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At least 523 records · Page 29Linked to original sources
PubMed2001

Postural control and torque of the knee joint after healed tibial shaft fracture.

Muscular atrophy occurs as a consequence of trauma and immobilisation. This cohort comparison study was conducted to evaluate the limb function after healed tibial shaft fractures, which were treated by casting versus nailing. Balance (as centre of pressure) and muscle strength (as torque of the knee joint during knee extension) have been measured in 27 patients with tibial shaft fractures with a mean age of 39 (19-73) years, 1 year after fracture healing. Fourteen patients were treated by intramedullary nailing 'nailed group' and 13 by plaster cast with or without minimal internal fixation 'casted group'. Centre of pressure was measured on a force platform. Knee extension torque was measured during isometric and concentric muscle actions by an isokinetic dynamometer. Centre of pressure tended to be more towards the uninjured leg in patients who had been treated by plaster cast (P<0.05). Side-to-side differences for isometric torque were significantly higher within the casted group (P<0.05). Patients with tibial shaft fractures treated by intramedullary nailing showed better postural control, one-leg standing test, and side-to-side differences for isometric muscle strength compared with patients treated by cast. Therefore, we recommend intramedullary nailing as a better method of treatment for tibial shaft fractures, with regard to recovery of muscle function.

Adult↗
PubMed2000

Quadriceps atrophy after knee traumatisms and immobilization: electrophysiological assessment.

Automatic analysis of EMG (T/A analysis) and invasive muscle fiber conduction velocity in situ (MFCV) were performed in 15 patients after traumatic lesions of the knee and immobilization with quadriceps atrophy. T/A analysis showed transient reduced number of turns, consistent with inhibition of quadriceps motoneurons, that recovered within the first 2 weeks after the plaster cast had been removed. MFCV was significantly slowed and showed a gradual improvement, reaching normal values after 6 weeks. These results suggest that decrement in activated motor units may be the cause of the disproportionate weakness of the quadriceps muscle on the first days after immobilization by the plaster cast. The recovery of MFCV was related with functional improvement of strength after the first weeks.

Adult↗
PubMed1989

Fixation not needed for undisplaced Colles' fracture.

A series of 68 undisplaced or minimally displaced Colles' fractures was randomized into two groups undergoing treatment with either a plaster cast or an elastic bandage. Pain, function, grip strength, and range of motion were evaluated 1 year later. There was a difference in the functional outcome in favor of the patients treated with an elastic bandage, who did not have more fracture redislocations than those treated with a plaster cast.

Adult↗
PubMed1992

[Halo-vest in the treatment of fractures of the upper cervical spine. Fractures of the epistropheus].

The authors examine the use of a halo-vest brace in the treatment of fractures of the upper cervical spine. This brace forms a valid alternative to the classic plaster cast in that it is easily positioned, well tolerated by the patient and has a high restrictive capacity for the centre of the fracture. In the cases treated by the authors no complications were reported during treatment, and consolidation time was shortened by 30 days in relation to traditional plaster cast treatment.

Axis, Cervical Vertebra↗
PubMed2004

Selective botulinum toxin injection in the treatment of recurrent deformity following surgical correction of club foot: a preliminary report of 3 children.

Management of a child with club foot deformity that recurs after an apparently successful posteromedial soft tissue release remains a challenge. Revision surgery is often attempted, but this carries a high risk of significant scarring or neurovascular complications. We have treated 3 children (3 feet) with relapsed club foot and fixed deformities, using Botulinum toxin A (BTX-A) injection into muscle groups clinically thought to be responsible for recurrent deformity, followed by moulded plaster casts. Two cases have maintained a good foot position with an minimum follow-up of 18 months, and one other is also doing well having had a tibialis anterior tendon transfer as well as the BTX-A therapy. In our limited experience, targeted BTX-A injection with plaster casting has been safe, and may obviate the need for major revision surgery in a proportion of cases with recurrent club foot deformity following previous posteromedial soft tissue release.

Botulinum Toxins, Type A↗
PubMedDate not supplied

[Mixed dentition space analysis in a eastern Sicilian population].

