Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection.Aims
Methods
The operation has the advantage of simplicity, and it avoids the slight danger of secondary cicatricial
We report the results of 23 soft-tissue release procedures in 15 patients who had juvenile chronic arthritis. The operation, which includes hamstring tenotomies and posterior capsulotomy, is a safe and effective way of eliminating
1. The modifications of standard Z-plasty technique that are necessary for its successful use in hand surgery are discussed with particular reference to the limiting factors imposed by the anatomical characteristics of the hand. 2. The use of the Z-plasty in Dupuytren's
1. A case of hernia of the anterior tibial muscles is described in which repair of the hernia under tension was followed by local muscle necrosis and
A case of Dupuytren's
1. Four cases of congenital lateral dislocation of the patella are described. 2. The significance of the associated flexion
Of 22 infants aged between 11 and 29 months who underwent a combined reconstruction of the upper brachial plexus and shoulder for the sequelae of a birth injury, 19 were followed up for two or more years. The results were evaluated using a modified Gilbert scale. Three patients required a secondary procedure before follow-up. Three patients had a persistent minor internal rotation
The use of technology to assess balance and alignment during total knee surgery can provide an overload of numerical data to the surgeon. Meanwhile, this quantification holds the potential to clarify and guide the surgeon through the surgical decision process when selecting the appropriate bone recut or soft tissue adjustment when balancing a total knee. Therefore, this paper evaluates the potential of deploying supervised machine learning (ML) models to select a surgical correction based on patient-specific intra-operative assessments. Based on a clinical series of 479 primary total knees and 1,305 associated surgical decisions, various ML models were developed. These models identified the indicated surgical decision based on available, intra-operative alignment, and tibiofemoral load data.Aims
Methods
1. The nature of flexion
1. Methods of correcting flexion
Eight children with paralytic drop foot after intramuscular injections later developed gluteal fibrosis. Sciatic palsy, presenting as equinovarus or equinus deformity, was diagnosed on average 3.8 months after the intragluteal injections, but gluteal fibrosis was not diagnosed until 5.1 years after the injections. In three patients the equinovarus recurred after surgical correction due to persistent muscle imbalance and the effect of the external rotation
In a consecutive series of 87 operations for knee replacement prospective observations were made of the pattern of articular destruction in the form of a triangle of erosion or osteophyte formation, which is seen on the medial femoral condyle, sometimes with an associated strip on the lateral femoral condyle. These areas represent the surfaces which are normally in contact with the anterior horns of the menisci when the knee is fully extended. The lesions in question were found only in association with a flexion
The aims of this study were to determine the effect of osteophyte excision on deformity correction and soft tissue gap balance in varus knees undergoing computer-assisted total knee arthroplasty (TKA). A total of 492 consecutive, cemented, cruciate-substituting TKAs performed for varus osteoarthritis were studied. After exposure and excision of both cruciates and menisci, it was noted from operative records the corrective interventions performed in each case. Knees in which no releases after the initial exposure, those which had only osteophyte excision, and those in which further interventions were performed were identified. From recorded navigation data, coronal and sagittal limb alignment, knee flexion range, and medial and lateral gap distances in maximum knee extension and 90° knee flexion with maximal varus and valgus stresses, were established, initially after exposure and excision of both cruciate ligaments, and then also at trialling. Knees were defined as ‘aligned’ if the hip-knee-ankle axis was between 177° and 180°, (0° to 3° varus) and ‘balanced’ if medial and lateral gaps in extension and at 90° flexion were within 2 mm of each other.Aims
Methods
In juvenile chronic arthritis the hips are commonly affected and this becomes the most important reason for losing independence and mobility: the joint develops a painful flexion
We describe the treatment of three boys with cavernous lymphangioma of the legs. The suggested guidelines for treatment are extensive surgical resection, although complete resection is usually impossible, and approximately two weeks after the operation aspiration of serous fluid which has accumulated at the operation site, followed by injection of OK-432 (Picibanil). There was pyrexia and local inflammation for several days but the accumulation of serous fluid disappeared after the injection. There were no complications with no recurrence, joint
1. Three families with the characteristic changes of the nail-patella syndrome are reported. In addition to the well established bone and nail defects they had soft-tissue
We compared the results in two groups of patients with late reduction of posterior elbow dislocations, one of which had lengthening of the triceps (group A, n = 36) and the other did not (group B, n = 34). The elbows had all been dislocated for more than one month and less than three months. The patients in group B had better clinical results and significantly less postoperative flexion
An eight-year-old boy presented with massive pseudomalignant heterotopic ossification around the upper femur. The mass was completely excised because of severe pain, systemic illness and a flexion
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