Treatment Of Chronic Injuries Research Articles

Perilunate Dislocations: Current Treatment Options.

Approximately 25% of all patients who sustain perilunate dislocations present in a delayed fashion. While management of acute injuries is relatively well-described, treatment of chronic injuries can be complex and there is a paucity of scientific evidence to guide management. Treatment options include open reduction internal fixation, proximal row carpectomy, scaphoid or lunate excision with or without arthrodesis, and total wrist arthrodesis, although indications vary based on chronicity of injury and patient factors. The purpose of this article was to determine the quality of evidence supporting surgical options for the treatment of these injuries.

Role of the Popliteal Fossa in Knee Problems: Theoretical Considerations and Practical Implications

The popliteal fossa is located at the back of the knee joint and it is an area where blood vessels and nerves and also lymph nodes pass. Popliteal fossa injuries includes nearly 2% of acute knee injuries. The treatment of chronic injuries are always more difficult than acute ones, because its diagnosis would depend on careful interpretation of specific clinical exams. In this review, we describe our current understanding of role of popliteal fossa in knee problems, and summarize the anatomy and functional role of popliteal fossa and popliteomeniscal fibers, and mechanism of popliteomeniscal fibers injuries, and discuss strategies for diagnosis of popliteomeniscal fibers lesions, differential diagnosis, and treatment of the posterolateral corner injuries.

A retrospective analysis of debridement in the treatment of chronic injury of lactating nipples

Treatment strategies for nipple injury are mainly based on aetiology. However, some damaged nipples do not heal after the aetiology was corrected. This study retrospectively analyses the effect of debridement for treating chronic injury of lactating nipples. The medical records on nipple injury management in the authors’ department from December 2015 to January 2020 were retrospectively analysed. A total of 167 patients were enrolled and grouped based on the presence or absence of nipple debridement. The difference in the healing effect, pain relief rate and recurrence rate of nipple injury between the two groups after 1 week was examined. The cure rate of nipple injury in the intervention group (54.3%) was significantly higher than in the control group (26.7%). In addition, the complete pain relief rate in the intervention group (48.1%) was significantly higher than in the control group (23.3%). However, the recurrence rates between the two groups (36.4% (16/44) vs. 34.8% (8/23)) had no statistically significant differences. For patients with no improvement after correction of the aetiology of the in the nipple damage, debridement can improve the healing environment of nipple breakage and thus relieve nipple pain.

Treatment of Patients with Ankle Fractures (Literature Review)

The consequences of ankle fractures are a leading cause of disability among injuries of the musculoskeletal system. The problems of treating patients with this pathology have been of interest to researchers throughout the entire period of development of ankle joint surgery. However, numerous attempts to define terminology and classify chronic ankle joint injuries were unsuccessful. It can be argued that the consequences of ankle fractures are a symptom complex that includes traumatic deformity and pseudoarthrosis of the ankles, subluxation of the foot, contracture and arthrosis of the ankle joint. Today, for the surgical treatment of chronic injuries of the ankle joint, a number of surgical techniques are used, the indications and contraindications for each of them are not completely determined. In addition, longterm results are also the subject of a debate. There is a need to develop an improved approach to the treatment of the pathology under consideration, to create a decision-making algorithm in each specific clinical case. There is no doubt that preference should be given to organ-preserving operations. Based on a review of world literature, data were obtained on the epidemiology, medical and social significance of the effects of ankle fractures, and the evolution of researchers' views on the treatment of patients with this pathology and their development prospects were examined.

Treatment of chronic injury associated with Achilles insertional tendinopathy using posterior ankle arthroscopy

Ruptures of the calcaneal tendon, when neglected, cause marked disturbance to gait and support at the tip of the foot. Most causes of pain in this region are related to overload injuries. Previous studies have shown that surgical treatment is the best option for chronic injuries. The purpose of this report is to describe a new endoscopic surgical technique used for treatment of chronic injury of the calcaneal tendon by reconstruction with flexor hallucis longus tendon transfer and fixation with an interference screw at the calcaneus in an elderly diabetic patient with signs of Achilles insertional tendinopathy. Level of Evidence V; Therapeutic studies; Expert opinion.

