The Rising Incidence of Operative Treatment of Mid-shaft Clavicle Fractures

To evaluate whether the incidence of operative fixation of mid-shaft clavicle fractures has increased.

State Emergency Department Databases (SEDD) and State Ambulatory Surgery Databases (SASD) were used to identify patients presenting with mid-shaft clavicle fractures from 2005 to 2010 in California and New York State.

Patients were identified by International Classification of Disease, Ninth Edition (ICD-9) and Current Procedural Terminology (CPT) codes. Multivariable logistic regression analysis was conducted to illustrate any demographic trends regarding patients undergoing operative fixation.

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Dance-based Exercise Therapy for People with Arthritis: An Update and Commentary

Arthritis, a broad term used to describe more than 100 different health conditions that result in considerable physical disability, is very challenging to treat effectively, regardless of disease type.

This brief review revisits the research base concerning the use of dance-based therapeutic exercises as a possible adjunct for ameliorating arthritis.

The goal was to provide an overview of the potential of this form of therapy for arthritis patients as well as health professionals working with this population.

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The Effects of Vitamin D Supplementation in Patients with Knee Osteoarthritis: Uncontrolled Open Label Clinical Trial

Osteoarthritis (OA) is a degenerative disease that affects joints. The current relationship between low vitamin D levels, functions, and symptoms of osteoarthritis is controversial.

The aim of this study is to investigate the relationship between knee osteoarthritis and serum levels of vitamin D. An uncontrolled open label clinical trial conducted on patients with low vitamin D levels using the Western Ontario and McMaster Universities Arthritis Index (WOMAC criteria).

The WOMAC criteria used objectively to assess knee-joint function and symptoms before and after vitamin D3 supplementation. The study conducted from March 2013 to October 2015 at King Abdulaziz Medical City.

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Minimal Invasive Percutaneous Repair of Acute Closed Rupture of Achilles Tendon

Achilles tendon injuries are fairly common nowadays due to prevalence of comorbid conditions. The proposed lines of treatment in the literature are conservative treatment with cast immobilization, open surgical repair and minimal invasive lines of treatment with percutaneous repair.

To achieve optimum return of function, surgical repair is clearly superior to non-operative treatment.

The purpose of this study is to determine the results of minimal invasive Percutaneous repair of acute closed rupture of Achilles tendon with special emphasis on how to protect the sural nerve during the procedure.

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First and Second Metacarpal Bone Fusion for First Carpometacarpal Joint Arthritis in Rheumatoid Arthritis: A Case Report

A case of rheumatoid thumb carpometacarpal (CMC) arthritis with advanced osteolysis is reported.

Although CMC joint arthrodesis was performed, bone union was not achieved, and pain and instability persisted. Therefore, first and second metacarpal bone fusion was performed with satisfactory results.

While CMC joint arthrodesis or arthroplasty is typically performed, first and second metacarpal bone fusion appears to be a useful treatment option when there is marked osteolysis.

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A Review of Competency Based Orthopaedic Training in the UK: A Trainee?s Perspective

This review explores the concepts and methodology in competency based education, with reference to orthopaedic training in the United Kingdom.

In 2006, a new competency based curriculum for postgraduate training in Trauma and Orthopaedics was approved by the Postgraduate Medical Education Training Board.

Though the curriculum is now widely accepted, few surgeons have a theoretical knowledge of the basis for competency-based medical education, beyond their own area of involvement.

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Improved Outcomes in Juvenile Idiopathic Arthritis Following Antihistamine Treatment in Patients with Concurrent Allergic Rhinitis

Fifty-two JIA patients with AR were enrolled and consecutively randomized. The control group comprised 26 patients who were treated with methotrexate (MTX) 10-15 mg/m2/week orally for 12 months and enteric-coated diclofenac sodium 0.5-2 mg/kg/day orally for 12 weeks.

The test group comprised 26 patients who received adjunctive therapy with oral and intranasal antihistamines for 12 months, in addition to MTX and diclofenac.

The responses were evaluated using American College of Rheumatology (ACR) pediatric (Pedi) 30/50/70 criteria, AR score, 27-joint Juvenile Arthritis Disease Activity Score (JADAS-27), and laboratory variables.

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Aberrant Regulation of Interleukin 18 Binding Protein A (IL-18BPa) by IL-18BPa Autoantibodies in Rheumatoid Arthritis

65 Rheumatoid Arthritis (RA) patients, 22 Osteoarthritis (OA) patients, and 40 sex and age matched healthy donors were enrolled in this study.

Synovial fluids mononuclear cells (SFMC) and peripheral blood mononuclear cells (PBMC) were prepared by using Ficoll-Hypaque separation procedure.

Super Array analysis was used to measure the expression profile of immune-related genes in RA synovial tissues (RA-ST) and in normal PBMC treated with recombinant human IL-18 binding protein a (IL-18BPa).

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Risk of Fall in Patients during the Early Months after Total Knee Arthroplasty

Falls are among the most common causes of injury in elderly people, whereas little is known about the risk of falls during the early months after hospital discharge in people undergoing Total Knee Arthroplasty (TKA).

Therefore, this study aimed to assess risk of falling in patients during the early months after TKA.

Seventy patients undergoing primary TKA for knee osteoarthritis participated in this study.

