Restoration Of Normal Anatomic Relationships Research Articles

Biofeedback Therapy Pelvic Floor Muscle Training Program Efficacy vs. Traditional Methods of Medical Rehabilitation in Patients with Chronic Endometritis Associated with Pelvic Floor Muscle Failure: a Prospective Randomized Study

INTRODUCTION. Inflammatory diseases of the pelvic organs are one of the main reasons for the decline in the reproductive potential of women. In this regard, modern technologies are being developed, including non-drug methods for correcting functional disorders associated with the inflammatory process. The creation of personalized programs based on the use of natural and preformed physical factors in patients with a burdened obstetric and gynecological history is still an urgent task.
 AIM. To evaluate the clinical effectiveness of the use of pelvic floor muscle training as part of a complex method for the treatment of patients with chronic endometritis, combined with pelvic floor muscle failure.
 MATERIALS AND METHODS. The randomized study included 55 patients with chronic endometritis associated with pelvic floor muscle failure. 28 women of the main group received a complex of amplipulse therapy procedures (10 procedures), sodium chloride baths (8 procedures) and pelvic floor muscle training using the biofeedback method (10 sessions). In 27 patients of the comparison group, restorative treatment was used, including only amplipulse therapy and sodium chloride baths.
 RESULTS AND DISCUSSION. In both groups, after treatment, there was a significantly significant increase in the uterine arterial perfusion index (p 0.01), as well as a significant improvement in the structure and thickness of the endometrium according to transvaginal ultrasound (p 0.001), an improvement in situational anxiety according to the Spielberger-Khanin scale (p 0.001). In addition, in patients of the main group, restoration of normal anatomical relationships of the pelvic floor muscles was observed according to translabial ultrasound of the pelvic floor (p 0.05).
 CONCLUSION. Taking into account the high efficiency of the short-term treatment program in patients of the main group, the use of pelvic floor muscle training as part of a complex rehabilitation treatment is recommended for chronic endometritis in combination with grade III genital prolapse.

Eyelid and Periorbital Soft Tissue Trauma.

Facial trauma often involves injuries to the eyelid and periorbital region. Management of these injuries can be challenging due to the involvement of multiple complex anatomic structures that are in close proximity. Restoration of normal anatomic relationships of the eyelids and periocular structures is essential for optimum functional and aesthetic outcome after trauma. This review provides an overview of the current literature involving soft tissue trauma of the eyelid and periorbital tissue, and highlights key steps in patient evaluation and management with various types of injuries.

Two-Incision Technique for Treatment of Complex Proximal Humerus Fractures

The treatment of complex proximal humerus fractures that involve displacement of the greater tuberosity remains challenging. Good functional outcomes and decreased pain are possible with open reduction and internal fixation. Keys to a successful outcome include preservation of blood supply through decreased soft-tissue stripping, restoration of normal anatomic relationships (particularly the greater tuberosity), and stable internal fixation that allows early range of motion. To attain these goals, we advocate fixation with a fixed-angle locking proximal humerus plate using a 2-incision approach. A deltopectoral incision is used to expose the humeral shaft and head while the greater tuberosity is visualized by using a lateral incision. The fracture fragments are reduced and the plate is secured by working through these 2 incisions.

Open Reduction of Traumatic Atlanto-Axial Rotatory Dislocation with Use of the Extreme Lateral Approach. A Report of Two Cases*

Irreducible rotatory injuries at the atlanto-axial level in children may result in torticollis and facial asymmetry4,10,22,25,35. The terminology associated with traumatic rotatory injuries at this level is somewhat confusing, and a clear distinction should be made between rotatory subluxation and rotatory dislocation, as the mechanisms of injury and the optimum management may differ. In this report, we use the term atlanto-axial rotatory dislocation to define a complete and persistent displacement of the adjacent articular surfaces at this level. Ideally, early closed manipulative reduction with use of distraction and derotation with spinal cord monitoring, followed by external bracing, restores both normal anatomical relationships and mobility in many patients. In some patients, however, the maneuver fails, and often the joint fuses spontaneously in malalignment. The exact cause of failure to achieve reduction is unclear. The purpose of this report is to describe our operative approach and findings in two patients who had atlanto-axial rotatory dislocation. These findings provide new information on the pathomechanics of irreducible atlanto-axial rotatory dislocation that distinguish it from rotatory subluxation. Furthermore, this approach allows for the correction of the deformity. The technique that we describe could potentially be associated with serious problems, such as damage to the neuraxis and vertebral artery, but it is the only method, to our knowledge, that allows restoration of normal anatomical relationships. The operation should not be performed by a surgeon who only occasionally operates on the cervical spine. CASE 1. A ten-year-old girl had a biopsy of a lymph node in the posterior triangle on the right side of the neck under general anesthesia in November 1990. She awoke with severe neck pain accompanied by dysesthesia over the occiput and neck and had torticollis; she had never had a previous episode of …

Stroboscopy and Phonosurgery-Reply

In Reply. —We thank Dr Alessi for his valuable remarks on endolaryngeal surgery for benign conditions of the vocal folds. We acknowledge the fact that indirect microlaryngoscopic surgery is more rarely performed in the United States than in some European centers. In Europe it is a procedure that is mostly performed in specialized phonosurgical centers. The important issue is, however, not about the cultural and historical differences between centers in the United States and Europe, but it is about the progress of phonosurgical techniques from a situation in which the restoration of normal anatomical relationships is considered good surgical practice to a situation in which the restoration of function is the main objective of the surgery. Restoration of normal anatomic relationships of the vocal folds is no guarantee for a good postoperative voice result as we all know. To optimize the chances for a good voice result, endolaryngeal surgery can

Posterior colporrhaphy and perineorrhaphy: Separate and distinct operations

Posterior vaginal repair is often poorly understood and ineffectively performed. The goals of reconstructive surgery emphasize relief of symptoms and restoration of normal anatomic relationships and of function. A useful method to preoperatively determine posterior vaginal wall weakness is outlined along with a surgical description of important steps in surgical reconstruction.