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

A case is presented of a bifid median nerve whose longest portion had a normal course while the other portion passed through a hole in the FDS tendon of the middle finger, at its musculotendinous junction. This caused nerve compression during muscle contraction, producing pain and dysaesthesia in the middle finger suggesting carpal tunnel syndrome.
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PMID:Bifid median nerve compression due to a musculotendinous anomaly of FDS to the middle finger. 782 22

A simple surgical technique to reconstruct the ACL deficient knee was described. A strip of ITB and fascia lata augmented by degradable suture materials was used as the substitute. The strip was introduced into the isometric area of the original ACL attachment through a drill hole made in the lateral femoral condyle. Drilling was guided by the anatomical landmarks without using special device. The graft was then rigidly fixed to the tibia by intraosseous compression, the method previously described by the author. Clinical results were assessed by both subjective symptoms and physical examinations. In 33 patients followed-up for an average of 34.1 months, thirty of them who were chronic cases had few or no symptoms concerning pain, swelling, laxity and stiffness at the last visit. Lachman test, anterior drawer and Slocum test were negative in 87.92, 81.87 and 100 per cent respectively. This technique requires only basic instruments and skill, and is thus generalizable to institutions having limited surgical facilities.
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PMID:Iliotibial band for anterior cruciate ligament reconstruction: a new technique for graft augmentation, placement and fixation. 787 51

Surgery for glaucomas unresponsive to conventional surgical strategies has always been frustrating and puzzling. I present preliminary results achieved by partial retinectomy in nine eyes that had complete synechial closure of the chamber angle accompanied by very high intraocular pressure (IOP), debilitating pain, and poor vision. The aim of this surgical procedure was to lower IOP by rerouting aqueous humor to the absorbing compartment of the choriocapillaris through a large retinal hole. Since a retinal wound will not heal, this "filtration site" will remain open and functional. Follow up ranged from 2 to 12 months. Preoperative IOPs ranged from 38 to 70 mm Hg; final postoperative IOPs, from 2 to 50 mm Hg. IOP decreased in all of the nine patients. Phthisis developed in two eyes and hypotony in three; the latter three eyes were not phthisical. The procedure was complicated by retinal detachment in one eye. A technique for determining the optimum size of the retinectomy for specific patients remains to be developed.
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PMID:Retinectomy lowers intraocular pressure in otherwise intractable glaucoma: preliminary results. 797 May 27

Presented is a case report of spontaneous rupture of the renal parenchyma associated with urinoma. A 3-year-old boy had a history of transient gross hematuria followed by sudden onset of left flank pain. Echograms and computed tomographic (CT) scan revealed a left hydronephrotic kidney with perirenal urinoma which had a cyclic change in size corresponding to the pain. Left retrograde pyelogram showed stenosis of the ureteropelvic junction without extravasation of contrast medium. A pin-hole tear was detected in the middle of the left renal parenchyma on exploratory surgery. Left pyeloplasty and retroperitoneal drainage were performed. The postoperative course was satisfactory. Spontaneous rupture of the renal parenchyma, which is frequently caused by renal tumor, vascular disease and/or infection, seems to be seldom caused by increased renal intrapelvic pressure as in rupture of the renal pelvis.
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PMID:[Spontaneous rupture of the hydronephrotic renal parenchyma associated with urinoma in a child]. 802 64

The present study was undertaken to clarify if needle positioning in percutaneous partial rhizotomy in the thoracic area based on bony landmarks and guided by fluoroscopic control leads to adequate placement in or at the targeted nervous tissue, i.e., the dorsal root ganglion (DRG), and to determine if needle localization by CT is more reliable than by fluoroscopic control. An investigation was performed in 2 cadavers, simulating the clinical setting as much as possible. At the levels T1-T8 a drill hole was made in the vertebral arc with a Kirschner wire. At the levels T9-T12 the "classic" dorsolateral technique was used. In 46 procedures the position of the needle tips was compared using hard copies of the fluoroscopic images, CT images at 1.5 mm intervals, surface photographs, and stained 25 microns sections obtained by a multirange heavy duty cryomicrotome. The position of the DRG in the foramen, and its size, were measured. In the sections, considered as the "golden standard", in 28 cases (60.9%) the needle tip was found in the DRG and in the extradural dorsal root in 14 cases (30.4%). In 4 cases (8.7%) no nervous tissue was encountered. In 8 of 32 "drill hole procedures" the facet joint was pierced. No accidental pleural puncture occurred in any of the procedures. The needle position was imaged more accurately by fluoroscopy. It is concluded that fluoroscopic control is a reliable guide to needle placement in percutaneous partial rhizotomy and permits standardization of the technique with the help of bony landmarks.
Pain 1994 May
PMID:Electrode positioning in thoracic percutaneous partial rhizotomy: an anatomical study. 809 May 19

Eight consecutive patients, mean age 17.25 years, underwent a medial displacement osteotomy and hip arthrodesis with a nine-hole Cobra plate. A transverse innominate osteotomy facilitated medial displacement of the femoral head and acetabulum. Alignment of the lower limb at 25 degrees flexion, neutral abduction, and neutral rotation was assisted by a long-limbed protractor and Steinmann pins placed in both anterior superior iliac spines. The greater trochanter was reattached to the Cobra plate so that hip abductor function could be restored should the fusion ever be converted to an arthroplasty. No postoperative immobilization was required. All patients had radiographic evidence of union by 12 months. One patient had a postoperative brachial plexus neuropraxia that resolved at three months. One patient required an ipsilateral femoral lengthening for limb-length inequality secondary to collapse of his femoral head before hip fusion. At a mean follow-up interval of 2.8 years (range, one to 4.5 years), all patients had significant improvements in pain (p < 0.05), function (p < 0.01), and gait (p < 0.01). The average preoperative Harris Hip Score of 45 points +/- 8 points (mean +/- SEM) improved to 84 points +/- 2 points (p < 0.01).
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PMID:Hip fusion in young adults. Using a medial displacement osteotomy and cobra plate. 813 27

