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

A successful treatment of the acromioclavicular separation is the repair of the acromioclavicular and coracoclavicular (CC-)ligaments and a stable reduction of the acromioclavicular (AC-)joint. To avoid dangerous breakage and migration of the K-wire an abduction humeral splint is necessary immobilizing the injured shoulder for 5-6 weeks. In the years 1987-1989 40 patients suffering AC-separation were treated (34 Tossy III separations, 4 Tossy II separations, 2 Tossy I separations). In these cases a stable reduction was achieved by a transarticular K-wire fixation and a combination of AC- and CC-fixation by loops. In 1987 wire loop was used. In 1988 a combination of wire and Polydioxanon (PDS) loops was used. The PDS-loop, a slowly resorbable suture material, fixed the CC-ligament. In 1989 the AC-joint was stabilized by a PDS-loop as well. The examination of 31 patients 6-24 months after the operation showed good clinical results no matter whether PDS-loops or wire loops were used. The advantage of the transarticular K-wire fixation in combination with PDS-loops was the easy removal, which could be done in mostly of the cases as an outpatient procedure. An operation of the AC-Tossy III separation on patients beyond their 4. decade should be well considered. A long time of treatment, remaining pain and a limitation of shoulder movement must be expected.
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PMID:[Stabilization of the injured shoulder joint with PDS cord]. 135 43

The three osseous parts of the human pelvis form a continuous structure because of the symphysis and both iliosacral joints that-owing to their mobility-make possible a shock-absorption of vertical forces. The goal in the treatment of ruptures of the symphysis and/or of the sacroiliac joints is the restoration of functioning joints. Especially in the adolescent, a stiffening of these joints has to be avoided. Therefore, we treat ruptures of the pelvic joints with an overbridging banding that preserves the function of shock absorption. Due to utilisation of a banding, made up of polydioxanone, another operation to remove internal fixation material is not necessary. Rupture of the symphysis or iliosacral joint in the pediatric patient is very rare. Only three among the 67 patients whom we operated on because of a rupture of the symphysis or iliosacral joints between 1984 and 1990 were children. These were an eleven-year-old girl and a nine-year-old boy, who had suffered a rupture of the symphysis, and an eight-year-old boy with a disrupted iliosacral joint. In these children a banding with PDS suture was performed. At a follow-up examination, the children were free from pain and did not feel restricted in their daily routine or their physical activities.
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PMID:Treatment of ruptures of the symphysis and iliosacral joint in pediatric patients. 147 62

During the years 1985-1988, a total of 41 patients were treated for acromioclavicular dislocations. 25 (61%) were followed postoperatively for an average of 21 months. Two different methods of direct fixation of the AC-joint were compared: in 13 patients the transarticular fixation with two Kirschner wires and a 7.5 mm biodegradable Polydioxanon band (group I); in 12 patients an extraarticular fixation with PDS-band alone (group II). In both groups the ruptured ligament were sutured. In the first group physiotherapy was instituted immediately with limitation in abduction range to ninety degrees. After six weeks the Kirschner wires were removed under local anaesthesia and physiotherapy progressed to full range of motion. The shoulders of the second group patients were immobilized for 4 weeks. All of the patients were evaluated at follow-up on a subjective (pain, stiffness), objective (strength, range of motion, stability of the AC-joint) and roentgenographic (degree of displacement, posttraumatic arthritis, calcifications around the injured ligaments) basis. In both groups we saw good and satisfying results in more than 90%. A significant difference exists only as far as rehabilitation time is concerned. It was shorter in group I. In spite of the complications we observed with the metallic implants, which didn't have any negative influence on the results, we prefer the transarticular fixation method, because an immobilization postoperatively is not necessary and the time of rehabilitation is shortened.
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PMID:[Results following the surgical treatment of acromioclavicular joint dislocations. A comparison of direct trans- and extra-articular fixation]. 168 14

Few methods exist to assess the affective or reactive dimension of chronic pain, and there are psychometric and practical limitations on the methods that do exist. The current paper reports on the development and validation of the Pain Discomfort Scale, a 10-item instrument designed to fill the need for a brief and psychometrically sound measure of pain affect. Preliminary evidence supports the reliability and validity of the measure. Its internal consistency and test-retest stability coefficients are high. In addition, the results of both correlational and factor analyses of the PDS with other measures support its distinctiveness (from measures of pain intensity) and construct validity (as indicated by its close association with other measures of pain affect). These results support the use of the PDS in situations where a measure of the affective response to chronic pain is needed.
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PMID:Assessing the affective component of chronic pain: development of the Pain Discomfort Scale. 204 49

Over a period of 9 years (1979-1988), more than 1000 patients have been seen in the Department of Hand Surgery with a tentative diagnosis of skier's thumb or a painful metacarpophalangeal of the thumb. Most injuries were treated conservatively, but 562 operations on the ulnar collateral ligament were done during this period. An X-ray Film was taken in all cases to exclude a fracture. The indications for an operation depend on the clinical symptoms. Swelling, pain just over the ulnar collateral ligament, and instability of the joint with a widening of the ulnar aspect of the joint of more than 30 degrees in comparison to the other hand are typical clinical symptoms, which together with the widening in the flexion position, prove a rupture of the collateral ligament. As part of our standard examination we take X-ray films of the hand in two projections to exclude a fracture, followed by abducted stress views in comparison to the other side. The best results were obtained when surgical therapy was performed within the first 8 days. Fractures of the base of the proximal phalanx of the thumb were operated on by pin wire fixation of the bone fragment in the anatomically correct position along with temporary transarticular pin wire arthrodesis. In ligamentous ruptures, periostal sutures together with a temporary arthrodesis were carried out. Old injuries without sufficient regeneration of the ligament and capsule necessitated plastic surgery using the long pulmar tendon or a PDS wire. In each case the joint was immobilized with a cast for 5-6 weeks, followed by active physiotherapy.
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PMID:[Skier's thumb]. 279 17

