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Sample records for ankylosis

  1. Temporomandibular ankylosis in the cat

    International Nuclear Information System (INIS)

    Ankylosis of the temporomandibular joint (TMJ) in the cat is an unusual complication of traumatic lesions involving articular (true ankylosis) or periarticular structures (false ankylosis). Seven cats with true ankylosis of the TMJ (four cases unilateral and three cases bilateral), of which previous trauma had been documented in five cases, were referred to the authors' clinic between September 1991 and October 1996. Radiographic assessment was performed in all cases, using dorsoventral and oblique projections. Five subjects underwent arthroplastic excision of the TMJ and, in the remaining two cases, stretching of the jaws was performed under general anaesthesia. The surgical outcome was satisfactory in all but one case, where partially decreased joint mobility was observed (follow-up time one to five years), but in the two cases where non-surgical treatment was carried out, recurrence of TMJ ankylosis was observed (follow-up time two to five months). In the authors' experience, surgery represents the treatment of choice for TMJ ankylosis in cats. Additional mandibular symphysiotomy can confirm the radiological findings in unilateral cases

  2. Bony ankylosis following thermal and electrical injury

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    Balen, P.F.; Helms, C.A. [Dept. of Radiology, Duke University Medical Center, Durham, NC (United States)

    2001-07-01

    Objective. Bony ankylosis has been described following trauma, paralysis, psoriasis, Reiter's syndrome, ankylosing spondylitis, juvenile chronic arthritis and rheumatoid arthritis. Reports of bony ankylosis following thermal and electrical injury are limited.Design and patients. Thirteen cases of burn-related joint ankylosis in four patients are presented.Conclusion. Patients with burns from thermal or electrical injury may develop bony ankylosis among other radiographic manifestations. This bony ankylosis may result either from bridging extra-articular heterotopic ossification with preservation of the underlying joint or from intra-articular fusion due to joint destruction. (orig.)

  3. Interposition arthroplasty in temporomandibular joint ankylosis

    OpenAIRE

    Ahmad, Q. G.; Siddiqui, R A; Khan, A H; S C Sharma

    2004-01-01

    We report a series of 60 cases of post- traumatic temporomandibular joint ankylosis that were treated at our unit from 1992 to 2002 by temporalis fascia flap interposition arthopiasty. Majority of these patients (21 patients, 35%) were in the age group of 15–20 years, with 39 males (65%) and 21 females (35%). The duration of ankylosis varied from 6 months to more than 4 years with 32 patients (54.32%) having a duration of 6 months to 2 years. 44 patients (73.33%) had unilateral white 16 patie...

  4. TEMPOROMANDIBULAR JOINT ANKYLOSIS: A CASE REPORT

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    Ankita

    2014-04-01

    Full Text Available Ankylosis is a Greek terminology meaning "stiff joint." It can be defined as "inability to open mouth due to either a fibrous or bony union between the head of the condyle and glenoid fossa."1 Temporomandibular joint (TMJ ankylosis is a disorder that leads to a restriction of the mouth opening from partial reduction to complete immobility of the jaw. It is most commonly associated with trauma (13-100%, local or systemic infection (0-53%, or systemic disease, such as ankylosing spondylitis, rheumatoid arthritis, or psoriasis.2, 3

  5. [Surgical treatment of temporomandibular joint ankylosis].

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    Worsaae, N; Hjørting-Hansen, E; Jensen, B; Seidler, B; Praetorius, F

    1992-09-14

    Surgical treatment of temporo-mandibular joint (TMJ) ankylosis may be a particularly difficult procedure due to unfavourable anatomic configurations and the proximity of vital structures. Postoperatively, it is followed by an often long and painful period of physiotherapy. The results of treatment of eight patients with TMJ ankylosis are reported. Different methods were used according to age of the patient and the extent of the ankylotic changes. The importance of early treatment is emphasized. This results in less extensive surgery and reduces secondary growth anomalies of the jaws.

  6. GAP ARTHROPLASTY IN TEMPOROMANDIBULAR JOINT ANKYLOSIS: A RETROSPECTIVE STUDY

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    Himanshu

    2015-03-01

    Full Text Available Temporomandibular joint (TMJ ankylosis is a disorder that leads to a restriction of the mouth opening from partial reduc tion to complete immobility of the jaw. The author retrospectively analyzed 20 patients with TMJ ankylosis which were treated by gap a rthroplasty in department of surgery, Government Medical Colleg e, Haldwani from March 2008 to J an 2015. Mean follow up was at least twenty - four months ( M inimum 24 and maximum 48 months. The purpose of this paper was to show that gap arthroplasty improve m outh opening when treating TMJ ankylosis. This was the first study in Kumaon region of U ttarakhand .

  7. Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.

    Science.gov (United States)

    van Lotten, Manon L; Schreinemakers, J Rieneke; van Noort, Arthur; Rademakers, Maarten V

    2016-09-01

    This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs. PMID:27583120

  8. Temporomandibular joint ankylosis contributing to coronoid process hyperplasia.

    Science.gov (United States)

    Wang, W H; Xu, B; Zhang, B J; Lou, H Q

    2016-10-01

    The purpose of this study was to investigate the association between coronoid process hyperplasia and temporomandibular joint (TMJ) ankylosis and to analyze the pathological mechanism and clinical significance of coronoid process hyperplasia. Forty-four patients treated for TMJ ankylosis between January 2007 and December 2014 were studied retrospectively; 176 patients with normal TMJs served as controls. The original DICOM data were used to reconstruct the jaw, and a three-dimensional cephalometric analysis (SimPlant Pro software version 11.04) was performed to assess the association between the severity of TMJ ankylosis and the height of the coronoid process. The height of the coronoid process was 20.41±5.00mm in the case group and 14.86±2.67mm in the control group; there was a significant difference between the two groups (Pprocess hyperplasia. Therefore, attention should be drawn to the coronoid process in patients with TMJ ankylosis. A coronoidectomy together with arthroplasty is recommended in patients with TMJ ankylosis.

  9. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

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    Song, Ju Seop; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University, Iksan (Korea, Republic of)

    2000-09-15

    A 31-year-old male with severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no faical swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the both condylar heads. Labortory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the labortary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

  10. Temporomandibular joint ankylosis in child: A case report

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    Rahul J Hegde

    2015-01-01

    Full Text Available Background: Ankylosis of the temporomandibular joint (TMJ is an intracapsular union of the disc-condyle complex to the temporal articular surface that restricts mandibular movements, including the fibrous adhesions or bony fusion between condyle, disc, glenoid fossa, and eminence. It is a serious and disabling condition that may cause problems in mastication, digestion, speech, appearance, and hygiene. Case Report: This report describes a case of a 12-year-old girl with inability to open her mouth, diagnosed with unilateral right bony TMJ ankylosis. The surgical approach consisted of gap arthroplasty with interpositional temporalis muscle flap followed by vigorous physiotherapy. Conclusion: The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. Its treatment includes the orthodontist, oral and maxillofacial surgeon, pediatric dentist, and psychologist and physical therapist as part of the healthcare team.

  11. Treatment of Post-Stroke Ankylosis by Warm-Needling

    Institute of Scientific and Technical Information of China (English)

    刘傲霜

    2004-01-01

    @@ Ankylosis is one of the post-stroke sequelae that hampers seriously the daily activities of the patients.Since 1996, the author has adopted warm needling for treatment of post-stroke ankylosis and obtained excellent therapeutic results. The statistical findings have shown that this therapeutic method can exert an important action in improving the joint spasm for patients with post-stroke sequelae. Especially, a better effect can be expected when it is used at the points of yin channels. A report follows.

  12. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

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    Ryan Chin Taw Cheong

    2016-01-01

    Full Text Available Congenital temporomandibular joint (TMJ ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1 much earlier insult to the TMJ, (2 reduced opportunity for neuromuscular development of the muscles of mastication, and (3 reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients.

  13. The management of traumatic ankylosis during orthodontics: a case report.

    LENUS (Irish Health Repository)

    McNamara, T G

    2000-01-01

    Dental ankylosis may be a significant complication in orthodontic clinical practice. This case report describes the management of a malocclusion, complicated by an ankylosed maxillary central incisor, which arose during orthodontic treatment, following an acute traumatic injury. The use of the ankylosed incisor in successfully managing the significant Class II division 1 malocclusion is described.

  14. Interposition arthroplasty of temporomandibular joint ankylosis using temporalis muscle flap: our experience

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    Nilam U. Sathe

    2011-10-01

    Full Text Available Ankylosis is defined as loss of joint movement resulting from fusion of bones within the joint or calcification of the ligaments around it. Satisfactory surgical correction of temporomandibular joint (TMJ ankylosis is limited by a high recurrence rate. This study aims to show that interposition arthroplasty with temporalis muscle flap improves mouth opening in 6 patients with TMJ ankylosis. Six patients with TMJ ankylosis were treated by interposition arthroplasty. The patients were evaluated between ten and 18 months after surgery. Preand postoperative assessment included a thorough analysis of case history and a physical examination to determine the cause of ankylosis, the maximal incisal opening and type of the ankylosis, recurrence rate and presence of facial nerve paralysis. All 6 patients had unilateral involvement. The mean age was 12.5 years ±6.5 (range 6-19 years. The mouth incisal opening in the preoperative period ranged from 5 mm to 11 mm and in the postoperative period it ranged from 30 mm to 35 mm. No recurrence and no facial palsy were observed in our series. No recurrence was noted, and in all the cases there was type IV ankylosis. Trauma was the major cause of temporomandibular joint ankylosis in our sample. Interpositional arthroplasty is a highly effective and safe surgical management option for TMJ ankylosis with acceptable immediate and long-term outcome, particularly when temporalis fascia and muscle are used.

