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Attention deficit disorder Comorbidity Structure as well as Problems: Connection between the particular Which Planet Mental Health Online surveys Worldwide Pupil Venture (WMH-ICS).
Hypothesis The purpose was to investigate joint stability and range of motion after a Bankart repair without superior labral anterior-posterior (SLAP) repair (termed "Bankart repair") and after combined Bankart and SLAP repairs (termed "combined repair"). Selleckchem SB203580 Methods Eight fresh-frozen shoulders were used. Combined Bankart and SLAP lesions were created (10- to 6-o'clock positions). The labrum and capsule were repaired at the 2-o'clock, 330 clock-face, and 5-o'clock positions in the Bankart repair group and at the 11-o'clock, 1-o'clock, 2-o'clock, 330 clock-face, and 5-o'clock positions in the combined repair group. The internal- and external-rotation ranges of motion were determined with the arm positioned at 0° and 60° of glenohumeral abduction. The rotation angle was defined when a constant torque of 200 N-mm was applied. Joint stability was measured with a custom stability-testing device. The peak translational force in the anterior-posterior direction was measured with the arm at the end range of external rotation. Results External rotation angles were greater at 0° and 60° of abduction in the Bankart repair group than in the combined repair group (0° of abduction, P less then .01; 60° of abduction, P less then .05). The internal rotation angle was greater at 60° of abduction in the Bankart repair group than in the combined repair group (P less then .01). The stability between the 2 groups was not significantly different (P = .60). Conclusion In patients with combined Bankart and SLAP lesions and the need for a wide range of motion, a Bankart repair alone may provide a greater range of motion without compromising the joint stability at the end range compared with a combined repair. © 2019 The Authors.Background The arthroscopic approach to acromioclavicular (AC) dislocation with methods such as AC TightRope fixation has reported radiographic failure rates between 18% and 50% with functional results graded as good or excellent. Our objective was to review the outcomes after arthroscopic fixation for acute AC joint dislocation using the TightRope device. Methods We reviewed the records of 52 patients, with a mean age of 31 years, who underwent arthroscopic fixation with the TightRope device for acute AC joint dislocation. Outcomes were evaluated using the Constant and University of California, Los Angeles scores. The coracoclavicular (CC) distance before and after surgery was compared by radiography. Results The mean follow-up period was 36.7 months (range, 6-65 months). Postoperatively, the mean Constant score was 97.13 and the mean University of California, Los Angeles score was 33.2. The CC distance was maintained in 73% of the patients, whereas partial loss of reduction occurred in 19.2% and failure of reduction occurred in 7.7%. Conclusion Arthroscopic fixation using the TightRope device for acute AC joint dislocation achieves satisfactory clinical outcomes. However, CC reconstruction appears to result in subluxation in cases with AC dislocation for a period of more than 10 days. © 2019 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons.Background Numerous fixed-stem implants exist for radial head arthroplasty; therefore, we conducted a systematic review to compare the safety and efficacy of different types of fixed-stem implants. Methods We conducted a literature search, updated from a previous systematic review, to identify studies evaluating a fixed-stem radial head arthroplasty implant for any indication. We extracted data on revision rates, specific complications, and functional scores. We pooled results across studies using a random-effects method, using proportions for dichotomous data and mean values for functional scores. We analyzed outcomes by indication and specific implant. Results We included 31 studies. Studies included patients with radial head fractures only, terrible-triad injuries, or Essex-Lopresti injuries or included a heterogeneous population. We identified 15 different fixed-stem implants. The results of our analysis revealed that patients with terrible-triad injuries may be at an increased risk of revision and instability and patients with Essex-Lopresti injuries may be at an increased risk of arthritis, capitellar erosion, and osteolysis. After removing these outliers and pooling the results by specific device, we observed variability across devices in the rates of revision, arthritis, capitellar erosion, instability, and osteolysis, as well as in functional scores. Conclusion Differences were seen across different implants in revision rates, certain complications, and functional scores. This study highlighted that these devices should be evaluated within the context of the patient population under examination, as patients with Essex-Lopresti or terrible-triad injuries may demonstrate worse outcomes relative to those with a fracture only. © 2019 The Author(s).Background The gold standard for surgical treatment of cubital tunnel syndrome is in situ decompression. However, this procedure does not come without complications. Subluxation of the ulnar nerve and ulnar nerve neuritis from adhesion formation remain 2 potential complications after this procedure. It has been shown in the literature that young, active, male patients are most likely to have these complications postoperatively. We have developed a modification to in situ decompression by developing a fascial turnover flap and using a porcine submucosa extracellular matrix (Axogen) to help reduce both ulnar nerve subluxation and adhesion formation postoperatively. Methods Thirteen patients underwent cubital tunnel surgery by the highlighted technique to prevent postoperative ulnar nerve subluxation and adhesion formation. Patient outcomes including elbow range of motion, functional status, paresthesia, and grip strength were recorded. Results Of the 13 patients, 10 had excellent results, 1 had a good result, and 2 required revision with anterior transposition of the nerve. The mean Mayo Elbow Performance Score of the 11 patients not needing revision was 92.7. Conclusion The described surgical technique provides surgeons with the ability to directly decompress the ulnar nerve while decreasing postoperative complications such as instability and adhesion formation. © 2019 The Authors.
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