Platelet-rich plasma injection in the treatment of frozen shoulder: A randomized controlled trial with 6-month follow-up .

Platelet-rich plasma (PRP) has been utilized in the treatment of chronic injuries. The current study aimed to evaluate the efficiency of PRP in the treatment of frozen shoulder compared to procaine. 60 patients with frozen shoulder were randomly divided into two groups. The PRP group was injected with 2mL prepared PRP, while in the control group procaine was used. The stretching and formal strengthening exercises were carried out in both groups during the 6-month follow-up. Visual analog scale (VAS) score was used to assess the subjective pain intensity of the patients. The general shoulder assessment instruments (University of California at Los Angeles (UCLA) shoulder scale) was applied to measure the shoulder function of the patients. The evaluation was performed before treatment and 1week, 1month, 3months, and 6months after the first injection. The efficiency of PRP was superior to and longer than procaine. VAS scores were both declined in PRP and control group after 1week, 1month, and 3months of first injection. By contrast, it was elevated was elevated in the control group while continued to decline in PRP group. The UCLA scores were almost linearly improved in the PRP group, while the UCLA scores decreased to a lower level at the final follow-up visit compared to that post 3 months in the control group. PRP and procaine were effective in treating frozen shoulder. PRP was more effective and had a more prolonged efficiency than the procaine control. Nevertheless, the definite conclusion should come from further large-scale clinical trials. .

ЭФФЕКТИВНОСТЬ КОМПЛЕКСНОГО МЕТОДА ЛЕЧЕНИЯ ХРОНИЧЕСКОЙ МЕХАНИЧЕСКОЙ ТРАВМЫ СЛИЗИСТОЙ ОБОЛОЧКИ РТА У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1 ТИПА

Background Diabetes mellitus is a chronic disease that affects several hundred million people. In the presence of type 1 diabetes mellitus, there is a xerostomia, a violation of microcirculation, epithelial regeneration, a change in local immunity, the accumulation of glycated hemoglobin, which disrupts the supply of nutrients, and reduces the resistance of tissues to the action of foreign microorganisms, leading to the formation of a hard-to-treat chronic mechanical injury of the oral mucosa. Objectives Conduct an analysis of the efficacy of the complex treatment for chronic mechanical trauma of the oral mucosa in patients with type 1 diabetes based on clinical, dental, immunological, sociological research methods and functional vascular studies. Methods The dental, clinical status, overall quality of life, local immunological status and hemodynamics of the oral mucosa before and after treatment of chronic injuries of the oral mucosa in patients with type 1 diabetes mellitus by the traditional method compared with the scheme developed by us. Results As a result of the study, the success of treatment of chronic injuries of the oral mucosa in patients with type 1 diabetes according to our method is more effective than traditional treatment: by 20 % in terms of dental status, clinical symptoms and cytokine profile; complete disappearance of inflammatory changes in the oral mucosa 50 % improved the quality of life; the condition of the microcirculatory channel of the oral mucosa reached the figures of the control group. Conclusions With the application of the method of treatment of chronic mechanical trauma proposed by us in patients with type 1 diabetes mellitus using the Optotan physiotherapeutic laser apparatus with 5 % of mexidol and Ozonid oil, the therapy proved highly effective, based on the results of the study.

Knee extensor mechanism reconstruction by complete cadaveric allograft. A treatment of chronic injuries of the knee extensor mechanism

Knee extensor mechanism reconstruction by complete cadaveric allograft. A treatment of chronic injuries of the knee extensor mechanism

Uso de hidrocolóide e alginato de cálcio no tratamento de lesões cutâneas

Hidrocolóide e alginato de cálcio são utilizados no tratamento de lesões cutâneas e muitos profissionais da saúde desconhecem as evidências que sustentam sua indicação na cicatrização. Objetivou-se nesse estudo identificar evidências da ação da placa de hidrocolóide e alginato de cálcio no tratamento de lesão cutânea. Utilizou-se o método de revisão integrativa da literatura. Fizeram parte da amostra 12 estudos com nível de evidências I, II, III e IV, formados por pacientes com lesão cutânea tratada durante qualquer período de tempo com hidrocolóide placa ou alginato de cálcio. Os desfechos avaliados foram redução da área, cicatrização da lesão, taxa de cicatrização, tempo e infecção. Os resultados permitiram estabelecer três recomendações para o uso de hidrocolóide e nenhuma para uso de alginato de cálcio no tratamento de lesão crônica.