Two hundred and eighty four patients undergoing laparotomy by vertical incision were randomly allocated to closure with interrupted mass sutures of No. 1 polydioxanone (PDS) or No. 1 polypropylene (Prolene). Dehiscence occurred in 0.7% of the PDS group but in 6.4% of the Prolene group (P = 0.018). Wound infection occurred in 8.6% of the PDS group and 15.4% of the Prolene group (P = 0.1). One hundred and ninety patients attended for review at a minimum of one year. Incisional herniation, usually asymptomatic, was present in 11% of each group. Knots were palpable in 2% of the PDS patients but in 12% of the Prolene: wound pain occurred in 12% of the PDS group but in 23% of the Prolene group (P = 0.06). These results suggest that PDS may be useful for abdominal closure.
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PMID:A randomised comparison of polydioxanone (PDS) and polypropylene (Prolene) for abdominal wound closure. 311 39

The use of dental services by immigrants in Sweden has been the object of several recent studies, but no investigations have been made about immigrants as patients from the dentist's point of view. A questionnaire, including detailed questions about treatment of adult immigrant patients during 1983, was sent to all private practising dentists and PDS clinics in the 10 local council areas with the highest percentages of immigrants in Stockholm County. The response rate was 93%. All PDS clinics and 84% of the private practitioners had treated immigrants. Language difficulties, poor knowledge of dentistry, difficulties in keeping treatment times and exaggerated expressions of pain were the most frequent problems with immigrant patients. The need for treatment was considered to be generally higher among immigrants than native patients. Prophylaxis and periodontics were unanimously considered to be the most difficult treatment measures for immigrants. Better information to immigrants on dental disease and dental care and a better interpreter service were suggested to improve the situation.
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PMID:Dentists' experiences of immigrants as patients. 386 31

The disc is an osmotic system that lives from motion. Because of the human sedentary nonmoving lifestyle, disc degeneration is progressive. The morbidity curve does not follow the degeneration curve. In patients between 40 and 50 years old, discs have highlights in their clinical course because of the biomechanical constellation, with the presence of tears and fissures in the anulus and maintained expansion power of nucleus material. In old discs, the nucleus is not willing to move. This is the comfortable rigidity of the aging spine. Not only during lifetime also in case of acute back pain and sciatica natural course is benign. If patients and their doctors wait long enough, most pain curves drop, so that initially planned surgery can be cancelled. This is the waiting list phenomenon. Few patients need a disc operation because of hard disc fragments, which can be identified on magnetic resonance imaging. Open disc surgery is the most frequent and important spine operation. Proper patient selection and good technique with a small approach by microsurgery can help avoid PDS, the worst course and prognosis of intervertebral disc disease.
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PMID:Natural course and prognosis of intervertebral disc diseases. International Society for the Study of the Lumbar Spine Seattle, Washington, June 1994. 760 37

From June 1983 to May 1990, 51 patients were operated on for acute, complete acromioclavicular dislocation (Tossy III). The operative technique includes suturing of the coracoclavicular and acromioclavicular ligaments and stabilization of the clavicle with resorbable, 10-mm coracoclavicular PDS banding. Six patients received primary resection of the lateral end of the clavicle due to significant injury of the AC joint cartilage. Forty-two patients with an average follow-up of 6.1 years were evaluated clinically using the UCLA and Constant-Murley Score, as well as subjective grading. Additional radiological assessment was performed in 36 cases. Excellent or good clinical results were obtained in 97.6%, with 85.7% being free of pain. All patients with primary resection of the lateral end of the clavicle had no pain. The incidence of postoperative complications was low (one deep wound infection with removal of the PDS band, three secondary dislocations). Post-traumatic arthritis developed in 14.7% of the patients. In those cases of acute grade III AC joint dislocations where operative treatment is indicated, this technique provides excellent results with a low complication rate.
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PMID:[Surgical treatment of acute, complete acromioclavicular joint dislocation. Indications, technique and results]. 873 82

We treated 17 patients with severe endometriosis involving the genitourinary tract. Eight women presented with persistent right or left flank pain, two presented with known ureteral obstruction, and five presented with urinary frequency and burning, and/or hematuria with their periods. Presented are the results of laparoscopic management in these patients. We performed segmental bladder resection in six patients and ureteral resection and reanastomosis in two. Nine additional patients underwent partial resection of the ureteral wall for complete removal of endometrial implants. The ureter was repaired with 4-0 PDS in seven patients and a stent was left in place for 4 to 6 weeks. Two required only a stent due to the small size of the ureterotomy. The postoperative course of these patients was uneventful. Following ureteral repair/reanastomosis, all women underwent an intravenous pyelogram at follow-up, and normal bilateral excretion was demonstrated. Cystoscopy revealed no abnormal findings in five patients who had undergone partial bladder resection. All patients reported significant pain relief or complete resolution of symptoms. Operative laparoscopy can be safely used to achieve relief from severe symptomatic endometriosis of the genitourinary tract.
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PMID:Laparoscopic Management of Genitourinary Endometriosis 907 28


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