The recent development of mini-invasive surgery includes appendectomy. We report our results of 4 years experience in this type of approach. We have operated on 154 patients (61 men, 93 women), mean age 26.7 years, presenting with clinical signs of appendicitis. The operation was completely carried out by laparoscopy in 144 cases, including treatment of abscess in 13 and peritonitis in 8 cases. Operation was converted into laparotomy in 10 cases, 4 of which because of some difficulty in appendix dissection. No deaths were recorded. Eight (5.2%) post-operative complications occurred: 4 infections of the trocar hole, one of which the cause of readmission; 3 cases of pain and fever (in one a re-laparoscopy was performed because of suspicion of leakage of the appendicular stump); 1 residual hematoma requiring second laparoscopy. Mean duration of hospitalisation was 4.9 days (range 2-25 days): at present, mean hospitalisation is 2 and 6 days respectively in cases with and without peritonitis. In conclusion, laparoscopic appendectomy appears to be feasible in the majority of cases, with better results when the appendix is ectopic and/or in the presence of peritoneal reaction.
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PMID:Laparoscopic appendectomy. A study of 154 consecutive cases. 817 51

Forty-five patients, 12 men and 33 women with an age range of 17 to 88 years (median 52 years), were selected for a posterior thoracic percutaneous partial rhizotomy (PPR) based on the following criteria. Each patient had at least a 6-month history of irradiating pain that followed the segmental pattern of an intercostal nerve and had not responded to conservative treatment. In addition, no causal treatment was available and there was a temporary positive response to an intercostal blockade with lidocaine. In the lower thoracic region (T8-12) PPR was performed with the usual dorsolateral technique; in the upper thoracic region a dorsal approach was used by means of a drill hole made with a Kirschner wire in the vertebral arch. The 45 patients underwent 53 thoracic PPR operations. Patients were evaluated 2 months after treatment. Thirty patients (66.7%) were pain-free: in 11 cases (24.4%) more than 50% improvement was achieved, and in four (8.9%) there was no improvement. Side effects consisting of a transient burning pain or a mild transient sensory loss occurred in eight patients (17.7%). After a follow-up period of 13 to 46 months (median 24 months) results were evaluated in 41 patients; five patients had undergone reintervention. Excellent long-term results were achieved in 20 patients (48.8%), good results in 15 (36.6%), and poor results in six (14.6%). It is concluded, that when conservative treatment fails, thoracic PPR may prove an effective and safe treatment for chronic segmental thoracic pain.
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PMID:The treatment of chronic thoracic segmental pain by radiofrequency percutaneous partial rhizotomy. 818 79

The main reasons for the importance of physiotherapy in treatment of rheumatoid arthritis are the biomechanical and neurophysiological factors, influencing not only joint function but also trophism. The dependence of the mechanical-structural differentiation of all parts of the joint from the regular practical usage, which is clinically obvious and can be pathophysiologically explained, enables us to use successfully all types of functional therapies. The treatment principle of calisthenics and ergotherapy must always again be derived from the therapy-relevant principles of joint physiology: the requirement of normal joint sensory; physiological instability; continuous activity for nutrition and structural differentiation; taking into consideration receptor sensitization during arthralgia; therapeutic usage of regeneration potency within its limits; and to avoid the unphysiological of an arthritis. The sketchy presentation of the hand's biomechanic lets us recognize easily the generation and prophylactics of the most important deformities: the so-called zig-zag deformities--button hole, swan neck, scoliosis of the hand, the subluxation, particularly those towards palmar, and the radial deviation of the carpus. In praxis we are searching for stabile joint positions, and we try to avoid lax joint positions to transmit force; also we are looking for early recognition of subluxations resp. deformities to train the joints, to fight reflex-dystrophic after-pain, the usage of orthotic devices, and finally treatment resp. prophylactics of contractures. Also part of physiotherapy are supporting and accompanying passive physiotherapeutic measures, therapeutic sport and handling of chronic states of pain. The sense and importance of all three supporting each other therapeutic concepts, will also be pointed out.
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PMID:[Value of physiotherapy in chronic rheumatoid arthritis]. 847 49

Two case histories are presented. In the first, a 49 year-old man fell on his right hip. He was able to walk, but because of pain he came to our emergency room. Radiographics gave an impression of an undislocated intertrochanteric fracture, scintigraphy confirmed the suspicion. There were no signs of infection. On starting osteosynthesis with the drilling of a hole in the lateral cortex, discharge of pus was observed and curettage of the abscess cavity was performed. In the second, a 21 year-old man hit his right knee against a table. Because of pain he was admitted to hospital. Primary signs of a lesion of the lateral meniscus were found and arthroscopy was scheduled. When readmitted we found signs of an infection and X-ray revealed a Brodie's abscess in the proximal tibia. The abscess cavity was opened and curettage was performed. Radiographics, scintigraphics, blood parameters and pathological and microbiological investigations revealed primary chronic osteomyelitis in both patients. Antibiotic therapy was instituted and six weeks after primary operation bone transplantation was performed. The further course was uncomplicated.
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PMID:[Brodie abscess. Primarily misinterpreted as traumatic lesion]. 855 90


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