BACKGROUND: The purposes of this study are: 1) predicting the sum of mesio-distal crown diameters of unerupted canines, first and second premolars, using the sum of mesio-distal diameters of lower permanent incisors, in a sample of Eastern Sicily population; 2) estimating the differences between our predictions and the ones developed by Tanaka & Johnston, by Moyers and by Ballard & Wylie. METHODS: We selected 150 plaster casts of permanent dentition of patients - 82 females and 68 males - examined at the School of Orthodontics of the University of Catania. The width of canines, first and second premolars and lower incisors were taken by means of a bow-compass and a sliding digital caliper on the selected plaster casts. RESULTS: We calculated the following linear regression equations, with statistical method, to predict the sum of mesio-distal dimensions of canines, first and second premolars (Y) using the width of the lower incisors (X): Yfs = 11.40 + 0.42X for females in the upper arch; Yfi = 11.34 + 0.41X for females in the lower arch; Yms = 12.84 + 0.39X for males in the upper arch and Ymi =11.38 + 0.44X for males in the lower arch. CONCLUSIONS: The results in our sample indicate that the sum of mesio-distal crown diameters of canines, first and second premolars is smaller in females than in males; besides those results suggest that the North-American authors' predictions overestimate the mesio-distal dimension of canines, first and second premolars in both sexes.

Adolescent↗
PubMed1987

Radiological investigation of alterations in the rat femur after long-term immobilization.

The right hind limb of female rats was immobilized by plaster cast. Following 8 weeks of immobilization the alterations were compared with either the contralateral extremity of the same rat or with the extremities of non-immobilized animals. The femurs were investigated by microradioscopic, morphometric, densitometric and atom absorption methods. The results obtained have unequivocally shown that long-term immobilization by plaster cast leads to development of osteoporosis in the rat. Even though no considerable loss of calcium could be demonstrated when calculated in terms of unit layer thickness quantitative analysis of the bone revealed a high degree of osteopenia.

Animals↗
PubMed1996

[Unstable fractures of the distal radius. External fixation or percutaneous pinning?].

The results of treatment for distal radial fractures of types Older 3 with more than 5 mm shortening and Older 4 were studied in a prospective randomized series of 41 patients with regular follow-up to six months after operation. The patients were treated with closed reduction under anaesthesia and either external fixation ad modum Hoffman or percutanous pinning and a plaster cast for six weeks. Both treatment groups achieved a clinically and radiologically good result without any significant difference. There were no infections, and except for one patient with persistent signs of mild reflex dystrophy we experienced no serious complications. Owing to simplicity and treatment costs we generally prefer treatment by pinning and plaster cast.

Adult↗
PubMed1980

[Secondary intramedullary nailing osteosynthesis in primarily conservative treatment of fractures of tibia and fibula shafts (author's transl)].

In a retrospective trial 235 patients with fractures of the tibia and/or fibula shafts were followed up. In 16 cases non-union of the fracture occurred after closed reduction and plaster cast treatment. In 16 of these patients closed nailing of the tibia was performed 8--14 weeks after the accident. The healing of the fracture was uncomplicated and occurred in 10--14 weeks p. op. The results in primary nailing cases 8--14 days after the accident were much better than in cases treated with plaster casts, with regard to joint mobility, venous insufficiency and duration of treatment; however two serious complications occurred. In two patients, osteitis occurred after primary nailing of the tibia. Localisation of the fractures (distal part of the tibia) and type of the fracture (short torsion fracture) correlated more frequently with formation of non-union than the rare changes in blood chemistry observed in our study. We regard intramedullary nailing of the tibia as the best available method in treating non-union or pseudarthrosis of the tibia.

Adult↗
PubMed2005

Palate morphology after unilateral and bilateral cleft lip and palate closure.