  15. Fibrous Ankylosis of the Temporomandibular Joint in a Young Child.

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    Figueiredo, Nigel R; Meena, Manoj; Dinkar, Ajit D; Khorate, Manisha M

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disccondyle complex to the temporal articular surface that restricts mandibular movements, including fibrous adhesions or bony fusion between the condyle, disc, glenoid fossa, and articular eminence. The leading causes include trauma and infection. It can be a serious and disabling condition that leads to difficulties in mastication, swallowing, speaking, esthetics and oral hygiene. Disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability. Treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function. The purpose of this report is to describe a case of unilateral fibrous ankylosis of the right TMJ in a three-year-old girl. PMID:26349799

  16. TMJ ANKYLOSIS: MANAGEMENT WITH RECONSTRUCTION AND INTERPOSITIONAL ARTHROPLASTY.

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    Madhumati, Singh; Shruthi, R; Mitul, Sojitra; Karan, Abhishek; Aziz, Abdul

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing. Trauma and Infections are usually responsible. If trauma occurs in young age, it leads to disturbance in growth & facial asymmetry. Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. Early mobilization, physiotherapy & strict follow up are essential to prevent postop adhesions. In our cases fascia lata was used as an interpositional grafting material. One case was treated by gap arthroplasty, second case by costochondral graft & third case was managed with titanium condylar prosthesis. PMID:27487617

  17. Management of temporo-mandibular joint ankylosis in growing children

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    Shashikiran N

    2005-03-01

    Full Text Available Although temporo-mandibular joint (TMJ ankylosis is one of the most common pathologies afflicting the facial skeleton, it is also the most overlooked and under-managed problem in children. The TMJ forms the very cornerstone of cranio-facial integrity and hence its ankylosis in growing children adversely affects the growth and development of the jaws and occlusion. Impairment of speech, difficulty in mastication, poor oral hygiene, rampant caries and acute compromise of the airway pose a severe psychologic burden on the tender minds of children. The aim of this article is to present an overview of efficient management strategies, based on a case report, so as to increase its awareness among all dental surgeons involved in the treatment of children.

  18. BILATERAL BIFID MANDIBULAR CONDYLE WITH TEMPORO-MANDIBULAR JOINT ANKYLOSIS

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    Amit Nandan

    2014-06-01

    Full Text Available We report a case of 10years old female child who presented with presenting complaints of progressive difficulty in jaw opening. The parents gave history of facial trauma suffered five years back. A radiograph obtained at that time was unremarkable. This time she was advised computed tomography (CT examination of temporo-mandibular joint (TMJ to evaluate the severity and extent of ankylosis. Examination was done on a 64 slice CT scanner (GE with isotropic images and additional volume rendered and multiplanar acquisitions. Findings were suggestive of bilateral mediolateral bifid mandibular condyles with fibrous, partial bony ankylosis. Both mandibular condylar head were enlarged with abnormal contour. Condyles were bifid separated by a distinct groove.

  19. Spontaneous Knee Ankylosis through Heterotopic Ossification after Total Knee Arthroplasty

    OpenAIRE

    Samuel Boulezaz; Emmanuel Gibon; Philippe Loriaut; Laurent Casabianca; Romain Rousseau; Benjamin Dallaudiere; Hugues Pascal-Moussellard

    2016-01-01

    This paper reports on a case of total ankylosis of the knee after a cruciate-sacrificing cemented total knee arthroplasty (TKA). An 82-year-old female patient previously underwent primary TKA for osteoarthritis twenty years ago in our institution. She had recovered uneventfully and returned to her regular activities. There was no history of postsurgical trauma; however, she progressively lost knee range of motion. Radiographs revealed severe bridging heterotopic ossification.

  20. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    Science.gov (United States)

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis.

  1. Aetiology and presentation of ankylosis of the temporomandibular joint: report of 23 cases from Abuja, Nigeria.

    Science.gov (United States)

    Bello, Seidu Adebayo; Aluko Olokun, Bayo; Olaitan, Abayomi Ademola; Ajike, Sunday O

    2012-01-01

    Several studies have reviewed the management of ankylosis of the temporomandibular joint (TMJ), but only a few focused on the aetiology and clinical features. We retrospectively studied the aetiology and clinical features of patients with ankylosis of the TMJ who presented to the Maxillofacial Unit, National Hospital, Abuja, Nigeria, between 2004 and 2009. There were 13 male and 10 female patients, M:F ratio 1.3:1, age range 6-62, mean (SD) 20 (13) years. The aetiological factors were trauma (n=11) that comprised falls (n=6), untreated fractures of the zygomatic arch (n=4) and myositis ossificans (n=1); infection (n=9), that comprised cancrum oris (n=3) and ear infection (n=6); congenital or unknown (n=2), and coronoid hyperplasia (n=1). The maximum interincisal distance at presentation ranged from 0 to 25 mm (mean (SD) 6.7 (7.2) mm). Seventeen had facial deformities. The diagnoses recorded were as follows: left extracapsular ankylosis, (n=8); right intracapsular bony ankylosis, (n=6); left intracapsular bony ankylosis, (n=4); bilateral intracapsular bony ankylosis, (n=4), and bilateral intracapsular fibrous ankylosis (n=1). Extreme poverty was the main predisposing factor. There is a need for a concerted effort among healthcare providers, policy makers, and the world in general to eradicate poverty and improve healthcare to limit the incidence of ankylosis of the TMJ.

  2. Modified Technique of Retrograde Intubation in TMJ Ankylosis

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    Shaila Kamat

    2008-01-01

    Full Text Available We are presenting a case report on the anaesthetic management of a case of ankylosis of temporomandibular joint for corrective surgery in a 7 year old child. Anticipated difficult airway in paediatric population has always been a perplexing problem, awake fibreoptic intubation almost impossible due to obvious difficulties with co-operation. Here we are describing a new approach to this problem, in which the patients were kept under GA with spontaneous ventilation while retrograde intubation was done quite comfortably by the conventional method.

  3. Zygomatico-coronoid ankylosis secondary to heterotopic bone formation: Combined treatment by surgery and radiation therapy

    International Nuclear Information System (INIS)

    Zygomatico-coronoid ankylosis is a rare, extra-articular form of ankylosis of the jaws. An unusual case is presented in which true bony zygomatico-coronoid ankylosis was produced by a mass of heterotopic bone. Surgical treatment consisted of an oblique ostectomy across the mandibular ascending ramus, with interposition of Silastic sheeting to form a pseudarthrosis. Since surgery is often the stimulus for this condition, 2000 rads were delivered to the surgical site postoperatively in order to inhibit recurrent heterotopic bone formation. The rationale and indications for this form of treatment are discussed. (orig.)

  4. Ankylosis of the temporomandibular joint and mandibular growth disturbance caused by neglected condylar fracture in childhood

    OpenAIRE

    Endrajana Endrajana

    2010-01-01

    Background: Fractures of the mandibular condyle may lead to complications such as disturbance of occlusal function, internal derangement of the joint, ankylosis and mandibular growth disturbance. When treating young patients with the history of mandible trauma, ankylosis of the temporomandibular joint and mandibular growth disturbance are two most important complications of condyle fracture that should be considered. Purpose: This case report attempts to emphasize the long term complication o...

  5. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  6. Lateral Thigh Fascia Lata as Interpositional Graft for Temporomandibular Joint Ankylosis

    OpenAIRE

    Alemán, Ramón Manuel; Martínez, María Guadalupe

    2011-01-01

    Successful management of temporomandibular joint (TMJ) ankylosis depends on adequate gap arthroplasty and interpositional graft; the objective is to produce a functioning pseudoarthrosis that prevents reankylosis and provides adequate mobility. Several interpositional grafts have been used for the treatment of temporomandibular joint ankylosis such as indigenous pterygomasseteric sling, temporalis muscle/fascia, auricular cartilage, fat and dermis-fat. Lateral thigh fascia lata (LTFL) graft i...

  7. COMPARION OF GAP ARTHROPLASTY AND INTERPOSITIONAL GAP ARTHROPLASTY ON THE TEMPOROMANDIBULAR JOINT ANKYLOSIS

    OpenAIRE

    M. Ramezanian T. Yavary

    2006-01-01

    Temporomandibular joint ankylosis causes limitation in mouth opening and establishes severe deformity and asymmetry in patient’s face, especially in children. Surgery is the only treatment. This study was conducted to compare the effect of two surgical approaches, gap arthropasty and interpositional gap arthroplasty, on rate of maximum interincisal opening in temporomandibular joint ankylosis. We also evaluated the relapse rate of these two surgical approaches. A total of 48 patients were enr...

  8. USE OF A BLIND INTUBATION DEVICE FOR NASOTRA-CHEAL INTUBATION IN TEMPOROMANDIBULAR JOINT ANKYLOSIS

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Objective To evaluate light-guided tracheal intubation using blind intubation device (BID) in adult patients with temporomandibular joint ankylosis. Methods Twenty adult patients, American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, with temporomandibular joint ankylosis were selected for awake blind nasal intubation. The patients were prepared with nasal decongestants and inhaled 100% oxygen for 3min, then fentanyl (2μg/kg) and midazolam (1-5 mg) were intravenously injected for sedation. Top...