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Platelet-Rich Plasma in Temporomandibular Joint Osteoarthritis Therapy: A 3-Month Follow-Up Pilot Study

The use of Platelet-Rich-Plasma (PRP) may provide a new and improved treatment option for early Temporomandibular Joint (TMJ) Osteoarthritis (OA).

However, there are no studies on its use in TMJ arthritis in the literature. The present study compares 30 early onsets OA patients divided equally into 3 groups who had experienced no pain reduction following conservative and minimally invasive arthrocentesis and arthroscopy treatment.

All patients had retrodiscitis and synovitis on arthroscopic examination and were without systemic joint disease, septic, or autoimmune arthritis.

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Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy

The primary aim of this study is to evaluate the functional outcomes of two surgical treatment groups with hallux rigidus. Our goal was to better understand the post-surgical outcomes between the two treatment groups from a practical, patient-centered point of view.

A retrospective case series of 63 patients with hallux rigidus undergoing cheilectomy (C group) or a cheilectomy plus proximal phalanx osteotomy (CPP group) over a 4-year period with a minimum clinical follow up of 12 months. Evaluation of the study was based on satisfaction scores, VAS score, functional outcomes, and radiographs.

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PARQVE-Project Arthritis Recovering Quality of Life by Means of Education Short-term Outcome in a Randomized Clinical Trial

Two hundred and five patients with knee OA were evenly allocated in four groups. Three groups had two days of lectures on Osteoarthritis (OA).

All groups received printed material to read and a video with all the lectures. Groups 1, 2, and 3, had lectures one, two and three months apart respectively.

Group 4 received the educational material only. Half of the patients (subgroups A) received a telephone call two months after the final lecture.

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Causes of Death in Autopsied Patients with Rheumatoid Arthritis in Japan

Numerous studies in the US and Western countries have demonstrated that excessive mortality associated with Rheumatoid Arthritis (RA) is mainly related to cardiovascular death.

Since most studies of mortality due to RA from Japan are relatively small, it is not clear whether cardiovascular death is common in Japanese with RA.

AA-amyloidosis is caused by sustained elevation of serum amyloid A and prolonged inflammation. Although AA-amyloidosis used to be a major cause of death in patients with RA, the incidence of this complication seems to have declined recently.

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Hereditary Multiple Exostoses HME of the Spine; is Really a Benign Bone Tumour Syndrome? Editorial

Hereditary multiple exostoses is the most common type of bone dysplasia, which was first described by Boyer in 1814.

It is characterized by the growth of cartilage-capped benign bone tumours around areas of active bone growth, particularly the long bones metaphysis.

Exostoses can involve all bones, but invariably spare the skull and the face. It is a rare pathology that occurs in around 1 in 50,000 individuals.

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Multiple Finger Extensor Tendon Dislocations in Systemic Lupus Erythematosus with Unique Trigger Phenomena

Dislocation of extensor tendons is the most frequently seen complaint for suffers of rheumatoid arthritis. Here, we present a rare clinical case of multiple finger extensor tendon dislocations in systemic lupus erythematosus (SLE).

Upon physical examination, active extension of middle, ring and little fingers were impossible at the MP joint. A trigger phenomenon was generated when these extensors were reduced in passive extension. The procedure was performed under local anesthesia.

A satisfactory clinical outcome was achieved with sagittal band reconstruction and reinforcement for the site using juncturae tendinum. Surgical intervention under the local anesthesia allowed for extensive gathering of information about repair site strength and dynamic stability.

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Efficacy of Combination Therapy with rhTNFR:Fc and Methotrexate in the Patients with Disease-modifying Antirheumatic Drug -resistant Rheumatoid Arthritis

 To observe the efficacy of combining recombinant human tumour necrosis factor-Fc and methotrexate (MTX) in patients with disease-modifying antirheumatic drug (DMARD)-resistant rheumatoid arthritis.

Collected 64 active RA patients with DMARD-resistant, according to patients’ gender, age, duration and extent of disease activity, divided the 64 patients randomly into comparable two groups. The experimental group within thirty-two patients, were treated with twice-weekly subcutaneous etanercept (25 mg) and meanwhile weekly oral MTX (15 mg).

The control group within thirty-two patients, were treated with daily oral prednisone (5-10 mg) and meanwhile weekly oral MTX (15 mg).Course of treatment is 12 weeks. Clinical response was assessed using American College of Rheumatology (ACR) criteria.

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Vitamin D Deficiency and its Repletion: A Review of Current Knowledge and Consensus Recommendations

In last few years we have witnessed an explosion of research revealing the wide spread prevalence of vitamin D deficiency among all ages, communities, and different disease spectrums.

Clearly, vitamin D has been shown to have effects beyond its traditional role in mineral metabolisms, which are mediated through the activation of vitamin D receptors distributed in a variety of tissues.

There are strong epidemiological links between vitamin D deficiency and chronic diseases and will continue to be a focus of future research. However, this research information has not yet been fully translated into clinical practice.

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The Tibial Pilon Fractures: Are there Problems?

French radiologist Destot primarily used the nomenclature of Tibial Pilon fractures (TPF) to describe distal tibia metaphyseal fractures.

The TPF represent a difficult problem in orthopedic surgical practice because the reduction of these fractures is complex both in the choice of “how” for surgery, both in the choice of “when” (operative timing) for surgery.

Their frequency is relatively low, about 1% of all lower limb fractures, with higher incidence in the 3rd and 5th decade.

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