The aim of the present study was to compare the morphology of the hard palate of patients with uni- and bilateral cleft lip and palate after palatoplasty using vomer and palatal pedicled flaps with the palatal morphology of non-cleft individuals. Eighty patients were enrolled into this retrospective study: 40 patients with cleft lip and palate (30 unilateral, 10 bilateral) and 40 non-cleft patients with class I occlusion, who served as controls. Analysis of the development of the maxillary arch and evaluation of palatal morphology were accomplished from reformatted CT scans from plaster casts of the maxilla at the age of 4, 10 and 15 years (cleft patients) and 10 years (controls). Width and symmetry of the maxillary arch and morphology of the hard palate were assessed in the canine and molar region and compared both among the cleft groups and the controls. Maxillary arch width as assessed from plaster casts did not differ significantly between uni- and bilateral cleft patients and was not significantly different from controls at the age of 10. Deviation from symmetry was present in both types of cleft and significant in unilateral clefts when compared to bilateral clefts and non-cleft patients. Palatal morphology did not differ significantly between uni- and bilateral clefts until the age of 15, but was significantly different from control patients in the molar area at the age of 10 presumably due to the medial shift of soft tissue flaps used for palatoplasty. It is concluded that palatoplasty significantly alters hard palate morphology particularly in the posterior area. The relevance of this alteration for speech and articulation remains to be explored.

Adolescent↗
PubMed1993

[Conservative therapy of ruptures of the medial collateral ligament of the knee. Results of a comparative follow-up study].

The rupture of the medial collateral ligament of the knee joint due to sports injuries is the most common lesion of ligaments of the knee in athletes. The treatment is usually non-operative. We compared in a retrospective study the conservative treatment of these ruptures by two different methods. One group of patients was immobilised in a plaster cast for six weeks, one group of patients was partially immobilised with a brace, initiating early functional therapy. The results proved that the group of early mobilisation was significantly better in late results, in shorter rehabilitation and in all other aspects regarded as important for the treatment of such an injury. Therefore we feel the treatment with plaster casting for isolated ruptures of medial collateral ligaments as the knee should be abandoned.

Adult↗
PubMed1991

[The Malleotrain bandage in a large clinical trial].

The authors tested the clinical efficacy of the malleotrain bandage in a clinical field trial on a very large mixed patient material from 1980 onwards. The patient material included a total of 350 cases of ankle joint injuries with partial and total fibular ruptures of ligament, ruptures of the inferior tibiofibular joint, conditions after malleolar fractures as well as posttraumatic or postoperative swelling.--It was found that the malleotrain bandage achieved subsidence of swelling of the periarticular soft parts, relief of complaints and considerable normalisation of functioning, within an unusually short time and without medication or other local measures.--Patients who had been operated on for complete rupture of fibulotalar ligament were given by Lippay the malleotrain bandage only, after having immobilised the malleolus by means of a plaster cast for 10 days, without any disadvantages in respect of healing and subsequent stability.--Blandfort had even treated complete lateral ankle joint ligament ruptures conservatively with the malleotrain bandage only and had thus achieved cure resulting in stable ligaments.--The ability to work and to resume sports activities returned on the average two weeks earlier than with plaster cast immobilisation.

Adolescent↗
PubMedDate not supplied

[Aseptic pseudarthrosis of the tibial shaft: cause and treatment].

A consecutive series of 23 aseptic pseudarthroses of the tibial shaft is proposed. The aetiology of a pseudarthrosis of the tibia depends on the original fracture form, the associated soft tissue injury, the treatment technique and the surgical procedure. Twelve times the pseudarthrosis developed after a primary treatment with an external fixation device, 6 times after plaster cast immobilization, and 5 times after plate osteosynthesis. Fifteen times, the pseudarthrosis was hypertrophic, and 8 times hypotrophic. Sixteen pseudarthroses were treated with a plate osteosynthesis, 8 times in combination with a decortication and a cancellous bone grafting. Seven times, a closed intramedullary nailing was performed. Healing was achieved after an average time of 5.1 month. After plaster cast immobilization and external fixation treatment, the non-union is caused by a lack of stability in the fracture region; after plate osteosynthesis by a too extensive decortication, resulting in fragment necrosis. Stability and vitality in the fracture site are the principles in the treatment of the pseudarthrosis.

Adult↗
PubMed1993

Incidence and prophylaxis of deep venous thrombosis in outpatients with injury of the lower limb.

