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Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose. To investigate the relationship between handgrip strength (HG) and upper limb functioning of hip fracture operated elderly patients and their functional outcome 6 months post-op. Methods. Retrospectively, data on 105 post-operative hip fracture patients was analyzed. Functional level was measured by the Functional Independence Measure (FIM) and HG by hand dynamometer, 7-10 days, 1, 3 and 6 months post-op. FIM1 up-to FIM4 (FIM1-FIM4) and HG1 up-to HG4 (HG1-HG4) were determined. Pre-fracture upper limb function was evaluated using the disabilities of the arm, shoulder and hand (DASH) questionnaire. The Mini-Mental-State Examination evaluated cognition. Results. FIM1-FIM4 scores increased during the 6-month follow-up; HG1-HG4 scores remained unchanged. No differences were found in FIM1-FIM4 and DASH scores between genders. HG1-HG4 scores were significantly higher in men (p = 0.04-0.005). FIM1-FIM4, HG1-HG4 and DASH scores were higher in the cognitively normal patients (p < 0.001). A fair correlation was found between all HG and FIM scores (R = 0.36-0.71, p < 0.001), and between DASH and FIM scores (R = 0.5-0.7, p < 0.001). Log HG1 and FIM4 scores were highly correlated (R(2) = 0.54, p < 0.001). Regression analysis found that only, and in the following order were Log HG1, FIM1, DASH and age significant factors affect FIM4 score (R(2) = 0.69). Conclusions. HG and FIM scores, a week post-op., combined with upper limb functioning and age, can have a 69% prediction accuracy for motor functioning 6 months post-fracture. HG measurement, a week post-hip fracture repair, might be considered in estimating functional motor outcome, and eventually additional interventions should be employed to increase muscle strength and, thus, improve functional outcome. [ABSTRACT FROM AUTHOR]

Background: Fishing involves millions of people throughout the world and is considered a pleasant and harmless sport. However, many kinds of injury can occur. Penetrating injuries to the extremities by fishing equipment such as hooks and harpoons, and even by scales, or infection from penetration of scales etc are relatively common although hardly ever reported in the literature.Methods: Illustrative cases of penetrating fishing injuries are presented and discussed, with suggestions for the recommended management of these types of injury.Results: Most of these objects are designed to catch and hold resisting fish, so are usually sharp and narrow in the front and wider in the rear with or without spurs. Because of their very irregular shape, simple extraction by pulling is not recommended, because further damage may occur.Conclusions: The use of the appropriate imaging modalities, a full knowledge of the contours of the object, and careful preplanning of the method of treatment are very important. [ABSTRACT FROM AUTHOR]

Treatment of osteosarcoma (OSA) of the proximal humerus poses many difficulties and challenges to the treating team. Between 1993 and 2000, we treated 11 patients (three women, eight men; age range, 17–74 years) suffering from OSA of the proximal humerus by ‘composite’: massive allografts and long humeral prosthesis. At presentation, 10 patients were at stage 2-B and one at stage 3-B of OSA. One patient presented with a pathologic fracture. All patients except patient No. 6, received preoperative chemotherapy followed by limb salvage surgery and postoperative chemotherapy. Surgical margins were graded as wide in all patients. Postoperative complications included non-union at the allograft/host junction (which united after auto grafting) and superficial wound infections that resolved after antibiotic therapy. All surgical procedures were performed by a team headed by an orthopedic oncologist and shoulder surgeon. At latest follow-up (December 2001) all patients, with the exception of one (who was at stage 3-B at presentation) were alive, and had good function of the upper limb. It is our opinion that the team approach comprising an orthopedic oncologist and shoulder surgeon greatly contributed to the good surgical outcome, and hence the good survival and functional results of the patients. Bone allograft offers a modular malleable durable solution to the resected bone segment. [ABSTRACT FROM AUTHOR]

Total hip arthroplasty (THA) in young patients is a controversial subject, due to the high failure rates reported in the literature, and even more so in patients with a history of developmental dysplasia of the hip (DDH). A group of 11 patients, all under the age of 30 years at the time of surgery, underwent THA due to congenital dislocation of the hip. Mean age at the time of operation was 23.3 years (range 16–30 years). The mean follow-up period was 9 years (range 3–14 years). The mean preoperative Harris' hip score (HHS) was 56.9 compared with the postoperative HHS of 90.6. Due to aseptic loosening of the cup, 4 patients underwent successful revision arthroplasty. These encouraging medium-term results in our patients suggest that THA may be a good solution for young patients suffering from coxarthrosis due to DDH, at least temporarily, especially when other alternatives, such as arthrodesis or resection arthroplasty, are considered. [ABSTRACT FROM AUTHOR]