  9. CT imaging in the surgical treatment of one-sided extraarticular temporomandibular joint ankylosis; Uso da tomografia computadorizada no planejamento cirurgico da anquilose temporomandibular extra-articular unilateral

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    Villamizar, Lenin A.; Ghirelli, Carolina de Oliveira; Baroni, Carina Outi; Ferro, Daniel; Pinto, Ana Carolina Brandao de Campos Fonseca, E-mail: carinaouti@yahoo.com.br [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia. Dept. de Cirurgia

    2012-07-01

    Temporomandibular joint (TMJ) ankylosis is characterized by difficulty to open the mouth. The ankylosis may be articular when TJM is involved and extra-articular when other factors lead to a restriction of chewing movements without TJM involvement. Case report of one patient with unilateral ankylosis and his surgical planning through the tomography imaging. CT imaging helps preoperative planning because it can locate the exact point of injury and can make the difference between the true and false ankylosis of the TJM. (author)

  10. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

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    Song, Ji Young [Dept. of Oral and Maxillofacial Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Seong Gon; Choi, Hang Moon [School of Dentistry, Gangneung-Wonju National University, Gangneung (Korea, Republic of); Kim, Hyun Jung [Dept. of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-06-15

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

  11. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    International Nuclear Information System (INIS)

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence

  12. Ankylosis of the temporomandibular joint. Follow-up of thirteen patients.

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    Schobel, G; Millesi, W; Watzke, I M; Hollmann, K

    1992-07-01

    We undertook a postoperative clinical study of 13 patients with ankylosis of the temporomandibular joints. The study consisted of an evaluation of the surgical concepts of resection and subsequent surgical reconstruction by osteotomy in previous height of the joint space and lining of the glenoid fossa with lyophilized dura. Early mobilization and aggressive physiotherapy are mandatory postoperative measures. According to the theory of mandibular growth as a result of functional matrix, early surgical intervention to correct ankylosis should be performed, regardless of the age of the patient, to prevent recurrence and later asymmetry or distoclusion.

  13. Temporomandibular joint ankylosis: Case-series of two different surgical procedures

    Directory of Open Access Journals (Sweden)

    Gholamreza Shirani

    2014-01-01

    Full Text Available Introducation: The long-term outcome and clinical results of gaparthroplasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. The purpose of this study was to compare the effect of gap arthroplasty and costochondral graft methods on reankylosis, a mount of mouth opening and growth. Materials and Methods: A non-randomized, retrospective clinical study of l0 cases (5-12 years old of condylar ankylosis of the mandible, surgically treated during a 10 year period from 2002 to 2012 was performed. Four patients were treated by condylectomy and interpositional flap, whereas six were treated by condylectomy and immediate costachondral rib grafts. The first group underwent long-term postoperative therapy using removable activator appliances. Casts, radiographs, photographs, and computed tomography (CT were used post surgically to evaluate rib graft, condylar growth and function, occlusion, facial, and condylar symmetry. Data were analyzed by SPSS 16 statistical software using Mann-Whitney, Paired T-test and Chi-square tests. Results: Children with long-standing condylar ankylosis of the mandible treated by condylectomy and interpositional flap showed more favorably when activators were used post-surgically. Conclusions: Gaparthroplasty with functional activator post-operatively can be considering for TMJ ankylosis.

  14. Zurich pediatric distractor for ramal condylar unit distraction in temporomandibular joint ankylosis.

    Science.gov (United States)

    Sahoo, Brig N K; Roy, I D; Sharma, Rohit; Kaur, Maj Preeti

    2016-01-01

    Temporomandibular joint (TMJ) Ankylosis is an extremely disabling condition characterized by difficulty or inability to open the mouth resulting in facial asymmetry, malocclusion and dental problems. Surgical excision of the ankylosed mass is the only treatment option available to gain mouth opening. The loss in vertical height of ramus following release of ankylosis is difficult to manage in both unilateral and bilateral TMJ ankylosis. Out of all the methods to restore this height Distraction Osteogenesis (DO) is gaining popularity because of predictable gain in the length without any associated morbidity. Recurrent bilateral TMJ ankylosis in a 32 year old male was treated by osteoarthrectomy and temporal fascia interpositioning arthroplasty. Bilateral reconstruction of ramal condylar unit (RCU) was carried out by Zurich paediatric distractor (KLS Martin, Tuttlingen Germany). Following a latency period of 7 days distraction was carried out at a rate of 1mm/day for 8 days. Distractors were removed after 12 weeks of consolidation period. The case was followed up for 12 months during which the mouth opening was maintained at 38 mm and there was no anterior open bite. PMID:27563617

  15. The characteristics of bony ankylosis of the facet joint of the upper cervical spine in rheumatoid arthritis patients

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    Iizuka, Haku; Nishinome, Masahiro; Sorimachi, Yasunori; Ara, Tsuyoshi; Nakajima, Takashi; Iizuka, Yoichi; Takagishi, Kenji

    2009-01-01

    This study investigated the bony ankylosis of the upper cervical spine facet joints in patients with a cervical spine involvement due to rheumatoid arthritis (RA) using computed tomography (CT) and then examined the characteristics of the patients showing such ankylosis. Forty-six consecutive patients who underwent surgical treatment for RA involving the cervical spine were reviewed. The radiographic diagnoses included atlanto-axial subluxation in 30 cases, vertical subluxation (VS) in 10 cas...

  16. Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis; Report of two cases

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    Noor J. Al-Saadi

    2015-11-01

    Full Text Available Temporomandibular joint (TMJ ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries.

  17. Arthroplasties of hips and knees ankylosis in an adolescent with acute lymphoblastic leukaemia.

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    Dipo Samuel OLABUMUYI

    2011-10-01

    Full Text Available Acute lymphoblastic leukaemia (ALL is the most common malignancy in children, representing one third of all paediatric malignancies. Patients are often at high risk for complications due aggressive chemotherapy regimes required for treatment. Musculoskeletal complications include septic arthritis, osteonecrosis, osteoporosis, avascular necrosis and bony ankylosis. We report the case of a 16-year-old boy with ALL who developed osteonecrosis of multiple bones on a background of septicaemia, resulting in bony ankylosis of both hips and knees. He was treated with bilateral conversion of ankylosed hips (one hip to total hip replacement, the second hip to Girdlestone arthroplasty and bilateral ankylosed knees to total knee replacements. He remained well in remission five years after the last surgery. Our case highlights he possible musculoskeletal complications of ALL. 

  18. Extraarticular bony ankylosis in a child with supracondylar fracture of humerus

    Directory of Open Access Journals (Sweden)

    Naranje Sameer

    2012-11-01

    Full Text Available 【Abstract】 Myositis ossificans is defined as forma-tion of bone at the site of injured muscle. It is one of the rare complications of supracondylar fracture of humerus in children. Myositis mass usually develops on the anterior aspect in the brachialis muscle and produces restriction of range of motion, but complete ankylosis is rare. To the best of our knowledge, this is the first case to be reported in the literature as a consequence of myositis ossificans traumatica. In this case, a six-year-old child presented to the casualty department with pain in the right elbow after a fall on out-stretched hand during play. After surgical excision through the anterior approach, the child had no symptoms referable to the elbow and a residual flexion deformity of 15 degrees with further painless flexion up to 100 degrees at last follow-up of one year after surgery. Key words: Humerus; Fractures, Bone; Myositis; Ankylosis

  19. Fluroscopic assisted airway intubation in temporomandibular joint ankylosis: A novel technique

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    Ibin Varughese

    2011-01-01

    Full Text Available Airway management is considered one of the most difficult and challenging procedures among the various anesthetic procedures. It becomes tougher when there is a diseased temporomandibular joint (TMJ due to inadequate mouth opening. In the current scenario there are only a few methods that ensure a safe, uneventful intubation in a TMJ ankylosis patient with a difficult airway. These include techniques ranging from minimally invasive techniques like blind nasal intubation, retrograde intubation using a guide wire, the latest technique of intubating with the help of a fiberoptic laryngoscope and the time tested tracheostomy. All these techniques have got their own disadvantages. So we report a case series of five patients with TMJ ankylosis who underwent fluoroscopic-assisted intubation for airway management. We found that this technique is 100% successful in managing the airway in these patients. To the best of our knowledge, this is the first case series detailing this novel technique in the entire English medical literature.

  20. Hypohidrotic ectodermal dysplasia with ankylosis of temporomandibular joint and cleft palate: A rare presentation

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    Manisha Goyal

    2015-01-01

    Full Text Available The ectodermal dysplasias are a heterogenous group of diseases, which have one or more anomalies of the hair, teeth, nails, and sweat glands. Hypohidrotic ectodermal dysplasia (HED is the most common type and is usually transmitted as an X-linked recessive trait. It is characterized by classical triad of hypotrichosis, anhidrosis/hypohidrosis, and hypodontia/anodontia. Here, we describe an Indian boy affected with HED and rare features including ankylosis of temporomandibular joint and cleft palate.

  1. Airway Management in a Mental Retardation Patient with Temporo-mandibular Joint Ankylosis

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    Rauf GÜL

    2012-01-01

    Full Text Available Temporo-mandibular joint (TMJ ankylosis makes it impossible orotracheal intubation for general anesthesia because of limited mouth opening. We applied a nasotracheal intubation via fiberoptic bronchoscopy (FOB guidance on a 36 years old mental retarded (MR patient with bilateral TMJ, having extremely limited mouth opening. As a result, nasotracheal intubation via FOB is reliable technique on even mental retarded patients with extremely limited opening.

  2. Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis.