253 outpatients were included in a prospective randomized study. All patients had incidence of injuries of the lower limb immobilized by a plaster cast. 126 patients (group I) received a subcutaneous injection of Fraxiparin daily, and 127 patients (group II) received no thromboprophylaxis. Without prophylaxis 21 (16.5%) cases developed a thrombosis, and with prophylaxis a thrombosis could be proven in 6 (4.8%) patients only (p < 0.01). Thus, for all patients with an injury of the lower limb being immobilized by a plaster cast, a thromboprophylaxis with a low-molecular-weight heparin is recommended.

Adolescent↗
PubMed2005

Changes in bone mass and bone turnover following tibial shaft fracture.

INTRODUCTION: Bone loss occurs in the regional bone following tibial shaft fracture. An earlier cross-sectional study showed that measurements made at the metaphyseal region of the tibia using peripheral quantitative computed tomography (pQCT) and the ultradistal region of the tibia using dual-energy X-ray absorptiometry (DXA) were the most responsive at monitoring this bone loss. Biochemical markers of bone turnover enable us to assess the activity of bone formation and resorption during fracture healing. The aim of this longitudinal study was to determine the pattern and distribution of bone loss and bone turnover following a tibial shaft fracture treated with either plaster cast or intramedullary nail. METHODS: Eighteen subjects underwent bone mass measurements using DXA at the tibia and hip and quantitative ultrasound (QUS) at the tibia and calcaneus of both limbs at 2 weeks, 8 weeks, 12 weeks and 24 weeks following fracture, with hip and tibia DXA measurements also performed at 52 weeks. Nine of the patients treated with plaster cast had pQCT measurements at the tibia at 24 weeks. We measured three bone formation markers, bone alkaline phosphatase (bone ALP), osteocalcin (OC) and procollagen type 1 N-terminal peptide (PINP), a marker of bone resorption, serum C-telopeptides of type 1 collagen (beta-CTX) and a marker of collagen III turnover, procollagen type III N-terminal peptide (PIIINP) at 1 day, 3 days and 7 days and at 2, 4, 8, 12, 16 and 24 weeks following fracture. The greatest bone losses were observed at the ultradistal region of the tibia using DXA (28%, p <0.001) and the metaphyseal region of the tibia using pQCT (26-31%, p <0.001) at 24 weeks. In the hip, the greatest loss was in the trochanter region at 24 weeks (10%, p <0.001). The greatest loss at the calcaneus measured using QUS was for broadband ultrasound attenuation (BUA) measured using CUBA Clinical at 24 weeks (13%, p =0.01). RESULTS: At 1 year, there was a small recovery in bone loss (ultradistal tibia DXA, 20%, p <0.01; trochanter DXA 9%, p <0.001). Bone turnover increased following fracture (PINP +72+/-21%, p <0.0001, bone ALP +199+/-22%, p =0.004, beta-CTX +105+/-23%, p <0.0001, all at 24 weeks). There was a smaller +33+/-10% increase in osteocalcin at 24 weeks. PIIINP concentration peaked at week 8 (+57+/-9%, p <0.0001). The bone resorption marker beta-CTX showed an earlier rise (week 2, 139+/-33%) than the bone formation markers. CONCLUSIONS: We conclude that: (1) bone loss following tibial shaft fracture occurs both proximal and distal to the fracture; (2) the decreased BMD is largest for trabecular bone in the tibia with similar measurements using DXA and pQCT; (3) there is limited recovery of bone lost at the hip and tibia at 1 year; (4) tibial speed of sound (SOS) demonstrated a greater decrease than calcaneal SOS when comparing z -scores; (5) BUA is the QUS variable that shows the biggest decrease of bone mass at the calcaneus; (6) increase in bone turnover occurs following fracture with an earlier increase in bone resorption markers and a later rise in bone formation markers.

Absorptiometry, Photon↗
PubMed2004

Activities and impairments in the early stage of rehabilitation after Colles' fracture.