Sonographic examination of the knee has been proposed by several authors in the past as a simple and reliable method to diagnose Osgood-Schlatter disease (OSD). Ultrasound was used to compare the knees of 25 boys and 10 girls with typical OSD with 35 symptom-free knees of an aged-matched group of children. Based on recorded data, patients were categorized (one affected knee in each individual) according to the classification system proposed by De Flaviis et al. in 1989. The results included the following pathological findings: pretibial swelling, fragmentation of the ossification center, insertional thickening of the patellar tendon, and excessive fluid collection in the infrapatellar bursa. Of our patients, 26% fell into the type 1 category, 43% were type 2, 20% type 3, and 11% type 4. This distribution of cases was found to be statistically similar to the initial findings reported by De Flaviis and colleagues. This study therefore supports the validity and reproducibility of their classification method for the ultrasonographic evaluation of children with OSD. This is only the first step, and further assessment of this classification is still required to elucidate its clinical as well as its prognostic value. [ABSTRACT FROM AUTHOR]

Myositis ossificans is usually the result of direct injury to a muscle and is a self-limiting disease. It may present as a soft-tissue mass with a broad differential diagnosis, including highly malignant tumours, such as soft-tissue sarcomas. Many theories can be found concerning the aetiology of myositis ossificans, but minor or major traumas are considered to be the most common cause. A unique case of myositis ossificans of the neck in a 17-year-old professional, female, ground gymnast, who presented initially with a soft-tissue tumour, was treated successfully. The main differential diagnosis is presented along with typical radiographic features on conventional radiography, computerised tomography and magnetic resonance imaging, and typical pathological appearance, such as the pathognomonic "zoning phenomenon". Myositis ossificans should be added to the differential diagnosis of every young patient who engages in sport presents with a soft-tissue mass. Careful padding of the area and teaching the rolling technique to avoid repeated injuries to the neck can prevent recurrence. [ABSTRACT FROM AUTHOR]

Penetrating wounds and lacerations are frequent pathologies treated in the emergency room. The management of hand trauma represents a large part of the work in any surgical practice. Although X-rays are routinely taken, numerous foreign bodies remain undetected, and the wounds are just locally debrided and the lacerations sutured. Unfortunately, as not all foreign bodies are radio-opaque, the radiography results may appear normal, but the patient fails to recover. Patients complaining of persistent wound tenderness were sent for ultrasound investigations, and foreign bodies were detected. Had ultrasonography been carried out initially in the emergency room, the correct diagnosis would have been made, and the sonographic equipment could have helped to guide the physician in his attempt to remove the foreign body. Usually, in response to continued pain, an ultrasound investigation is ordered, and the pathology becomes apparent. A number of examples are briefly described in order to highlight the present inadequacies. It is suggested that hospital administrators consider the need to provide ultrasonographic services as an integral facility of the emergency room. [ABSTRACT FROM AUTHOR]

Objective: According to the literature, 30-70% of cyclists suffer from cervical, dorsal, or lumbar back pain. This study was conducted to evaluate one of the possible causes of low back pain and to suggest a solution by appropriate adjustments to the bicycle.Methods: Serial fluoroscopic studies were performed while cyclists sat on different types of bicycle (sports, mountain, and city). Pelvic/spine angles were measured at different seat angles, and the related force vectors analysed.Results: There was a tendency towards hyperextension of the pelvic/spine angle which resulted in an increase in tensile forces at the promontorium. These forces can easily be reduced by appropriate adjustment of the seat angle--that is, by creating an anterior inclining angle. The findings of the biomechanical analysis were then applied to a group of cyclists who were members of a cycling club and who complained of low back pain. After appropriate adjustment of the saddle angle, most of the cyclists (>70%) reported major improvement in the incidence and magnitude of their back pain.Conclusions: The incidence and magnitude of back pain in cyclists can be reduced by appropriate adjustment of the angle of the saddle. It is important that these findings be conveyed to cyclists, bicycle salesmen, trainers, and members of the general public who engage in cycling, in order to decrease the prevalence of back pain. [ABSTRACT FROM AUTHOR]

