RESUMEN
In 79 patients athletic activities were evaluated retrospectively 32 months after grade II and grade III sprains of the acromioclavicular joint. Group I consisted of 29 patients with grade II sprains according to Tossy and group II consisted of 50 patients with grade III sprains according to Tossy. In group Ia 14 patients underwent surgery, and in group Ib 15 patients were treated nonsurgically. In group IIa 41 patients were treated surgically, and in group IIb 9 patients were treated conservatively. Forty-seven patients were injured during participation in sports. Among these 16 were injured during participation in their specific sport. In group I patients had to curtail sports activities more frequently after surgery than after conservative treatment (p < 0.05). In group II the reduction of sports activities was not different for the two treatment groups. Of a total of 79 patients, 23 had to reduce their sports activities. Among these, 7 patients had to give up sports. All patients had performed overhead athletic activities. Climbers and patients performing strength training had to reduce their activities or give up sports. Additionally, sprains of the acromi-oclavicular joint adversely affected athletic activities in overhead ball sports, bicycling, and skiing irrespective of treatment.
Asunto(s)
Articulación Acromioclavicular/lesiones , Traumatismos en Atletas/cirugía , Luxaciones Articulares/cirugía , Complicaciones Posoperatorias/rehabilitación , Deportes , Esguinces y Distensiones/cirugía , Articulación Acromioclavicular/cirugía , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Estudios RetrospectivosRESUMEN
Forty-four patients who had undergone unilateral anterior cruciate ligament reconstructions were evaluated retrospectively with seven different scoring systems (International Knee Documentation Committee, Orthopadische Arbeitsgruppe Knie, Lysholm, Feagin and Blake, Zarins and Rowe, Cincinnati, and Marshall scores). The results varied between systems and therefore lacked reliability. Of the 44 patients, 32 were rated as excellent according to the Cincinnati score while only 3 patients were rated as normal according to the International Knee Documentation Committee form. Good and excellent results were found twice as frequently with the Cincinnati and Lysholm scores compared with the scores of Zarins and Rowe or the International Knee Documentation Committee form. Statistical analysis confirmed this observation and revealed significant differences between the scoring systems. Side-to-side differences using the manual maximum displacement test with the KT-1000 arthrometer revealed good correlation with the International Knee Documentation Committee and the Orthopadische Arbeitsgruppe Knie questionnaires. None of the other scoring systems, which do not measure anterior laxity, produced reasonable correlation with instrumented measurements. We found that certain population-specific factors as well as the distribution of single findings can distort the results of scoring systems. To avoid these interference factors, the patient sample should be homogeneous and selected prospectively and there should be agreement about the value of single findings.
Asunto(s)
Ligamento Cruzado Anterior/cirugía , Indicadores de Salud , Adolescente , Adulto , Lesiones del Ligamento Cruzado Anterior , Distribución de Chi-Cuadrado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
BACKGROUND: From 1992 through 1997 96 patients with per- or subtrochanteric femur fractures were treated with a Gamma nail. We retrospectively evaluated the influence of patient age, additional diseases, type of fracture, time of operation, type of implant (short/long Gamma nail) and surgical approach (open/closed reduction) on the mobility of the patients, healing of the fractures on radiographs, and possible complications. PATIENTS AND METHODS: The average patient age was 72.5 years (range 27 to 101). There were 27 male and 69 female patients. Surgery was performed 1.19 (0-10) days after injury. At 3, 6, and 12 months after surgery radiographs of the involved hip joint and femur were obtained and the degree of mobility was assessed. RESULTS: Additional diseases, type of fracture, time of operation, type of implant (short/long Gamma nail) and surgical approach (open/closed reduction) did not influence mobility of the patients, healing of the fractures on radiographs or rate of complications. It was more difficult to mobilize older patients (P < 0.001). After 1 year 97% of all fractures had healed on radiographs. In 15 patients (18%) complications occurred due to technical errors using the Gamma nail. DISCUSSION: With the Gamma nail stable osteosynthesis of per- and subtrochanteric femur fractures is obtained independently of the fracture classification. Patients can be mobilized immediately. Technical errors must be avoided.