PURPOSE: The purpose of this study was to investigate problems in performing activities after Colles' fracture, and to correlate activity limitations with impairments in the early stage of rehabilitation. METHOD: Assessments were performed 1 and 5 weeks after removing plaster casts. A client-specific instrument, The Canadian Occupational Performance Measure, and a disease-specific dichotomous scale of 10 activities of daily living were used. Range of motion, grip strength, pain and dexterity were also assessed according to standardized methods. RESULTS: Thirty-three women, aged 51-87 years, with Colles' fracture treated with closed reduction and a plaster cast participated. Highly significant statistical and clinical improvements were found in the capacity, number and performance of activities. Problems were mainly classified as self-care activities at 1 week, and as productivity activities at 5 weeks, while problems in leisure activities were practically the same. However, one-third of the patients were not able to perform all basic activities of daily living at 5 weeks. Improvements in pain frequency, range of motion, grip strength and dexterity did not correlate very well with improvements in performance or the patients' satisfaction with the performance of their activities. CONCLUSIONS: The importance of assessing both impairments and activities in patients with Colles' fracture must be stressed.

Activities of Daily Living↗
PubMed2002

[Treatment using the Lehman apparatus in patients with malocclusion in light of teleradiologic tests and dental arch measurements].

The aim of this study was to assess the usefulness of Lehman's appliance for the management of distocclusion and to establish indications and contraindications to its use. The mean duration of treatment was also determined and compared to such in similar form of malocclusion treated with other types of functional appliances. Linear measurements were performed on dental plaster casts before and after treatment. Cephalometric analysis served to establish the mechanism of Class II correction (skeletal or dentoalveolar) and to reveal any increase in mandibular length caused by Lehman's appliance. The material consisted of thirty-three Class II patients (18 girls and 15 boys), aged 9 to 15 years, treated successfully with Lehman's appliance for distocclusion. Dental plaster casts and lateral cephalograms were obtained at the beginning and end of treatment. Improvement in occlusal relationship in the molar, canine and incisor segments was the result of dental and skeletal changes. Metric analysis of dental casts before and after treatment showed that active treatment was associated with an increase in transversal dimensions of the upper arch ranging from 1.8 to 2.4 mm. Overbite and overjet decreased considerably. Anterior length of upper arch was reduced significantly in boys only and was accompanied by distraction and transition from a V-shaped to U-shaped type of arch. These changes helped to harmonize transversal dental relationship of both arches and improved conditions for functional skeletal base adaptation. Treatment with Lehman's appliance improved the intermaxillary relationship and led to a decrease in the ANB angle attributable to a change in the SNA angle in girls and the SNB angle in boys. The mandibular reaction in girls with Class II/2 was interesting: the SNB angle increased considerably, indicating "unblocking" of the mandible. Changes in the vertical skeletal relationship were limited to a minor reduction in the index. Maxillary incisors moved little, but mandibular incisors showed significant proclination. The present findings demonstrate an additional increase in total mandibular length achieved with Lehman's appliance. This important effect contributed to a successful treatment of Class II malocclusion. Nevertheless, it should be remembered that this growth process depends on other factors, such as age, growth potential, growth pattern, and duration of appliance use. Average duration of treatment was 15 +/- 5.2 months in girls and 17.1 +/- 7.1 months in boys. In the case of girls, treatment in skeletal Class I was shorter than in skeletal Class II; the contrary was true in boys. Duration of treatment was shorter in patients with orthognathic type of face, irrespective of gender. Patients with deep vertical relationship showed a better prognosis in terms of duration and effects of treatment.

Adolescent↗
PubMed1977

Experimental investigations on hypokinesis of skeletal muscles with different functions, II. Quantitative changes in the nucleic acids.

The effect of hypokinesis on the quantitative changes in the nucleic acids was studied in functionally different muscles of rabbits on the 5th, 10th, 14th and 28th days following plaster cast immobilization of the limbs. As a consequence of the immobilization, the total amount of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) decreased in both the tonic and the tetanic nuscles. The decrease was more marked in the tonic muscles. As a result of the hypokinesis, the RNA/DNA ratio increased in the m. gastrocnemius, and decreased in the m. soleus. The plaster cast immobilization has a greater effect on the homoeostasis of the nucleic acids of the tonic muscles than in the case of the tetanic muscles.

Animals↗