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World Journal of Surgical Oncology Jun 2024Clinical diagnosis and surgical treatment of chondrosarcoma (CS) are continuously improving. The purpose of our study is to evaluate the effectiveness of microwave...
AIM
Clinical diagnosis and surgical treatment of chondrosarcoma (CS) are continuously improving. The purpose of our study is to evaluate the effectiveness of microwave ablation (MWA) assisted degradation therapy in the surgical treatment of intramedullary chondrosarcoma of the extremities, to provide a new reference and research basis for the surgical treatment of CS.
METHODS
We recruited 36 patients with intramedullary CS who underwent MWA assisted extended curettage. Preoperative patient demographics and clinical data were recorded. Surgery was independently assisted by a medical team. Patients were followed up strictly and evaluated for oncological prognosis, radiological results, limb joint function, pain, and complications.
RESULTS
We included 15 men and 21 women (mean age: 43.5 ± 10.1). The average length of the lesion was 8.1 ± 2.5 cm. Based on preoperative radiographic, clinical manifestations, and pathological results of puncture biopsy, 28 patients were preliminarily diagnosed with CS-grade I and eight patients with CS-grade II. No recurrence or metastasis occurred in the postoperative follow-up. The average Musculoskeletal Tumor Society score was 28.8 ± 1.0, significantly better than presurgery. Secondary shoulder periarthritis and abduction dysfunction occurred in early postoperative stage CS of the proximal humerus in some, but returned to normal after rehabilitation exercise. Secondary bursitis occurred at the knee joint in some due to the internal fixation device used in treatment; however, secondary osteoarthritis and avascular necrosis of the femoral head were not observed. Overall, oncological and functional prognoses were satisfactory.
CONCLUSIONS
The application of MWA assisted degradation therapy in intramedullary CS can achieve satisfactory oncology and functional prognosis, providing a new option for the limited treatment of CS.
Topics: Humans; Male; Female; Chondrosarcoma; Adult; Bone Neoplasms; Microwaves; Middle Aged; Follow-Up Studies; Prognosis; Extremities; Curettage; Ablation Techniques
PubMed: 38914990
DOI: 10.1186/s12957-024-03443-0 -
BMC Musculoskeletal Disorders Jun 2024Most studies infer increasing incidence of proximal humeral fractures (PHF) from the 1950´s until the 1990´s. Recent time trends are less clear.
BACKGROUND
Most studies infer increasing incidence of proximal humeral fractures (PHF) from the 1950´s until the 1990´s. Recent time trends are less clear.
OBJECTIVES
Our primary objective was to identify time trends in the age- and sex-adjusted adult incidence of PHF in Malmö, Sweden, from year 1944 until 2020. Our secondary objectives were to describe the variation in incidence according to age, the monthly distribution, and to compare data from the two most recent decades with earlier.
STUDY DESIGN AND METHODS
Malmö has one emergency hospital where acute fractures are treated. We identified PHF in adult patients (≥ 18 years) by reviewing relevant radiology examinations during 17 sample years from year 1944 to 2020. We used jointpoint analyses to estimate time trends.
RESULTS
We identified 3 031 PHF during the study period (3 231 161 person years), 73% were sustained by women with mean age of 69 years (mean age in men 59). Joinpoint analyses indicated an increase in the age- and sex-adjusted incidence of PHF from year 1944 (52 per 100 000 person years) until 1977 (120 per 100 000) and thereafter a decrease until 2020 (85 per 100 000). A seasonal variation with more fractures during winter months, was apparent in earlier but not recent decades.
CONCLUSIONS
The age- and sex-adjusted incidence of PHF increased in Malmö, Sweden, from the 1940´s until year 1977 and thereafter decreased until 2020. More fractures were seen during winter months in earlier but not recent decades.
Topics: Humans; Sweden; Female; Male; Aged; Middle Aged; Shoulder Fractures; Incidence; Adult; Aged, 80 and over; Time Factors; Young Adult; Cohort Studies; Seasons; Adolescent
PubMed: 38914972
DOI: 10.1186/s12891-024-07602-y -
PloS One 2024Muscle fatigue is one of the leading causes that contributes tremendously to injuries among volunteer firefighters in the workplace. The purpose of this study was to...
Muscle fatigue is one of the leading causes that contributes tremendously to injuries among volunteer firefighters in the workplace. The purpose of this study was to investigate the impact of positive-pressure breathing apparatus on muscle fatigue in the shoulder, back, and legs of volunteer firefighters. A total of 60 volunteer firefighters were recruited to perform a running task on a motorized treadmill in a controlled laboratory environment. Surface electromyography and rating of perceived exertion scores were collected from all participants every 60 seconds during the running task. Results show that the median frequency values for all measured muscle groups were significantly lower, and the rating of perceived exertion score was significantly higher after running with the positive-pressure breathing apparatus. Meanwhile, there were no significant differences in the median frequency values for the upper trapezius, erector spinae, and biceps femoris between the initial and final periods of running task without load. However, the median frequency values with load for gastrocnemius, rectus femoris, and tibialis anterior exhibited a greater downward trend compared to those without load. Additionally, using a breathing apparatus can cause asymmetric muscle fatigue in bilateral upper trapezius, erector spinae, gastrocnemius, and tibialis anterior muscles. The decreased performance due to muscle fatigue increases the risk of accidents, thereby posing a threat to the safety of volunteer firefighters. This study offers valuable insights into the effects of positive-pressure breathing apparatus on muscle fatigue among volunteer firefighters. These results may serve as a reference for developing improved fatigue management strategies and optimizing the design features of breathing apparatus.