    Science.gov (United States)

    Bartlett, Scott P; Reid, Russell R; Losee, Joseph E; Quinn, Peter D

    2006-05-01

    The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances. PMID:16770209

  3. Temporomandibular joint ankylosis caused by chondroid hyperplasia from the callus of condylar neck fracture.

    Science.gov (United States)

    Kim, Soung Min; Park, Jung Min; Kim, Ji Hyuck; Kwon, Kwang Jun; Park, Young Wook; Lee, Jong Ho; Lee, Sang Shin; Lee, Suk Keun

    2009-01-01

    A patient who complained of difficulty in opening his mouth after condylar neck fracture 1 year ago presented typical features of temporomandibular joint ankylosis in clinical and radiologic examinations. To demonstrate a possible pathogenesis of temporomandibular joint ankylosis after condylar neck fracture, the fractured condylar portion removed was examined by histologic and immunohistochemical stainings. Interpositional gap arthroplasty was performed by removing the inferomesially displaced fractured condyle, and reconstruction with subcutaneous dermis to the previous vertical height was performed immediately. The fractured condylar portion was almost intact with slight erosion of the condylar cartilage. In the hematoxylin and eosin and Masson trichrome stainings, an extensive chondroid hyperplasia with abundant hyaline cartilage was shown in the removed condylar portion. There were also hyperplastic features of the synovial membrane, which were abnormally distributed throughout the chondroid tissues. In the immunohistochemical stainings of proliferating cell nuclear antigen (PCNA) and bone morphogenetic protein (BMP)-2 and BMP-4, the chondroid tissues were conspicuously hyperplastic and strongly positive for BMP-4 but sparse for BMP-2. From these results, we think that the hyperplastic chondroid tissue was derived from the callus of the primary fractured site of the condylar neck and propose that the chondroid tissue could proliferate continuously because of synovial tissue support from around the temporomandibular joint, resulting in temporomandibular joint ankylosis. This pathogenesis is quite different from those of other diaphyseal fracture of long bones. PMID:19165036

  4. Temporomandibular joint ankylosis as part of the clinical spectrum of Carey-Fineman-Ziter syndrome?

    Science.gov (United States)

    Pasetti, Martina; Mazzoleni, Fabio; Novelli, Giorgio; Iascone, Maria; Bozzetti, Alberto; Selicorni, Angelo

    2016-08-01

    The Carey-Finema-Ziter syndrome (CFZS, MIM 254940) is an apparently autosomal recessively inherited disorder consisting of the combination of non-progressive congenital myopathy with Moebius and Pierre Robin sequence, facial anomalies and growth delay. Mental development has been described as normal or delayed. Temporomandibular joint (TMJ) ankylosis is the immobility of the joint caused by ankylotic fusion of the mandible to the cranial base or zygoma. It is a serious and disabling condition that may cause problems in mastication, digestion, speech, appearance, and oral hygiene. Most often is a true ankylosis of the TMJ but other pathological mechanisms are described (i.e., the fusion of the coronoid process to temporal bone or with the zygoma, or a variety of soft tissues disorders like Fibrodysplasia Ossificans Progressiva). Here we report a 2-year-old girl fitting with a clinical diagnosis of CFZS associated with a limited mouth opening in which temporomandibular joint ankylosis was suspected. Because it has been postulated that many clinical features in CFZS may only be secondary effects of brainstem anomalies and muscle weakness during development, the limited opening of the mouth observed in our patient could represent a rare clinical feature of CFZS itself. © 2016 Wiley Periodicals, Inc.

  5. Ankylosis of the temporomandibular joint and mandibular growth disturbance caused by neglected condylar fracture in childhood

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    Endrajana Endrajana

    2010-06-01

    Full Text Available Background: Fractures of the mandibular condyle may lead to complications such as disturbance of occlusal function, internal derangement of the joint, ankylosis and mandibular growth disturbance. When treating young patients with the history of mandible trauma, ankylosis of the temporomandibular joint and mandibular growth disturbance are two most important complications of condyle fracture that should be considered. Purpose: This case report attempts to emphasize the long term complication of neglected condylar fracture in children i.e. ankylosis of the temporomandibular joint and subsequently lead to mandibular growth disturbance. Case: A case of right temporo-mandibular joint ankylosis and mandibular growth disturbance in a 28 years old male patient is presented. He had a history of trauma to the mandible after a traffic accident when he was 8 years old. Since then, he experienced difficulty in mouth opening which eventually developed into severe trismus. Case management: The case was treated surgically with gap and interpositional arthroplasty using Mersilen mesh™. Conclusion: Mandibular fractures involving temporomandibular joint in young children should be examined thoroughly and treated adequately in order to prevent ankylosis of the TMJ and the subsequent mandibular growth disturbance.Latar belakang: Fraktur pada kondilus mandibula dapat menyebabkan beberapa komplikasi berupa: gangguan oklusi, internal derangement sendi, ankilosis serta gangguan pertumbuhan mandibula. Pada perawatan penderita usia muda dengan riwayat trauma pada mandibula, perlu diwaspadai dua macam komplikasi akibat fraktur pada kondilus, yaitu ankilosis sendi temporo mandibula dan adanya gangguan pertumbuhan mandibula. Tujuan: Laporan kasus ini bertujuan untuk menekankan bahwa fraktur kondilus pada anak-anak yang tidak mendapatkan perawatan yang semestinya akan mengakibatkan komplikasi jangka panjang berupa ankilosis sendi temporomandibula yang diikuti dengan

  6. Anquilose da articulação têmporo-mandibular Temporo mandibular joint ankylosis

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    Belmiro Cavalcanti do Egito Vasconcelos

    2008-02-01

    Full Text Available A anquilose pode ser definida como sendo a fusão das superfícies articulares e seu tratamento é um verdadeiro desafio devido à alta taxa de recorrência. OBJETIVO: Descrever seis casos clínicos tratados pela técnica da reconstrução articular, avaliar os resultados dessas cirurgias e fazer uma revisão da literatura. METODOLOGIA: A população estudada neste estudo retrospectivo foi obtida dos prontuários do hospital universitário e tinha que ter sido submetida a cirurgia para tratamento de anquilose por reconstrução aloplástica ou autógena entre os períodos de março de 2001 e outubro de 2005. Dados como a máxima abertura de boca (MAB, etiologia, tipo de anquilose e tratamento, e ocorrência de recidiva e lesão do nervo facial foram coletados no pré-operatório, através dos prontuários, e no pós-operatório, através de entrevista. RESULTADOS: A média da MAB no pré-operatório foi de 9,6mm (0 a 17mm e no pós-operatório foi de 31,33mm (14mm a 41mm, não houve lesão do nervo facial e apenas em um caso houve recidiva da anquilose. CONCLUSÃO: A reconstrução da articulação com material autógeno ou alógeno, para o tratamento da anquilose da ATM se mostrou eficaz em relação à MAB pós-operatória, recidiva e função da articulação.Ankylosis may be defined as joint surfaces fusion. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high recurrence rate. AIM: The aim of this study is to report six cases treated by joint reconstruction, evaluate the results of these surgeries and review the literature. METHODS: The sample in this retrospective study was obtained from the records of the university hospital, patients who had to undergo ankylosis treatment by alloplastic or autogenous graft between March 2001 and October 2005. Pre - and post-operative assessment included a throughout history and physical examination to determine the cause of ankylosis, the Maximum mouth

  7. Retrograde Intubation in Temporomandibular Joint Ankylosis-A Double Guide Wire Technique

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    Vitha K Dhulkhed

    2008-01-01

    Full Text Available Intubating a patient with temporomandibular joint ankylosis is always a challenge particularly when fibreoptic laryngo-scope is not available. In a 20-year-old male patient we successfully carried out endotracheal intubation with 7 mm portex cuffed PVC tube with the help of two flexible J tipped guide wires. One guide wire was passed into the airway from cricothyroid puncture site and another from subcricoid site. Both were brought out through the nose. The first guide wire was used for retracting the epiglottis and the second as a guide for passing the endotracheal tube.

  8. Ankylosis of the distal interphalangeal joint in a horse after septic arthritis and septic navicular bursitis.

    Science.gov (United States)

    Honnas, C M; Schumacher, J; Kuesis, B S

    1992-04-01

    A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an attempt to prevent ascending contamination of the joint, placing the limb in a short limb cast, and inserting a Penrose drain into the joint for passive drainage of septic exudate. The goal of treatment was to encourage ankylosis of the distal interphalangeal joint. Because of the filly's persistent lameness and laxity of the lateral collateral ligament in the contralateral carpus, the palmar nerves of the affected foot were injected with a long-acting local anesthetic at the level of the proximal sesamoid bones to encourage weight-bearing. Ankylosis of the distal interphalangeal joint was complete 9 months after the puncture, but a grade-2 lameness remained and the horse had a varus deformity resulting from ligamentous laxity of the lateral collateral ligament in the contralateral carpus.

  9. Pseudoarthrosis and ankylosis of the vertebral spine without sacroiliitis associated with Takayasu's arteritis: review of the association

    Energy Technology Data Exchange (ETDEWEB)

    Schuetz, C.T.; Anderson, S.E. [Department of Diagnostic Radiology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland); Aeberli, D.; Oertle, S. [Department of Rheumatology, University Hospital of Berne, Inselspital, 3010 Berne (Switzerland)

    2002-09-01

    Pseudoarthrosis and ankylosis of the vertebral spine associated with Takayasu's arteritis is extremely rare. We present a patient with the entity who was HLA-B27 negative and had normal sacroiliac joints. The association between Takayasu's arteritis and ankylosing spondylitis appears real but seemingly rare. (orig.)

