Early results of continuous passive motion after rotator cuff repair: a prospective, randomized, blinded, controlled study.
(1996)
Journal - American journal of orthopedics (Belle Mead, N.J.) (UNITED STATES )
Abstract :
PURPOSE: To determine the effect of continuous passive motion (CPM) on rotator cuff repair (RCR). METHODS: A prospective, randomized, blinded, controlled study was performed on all patients undergoing primary RCR between December 1992 and January 1994. A preoperative "shoulder score" was calculated for each patient based on four scales: function (50%), pain (20%), muscle strength (15%), and range-of-motion (ROM) (15%). A standard questionnaire and single blinded physical therapist were employed. At the time of operation, patients were randomized into the control group (postoperative physical therapy [PT]) or the study group (PT plus CPM). Postoperative shoulder scores were then calculated by repeat questionnaires and physical examinations at 3-month follow-up. RESULTS: Twenty-six patients (12 control, 14 study; 24/26 tears were full thickness) underwent RCR and completed 3-month follow-up. Both groups had similar age and sex distributions; the study group had larger tears than the control group. All patients underwent RCR and subacromial decompression. No statistically significant difference in shoulder score increases was seen between the two groups at follow-up. A statistically significant (P = 0.0138) increase in ROM subscore was seen in the study group. Other subscores showing improvement with CPM included pain relief in female patients (P = 0.0185), and pain relief in patients > or = 60 years of age (P = 0.0364). CONCLUSIONS: CPM has no effect on overall shoulder score at 3-month follow-up. CPM has a beneficial effect on ROM for all patients, as well as on pain relief in female patients and patients > or = 60 years of age.
| ISSN : | 1078-4519 |
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| Mesh Heading : | Activities of Daily Living Female Humans Male Middle Aged Prospective Studies Rotator Cuff Single-Blind Method Tendon Injuries Treatment Outcome rehabilitation |
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| Mesh Heading Relevant : | Motion Therapy, Continuous Passive injuries surgery |
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Sideswipe elbow fractures.
(1995)
Journal - Contemporary orthopaedics (UNITED STATES )
Abstract :
A retrospective review of all cases of sideswipe elbow fractures (SSEFs) treated at two community hospitals from 1982 to 1992 was conducted to determine the functional outcome of the operative treatment of SSEFs. All five injuries involved the left elbow, and they included open fractures of the olecranon, the radius and ulna, the ulna and humerus, the humerus, and traumatic amputation of the arm. Concomitant injuries included three radial nerve palsies and two injuries each to the median nerve, ulnar nerve, and brachial artery. Treatment included irrigation, debridement (repeated if necessary), open reduction and internal fixation, external fixation (one case), and delayed amputation (one case). An average of 130/-10 degrees elbow flexion/extension, and 60/60 degrees supination/pronation was obtained for the three of four patients with reconstructions who returned for follow-up.
| ISSN : | 0194-8458 |
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| Mesh Heading : | Accidents, Traffic Adult Amputation Amputation, Traumatic Elbow Joint External Fixators Female Follow-Up Studies Fracture Fixation, Internal Fracture Healing Fractures, Comminuted Fractures, Open Humans Humeral Fractures Immobilization Male Postoperative Complications Pregnancy Radius Fractures Range of Motion, Articular Replantation Retrospective Studies Ulna Fractures radiography surgery radiography surgery physiology radiography radiography radiography radiography radiography physiology radiography |
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| Mesh Heading Relevant : | injuries methods surgery surgery surgery surgery surgery |
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Postoperative toxic shock syndrome.
(1995)
Journal - American journal of orthopedics (Belle Mead, N.J.) (UNITED STATES )
Abstract :
PURPOSE: To determine risk factors for postoperative toxic shock syndrome (PTSS), a rare, rapidly progressive, and potentially fatal syndrome associated with postoperative wound infections. Components of PTSS include fever, rash, desquamation, hypotension, and multisystem organ dysfunction. METHODS: We conducted a retrospective review of all cases of PTSS occurring in 2 community hospitals from 1981 to 1993, following 390,000 surgical procedures. RESULTS: There were 12 cases of PTSS among the procedures reviewed (0.003%). Orthopedic procedures included excision of accessory navicular and patellar realignment. Wounds ranged from those with scant superficial exudates to those with gross purulence; all cultures yielded Staphylococcus aureus. All tested isolates were susceptible to methicillin or cephalothin. Mean time from surgery to onset of symptoms was 4 days. All patients had sudden onset of fever; mean maximal temperature was 40 degrees C. All patients displayed a rash, most in a truncal "sunburn" pattern. Eleven of 12 patients desquamated. All patients required vigorous fluid resuscitation. All patients survived. No correlation could be demonstrated between PTSS and patient age, sex, preoperative skin preparation or antibiotics, members of surgical team, or duration of procedure. CONCLUSIONS: Early recognition and treatment of PTSS are essential. No risk factors for PTSS have been identified. PTSS should be considered in the postoperative, acutely febrile, systemically ill patient, though surgical wounds may be deceptively benign in appearance.
| ISSN : | 1078-4519 |
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| Mesh Heading : | Adolescent Adult Aged Anti-Bacterial Agents Drug Resistance, Microbial Female Humans Male Middle Aged Prognosis Retrospective Studies Risk Factors therapeutic use drug therapy physiopathology drug therapy physiopathology drug therapy physiopathology |
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| Mesh Heading Relevant : | Orthopedics Shock, Septic Staphylococcal Infections Surgical Wound Infection |
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