Topics: Humans; Muscle Fatigue; Firefighters; Adult; Male; Electromyography; Muscle, Skeletal; Volunteers; Female; Running
PubMed: 38913654
DOI: 10.1371/journal.pone.0305599 -
PloS One 2024Although a common injury there is a lack of published primary data to inform clinical management of sports related brachial plexus injuries. (Review)
Review
BACKGROUND
Although a common injury there is a lack of published primary data to inform clinical management of sports related brachial plexus injuries.
METHODS
A systematic search was completed in Medline, CINAHL, PubMed, SPORTDiscus and Web of Science databases and Google Scholar from inception to August 2023 according to the PRISMA-ScR guidelines. Methodological quality assessment of included articles was with the Joanna Briggs Institute tool. Studies providing primary data as to the rehabilitative management of diagnosed or suspected brachial plexus injuries sustained when playing contact sports were included.
RESULTS
Sixty-five studies were identified and screened, of which, 8 case reports were included, incorporating 10 participants with a mean age of 19.8 (±4.09) years. There was wide heterogeneity in injury severity, injury reporting, physical examination and imaging approaches documented. 9 of 10 participants returned to competitive sports, though follow-up periods also varied widely. Whilst return to play criteria varied between studies, the most consistent indicator was pain-free shoulder range of motion and strength.
CONCLUSIONS
There is a distinct lack of data available to inform evidence-based rehabilitation management of sports related brachial plexus injury. Only 8 individual case reports contain published data reporting on 10 athletes. Further reporting is critical to inform clinical management.
Topics: Humans; Brachial Plexus; Athletic Injuries; Young Adult; Male; Female; Range of Motion, Articular; Adult; Return to Sport; Brachial Plexus Neuropathies; Adolescent
PubMed: 38913647
DOI: 10.1371/journal.pone.0298317 -
The Indian Journal of Radiology &... Jul 2024Hydroxyapatite crystal deposition disease (HADD) is a common disorder resulting from the deposition of calcium hydroxyapatite crystals in various soft tissues, typically...
Hydroxyapatite crystal deposition disease (HADD) is a common disorder resulting from the deposition of calcium hydroxyapatite crystals in various soft tissues, typically in periarticular distribution, including tendons, tendon sheaths, joint capsules, ligaments, bursae, periarticular soft tissues, and occasionally within the joints. The more commonly known subtypes of HADD are calcific tendinopathy and calcific periarthritis. Carpal tunnel syndrome (CTS) can be rarely caused by calcific deposits within the carpal tunnel in the setting of HADD-related calcific periarthritis. Imaging, particularly ultrasound and radiographs, is crucial in distinguishing this entity from the conventional form of CTS that tends to be idiopathic. We describe a rare presentation of CTS secondary to calcific periarthritis in a 45-year-old patient, with imaging demonstrating mass-like calcification within the carpal tunnel, with typical features of those seen with HADD. The patient was treated with ultrasound-guided barbotage, with significant clinical improvement. The case highlights a lesser-known cause of CTS as well as a presentation of HADD, and the role of ultrasound-guided barbotage, a minimally invasive procedure, as a viable first-line management option as an alternative to surgery.
PubMed: 38912254
DOI: 10.1055/s-0043-1778650 -
The Indian Journal of Radiology &... Jul 2024Glenoid version refers to the angle subtended by the glenoid with the scapula. On average, it is 0 ± 10 degrees with a slight propensity toward retroversion....
Glenoid version refers to the angle subtended by the glenoid with the scapula. On average, it is 0 ± 10 degrees with a slight propensity toward retroversion. Numerous factors such the dominance(handedness), gender, ethnicity, and pathology are known to affect version. Version has important consequences on the biomechanics of the shoulder joint and is altered in those with arthritis and shoulder joint instability. Our study aimed to determine the normal range of glenoid version in the population. Further, we aim to assess the relationship between gender and version. We conducted a retrospective observational study in a tertiary referral hospital with a target sample size of 200 shoulders. The computed tomography images were retrospectively reviewed to determine the scapular shape and the glenoid version angle. Statistical analysis was done using SPSS v.22 software with -value less than 0.05 considered as significant. The mean age of the individuals in our study was 44 years. In our study, irrespective of gender, most individuals had some degree of anteversion and males had lower degree of anteversion. Previous studies have shown that most normal individuals usually have retroverted shoulder joints. The mean glenoid version was significantly lower in the right than in the left shoulder and males had significantly lower mean glenoid version than females in both shoulders. Most individuals in our study had a flat scapular spine. This study shows that the Indian population may have a slight propensity toward anteversion and this has an important bearing on shoulder arthroplasty. Further, this study shows that significantly lower degrees of version are found on the right side and that the degree of version is significantly lower in males. Understanding the role of glenoid version in shoulder biomechanics will go a long way in the early identification of pathology, the preoperative planning of shoulder arthroplasty, and the operative restoration of a functional shoulder joint.
