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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two adolescents with bilateral radial clubhand, hypoplastic thumbs, and thrombocytopenia are reported. Ulnocarpal arthrodesis provided these patients with pain-free wrists and improved their function.
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PMID:Ulnocarpal arthrodesis for recurrent radial clubhand deformity in adolescents. 153 7

A case of posttraumatic carpal dislocation in volar inclination of the intermediary segment (VISI), treated by a lunate-triquetrum-hamate arthrodesis (LTH) is presented. This operation leaves the rupture of the radio-triquetrum dorsal ligament; rather the entire carpus rotates in supination postoperatively. This repair of the radio-triquetrum dorsal ligament permits realignment and stabilization of the carpus and results in resolution of pain.
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PMID:[Salvage ligament repair following failure of arthrodesis of the lunate-triquetrum-hamate joint for internal instability of the joint. Apropos of a case report]. 156 81

Sixteen total knee arthroplasties performed between 1977 and 1985 in 13 patients with prior ipsilateral hip arthrodesis or ankylosis were studied to determine the preferred sequence and long-term follow-up of procedures in this clinical setting. Twelve of 16 underwent fusion takedown and total hip arthroplasty prior to knee replacement. The average age at total knee arthroplasty was 52.7 years and the average time from hip fusion to total knee arthroplasty was 36.3 years. Mean follow-up after total knee arthroplasty was 5.5 years (range, 2.3 to 10 years). The Hospital for Special Surgery knee score increased from a mean of 31.8 preoperatively to 72.2 after surgery. In patients who had conversion of the hip fusion prior to knee replacement, knee scores were 28 before and 72.5 after both procedures. Patients who retained their hip fusion had mean scores of 43.5 and 72.1, respectively. None of the knees has been removed and 14 of 16 had no pain at last follow-up. One had mild pain and one had moderate pain attributed to pes anserine bursitis. Although the numbers are small, this experience reveals that takedown of the fusion with total hip arthroplasty is an effective technique before performing the knee replacement. Though successful in some instances, the experience is too small to show that if hip fusion is in good position, knee replacement without fusion takedown is acceptable.
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PMID:Total knee arthroplasty in patients with prior ipsilateral hip fusion. 156 67

Malunion of ankle fractures will lead to severe osteoarthritis when the architecture and mechanics of the talocrural joint are deranged. When fibular shortening is present, ankle reconstruction can be achieved by fibular lengthening and can provide an alternative to early arthrodesis for deformity and pain. Acceptable clinical and radiographic results can be achieved, provided that accurate reconstruction is achieved and intra-articular osteochondral injury is minimal. Restoration of fibular length, necessary for a good clinical result, can be estimated radiographically by the bimalleolar angle. We report three cases of ankle reconstruction by fibular lengthening with an average follow-up of 33 months.
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PMID:Ankle reconstruction for malunion by fibular osteotomy and lengthening with direct control of the distal fragment: a report of three cases and review of the literature. 157 42

Synovectomy, total arthroplasty and arthrodesis are the main surgical methods for rheumatoid arthritis. Although recurrent synovitis and radiological deterioration after synovectomy have been reported, the procedure can be an effective treatment if it is performed in the early stage where articular cartilage and bone are minimally damaged. Arthrodesis is indicated for severely destroyed joints. However, since loss of motion in the proximal joints often leads to severe disability, its indication is limited to the distal joints, such as the wrist and ankle. Total rthroplasty seems to be an ideal method because relief of pain and recovery of function can be obtained simultaneously. However, there are some complications, such as loosening and wear of the prosthesis. Solution of these would bring much benefit to the disabled rheumatoid arthritis patient.
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PMID:[Surgical treatment of rheumatoid arthritis]. 158 44

Sixty-seven closing wedge arthrodesis procedures of the first metatarsocuneiform joint were performed in 41 females and 12 males. Follow-up averaged 28 months (range 16-49 months) and was performed in 51 of 53 patients with a questionnaire, clinical examination, and comparison of pre- and postoperative weightbearing radiographs. The average hallux valgus angle was 34.5 degrees (range 20 degrees-75 degrees) and was corrected to 13.0 degrees (range-10 degrees-22 degrees) postoperatively. The average intermetatarsal angle was 14.3 degrees (range 9.5 degrees-34 degrees) and was corrected to an average of 5.8 degrees (range 0 degrees-12 degrees) postoperatively. Complications included seven superficial pin tract infections, three symptomatic dorsal bunions, one of which required repeat surgery, seven nonunions, one of which was symptomatic, one hallux varus, and three neuromas of the deep peroneal nerve. The range of motion of the hallux metatarsophalangeal joint was 85% of normal postoperatively. A total of 77% of the patients were totally relieved, 15% partially relieved, and 8% not relieved with respect to pain, comfort, appearance of the foot, and shoewear following surgery. The specific indications for performing this operation are discussed.
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PMID:Metatarsocuneiform arthrodesis for management of hallux valgus and metatarsus primus varus. 160 37

