Orthotics & Prosthetics
Fatemeh Azadinia; Ismail Ebrahimi-Takamjani; Mojtaba Kamyab; Morteza Asgari; Mohamad Parnianpour
Abstract
Background: Lumbosacral orthosis (LSO) is commonly used for the treatment of back pain. The clinical andmechanical effectiveness of this device has been repeatedly investigated in several studies; however, its sensorimotoreffectiveness has been rarely considered. Regarding this, the aim of the current ...
Read More
Background: Lumbosacral orthosis (LSO) is commonly used for the treatment of back pain. The clinical andmechanical effectiveness of this device has been repeatedly investigated in several studies; however, its sensorimotoreffectiveness has been rarely considered. Regarding this, the aim of the current study was to investigate the effect ofa non-extensible LSO on postural stability (as a construct of sensorimotor function) in patients with nonspecific chroniclow back pain (LBP).Methods: This preliminary study was conducted on 17 patients with nonspecific chronic LBP using a single-groupquasi-experimental design. Postural stability was measured while the participants were placed in a quiet standingposition, under the combined conditions of base of support (rigid and foam surface), visual input (open eyes and closedeyes), and LSO (with and without orthosis).Results: The findings demonstrated that wearing orthosis during the most challenging postural task (i.e., blindfoldedwhile standing on a foam surface) significantly reduced postural sway parameters related to the position anddisplacement of the center of pressure (COP; the sway area and sway amplitude in the anteroposterior direction;P<0.001). However, the use of this device had no significant effect on COP velocity.Conclusion: As the findings of the present study indicated, the use of a non-extensible LSO decreased the COPdisplacement; however, it did not affect the COP velocity. Therefore, our data could not utterly support the effectivenessof non-extensible LSO on postural stability as a construct of sensorimotor function. Postural control is an appropriateindicator for assessing the global functioning of the sensorimotor system due to its dependence upon the interactionbetween the neural and musculoskeletal systems. Consequently, further studies are needed to elucidate the positiveeffects of LSO on the aspects of sensorimotor function.Level of evidence: III
Orthotics & Prosthetics
Martin Kiechle; Andreas Thannheimer; Sven Hungerer; Jan Friederichs; Volker Bühren; Christian Von Rüden
Abstract
Background: Aim of this study was to compare the clinical and radiological long-term outcomes following operativetreatment of comminuted radial head fractures using 1) primary radial head resection arthroplasty, 2) acute radial headresection, or 3) necessary secondary prosthetic removal. Additionally, ...
Read More
Background: Aim of this study was to compare the clinical and radiological long-term outcomes following operativetreatment of comminuted radial head fractures using 1) primary radial head resection arthroplasty, 2) acute radial headresection, or 3) necessary secondary prosthetic removal. Additionally, we evaluated complex radial head fracturescombined with elbow dislocation and verified the hypothesis of whether primary radial head resection arthroplasty couldcontribute to ligament healing.Methods: In a comparative retrospective cohort study between 2004 and 2014, 87 (33 female, 54 male) patients withcomminuted radial head fractures with a median age of 45 (range 18-77) years were included and followed-up clinicallyand radiologically. Functional results were evaluated according to MEPS, DASH, Broberg and Morrey, and VAS scores.Results: After a median range of 46 months postoperatively, 48 patients (group 1) obtained an acute radial headresection arthroplasty (MEPS: 70 points, Broberg and Morrey: 63 points, DASH: 34 points, VAS: 3.3 points). Twentypatients (group 2) were treated by radial head resection (MEPS: 63 points, Broberg and Morrey: 50 points, DASH: 49points, VAS 4.2 points) and 19 patients (group 3) needed secondary prosthesis removal (MEPS: 73 points, Brobergand Morrey: 66 points, DASH: 38 points, VAS: 2.8 points). The overall outcome demonstrated a trend towards betterresults and the Kellgren-Lawrence grade of postoperative osteoarthritis was significantly better in groups 1 and 3compared to group 2 (P=0.02).Conclusion: Clinical and radiological long-term results of this study demonstrate a trend towards a better outcomeafter acute radial head resection arthroplasty compared to primary radial head resection, especially in complex fracturesassociated with elbow dislocation. Furthermore, our results encourage the use of primary radial head replacement incases of comminuted non-reconstructable radial head fractures.Level of evidence: III