Triggering,locking,clicking,and crepitus of the fingers are common symptoms patients present with.Even though crepitus and triggering can occur as part of the same underlying diagnosis,it is important to differentiate...Triggering,locking,clicking,and crepitus of the fingers are common symptoms patients present with.Even though crepitus and triggering can occur as part of the same underlying diagnosis,it is important to differentiate between them,as they usually indicate different possible diagnoses.The differential diagnoses that should be considered include trigger finger,metacarpophalangeal joint(MCPJ)arthritis,fractures or dislocations,extensor digitorum communis subluxation or dislocation,locked MCPJ,avascular necrosis of the metacarpal head,and Dupuytren’s disease.A thorough clinical examination with appropriate special investigations can permit the clinician to make the correct diagnosis.Appropriate management of a confirmed diagnosis is successful in providing symptomatic improvement.展开更多
BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have...BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral preparation.AIM To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for THA.METHODS This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related outcomes.RESULTS Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to 95.CONCLUSION The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.展开更多
文摘Triggering,locking,clicking,and crepitus of the fingers are common symptoms patients present with.Even though crepitus and triggering can occur as part of the same underlying diagnosis,it is important to differentiate between them,as they usually indicate different possible diagnoses.The differential diagnoses that should be considered include trigger finger,metacarpophalangeal joint(MCPJ)arthritis,fractures or dislocations,extensor digitorum communis subluxation or dislocation,locked MCPJ,avascular necrosis of the metacarpal head,and Dupuytren’s disease.A thorough clinical examination with appropriate special investigations can permit the clinician to make the correct diagnosis.Appropriate management of a confirmed diagnosis is successful in providing symptomatic improvement.
文摘BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral preparation.AIM To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for THA.METHODS This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related outcomes.RESULTS Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to 95.CONCLUSION The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.
