BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To ...BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.展开更多
Pyle’s disease is a rare genetic skeletal disorder also known as Metaphyseal dysplasia. A case of 36 yrs old female with fracture supracondylar femur in Pyle’s disease is presented. She had mild facial dysmorphism, ...Pyle’s disease is a rare genetic skeletal disorder also known as Metaphyseal dysplasia. A case of 36 yrs old female with fracture supracondylar femur in Pyle’s disease is presented. She had mild facial dysmorphism, dental malformation & mild genu valgum. Skeletal radiology revealed the characteristic Erlenmeyer flask sign at distal femoral and proximal tibial metaphysis. The fracture supracondylar femur was treated with interlocking nail. The fracture was united in sixteen weeks period. The patient is followed up for two years. The aim of the case report is the rarity of the condition with fracture supracondylar femur in adult female successfully treated with interlocking nail.展开更多
BACKGROUND Subsidence is one of the concerning early complications in cementless femoral stem.Few publications have studied the influencing factors for subsidence in short cementless stems,due to their metaphyseal anc...BACKGROUND Subsidence is one of the concerning early complications in cementless femoral stem.Few publications have studied the influencing factors for subsidence in short cementless stems,due to their metaphyseal anchoring without diaphyseal invasion,they might demonstrate different subsidence patterns than with the conventional stems.AIM To analyze the factors associated with significant subsidence in short stems,including any radiographic parameters.METHODS The digitized radiographs of 274 consecutive short stem total hip arthroplasties were retrospectively reviewed.Subsidence,neck-filling ratio(NFR),seating height and lateral stem contact were evaluated after a minimum of two years follow-up.A threshold of subsidence>3 mm was considered a clinically significant migration.RESULTS For the entire cohort,subsidence occurred in 75 cases(27.4%)with the mean stem subsidence of 0.5 mm.(0-12.7,1.68).Twelve hips(4.4%)had significant subsidence(>3 mm).The univariate regression analysis demonstrated that age,diagnosis,BMI,Dorr’s type B,NFR,and seating height had no significant influence on significant subsidence,whereas insufficient lateral stem contact(≥1 mm)did have a statistically significant influence[Odds ratio(OR)=5.02;95%CI:1.3-18.9;P=0.017].The multivariate regression analysis also demonstrated that insufficient lateral stem contact was a statistically significant influencing factor(OR=5.5;95%CI:1.4-21.4;P=0.014).There was no femoral stem revision for aseptic loosening in our cohort.CONCLUSION This study demonstrated that insufficient lateral stem contact was a statistically significant influencing factor on significant subsidence.Therefore,it is a particularly important step to create proper lateral cortical contact when performing the short stem total hip arthroplasty.展开更多
文摘BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.
文摘Pyle’s disease is a rare genetic skeletal disorder also known as Metaphyseal dysplasia. A case of 36 yrs old female with fracture supracondylar femur in Pyle’s disease is presented. She had mild facial dysmorphism, dental malformation & mild genu valgum. Skeletal radiology revealed the characteristic Erlenmeyer flask sign at distal femoral and proximal tibial metaphysis. The fracture supracondylar femur was treated with interlocking nail. The fracture was united in sixteen weeks period. The patient is followed up for two years. The aim of the case report is the rarity of the condition with fracture supracondylar femur in adult female successfully treated with interlocking nail.
文摘BACKGROUND Subsidence is one of the concerning early complications in cementless femoral stem.Few publications have studied the influencing factors for subsidence in short cementless stems,due to their metaphyseal anchoring without diaphyseal invasion,they might demonstrate different subsidence patterns than with the conventional stems.AIM To analyze the factors associated with significant subsidence in short stems,including any radiographic parameters.METHODS The digitized radiographs of 274 consecutive short stem total hip arthroplasties were retrospectively reviewed.Subsidence,neck-filling ratio(NFR),seating height and lateral stem contact were evaluated after a minimum of two years follow-up.A threshold of subsidence>3 mm was considered a clinically significant migration.RESULTS For the entire cohort,subsidence occurred in 75 cases(27.4%)with the mean stem subsidence of 0.5 mm.(0-12.7,1.68).Twelve hips(4.4%)had significant subsidence(>3 mm).The univariate regression analysis demonstrated that age,diagnosis,BMI,Dorr’s type B,NFR,and seating height had no significant influence on significant subsidence,whereas insufficient lateral stem contact(≥1 mm)did have a statistically significant influence[Odds ratio(OR)=5.02;95%CI:1.3-18.9;P=0.017].The multivariate regression analysis also demonstrated that insufficient lateral stem contact was a statistically significant influencing factor(OR=5.5;95%CI:1.4-21.4;P=0.014).There was no femoral stem revision for aseptic loosening in our cohort.CONCLUSION This study demonstrated that insufficient lateral stem contact was a statistically significant influencing factor on significant subsidence.Therefore,it is a particularly important step to create proper lateral cortical contact when performing the short stem total hip arthroplasty.