The authors studied a series of 104 rheumatoid wrists, stages II, III or IV according modified Larsen's grading, treated between 1980-1988 by synovectomy realignment stabilization. The mean follow-up period was 5 years. The operation presents different steps which have an additive effect and must be associated in order long term clinical and radiological stability. They associated: extensor tendons and articular synovectomy stabilization of the distal radio ulnar complex by Sauve-Kapandji's operation, tendon transfert: the extensor carpis radialis longus is transferred on the extensor carpi radialis brevis the extensor carpi ulnaris is relocated with posterior annular dorsal ligament plasty. Results concerning relief of pain were very clear because the patients presented either complete relief of pain (73%) or only intermittent occasional pain. The overall active range of motion is nearly the same, when compared pre- and post-operative ratings. In general the patients who presented good pre-operative mobility usually improved them and the others preserved them. Larsen's radiological grading was modified by the authors to include instability's criteria in frontal and sagittal plane. Carpal height remained stable (75% less than or equal to 1 mm), ulnar deviation has never overreached 3 mm, radial deviation was not modified in 50% of cases. They found only 4 wrists presenting a stage II radiological grading with an evolution to the stage III and 12 of the stage III grading became stage IV. The instable type of the stage IV was stabilized by a surgical radiolunate arthrodesis. The stabilized type was nearly not modified. The different steps of operation (articular and tenosynovectomy, carpus stabilization and realignment with stabilization by stabilization of the radio ulnar complex joint using Sauve-Kapandji operation, tendons transfers and dorsal retinacular plasty) have an additive effect in achieving relief of pain with preservation of the pre-existing mobility. The stabilization of the radio ulnar complex by the Sauve-Kapandji operation constitutes a new approach in rheumatoid arthritis published by the author in 1985 and in our opinion appears to be simple and is very efficient in stabilizing wrist immediately, thus allowing early rehabilitation of these patients. Long term stability is affirmed by clinical and roentgenologic follow-up and globally a painless wrist, a preservation of the pre-operative motion and a stabilization in frontal and sagittal plane is obtained.
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PMID:[Synovectomy in the realignment-stabilization of the rheumatoid wrist. Apropos of a series of 104 cases with average follow-up of 5 years]. 160 38

A case of Lyme arthritis with advanced degenerative changes localized to the midcarpal joint was treated with a limited wrist arthrodesis with relief of pain and improved function. Chronic Lyme arthritis occurs as the third stage of Lyme disease. Serologic testing and a history of a characteristic rash may be helpful in the diagnosis. Radiographic and histopathologic findings are nonspecific, with both degenerative and inflammatory characteristics. Intravenous antibiotics provide an effective treatment of chronic Lyme arthritis.
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PMID:Chronic Lyme disease arthritis: review of the literature and report of a case of wrist arthritis. 161 42

The medical records and radiographs of forty-two adolescents (twenty-three male and nineteen female) who had had a posterolateral spinal arthrodesis for spondylolisthesis between 1950 and 1986 were reviewed to assess the long-term outcome of this form of treatment. The average age of the patients at the time of the operation was fourteen years (range, seven years and nine months to seventeen years and eleven months). The duration of the clinical and radiographic follow-up ranged from two years to twenty-seven years and seven months. All patients had an in situ arthrodesis of the involved vertebrae. Eighteen patients had no additional intervention, and twenty-four patients had reduction and application of a cast. Use of the cast led to a decrease in sagittal translation of more than 5 per cent in eighteen patients and a decrease in lumbosacral kyphosis (the slip angle) of more than 5 degrees in fourteen patients. Of the patients who did not have a cast, eight had an increase in sagittal translation of more than 5 per cent and ten had an increase in lumbosacral kyphosis of more than 5 degrees. There were no neurological problems at the time of the initial operation or after the reduction maneuver. At the most recent clinical follow-up examination, thirty-eight patients had no complaints of low-back pain or any restriction of work-related or recreational activities. Persistent low-back pain and pain in the lower extremities limited the activities of the remaining four patients, two of whom had another operation to alleviate these symptoms.
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PMID:Long-term evaluation of adolescents treated operatively for spondylolisthesis. A comparison of in situ arthrodesis only with in situ arthrodesis and reduction followed by immobilization in a cast. 162 85

Localized C1-C2 lateral mass osteoarthritis is a degenerative disorder of the upper cervical spine that has a natural history markedly different from that of degenerative afflictions of the lower cervical spine. Atlantoaxial lateral mass arthritis is a distinct cause of occasionally severe occipitocervical pain in elderly persons. In this series, the diagnosis was suggested by the medical history of nine elderly patients who presented with severe occipitocervical pain (frequently diagnosed as occipital neuralgia). Physical examination demonstrated marked restriction of rotation of the cervical spine to the affected side, and localized tenderness unilaterally at the occipitocervical junction. The diagnosis was confirmed by plain radiographs of the C1-C2 articulation (open-mouth view), demonstrating marked, usually unilateral joint-space narrowing, osteophyte formation, and subchondral sclerosis. Bone scanning demonstrated focal uptake unilaterally at the occipitocervical junction. Additional imaging studies, including computed tomography, magnetic resonance imaging, or cervical myelogram, were performed to rule out coexisting intraspinal pathology. Conservative treatment was usually successful; however, C1-C2 arthrodesis was successful for severe occipitocervical pain due to atlantoaxial lateral mass arthritis not responsive to conservative treatment.
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PMID:Atlantoaxial lateral mass osteoarthritis. A frequently overlooked cause of severe occipitocervical pain. 163 22


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