  10. One-stage operation for noma-induced bilateral ankylosis accompanied with mouth verrucous carcinoma - a case report and review of literature.

    Science.gov (United States)

    Lu, Xu Guang; Cai, Zhi Gang; Zhang, Yi; Sun, Yong Gang

    2010-01-01

    A rare case of a male patient who suffered from noma with sequelae of ankylosis in bilateral temporomandibular joints for 52 years and a neoplasm in the right commissure of the lips for 1 year, was operated on to resolve the ankylosis, remove the neoplasm and reconstruct the soft tissue defect with a forearm flap through a one-stage operation. The neoplasm pathology was verrucous carcinoma.

  11. Surgical Treatment of Neglected Traumatic Quadriceps Tendon Rupture with Knee Ankylosis.

    Science.gov (United States)

    Lee, Seung-Hun; Song, Eun-Kyoo; Seon, Jong-Keun; Woo, Seong-Hwan

    2016-06-01

    Quadriceps tendon rupture is an uncommon injury. This disabling condition is the result of direct or indirect trauma. It requires surgical repair to avoid poor outcomes in cases of neglected or chronic rupture. In most acute cases, simple tendon suture or reinsertion is suitable for an extensor mechanism reconstruction of the knee joint. However, chronic lesions often require a tendon graft or flap reconstruction. We report a case of a 15-year-old male who was diagnosed with a chronic quadriceps rupture with a patellar superior pole fracture. We performed quadriceps reconstruction using tibialis anterior allograft tendon and additional screw fixation to reconstruct the extensor mechanism and recover knee joint range of motion to prevent a high-level functional restriction. The treatment was difficult and limited due to neglect for 9-months that led to ankylosis accompanied with nonunion of tibial fracture. Our surgical treatment using allograft tendon resulted in a very good outcome after 30 months of follow-up.

  12. Extraarticular bony ankylosis in a child with supracondylar fracture of humerus

    Institute of Scientific and Technical Information of China (English)

    Sameer Naranje; Ramprasad Kancherla; Arun Kannan; Rajesh Malhotra; Lalit Sharma; Sukesh Rao Sankineani

    2012-01-01

    Myositis ossificans is defined as formation of bone at the site of injured muscle.It is one of the rare complications of supracondylar fracture of humerus in children.Myositis mass usually develops on the anterior aspect in the brachialis muscle and produces restriction of range of motion,but complete ankylosis is rare.To the best of our knowledge,this is the first case to be reported in the literature as a consequence of myositis ossificans traumatica.In this case,a six-year-old child presented to the casualty department with pain in the right elbow after a fall on outstretched hand during play,After surgical excision through the anterior approach,the child had no symptoms referable to the elbow and a residual flexion deformity of 15 degrees with further painless flexion up to 100 degrees at last followup of one year after surgery.

  13. Surgical Treatment of Ankylosis of Temporomandibular Joint with Temporalis Myofascial Flap

    Institute of Scientific and Technical Information of China (English)

    朱志军; 邢树忠; 万林忠; 陶震江; 吴煜农

    2003-01-01

    Objective:To study the effects of temporalis myofascial flap(TMF)transferred to treat the long ankylosis of temporomandibular joint(TMJ).Methods:Seventeen cases with ankylosed condyles received arthroplasly.The degrees of mouth opeing pre-and post-operatium were evaluated,and the spaces of joints in the X-ray films were also measured.The evaluation of the results of the surrgical treatment was based on the TMJ functions.Results:Following up 0.5-3.0 years,in 12 of 17 cases the degree of mouth opening improved up to 27mm.The doctors and the patients were both satisfied with the results.Conclusion:The use of TMF in arthroplasty of temporomandibular joint is a good approach in the treatment of TMJ.

  14. ANAESTHETIC MANAGEMENT OF A CASE OF TEMPOROMANDIBULAR JOINT ANKYLOSIS POSTED FOR BILATERAL BREAST SURGERY: A CASE REPORT

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    Athaluri Vishnu

    2014-07-01

    Full Text Available BACKGROUND: Temporomandibular joint (TMJ ankylosis is associated with partial or complete restriction of mouth opening and poses a significant problem to the anesthesiologist making the airway management very challenging. Alternative methods of securing the airway should be kept ready because conventional laryngoscopy and intubation are impossible. Thoracic epidural anesthesia (TEA is one of the options to avoid general anesthesia in this case. We aimed to manage a case of bilateral modified radical mastectomy with TMJ ankylosis solely under thoracic epidural anesthesia. METHODOLOGY: Female patient of 32 years of age, with bilateral TMJ ankylosis with no mouth opening was posted for bilateral breast surgery. Thoracic epidural was instituted at T4-T5 interspace and 18G epidural catheters was secured. Alternative airway management strategies were included in our plan if thoracic epidural fails. OBSERVATION: Adequate preparation of the patient, counseling about anesthetic plan of management, placement of epidural catheter by an experienced anesthesiologist helped in the successful management of this case. CONCLUSION: Regional anesthesia techniques are safer alternatives to provide intraoperative anesthesia with difficult airway for bilateral breast surgeries.

  15. Free flap transfer for closure and interposition-arthroplasty in noma defects of the lateral face associated with bony ankylosis.

    Science.gov (United States)

    Giessler, Goetz A; Schmidt, Andreas B; Deubel, Ute; Cornelius, C-Peter

    2004-09-01

    Noma defects of the anterolateral face are often associated with fibrous or bony ankylosis fusing the mandibula to the skull base. According to the extent of the ankylosis, the temporomandibular joint mobility can be restricted or even completely frozen. In third world conditions the surgical approach to severe forms of bony ankylosis consists of a single linear opening osteotomy (trismus release) and the closure of the noma defect with locoregional flaps. Relapse of jaw immobility is common and may be caused by minor bone resection, the lack of adequate postoperative physiotherapy, or even the scarring of the defect coverage. In 4 years the authors have gained increasing experience with folded free flaps for simultaneous closure of outer and inner lining of large noma defects and the maintenance and training of re-established jaw function by the use of a dynamic external distractor fixed between the zygoma and the mandibular body. The authors report the bony reankylosis can be reduced by extended wedge osteotomies of the bony bridge and tip-like shaping of the ascending mandibular ramus. To preclude the reossification of the osteotomy site and fibrous scar formation, a dermofatty or muscular tail of the free flap is interposed into the bone gap. Two cases were treated according to this concept with a free parascapular and a latissimus dorsi flap in combination with simultaneous arthroplasty. During a 6-month follow-up period, no signs of a recurrent reduction of mandibular movement were noted in either case.

  16. Postinfectious ankylosis of the knee after bacterial arthritis following routine anterior cruciate ligament (ACL) reconstruction

    Science.gov (United States)

    Mester, Bastian; Schoepp, Christian; Glombitza, Martin; Rixen, Dieter

    2016-01-01

    Aims and Objectives: Knee arthroscopy is a very common surgical procedure. It belongs to the most frequently performed procedures in orthopedics and traumatology and is considered to have a low complication rate. The risk of postoperative knee infection following ACL reconstrucion is estimated 1-2 %. Thereby the ACL reconstruction cannot always be preserved. Persistent defects after healing and postinfectios osteoarthritis are observed. We present the case of an adolescent patient suffering from postoperative knee infection following routine ACL reconstruction, who is developing - while infection is decreasing - a complete bony ankylosis of the knee, clinically meaning a severe constraint to joint function with complete stiffness of the knee. Materials and Methods: The 13-year-old male patient sustained a distorsion of the right knee during sports at school, after clinical examination magnetic resonance tomography showed a complete tear of the ACL. Single bundle ACL reconstruction was done using autologous hamstrings in Transfix technique. After 5 days at hospital the patient was discharged without any complications. Shortly afterwards the patient was admitted to hospital again presenting a postoperative knee infection. After primary operative revision the patient was shifted to our intensive care unit in a septic condition for stabilization. During 4 month of stay at our hospital multiple operative revisions were performed as arthrotomy, debridement, insertion of antibiotic carriers, complete removal of the autograft and total synovectomy. We found a severe bacterial infection (staphylococcus aureus) of the knee joint, classified Gaechter IV, histopathologically mostly avital cartilage tissue and chronic synovialitis. After decrease of the infection we could discharge the patient from hospital. Results: During the following 8 month under ongoing physiotherapy the patient was developing an increasing stiffness of the knee, finally fixed at 30 degrees of flexion and

  17. Anquilosis mandibular: una frecuente secuela por Noma Mandibular ankylosis: a Noma frequent sequel

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    R. Fernández García-Guilarte

    2009-12-01

    Full Text Available Conocemos poco sobre el Noma o Enfermedad Cancrum Oris. Esta entidad afecta a niños con malnutrición crónica, poca higiene oral, poco desarrollo sanitario y enfermedades concurrentes debilitantes. Existe un consenso general sobre que el Noma empieza como una gingivitis; en su fase aguda, puede haber respuesta al tratamiento antibiótico, no obstante, las secuelas tras su curación incluyen daños estéticos y funcionales variables, que pueden requerir cirugía reconstructiva. Presentamos 3 casos de anquilosis mandibular que en el examen preoperatorio presentaron dimorfismo mandibular, fusión de hueso maxilar y mandibular y anquilosis de la articulación témporomandibular. La ortopantografía y la Tomografía Axial Computerizada (TAC fueron muy útiles en la planificación de la cirugía. El tratamiento quirúrgico consistió en todos los casos en la resección del hueso anquilótico y la reconstrucción con injerto condrocostal en uno de los casos. En el postoperatorio se siguió fisioterapia intensiva. Clínicamente todos los pacientes mostraron una gran mejoría en la masticación, la alimentación y el habla, obviamente debido a una buena oclusión. El problema más común fue la baja colaboración en la rehabilitación mandibular por parte de los pacientes.Little is known about Noma or Cancrum Oris Disease. This entity affects to children with chronic malnutrition, poor oral hygiene, poor environmental sanitation and debilitating concurrent illness. There is general consensus that noma starts as gingivitis. The acute stage responds readily to antibiotic treatment. The sequelae after healing include variable functional and aesthetic impairments, which require reconstructive surgery. We report 3 cases of mandibular ankylosis. Preoperative examination revealed mandibular dismorphism, fusion of maxilla and mandible and ankylosis of the temporomandibular joint. Orthopantography and Computed Thomography scan (TCS were very useful in planning

  18. Rehabilitation treatment of ankylosis after relaxing and plastic operation of adhesion of knee extension apparatus%伸膝装置粘连松解成形术后康复治疗膝关节僵直

    Institute of Scientific and Technical Information of China (English)

    史桂秋; 尹中华

    2002-01-01

    Background:Ankylosis is the result of adhesion of knee extension apparatus that is often the complications of trauma of femoral shaft and knee .Because ankylosis will impair the flexion of knee joint,postoperational exercise is the key to rebuild flexing function of knee joint.

