Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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Comparative Study
Improvement in the rate of inadequate pharmaceutical treatment by orthopaedic surgeons for the prevention of a second fracture over the last 10 years.
We have previously reported that the low rate of osteoporosis patients treated with anti-osteoporotic drugs following surgical treatment for the first fragility fractures by orthopaedic surgeons during 3 years from 2000 to 2003 was only 13.1%. Ten years have now passed our previous study, and we hypothesized that the rate of appropriate pharmacologic treatment for the prevention of secondary fractures has improved. ⋯ We demonstrated that the rate of pharmacologic treatment by orthopaedic surgeons and the rate of more effective anti-osteoporotic drugs prescribed to the patients following surgical intervention for the first fragility fracture in the present study were improved in comparison with those of 10 years ago.
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Comparative Study
Clinical course of the bony lesion of single-system single-site Langerhans cell histiocytosis - Is appropriate follow-up sufficient treatment?
Langerhans cell histiocytosis (LCH) is categorized into three types, which include single-system single-site (SS-s), single-system multiple-site (SS-m) and multisystem (MS). The most commonly affected site in LCH is bone, and the bony lesion of SS-s LCH has a good prognosis. The bony lesion of SS-s LCH has been thought to regress spontaneously. Although treatments such as curettage, direct injection of corticosteroids, and chemotherapy have been performed, regular follow-up is the first line of treatment for the bony lesion of SS-s LCH. For preventing orthopedic sequelae, strict and appropriate follow-up should be performed, but the appropriate period and method of follow-up has not yet been established. ⋯ Careful follow-up and the use of an appropriate orthosis can lead to a good clinical course for the bony lesion of SS-s LCH. Future research should seek to determine the appropriate follow-up period.
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There have been no prospective studies comparing anterior surgery and posterior method in terms of long-term outcomes. The purposes of this study is to clarify whether there is any difference in long-term clinical and radiologic outcomes of anterior decompression with fusion (ADF) and laminoplasty (LAMP) for the treatment of cervical spondylotic myelopathy (CSM). ⋯ A prospective comparative study (not randomized).
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Management of a displaced comminuted patellar fractures is challenging, and various surgical fixation methods have been suggested. However, issues of loss of reduction and breakage of fixatives have not yet been resolved. In the current study, we describe a new technique for exposure and stabilization of comminuted patellar fractures and evaluate the clinical and radiologic outcomes of this new treatment. ⋯ Articular fixations with headless compression screws under direct visual reduction of the articular surface resulted in good clinical outcomes and were considered clinically effective for comminuted patellar fractures.
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Fall-induced injuries represent a major public health concern for older individuals. The relationship between risk of falling and the severity of locomotive syndrome (LS) remains largely unknown. ⋯ Postoperative patients with cervical myelopathy had a 62% prevalence of LS. The GLFS-25 may be useful to predict the risk of recurrent falls in patients with cervical myelopathy.