PubMed: 38912251
DOI: 10.1055/s-0044-1778725 -
The Indian Journal of Radiology &... Jul 2024Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not... (Review)
Review
Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not available. Wrist and hand radiographs are the most common skeletal radiograph considered for age estimation. Other parts imaged are elbow, shoulder, knee, and hip according to suspected age categories. Age estimation by wrist radiographs is usually done by the Tanner-Whitehouse method where the maturity level of each bone is categorized into stages and a final total score is calculated that is then transformed into the bone age. Careful assessment and interpretation at multiple joints are needed to minimize the error and categorize into age-group. In this article, we aimed to summarize a suitable radiographic examination and interpretation for bone age estimation in living children, adolescents, young adults, and adults for medicolegal purposes.
PubMed: 38912231
DOI: 10.1055/s-0043-1778651 -
Hong Kong Journal of Occupational... Jun 2024Wearable sensors are increasingly applied to rehabilitation for arm movement analysis. However, simple and clinically relevant applications are scarce.
INTRODUCTION
Wearable sensors are increasingly applied to rehabilitation for arm movement analysis. However, simple and clinically relevant applications are scarce.
OBJECTIVES
To investigate the feasibility of single smart watch-based parameters for functional assessment in upper limb rehabilitation for musculoskeletal injuries using a commercial smart watch.
METHOD
Ten patients with unilateral shoulder pain and range-of-motion limitations were enrolled. They wore Galaxy Watch and performed three sets of upper extremity tasks consisting of gross activities-of-daily-living tasks, Wolf Motor Function Test (WMFT), and Upper Extremity Functional Index (UEFI), and the acceleration and angular velocities were acquired. The motion segment size (MSS), representing motion smoothness from a clinical perspective, and various sensor-based parameters were extracted. The correlation between the parameters and clinical outcome measures were analyzed. The percent relative range (PRR) of the significant parameters was also calculated.
RESULTS
For overhead and behind body activity task set, mean MSS for elbow flexion/extension axis significantly correlated with WMFT score (R = 0.784, = .012). For planar tasks, mean MSS for the forearm supination/pronation (R = 0.815, = .007) and shoulder rotation (R = 0.870, = .002) axes significantly correlated with WMFT score. For forearm and fine movement task set, mean MSS of the elbow flexion/extension angle showed significant correlation with WMFT (R = 0.880, < .001) and UEFI (R = 0.718, = .019). The total performance time (R = -0.741, = .014) also showed significant correlation with WMFT score. The PRR for mean MSS in forearm supination (71.5%, planar tasks) and mean MSS in -direction (49.8%, forearm and fine motor movements) were similar to the PRR of WMFT (58.5%), suggesting sufficient variation range across different degree of impairments.
CONCLUSION
The commercial smart watch-based parameters showed consistent potential for use in clinical functional assessments.
PubMed: 38912103
DOI: 10.1177/15691861241241775 -
Anatomic Total Shoulder Arthroplasty Outcomes Were Not Negatively Affected by the COVID-19 Pandemic.Revista Brasileira de Ortopedia Jun 2024To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes...
To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; = 0.008), external rotation (ER; 33.0° to 47.7°; < 0.001), and internal rotation (IR; S1 to L4; = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; = 0.009), ER (32.9° to 42.0°; = 0.037), and IR (S1 to L3; = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019.
PubMed: 38911891
DOI: 10.1055/s-0044-1785661 -
Revista Brasileira de Ortopedia Jun 2024To investigate the epidemiology of injury types among jiu-jitsu practitioners, as well as the incidence regarding different skill and experience levels, through the...
To investigate the epidemiology of injury types among jiu-jitsu practitioners, as well as the incidence regarding different skill and experience levels, through the question: "What are the characteristics and prevalence of musculoskeletal injuries in Jiu-Jitsu practitioners?". Since the beginning of the study, in August 2020, we conducted a search on the MEDLINE, LILACS, and SciELO electronic databases. We included cross-sectional studies published between 2018 and 2023 on the epidemiology of the types of injuries among jiu-jitsu practitioners that compared their incidence regarding different levels of ability and experience. Two independent researchers performed the data extraction and assessed the risk of bias. Seven studies were included. The common outcomes involved 2,847 jiu-jitsu practitioners. A high prevalence in the knee joint and chest and rib areas was reported. Considering the difference in experience level among the practitioners, we could observe that most of the individuals included were beginners. Among the age groups observed, male practitioners older than 30 years of age were the ones who presented the highest rate of musculoskeletal injury, especially during training sessions. There is a high prevalence of musculoskeletal injuries among jiu-jitsu practitioners. The most affected anatomical segments are the knee joint, the chest, and the rib region, followed by the shoulder joint. The related factors change according to certain variables, being more common during training in male individuals over 30 years of age and beginners in the sport.
PubMed: 38911890
DOI: 10.1055/s-0044-1785662