  19. Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Kumkum Gupta

    2012-01-01

    Full Text Available Background : Fiberoptic intubation is the gold standard technique for difficult airway management in patients of temporomandibular joint. This study was aimed to evaluate the clinical efficacy and safety of dexmedetomidine as premedication with propofol infusion for fiberoptic intubation. Methods: Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups - Group D and Group P, of 23 patients each. Group D patients had received premedication of dexmedetomidine 1 μg/kg infused over 10 min followed by sedative propofol infusion and the control Group P patients were given only propofol infusion to achieve sedation. Condition achieved at endoscopy, intubating conditions, hemodynamic changes and postoperative events were evaluated as primary outcome. Results : The fiberoptic intubation was successful with satisfactory endoscopic and intubating condition in all patients. Dexmedetomidine premedication has provided satisfactory conditions for fiberoptic intubation and attenuated the hemodynamic response of fiberoptic intubation than the propofol group. Conclusion : Fiberoptic intubation was found to be easier with dexmedetomidine premedication along with sedative infusion of propofol with complete amnesia of the procedure, hemodynamic stability and preservation of patent airway.

  20. TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement—A Case Report

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    Pavankumar Janardan Vibhute

    2011-01-01

    Full Text Available This report describes the multidisciplinary phasewise treatment of a 20-year-old female patient having unilateral right TMJ bony (true ankylosis whose mouth opening was restricted to 2 mm and mandibular retrognathism; additionally, she was also suffering from speech problems, snoring, difficulty in breathing, and low level of self-esteem and self-confidence. Bilateral gap arthroplasty and temporalis myofascial graft interpositioning through preauricular approach were done in surgical phase followed by the aggressive jaw physiotherapy in postsurgical period. Oral prophylaxis and restorations were followed by the fixed orthodontic therapy to resolve bimaxillary protrusion. Advancement sliding genioplasty was performed to enhance the chin button. Speech therapy and psychological counseling were also performed from time to time to boost up the self-esteem and self-confidence. At the end of treatment, facial esthetics was improved considerably and patient got over the impact of disfigurement, impaired functions, and psychosocial stigma. Rationale to use the multidisciplinary team approach in treatment of such cases is discussed.

  1. Is aggressive gap arthroplasty essential in the management of temporomandibular joint ankylosis?-a prospective clinical study of 15 cases.

    Science.gov (United States)

    Babu, Lokesh; Jain, Manoj Kumar; Ramesh, C; Vinayaka, N

    2013-09-01

    The purpose of this three-year, prospective, follow-up study was to evaluate whether aggressive gap arthroplasty is essential in the management of ankylosis of the temporomandibular joint (TMJ). Fifteen patients were treated by the creation of a minimal gap of 5-8mm and insertion of an interpositional gap arthroplasty using the temporalis fascia. Eleven patients had unilateral coronoidectomy and 4 bilateral coronoidectomy based on Kaban's protocol. Preoperative assessment included recording of history, clinical and radiological examinations, personal variables, the aetiology of the ankylosis, the side affected, and any other relevant findings. Patients were assessed postoperatively by a surgeon unaware of the treatment given for a minimum of 3 years, which included measurement of the maximal incisal opening, presence of facial nerve paralysis, recurrence, and any other relevant findings. Of the 15 patients (17 joints), 12 had unilateral and three had bilateral involvement, with trauma being the most common cause. The patients were aged between 7 and 29 years (mean (SD) age 20 (8) years). Preoperative maximal incisal opening was 0-2mm in 8 cases and 2-9mm in 9. Postoperatively adequate mouth opening of 30-40mm was achieved in all cases, with no recurrence or relevant malocclusion during 3-year follow up. However, patients will be followed up for 10 years. Aggressive gap arthroplasty is not essential in the management of ankylosis of the TMJ. Minimal gap interpositional arthroplasty with complete removal of the mediolateral ankylotic mass is a feasible and effective method of preventing recurrence. PMID:23219020

  2. [Interposition of a full-thickness skin graft in the surgery of temporomandibular joint ankylosis. A study of 31 cases of which 20 had long-term follow-up].

    Science.gov (United States)

    Guyot, L; Chossegros, C; Cheynet, F; Gola, R; Lachard, J; Blanc, J L

    1995-01-01

    Recurrence is the main problem in temporo-mandibular joint ankylosis treatment. Two therapy are used against this, physiotherapy and surgical joint interposition. Following ankylosis removal, many materials can be interposed but, for us, fullthickness skin graft using Popescu and Vasiliu technique seems to be the best and simplest one. This retrospective study of 31 cases, 20 with long-term follow-up, shows that good results are obtained using this skin graft, with 90% successful rate.

  3. Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis

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    Yadavalli Guruprasad

    2012-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty.

  4. The application of distraction osteogenesis in the temporomandibular joint ankylosis and secondary dentofacial deformities%牵张成骨在颞下颌关节强直及其继发畸形矫治中的应用

    Institute of Scientific and Technical Information of China (English)

    祝颂松; 胡静

    2016-01-01

    Temporomandibular joint ( TMJ) ankylosis is a joint disorder which refers to bone or fibrous adhesion of the anatomic joint components and the ensuing loss of function. When it occurs in children, it can cause secondary dentofa-cial deformities with physical and psychological disability. Correction of TMJ ankylosis and secondary deformities remains a great challenge for oral and maxillofacial surgeons. Distraction osteogenesis ( DO) has been used for the treatment of TMJ ankylosis and secondary deformities with satisfactory outcomes. An average of 50-60 patients with TMJ ankylosis is referred to our department annually. In this review, we summarized the characteristics of DO and discussed some factors involved in the treatment of TMJ ankylosis with dentofacial deformities.%儿童时期发生的颞下颌关节强直可以导致不同程度的颌面部骨骼发育障碍,并引起自卑、社交障碍等一系列心理问题,其矫治是口腔颌面外科医生面临的一大挑战. 牵张成骨( distraction osteogenesis,DO)一直被国内外学者用于颞下颌关节(temporomandibular joint,TMJ)强直及其继发畸形的矫治,并取得了良好的临床效果.笔者所在科室每年大概收治50~60例TMJ强直患者,对DO技术在TMJ强直及其继发畸形矫治中的应用积累了较为丰富的临床经验. 本文中,笔者对DO技术在TMJ强直及其继发畸形矫治中的优缺点及相关问题进行述评.

  5. Effect of distraction osteogenesis combined with postoperative rehabilitation nursing on obstructive sleep apnea syn-drome after ankylosis of temporomandibular joint%牵张成骨并术后康复护理对颞凳关节强直后睡眠呼吸暂停综合征的作用

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    于擘; 刘彦普; 侯锐; 史亮

    2003-01-01

    @@ INTRODUCTION Ankylosis of temporomandibular joint can cause severe mandibofacialasymmetry, postmandibular stenosis. Ankylosis of temporomandibularjoint(TMJ) in infants can lead to obstruction of upper airway due toinfluencing on development of mandible and obstructive sleep apncasyndrome(OSAS) is caused. Previous surgical treatment of ankylosisof temporomanibular joint needs large scope with big trauma andhigh relapse rate. Distraction osteogenesis technique can simplifysurgical operation, decrease operation risk and relapse rate and theeffect definitive.

