Substantial functional and pain improvement was reported almost 6 months after surgery. We did not find any nerve injury or post-operative infection.

Arthroscopic recession surgery by using a knife is a safe and effective way in managing recalcitrant tennis elbow although patients should be informed of the expected time to improve. A simple tendon recession by a sharp cut is a time-saving technique that works effectively and is comparable with the piecemeal shaving.

The modified muscle recession technique is a rapid and safe way to manage the recalcitrant tennis elbow arthroscopically while the outcomes are comparable to the routine piecemeal shaving of the pathologic tissue.

The modified muscle recession technique is a rapid and safe way to manage the recalcitrant tennis elbow arthroscopically while the outcomes are comparable to the routine piecemeal shaving of the pathologic tissue.

This randomized clinical trial was undertaken to document the clinical presentation of de Quervain’s disease and evaluate the outcome of management with triamcinolone acetonide (TAC) injection versus surgical decompression.

Half of the patients were assigned to the corticosteroid injection group (group A) and half to the surgery group (group B). In group A, 40 mg of TAC was injected into the affected first extensor compartment. In group B, surgical decompression of first extensor compartment was performed.

There were 56 patients with 38 (67.85 %) females and 18(32.14%) males. The age range was 23-66 years. In group A, one injection was employed among 7(25%) patients whereas two injections among 21(75%) patients. Local complications with injections were observed among 7 patients. Symptomatic relief with injection at 6-weeks was observed among 25% patients whereas recurrence at one year was observed among 9(32.14%) patients. In group B, no critical complications were encountered following surgery; all the patients had symptomatic relief at 6-weeks and there was no case with recurrence at one year.

Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.

Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.

Treatment recommendations for trapeziometacarpal (TMC) arthrosis are highly variable from surgeon to surgeon. This study addressed the influence of viewing radiographs on a decision to offer surgery for TMC arthrosis.

In an online survey, 92 hand surgeons viewed clinical scenarios and were asked if they would offer surgery to 30 patients with TMC arthrosis. ACBI1 Forty-two observers were randomly assigned to review clinical information alone and 50 to review clinical information as well as radiographs. The degree of limitation of daily activities, time since diagnosis, prior treatment, pain with grind, crepitation with grind, and metacarpal adduction with metacarpophalangeal hyperextension were randomized for each patient scenario to determine the influence of these factors on offers of surgery. A cross-classified binary logistic multilevel regression analysis identified factors associated with surgeon offer of surgery.

Surgeons were more likely to offer surgery when they viewed radiographs (42% vs. 32%,

).bias, and the potential for surgeon and patient impatience with the adaptation process, methods for increasing patient participation in the decision-making process merit additional attention and study.

Soft tissue injury associated with fractures of the distal tibia is a predictive factor for a poor prognosis. The purpose of this study was to investigate factors associated with the need for a flap coverage after distal tibial fracture, and whether there was a difference in functional outcomes between patients with flap coverage or no flap coverage for a distal tibial fracture.

All fractures of the distal tibia treated in our department between 2010 and 2017 were reviewed. The functional result was assessed using the SF-36 Quality of Life Questionnaire, the Visual Analog Scale (VAS) when walking and the AOFAS scale (American Orthopedic Foot and Ankle Society).

132 distal tibia fractures were reviewed, of which 51 required soft tissue flap reconstruction, which was associated with open fractures (

, OR 5.25), high energy trauma (

, OR 1.7)), the use of external fixation (

, OR 12.5) and the presence of vascular alterations on the Angio-CT scan (

). No significant differences were found in any of the scales that assessed the functional results between the group of patients who required soft tissue flap reconstruction and the group of patients who did not.

We found that the need for a soft tissue flap was associated with the following parameters open fracture, high energy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation to functional results, differences were not found between the group that needed coverage with a flap and the one that did not.

We found that the need for a soft tissue flap was associated with the following parameters open fracture, high energy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation to functional results, differences were not found between the group that needed coverage with a flap and the one that did not.

Disability following hand and upper extremity conditions is common. Patient-reported outcome measures (PROs) are used to capture patients‘ status subjectively. This review has aimed to synthesis the literature regarding the extent and methodological quality of translation, cross-cultural adaptation, and psychometric properties of the hand and upper extremity disability PROs in the Persian language.