Treatment of Chronic Injuries to the Medial Side of the Knee

ABSTRACT Chronic medial collateral ligament insufficiency is seen less commonly today because of modern-day orthopaedists' ability to recognize the acute medial injury and treat it. Failure of nonoperative or operative management is often the result of unaddressed associated injuries, including those of the posteromedial corner, meniscus, or cruciate ligaments. In patients with chronic medial instability, primary repair supplemented with appropriate reconstruction can restore stability to the knee.

Surgical treatment of chronic mallet finger by shortening--suture of the tendon scar. Sixty six cases

Acute mallet fingers are commonly treated by splinting. Treatment of chronic injuries is more debated. Since 1989, a "shortening and suture" technique have been used for such chronic injuries on the elongated tendon scar. Sixty six of 77 patients treated on a 10 years period were reviewed with a mean follow-up of 21 months. The mean active extension lag at the distal interphalangeal (DIP) joint was 4.5 degrees (41 degrees of improvement) with 52% of fingers which recovered a full extension, representing 77% of good and excellent results according to Abouna's and Brown's modified criteria. There were two failures which lead to reoperation, and no complication (2 painful scars and 20% of cold intolerance). We propose this safe and simple technique for chronic mallet fingers if deformity exceeds 30 degrees, for patients untreated (after the second month), or when splinting has failed. "Swan-neck" deformities were improved by an associated Fowler procedure. In case of failure, a new "shortening and suture" or a DIP arthrodesis can be discussed.

Cryotherapy in sports medicine.

The use of cryotherapy, i.e. the application of cold for the treatment of injury or disease, is widespread in sports medicine today. It is an established method when treating acute soft tissue injuries, but there is a discrepancy between the scientific basis for cryotherapy and clinical studies. Various methods such as ice packs, ice towels, ice massage, gel packs, refrigerant gases and inflatable splints can be used. Cold is also used to reduce the recovery time as part of the rehabilitation programme both after acute injuries and in the treatment of chronic injuries. Cryotherapy has also been shown to reduce pain effectively in the post-operative period after reconstructive surgery of the joints. Both superficial and deep temperature changes depend on the method of application, initial temperature and application time. The physiological and biological effects are due to the reduction in temperature in the various tissues, together with the neuromuscular action and relaxation of the muscles produced by the application of cold. Cold increases the pain threshold, the viscosity and the plastic deformation of the tissues but decreases the motor performance. The application of cold has also been found to decrease the inflammatory reaction in an experimental situation. Cold appears to be effective and harmless and few complications or side-effects after the use of cold therapy are reported. Prolonged application at very low temperatures should, however, be avoided as this may cause serious side-effects, such as frost-bite and nerve injuries. Practical applications, indications and contraindications are discussed.

Osteoplastic Correction of the Pelvic Ring in Old Injuries of the Sacroiliac and Pubic Joints Aggravated by a Large Divergence of the Pubic Symphysis

Surgery to treat old injuries of the pelvis was performed to reconstruct the pelvic ring (its anterior and posterior compartments) using autoplastic materials and various fixators. The reconstructive operation for extensive disjunction of the pubic symphysis and sacroiliac joint is performed in three stages. The first stage is to attain the greatest possible elimination of complete dislocation of the pelvis, producing a closer apposition of pubic bones, with the aid of an external pivotal fixator. The second stage of the surgical restoration of the structure is aimed at stabilization of the posterior elements, which bear the main static load; for this purpose, arthrodesis of the sacroiliac joint is performed. In the third stage, bone is transplanted for fusion of the anterior elements of the pelvic ring. Fifty-seven operations were performed on 23 patients. Good results were observed in all of the patients. One group (13 of 23) returned to their previous activities; this alone is evidence of the value of the multistage method of surgical reconstruction of the pelvic ring for treatment of chronic injuries.