  6. TREATMENT OF SLEEP APNEA SYNDROME DUE TO ANKYLOSIS OF TMJ USING ORTHOGNATHIC SURGERY TECHNIQUE%正颌外科技术治疗TMJ后OSAS

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    于擘; 顾晓明; 张良; 门志光

    2002-01-01

    Objective To evaluate orthognathic surgery in the treatment of sleep apnea syndrome (SAS) resulted from ankylosis of TMJ. Methods Firstly, the arthroplasty was carried out to relieve the TMJ ankylosis and to open mouth according to design. The mandibles of 14 patients with SAS were advanced by "L"-osteotomy of ramus at the affected side and a sagittal split ramus osteotomy at normal side combined with TMJ arthroplasty. Results After operation, maximal mouth opening of the 14 patients reached 2.5cm-3.5cm. The follow-up 2 years later showed the maximal mouth opening was kept between 2.5cm and 3.2cm. AHI of all the patients were less than 20 postoperatively. Snoring while asleep disappeared in 12 patients and their SaO2 increased by 18.45% in average (P<0.01), which fell into the normal range. No patients were waken up by suffocation. Continuous SaO2 increased from 58% to over 95% in average. Conclusion The obstruction of the upper airway can be relieved through orthognathic surgery. Thus the hypoxemia of the patients was relieved or corrected. This technique is effective in the treatment of SAS due to TMJ ankylosis.%目的评估正颌外科技术矫治14例颞颌关节强直所致OSAS的效果.方法手术采用患侧关节成形,下颌升支、体部的"L"形半层截骨及健侧矢状截骨术,将患侧下颌升支加高固定,下颌前部整体前移.结果 14例颞颌关节强直伴OSAS患者术后张口度达2.5~3.5cm,术后2年随访张口度仍维持在2.5~3.2cm之间.所有患者的AHI指数下降了20以上,12例患者的打鼾症状消失,持续血氧饱和度平均提高了18.45%(P<0.01),达到了正常人的范围,持续血氧饱和度最低值由术前的58%提高至术后的95%以上,OSAS得以治愈.结论颞颌关节强直伴OSAS患者通过正颌外科手术可以在关节成形的同时,解决患者下颌后缩的缺陷,解除上气道狭窄,从而缓解或纠正患者的低氧血症.

  7. Tratamiento de anquilosis tempomandibular en la infancia mediante artroplastia y distracción de tejidos blandos Management of temporomandibular ankylosis during childhood by means of arthroplasty and soft tissue distraction

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    M.A. Morey Mas

    2004-08-01

    Full Text Available Los traumatismos que afectan a los cóndilos mandibulares pueden ocasionar una anquilosis de la articulación temporomandibular que, si se produce en edad de crecimiento, puede dar lugar a una deformidad facial con asimetría o retrognatia. Entre los diferentes tratamientos utilizados, la distracción osteogénica ofrece unas ventajas, entre ellas la posibilidad de aplicación en la infancia y la elongación de tejidos blandos. Presentamos un caso de anquilosis temporomandibular bilateral en una niña de 9 años, que tratamos con distracción extraoral tras resección del bloque anquilótico, pero sólo con la finalidad de elongar los tejidos blandos y mantener el espacio en la nueva cavidad glenoidea para evitar la reanquilosis y favorecer la remodelación del cóndilo.Condylar damage can produce temporomandibular joint ankylosis. If ankylosis ocurrs in early childhood can develope facial asymmetry or mandibular hypoplasia. In these cases, several therapeutic options have been used, but distraction osteogenesis offers a new excellent alternative because it allows elongation of soft tissues and can be performed in childhood. We present a bilateral temporomadibular joint ankylosis in a 9 years old girl, who was treated by means an arthroplasty and extraoral distraction devices, only for elongation of soft tissues and keeping space between skull base and mandibula to avoid reankylosis and to allow condylar remodelation.

  8. Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.

    Science.gov (United States)

    Bansal, V; Singh, S; Garg, N; Dubey, P

    2014-02-01

    This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients.

  9. Experimental establishment of animal model of temporomandibular joint ankylosis secondary to condylar sagittal fracture%髁突矢状骨折继发颞下颌关节强直动物模型的建立

    Institute of Scientific and Technical Information of China (English)

    王霄; 张益; 李江明

    2011-01-01

    目的:建立髁突矢状骨折继发颞下颌关节强直动物模型,为进一步研究创伤性颞下颌关节强直发生机制提供实验载体.方法:小尾寒羊4只,双侧关节互为对照.实验侧通过手术造成髁突矢状骨折,破坏关节窝表面软骨,切除外侧1/2关节盘;对照侧仅造成髁突矢状骨折.术后6个月,通过CT检查和组织学观察评价实验侧颞下颌关节强直的形成.结果:4只小尾寒羊的实验侧关节均发生混合性强直,CT检查发现,关节结构消失,关节间隙变窄,周缘出现不规则增生或吸收,上、下关节面被若干上、下贯通的高密度影像所分隔,呈骨痂样改变.组织学观察可见,实验侧关节窝与髁突之间散在有骨与骨样的基质,部分区域可分辨出强直骨桥的形成.对照侧未出现强直迹象.结论:本研究中的动物实验重现了临床髁突矢状骨折继发颞下颌关节强直的发生过程,实验具有可重复性,可作为动物模型用于对创伤性关节强直的研究载体.%Objective: To experimentally develop an animal model of traumatic temporomandibular joint ankylosis secondary to condylar fracture in small Tail Han sheep. Methods: Four sheep were used to make sagittal fracture of condyles. The cartilage layer of articular surface was damaged and lateral half of articular disc was removed in the right side and conserved in the left side as a control. All animals were sacrificed at the end of 6 months postoperatively. CT observation and histological examination were carried out to evaluate the formation of ankylosed joints. Results: All of the animals showed a change of mixed ankylosis on the right sides. On the CT image, the joint space became narrow and the articular surfaces became irregular with high-density callus formation. Histological observation validated that the bone-like and the cartilage-like matrix scattered between the condyle and temporal fossa. The ankylosis bone bridge could be figured out in

  10. 全髋关节置换术治疗强直性脊柱炎髋关节强直%Total hip arthroplasty in the treatment of ankylosing spondilitis with hip ankylosis

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    王贵清; 蔡显义; 汤勇智; 杨立群; 黎昭华; 利洪艺

    2011-01-01

    目的 探讨全髋关节置换术治疗强直性脊柱炎髋关节强直的临床效果.方法 对11例强直性脊柱炎髋关节强直患者(22髋)进行全髋关节置换术,术后行踝关节及足趾屈伸等功能锻练.结果 术后髋关节活动度明显改善,屈曲畸形基本矫正.11例均获随访,时间2~6年.未出现关节脱位和假体松动.Harris评分由术前9~58(36±9.8)分提高到末次随访时64~94(81.2±10.6)分,优13髋,良6髋,中3髋.结论 全髋关节置换术治疗强直性脊柱炎髋关节强直能显著改善髋关节功能,矫正髋关节畸形,近期疗效满意.%Objective To study the curative effect of total hip arthroplasty( THA )in the treatment of ankylosing spondilitis with hip ankylosis.Methods 11 cases of ankylosing spondilitis with hip ankylosis( 22 hips ) were performed by THA and ankle and foot exercises were done after operation.Results Function of hip joint improved evidently after operation, and flexion deformity disappeared basically.After following up for 2 ~ 6 years, there was no sign of loosening, dislocation.The clinical results were evaluated by the Harris hip scoring system.Harris hip score improved from 9 ~58( 36 ±9.8 ) points preoperatively to 64 ~ 94( 81.2 ± 10.6 ) points at the final postoperatively evaluation.13 hips were excellent effect, 6 good and 3 fair.Conclusions THA can greatly improve the function and rectify deformity of hip joint of patients with ankylosing spondilitis with hip ankylosis.The short term curative effect is satisfactory.

  11. Prosthetic replacement of condylar head for management of traumatic temporomandibular joint ankylosis%髁突置换治疗创伤性颞下颌关节强直五例

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    安金刚; 张益; 何锦泉; 贺洋; 李江明

    2009-01-01

    Objective To preliminarily evaluate the method of using titanium condylar protheses in management of traumatic temporomandibular joint ankylosis.Methods Between August 2006 and April 2008,titanium condylar replacement was performed in 5 male patients.Preoperative CT datum of patient was obtained and a resin model was then produced and used as a reference to select a suitable titanium condyle for reconstruction of the joint.In the operation,the bony ankylosis was removed.According to the preoperation planning,the selected prosthesis was inserted and fixed to the distal mandibular segment.The results were assessed by means of examinations and measurements postoperatively and during follow-up.Results The 5 patients received alloplastic replacement of 6 condyles.Three patients were under follow-up and follow-up time ranged from 8 months to 2 years and 6 months.The mean mouth opening was 30 mm.Two patients had good occlusion and one patient developed a slight open bite.Conclusions Prosthetic condylar replacement can provide a choice for management of traumatic temporomandibular joint ankylosis.%目的 总结用人工髁突置换治疗创伤性颞下颌关节强直(temporomandibular joint ankylosis,TMJA)的临床效果.方法 2006年8月至2008年4月北京大学口腔医学院·口腔医院口腔颌面外科共5例创伤性TMJA患者接受人工髁突置换手术,患者均为男性.术前行CT检查后,用快速成形技术制作三维头模,在头模上模拟切除关节骨球、关节成形、选择适宜的人工髁突,术中依术前设计安放并固定人工髁突.术后1周和复查时评价手术效果.结果 5例共植入6侧人工髁突(1例为双侧).3例复查时间为术后8~30个月,另外2例失访.复查时张口度平均为30 mm,2例咬合关系良好,1例前牙区有约1 mm的开骀.结论 人工髁突置换可以作为创伤性TMJA手术治疗的方法之一,其临床效果还需进一步验证.

