients is beyond the scope of this article.