We retrospectively reviewed 207 patients suffering from traumatic bone defect who had been treated at our institution between 1973 and 1993. Three types of traumatic bone defects were identified: I, minor; II, major cortical; III, major articular. Each type was further subdivided into: A, open injury; B, closed injury. The proposed treatment modality of each type was included within each classification. Types II and III posed the greatest difficulties in management. However, massive bone allografts can be successfully used in these situations, even in the early phases of treatment, but only given specific prerequisites. [ABSTRACT FROM AUTHOR]

Three-dimensional computerized imaging is a new modality of radiological imaging. This new technique transforms the two-dimensional slices of bi-plane CT into a three-dimensional picture by a computer’s monitor adjusted to the system. This system enables the physician to rotate the angle of viewing of the desired region to any desired angle. Moreover, this system can delete certain features of different densities from the picture, such as silicone implants, thus improving visualization. Our preliminary results using this technique are presented. The advantages, pitfalls, and suggested future applications of this new technique in hand surgery are discussed. [ABSTRACT FROM PUBLISHER]

Ankle fractures in the elderly are extremely common (up to 184 fractures per 100,000 persons per year, and of these approximately 20%-30% occur in the elderly). The medical literature contains no research that has investigated ankle fractures in the elderly. A prospective, randomised study was conducted of 84 patients with displaced ankle fractures, who were over the age of 65 years and were assigned to operative or conservative treatment after closed reduction. The results of treatment assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) Score showed a mean of 91.37 +/- 8.96 in the non-operated group compared with 75.2 +/- 14.38 (P = 0.001) in the operated group. The costs of treatment were accordingly higher. These results call for consideration of a non-operative approach to the treatment of well-reduced ankle fractures in the elderly. Increased efforts should be invested in the prevention of these common fractures. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Orthopaedic Surgery & Traumatology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The treatment of deep chondral defects at the knee joint poses major difficulties and challenges to the orthopaedic surgeon, particularly in young patients for whom solutions like total or hemi-joint arthroplasty are not recommended, because of their limited durability. Biological resurfacing with materials such as perichondrium, periosteal allografts, and cultured chondrocytes is still at the experimental stage and there has been limited clinical validation. Since 1978, we have successfully used fresh osteochondral (`shell') allografts for the treatment of selected patients with a chondral defect at the knee joint. These grafts, implanted mainly in young patients, have proved durable and have provided good functional results for more than 15 years, as shown by an average of 84.6 in the Hospital for Special Surgery (HSS) Knee Score. The operative technique and results of long-term follow-up of patients receiving fresh, osteochondral (‘shell’) allografts are presented and discussed. [ABSTRACT FROM AUTHOR]

Total hip arthroplasty (THA) is one of the major breakthroughs in modern orthopedics this century. Since its introduction in the early 1960s by Sir J. Charnley, it has become the most common form of arthroplasty. The art of performing THA has developed to a large extent, yet with the inevitable “price” of a learning curve. The rates of early and late complications reported in the orthopedic literature have been decreasing gradually, along with improved short- and long-term results. We report the results of two similar series of THA performed with an interval of 15 to 20 years, which show that the improvement of the results that form the learning curve of THA at our institution is statistically significant. [ABSTRACT FROM AUTHOR]

Limb salvage operations using large custom-made prostheses have become the treatment of choice for juxta-articular tumours at the knee. Resection-arthrodesis has been used since the 1920s and offers a satisfactory long term solution for young active patients. The good functional results after this procedure in 9 patients is presented here. This method should still be considered in selected cases. [ABSTRACT FROM AUTHOR]

We report a rare case of intramuscular hydatid cyst in a boy who presented clinically as having a soft-tissue thigh mass. A high level of awareness concerning the occurrence of these cysts is important, especially in regions where Echinococcus is endemic. Surgical treatment follows the principles of malignant tumour, namely, wide surgical resection. [ABSTRACT FROM AUTHOR]

Non-union of an undisplaced fracture of the radial neck in a rheumatoid patient is presented. Possible causes are discussed, and the literature reviewed. [ABSTRACT FROM AUTHOR]