Ali Moazemi pour; Farivar Lahiji; Mehrak Ashouri
Abstract
Background: Previous studies suggest an existingassociation between massive rotator cuff tear (RCT) and peripheral neuropathy. However, the findings are often inconsistent. In the present prospective study we assessed the prevalence of peripheral neuropathy in patients with massive RCT. In addition, ...
Read More
Background: Previous studies suggest an existingassociation between massive rotator cuff tear (RCT) and peripheral neuropathy. However, the findings are often inconsistent. In the present prospective study we assessed the prevalence of peripheral neuropathy in patients with massive RCT. In addition, we evaluated the effect of surgical repair of this rupture on thetreatment outcomes of neuropathies.Methods: In this study, 58 patients were evaluated with a massive RCT. All patients underwent arthroscopic repair using suture anchor groups. Before surgery, electromyography (EMG)/nerve conduction velocity(NCV)were performed to check for neuropathy.In addition, before and after the surgery, Quick Disabilities of the Arm, Shoulder and Hand (DASH) score was calculated for all patients and the pain intensity was measured using visual analogue scale (VAS). Patients were followed up for 6 months. In the final visit, EMG/NCV was reperformed for those patients with neuropathy.Results: A total of 8 patients with neuropathy were observed (13.5%), of which 5 cases were presented with suprascapular neuropathy, 2 cases of upper trunk neuropathy and 1 case of neuropathy. In the final visit examinations, all cases except one suprascapular neuropathy and an upper trunk neuropathy were recovered.In the final visit, the average Quick DASH score was significantly reduced from 72.6 to 19.7 (p <0.001).Similarly, the severity of pain significantly decreased from 5.3 to 1/1 (p <0.001). In the final visit, the most important complaint of the patients was a limitation of motion in 11 patients (19%). Three patients also complained of pain, two of whom were those whose neuropathy had not improved.Conclusion:Precise screening for neurological damage is recommended in all patients with extensive RCT.Moreover,electromyographic studies can be of benefit in suspected cases of neuropathy before repair of rotator cuff.
Ali Akbar Esmailiejah, MD طEsmailiejah, MD; Ali Akbar Esmailiejah, MD طEsmailiejah, MD; Manoochehr Vahid Farahmandi, MD; Mohammadreza Abbasian, MD; Ali Moazamipour, MD; Farshad Safdari, MSc
Abstract
Background: Forefoot fractures are the most common orthopaedic injuries. In this study the outcomes of nonoperative treatment of forefoot fractures using off-loading shoes was studied and compared with those of casting.Methods: In this case-control study, 60 patients with forefoot fractures in two hospitals ...
Read More
Background: Forefoot fractures are the most common orthopaedic injuries. In this study the outcomes of nonoperative treatment of forefoot fractures using off-loading shoes was studied and compared with those of casting.Methods: In this case-control study, 60 patients with forefoot fractures in two hospitals in Tehran, Iran, who were not surgical candidates, were divided into two treatment groups: casting and off-loading shoe. The rate of bone healing was investigated. Also, patients' satisfaction and the pain severity were measured before and after treatment. The AFAOS (American Orthopaedic Foot and Ankle Society) was completed. The treatment results were compared between the two groups. The patients were followed for 36.5±4.2 days in group C and 33.3±4.7 days in OS group (p < /em>≥.05). Results: Clinical and radiolographic success were achieved in all of the cases and all the patients returned to their previous activities. At final visit, the pain intensity was as follows: 5.4±1.4 in group C versus 5.9±1.1 in group OS (p < /em>≥.05). The AOFAS was 92.3±14.7 points in group C and 94.5±12.3 in group OS Two patients developed skin problems and another one developed symptoms of deep venous thrombosis, all in group C. Conclusions: Off-loading shoes are suitable tools to treat forefoot fractures. Although no significant difference was found between the two groups, but due to satisfactory outcome and lack of complication, off-loading shoes are recommended in non-operative treatment of forfoot fractures.