Seven electronic databases (MEDLINE, EMBASE, Psychinfo, Scopus, ISI, Science direct, and Google Scholar) were searched until May 2020. Studies reporting cross-cultural adaptation and psychometric properties testing of the Persian validated disability PROs of the hand and upper extremity were identified. We appraised the eligible studies using Guidelines for the Process of Cross-cultural Adaptation of Self-report Measures and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist.

Out of 98 identified records, 22 studies on 17 PROs were reviewed. Most of tt quality to be used in clinical settings.

There have been studies indicating that the non acute rotator cuff repair can be augmented with reconstituted absorbable collagen scaffold (RACS)which results in better structural integrity and functional outcome. Hence, this review aims to systematically analyse the available evidence based on its methodological quality, technique and functional outcome.

Systematic review was carried on PubMed for articles related to non acute rotator cuff repair reconstituted absorbable collagen scaffold. Also, Colemans method of scoring was used to assess the methodological quality of the studies.

mong the studies included, the minimum follow up duration was 12 months. All the studies reported statistically significant improved outcomes following repair with reconstituted absorbable collagen scaffold for partial thickness tears, full thickness tears and in massive tears.

Repair reconstituted absorbable collagen scaffold seems to be a viable option to improve the structural integrity following non acute rotator cuff repair.

Repair reconstituted absorbable collagen scaffold seems to be a viable option to improve the structural integrity following non acute rotator cuff repair.Objective To develop a conceptual model that confirms whether mobility-related activities of daily living (ADLs) abilities are strongly associated with reduced health-related quality of life (HRQOL) in older adults. Methods A total of 153 participants (63 men, 90 women) were analyzed. The mobility-related ADL survey from the Ministry of Education, Culture, Sports, Science, and Technology of Japan was used. The Japanese version (v1.2) of the Medical Outcomes Study 36-item Short-Form Health Survey was administered to evaluate HRQOL. Structural equation modeling was performed to test a hypothetical model mobility-related ADL abilities would influence HRQOL. Results The chi-square value was not significant (chi-square = 9.463, p = .305), and goodness-of-fit values were high, implying that the model was validated; goodness-of-fit index, 0.981; adjusted goodness-of-fit index, 0.949; comparative fit index, 0.996; and root mean square error of approximation, 0.035. Results showed that mobility-related ADL abilities influenced the physical health including physical function and general health in HRQOL. Conclusions This study developed the conceptual model confirming the influence of mobility-related ADL abilities especially on physical health. Further intervention studies on instructions/training for physical activity of healthy older adults should assess this causal relationship.Urinary tract infection (UTI) is a common cause of delirium in the elderly. Although diagnosis of delirium secondary to UTI is relatively straightforward, a lack of thorough investigation could result in missing underlying factors and medical conditions that may require immediate clinical/surgical intervention. Case of a 77-year-old male with delirium diagnosis and multiple psychiatric hospital admissions is reported here. This patient with multiple medical disorders and anxiety was admitted to psychiatric facilities on three different occasions with multiple psychiatric diagnoses including delirium. After a month of hospital stay and thorough medical and radiological examinations, the cause of refractory delirium was identified as multifactorial including urothelial carcinoma. Although UTI and urinary retention are common in the elderly, this case shows the importance of multifactorial diagnoses in cases of prolonged or refractory delirium to avoid delays in appropriate treatment.The challenges of implementing interventions in healthcare settings have been more apparent during the COVID-19 pandemic. This pre-implementation evaluation used a rapid qualitative approach to explore barriers and facilitators to an intervention in intensive care units in Argentina, aimed to promote the use of personal protection equipment, provide emotional support for professionals, and achieve patient flow goals. Data were collected using semi-structured interviews with health professionals of 15 public hospitals in Argentina. Normalization Process Theory was used to guide content analysis of the data. Participants identified potential barriers such as the incorporation of non-specialist staff, shortage of resources, lack of communication between groups and shifts. Potential facilitators were also identified regular feedback and communication related to implementation, adequate training for new and non-specialist staff, and incentives (e.g., scholarships). The immediacy of the pandemic demanded rapid qualitative research, sharing actionable findings in real time.