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At least 271 records · Page 15Linked to original sources

Chiropractic care and ochronotic arthropathy.

OBJECTIVE: To discuss the case of a patient with ochronotic arthropathy whose symptoms were treated with chiropractic care. An emphasis is placed on this condition's radiographic features. CLINICAL FEATURES: A 59-year-old woman with pain in her low back, right knee, and left ankle sought chiropractic evaluation. Black pigmentation was found in the sclera of both eyes, and homogentisic acid was present in the urine. Orthopedic evaluation revealed uncomplicated, nonspecific joint pain, and radiographs demonstrated characteristic spinal changes. INTERVENTION AND OUTCOME: The patient was treated with chiropractic manipulation, physiotherapy modalities, bracing, and exercises. This type of therapy was successful in reducing the symptoms and helped decrease the severity and frequency of acute exacerbations. CONCLUSION: Ochronotic arthropathY is a rare metabolic disorder that can be diagnosed from spinal radiographs. Chiropractic care is an appropriate tool for reducing its symptomatology.

Arthritis↗

Manual therapy with steroid injections--a new approach to treatment of low back pain. A controlled multicenter trial with an evaluation by orthopedic surgeons.

Fifty-three acute or subacute patients with low back pain were given standardized but optimized activating conventional treatment by primary health care teams. Forty-eight patients received an experimental treatment that included specific manual treatment, such as manipulation and specific mobilization, muscle stretching, auto-traction, and cortisone injections. After 4 months, the experimental group had a less restricted range of movement in extension, less restricted side-bending to the right and to the left, less local pain caused by extension and side-bending to the right, less pain radiating to the right leg caused by side-bending to the left, and a less positive straight leg raising test (both sides) than the conventionally treated group. Manual treatment was superior to the conventional activating treatment in normalizing pathologic findings on physical examination of the lower back. These results agree with the positive influence on pain, drug consumption, sick-leave, disability rating, and quality of life reported in other reports from the same study.

Adult↗

[Internal pinning of the humerus by the supra-epitrochlear route. Apropos of 20 cases].

The authors report 20 cases of internal fixation of the humerus by the internal route, they discuss the place of internal fixation among other therapeutic methods and recall the advantages of the supratrochlear internal route, more simple to carry out and always atraumatic. This method is however only used where orthopedic treatment has failed.

Adolescent↗

Sacro-iliac joint pain: etiology and conservative treatment.

Orthopedic surgeons use many modalities in conservative treatment of low back pain (LBP) and sacroiliac pain (SIP) but few have been studied with randomized controlled trials. We have been studying the physiological effects of manipulation on joints and the clinical effect on patients. Manipulation is different from other forms of manual therapy. Quantitative sacroiliac scintigraphy and three clinical tests in patients with unilateral pain and tenderness over the SI joint suggest sacroiliac joint syndrome is a clinical entity. The iliac and sacral surfaces of the sacroiliac joint develop differently. Although this statement need further study it seems that manipulations may play a role in the treatment of LBP and SIP.

Biomechanical Phenomena↗

A nonsurgical approach to low back pain.

Low back pain, a leading cause of disability in the United States, has a significant economic impact not only on lost productivity but also on healthcare expenditures. Approximately a fifth of patients will see multiple physicians in their quest for relief of low back pain. Primary care physicians therefore play a crucial role in the initial approach to these patients. A thorough history and physical examination directed toward the neurologic, orthopedic, and osteopathic evaluation are essential. This article reviews the diagnosis and assessment of pain levels and a triad system of therapy involving cortical, spinal, and peripheral levels. Options include antidepressants, neuroleptics, neurostimulants, and osteopathic manipulative treatment (OMT) (cortical level); opiates, tramadol hydrochloride, and transcutaneous electrical nerve stimulators (spinal level); and nonsteroidal anti-inflammatory drugs, epidural injections, spinal blocks, antispasmodics, physical therapy, muscle relaxants, exercise, and OMT (peripheral level), By choosing a modality directed at each level, the clinician may provide the patient with a pain management program that will maximize the chosen mode of therapy and restore function and mobility.

Analgesics↗

[Orthopedic treatment of fifth metacarpal neck fractures: prospective study].

Many methods of treatment have been proposed for the metacarpal neck fractures of the little finger, from early mobilisation to open or closed surgical techniques. A prospective studies of 20 cases treated by a non surgical technique is presented. The reduction was performed by manipulation under local anesthesia according to the Jahss technique and a modified Thomine brace was applied for four weeks. All patients were reviewed for follow-up at 30, 60, and 180 days. The fracture displacement was initially 34 degrees. It was reduced by manipulation to 12 degrees. All fractures healed with an average final displacement of 20 degrees. At 6 months for final examination, average T.A.M. was 245 degrees, T.P.M. was 276 degrees, grip strength reached 96% of the other hand. There were 19 excellent and one bad results. In conclusion, ambulatory non surgical treatment by reduction and local immobilisation of the fractures of the fifth metacarpal provide a good final result with a low cost.

Absenteeism↗

[Baumann shoulder reposition].

An untraumatic method for the reposition of dislocated shoulders without any analgesia is presented. That the way of this method must be right, is proved by a short historical view and by case reports; On one side by the inventor of this method and on the other side by a retrospective study from the orthopedic department of the Kantonsspital of St. Gallen. How to do this reposition is clearly described by words and pictures.

Adult↗

[Medical treatment of hemophilic hemarthrosis and surgical prospects].

The treatment of acute hemarthrosis as utilized by eighteen hemophilic centers in different towns from France was presented. The amount of F.VIII infused, the use of cortisone and analgesic drugs, immobilisation and rehabilitation were discussed by each center. Discrepancies from one center to another appeared except for one point: the amount of F.VIII to be infused and the interest of early infusion. The interest of orthopedic surgery in the evolution of hemophilic arthropathies was developed.

Acute Disease↗

Luxatio erecta: a rarely seen, but often missed shoulder dislocation.

Luxatio erecta is an uncommon disorder and presents in a unique, unusual manner. Luxatio erecta is often misdiagnosed as an anterior dislocation. The presentation is unmistakable and classic: the arm hyperabducted and locked above the head. Neurovascular injuries consist of neuropraxia of brachial plexus, radial and ulnar nerve. Vascular injuries are complicated by intimal tears, transections, and/or thrombosis of the axillary artery or vein. Reduction is done with the traction and countertraction maneuver. Once it is reduced the arm is then placed and maintained with a sling in adduction to the chest. Orthopedic referral is required because of the high incidence of rotator cuff injury.

Accidental Falls↗

The often overlooked posterior dislocation of the shoulder.

Unlike most shoulder dislocations, the posterior dislocation is truly a diagnostic challenge to the treating physician because it may be missed more often than it is recognized. In fact, more than 60% of posterior dislocations are misdiagnosed initially by the treating orthopedic surgeon, and the correct diagnosis is often delayed for months or years. A history of seizures, electroshock, or a fall onto a flexed, adducted arm should alert the physician to the possibility of posterior dislocation. A careful physical examination with comparison to the unaffected arm must be performed with particular attention given to subtle posterior fullness and anterior flatness of the shoulder, along with a lack of external rotation and abduction. A radiographic trauma series made in the scapular plane must always be obtained in cases of shoulder trauma to rule out posterior dislocation. A computed tomographic scan may also be necessary. The correct diagnosis of this injury will facilitate proper orthopedic evaluation and treatment and will reduce the incidence of missed posterior shoulder dislocation and its associated morbidity.

Casts, Surgical↗