Objective To evaluate the effect of including the fractured vertebra in the short‐segment fixation of thoracolumbar (TL) fractures. Methods A total of 32 patients with thoraco‐lumbar fractures, selected between August 2013 and February 2016, were managed by short‐segment fixation with screws at the level of the fracture, and decompression was performed only for patients with neurological deficits. The patients' functional outcome was assessed using the visual analogue scale (VAS) score for pain and the American Spinal Injury Association (ASIA) score for neurological condition. All patients were followed up with radiographs. Results Patients with complete neurologic deficits (n = 3) did not show any neurologic recovery. All ASIA B patients improved to ASIA C. Five ASIA C patients improved to ASIA E. The remaining five ASIA C patients improved to ASIA D. All ASIA D patients improved to ASIA B. At the final follow‐up examination, the mean anterior vertebral height was 21 ± 5 mm, indicating no significant height loss during the follow‐up period. Conclusion Short‐segment fixation of TL fractures with inclusion of the fracture level into the construct offers good correction of segmental kyphosis, vertebral wedging, and vertebral height loss.
Chronic non-specific low back pain (CNLBP) is the most common musculoskeletal problem. The purpose of this study was to investigate the effects of advanced physiotherapeutic exercise programs on imaging findings and inflammatory biomarkers in soccer players with CNLBP. In total, 60 CNLBP participants were divided into virtual reality exercise (VRE; n = 20), isokinetic exercise (IKE; n = 20), and conventional exercise (n = 20) groups. Pain intensity, imaging findings (muscle cross-sectional area (CSA) and muscle thickness), and changes in inflammatory biomarkers (CRP, TNF-α, IL-2, IL-4, and IL-6) were measured at baseline and after four weeks. After four weeks of intervention, there was a significant improvement (p = 0.001) in pain intensity for the VRE vs. IKE (0.7; CI 95% 0.38 to 1.07) and VRE vs. conventional (3.0 CI 95% 2.68 to 3.31) groups. The IKE group showed a greater number of significant changes in muscle CSA and muscle thickness than the other two groups (p < 0.001). Moreover, the VRE group showed significant improvement in inflammatory biomarker measures compared with the other two groups (p < 0.001). In CNLBP, virtual and isokinetic exercises had equal effects on reducing pain intensity. Isokinetic exercise is beneficial in increasing the muscle CSA and thickness, and virtual exercises are helpful for attenuating the inflammation process in soccer players with CNLBP.
Background The knowledge about the effective implementation of corticosteroid injection (CS) with deep transverse friction massage (DTFM) and Mill’s manipulation (MM) on clinical and radiological changes (Magnetic resonance imaging—MRI and Ultra sound) in lateral epicondylalgia (LE) is lacking. Therefore, the objective of this study is proposed to find and compare the effects of corticosteroid injection (CS) DTFM and Mill’s manipulation on clinical and radiological changes in lateral epicondylalgia. Design, setting, participants Randomized, single-blinded, controlled study was conducted on 60 LE participants at university hospital. The active MM group (n = 30) received corticosteroid injection with DTFM and active Mill’s manipulation (MM) three sessions a week for 4 weeks and the sham MM group received corticosteroid injection with sham manipulation. The primary outcome was pain intensity, measured with the visual analog scale. The other outcome measures were percentage of injury measured by MRI and ultrasound, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life which were measured at 4 weeks, 8weeks and at 6 months follow up. Results The between-group difference in pain intensity at 4 weeks was 1.6 (CI 95% 0.97 to 2.22), which shows improvement in the active group than sham group. The similar effects have been noted after 8 weeks and at 6 months 2.0 (CI 95% 1.66 to 2.33) follow up in pain intensity. Similar improvements were also found on percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life (p = 0.001). Conclusion Corticosteroid injection with DTFM and Mill’s manipulation was superior to sham group for improving pain, percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life in people with lateral epicondylalgia. Trial registration Clinical trial registration: CTRI/2020/05/025135 trial registered prospectively on 12/05/2020. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2020/05/025135.
Background: The current literature contains no guidelines for choosing the method of fixation for fractures of the distal humerus. This study aims to compare the functional and radiological outcomes between anatomical locking compression plates and nonlocked reconstruction plates in fractures of the distal humerus (AO type A 3).Methods: This was a prospective cohort study that was conducted between 2015 and 2021 on 60 patients with distal humeral fractures (AO type A 3). There were 30 patients (23 males and 7 females) with a mean age of 40 years and two months who were followed up for 62 months in group 1. The patients in group 1 underwent Open reduction and internal fixation with double anatomical LCP. There were 30 patients (21 males and nine females) with a mean age of 41 years and seven months in group 2. The mean follow-up period was 58 months. Fifteen of the patients in group 2 underwent open reduction and internal fixation with nonlocked plates.Results: There was no significant difference in the degree of extension, flexion, arch of motion, and MEPS between the two groups at the six-month follow-up appointment. There was a highly significant difference between the study groups in the mean union time (3.27 ± 0.46 months vs. 4.27 ± 0.70 months) and time taken to mobilize the elbow joint after surgery (10–14 days [mean 11.33 ± 1.40] vs. 21–30 days [mean 24.87 ± 4.45] days) in groups A and B, respectively.Conclusions: There was no difference in the functional outcomes of distal humeral fractures (AO type A 3), including range of motion and MEPS, between the precontoured anatomical LCP and 3.5-mm nonlocked reconstruction plates. There was improvement in the union time and short postoperative time of mobilization in group 1.
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