  12. 创伤性颞下颌关节强直的分类和治疗-84例临床资料分析%Classification and treatment of traumatic temporomandibular joint ankylosis:An analysis of 84 consecutive patients

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    杨驰; 何冬梅; 陈敏洁; 张晓虎; 邱亚汀; 杨秀娟; 李凌志

    2011-01-01

    PURPOSE: This study was to investigate the classification of traumatic temporomandibular joint ankylosis (TMJA) based on coronal CT sean and to present our treatment experience in the TMJ division of Shanghai Ninth People's Hospital. METHODS: From 2001 to 2009, 130 patients diagnosed of TMJA were treated in TMJ division. Among them,84 patients with 124 joints were caused by trauma and treated first by our group of surgeons. They were included in this study. All of them had CT scan, especially coronal reconstruction through the TMJ area before and after surgery. A new classification based on the coronal CT scan was proposed. The treatment protocol for Type A 1 ankylosis was fibrous tissue release or condylar head resection with costochondral graft (CCG) and temporalis myofascial flap (TMF). For Type A2 and A3 ankylosis, the lateral bony fusion was resected while the intact residual condylar fragment displaced medially was remained. The operation was named "lateral arthroplasty" (LAP). TMF or masseter muscle flap (MMF) was used as a barrier in the lateral gap between temporomandibular joint fossa and stump of the mandibular ramus, If the medial condylar fragment in Type A3 ankylosis was too small to bear the load, it was resected with the bony mass. The joint was then reconstructed with CCG and TMF or MMF. For Type A4 ankylosis, the bony fusion was completely removed and the joint was reconstructed with CCG and TMF or MMF. The result of the treatment were evaluated by CT scan and clinical follow-up. RESULTS: Among the 124 ankylotic joints, 14 were Type Al ankylosis (11.3%); 43 were Type A2 (34.7%);46 were Type A3 (37.1%) and 21 were Type A4 ankylosis (16.9%). Part of Type Al, all Type A2 and A3 ankylosis had residual condylar head displaced medially which accounted for 75% (93/124) of the TMJ ankylosis. Treatment according to the classification was: LAP for 82 joints (66.1%); CCG for 33 joints (26.6%); and other treatment for 9 joints (7.3

  13. Tooth ankylosis in deciduous teeth of children with cleft lip and/or palate Anquilose dentária na dentição decídua em crianças com fissura de lábio e/ou palato

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    Andreza Maria Fábio Aranha

    2004-12-01

    Full Text Available The present study aimed at evaluating the prevalence of tooth ankylosis in deciduous molars of Caucasian children with cleft lip and/or palate aged 5 to 12 years, of both genders. A total of 330 patients seen at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo for routine treatment were clinically evaluated. The prevalence of ankylosis was analyzed in relation to gender, age range (5-7, 8-10, 11-12 years, type of cleft, affected tooth and arch. The total group showed a prevalence of 18%, with no statistical difference between genders and among types of cleft; ankylosis was more often in the mandibular arch, lower first molars and among children in the age ranges 8-10 and 11-12 years. The results agreed with those observed in the related literature for patients without clefts, pointing out the absence of influence of the cleft on the prevalence of ankylosis. This reinforces the importance of early diagnosis of this anomaly and of the treatment of choice, which are similar in patients with or without clefts.Este estudo avaliou a prevalência de anquilose dentária em molares decíduos de portadores de fissura de lábio e/ou palato, brancos, de ambos os sexos, com idade entre 5 e 12 anos. Um total de 330 pacientes atendidos no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo para tratamento de rotina foi clinicamente avaliado. A prevalência de anquilose foi analisada em relação a gênero, idade (5-7; 8-10; 11-12 anos, tipo de fissura, dente e arco afetados. O grupo total demonstrou prevalência de 18%, sem diferença estatística entre gêneros e tipos de fissura, sendo mais acometido o arco mandibular, o primeiro molar inferior e as faixas etárias de 8 a 10 e de 11 a 12 anos. Os resultados estão de acordo com aqueles observados na literatura para pacientes sem fissuras, destacando a ausência da influência das fissuras na prevalência de anquilose. Isso reforça a

  14. A anquilose tíbio-társica e sua importância na insuficiência venosa crônica Ankle ankylosis and its importance in chronic venous insufficiency

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    Jorge Ribas Timi

    2009-09-01

    Full Text Available CONTEXTO: O desenvolvimento de anquilose em pacientes com insuficiência venosa crônica (IVC pode ser evidenciado em diversos estágios da patologia através de medidas da amplitude de movimento da articulação do tornozelo tomadas com a utilização de um goniômetro. OBJETIVO: Relacionar a diminuição da amplitude de movimento da articulação tíbio-társica na IVC dos membros inferiores (MMII medida por goniometria com a gravidade da IVC, utilizando-se a classificação CEAP. MÉTODOS: No período de março de 2003 a agosto de 2004, 86 pacientes (67 mulheres e 19 homens com média de idade de 50,6 anos foram submetidos à goniometria do tornozelo. Os indivíduos foram divididos conforme a gravidade da IVC de seus MMII (121 avaliados de acordo com a classificação CEAP. Quarenta membros foram caracterizados como C0 (grupo-controle, 40 como C3, e 41 como C4. As medidas obtidas nos diferentes grupos foram comparadas entre si. RESULTADOS: A média da amplitude de movimento da articulação tíbio-társica do grupo C0 foi de 42,4º (variação de 26-54; a do grupo C3 foi de 37,9º (variação de 10-61; e a do grupo C4 foi de 24,5º (variação de 8-50. A diferença das médias de C4 e C3 foi de 36%, e a de C3 comparada com o grupo-controle (C0, de 11%, caracterizando a maior diferença entre C3 e C4. CONCLUSÃO: A goniometria do tornozelo auxilia a graduar a hipertensão venosa crônica, pois demonstra a existência de correlação entre a gravidade da anquilose e a severidade da IVC.BACKGROUND: Development of ankylosis in patients with chronic venous insufficiency (CVI can be observed in different stages of the disease as the ankle range of motion is measured by a goniometer. OBJECTIVE: To relate a reduced ankle range of motion in patients with CVI of the lower limbs measured by goniometry and the severity of CVI according to the CEAP classification. METHODS: From March 2003 to August 2004, 86 patients (67 females and 19 males with a mean

  15. 颞肌筋膜瓣转移治疗颞下颌关节强直的临床研究%Surgical Treatment of Ankylosis of Temporomandibular Joint with Temporalis Myofascial Flap

    Institute of Scientific and Technical Information of China (English)

    朱志军; 邢树忠; 万林忠; 陶震江; 吴煜农

    2003-01-01

    目的:观察颞肌筋膜瓣转移治疗下颌关节真性强直的临床疗效.方法:采用颞肌筋膜瓣移植治疗颞下颌关节真性强直17例,通过测量术前、术后开口度,摄全景片及关节片测量关节间隙大小,术后随访等综合评价疗效.结果:全部病例均痊愈出院,开口度在30 mm以上,咬(牙合)关系恢复良好.12例经6个月~3年随访观察,张口度均在22 mm以上,手术效果稳定,令人满意.结论:颞肌筋膜瓣转移是治疗颞下颌关节真性强直的一种比较理想的方法.%Objective:To study the effects of temporalis myofascial flap (TMF) trans-ferred to treat the long ankylosis of temporomandibular joint (TM J). Methods : Seventeen cases withankylosed condyles received arthroplasty. The degrees of mouth opening pre- and post-operation were e-valuated, and the spaces of joints in the X-ray films were also measured. The evaluation of the resultsof the surgical treatment was based on the TMJ functions. Results:Following up 0. 5-3. 0 years, in12 of 17 cases the degree of mouth opening improved up to 27 mm. The doctors and the patients wereboth satisfied with the results. Conclusion:The use of TMF in arthroplasty of temporomandibularjoint is a good approach in the treatment of TMJ.

  16. 伸直位骨性强直膝的全膝关节置换术%Total knee arthroplasty in the treatment of knees with bony ankylosis in extension

    Institute of Scientific and Technical Information of China (English)

    童培建; 何帮剑; 储小兵; 厉驹; 叶福生; 肖鲁伟

    2012-01-01

    Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.%目的 探讨伸直位骨性强直膝全膝关节置换术的手术方法与临床疗效.方法 2000年6月至2007年6月,对10例伸直

  17. Total knee arthroplasty for extension ankylosis of the knee:an analysis of 1 3 cases%膝关节置换治疗膝关节伸直位强直13例

    Institute of Scientific and Technical Information of China (English)

    张有伟; 郭礼跃

    2015-01-01

    Objective:To investigate the treatment method and curative effect of total knee arthroplasty for extension ankylosis of the knee. Methods:Total knee arthroplasty was performed to 13 patients with extension anky-losis of the knee from March 2008 to February 2014,including 6 male and 7 female patients with an average age of 41.4 years(36.0 -63.0 years),among whom 3 patients had rheumatoid arthritis and 10 patients had trauma around the knee joint. Before surgery,the range of motion was (0 ±0)°,the score of HSS and the Lysholm function score were(38 ±13.80)points and (15 ±13.29)points. Results:All of the 13 patients received total knee arthroplasty.The average follow-up was 48.7 months (9.0 -78.0 months). In the last follow-up,the range of motion was (96 ±12.17)°,the score of HSS and the Lysholm function score were (85 ±7.15)points and (82 ±6.94)points, indicating there were statistically significant differences before and after operation. The postoperative complications included patellar fracture in 1 patient,patellar tendon avulsion in 1 patient,part of incision necrosis in 2 patients and superficial infection in 1 patient. They were all cured after treatment,however,extension lag occurred in 3 pa-tients with degrees of 5°,10°and 15°respectively.Conclusion:Total knee arthroplasty for extension ankylosis of the knee can achieve satisfactory clinical results,but the operation is difficult and the chance of complications is high, and rehabilitation exercise is very important.%目的:探讨膝关节置换治疗膝关节伸直位强直的方法和疗效。方法:2008年3月至2014年2月,笔者采用膝关节置换治疗膝关节伸直位强直患者13例,男6例,女7例,平均年龄41.4岁(36.0~63.0岁),其中类风湿性关节炎3例,膝关节周围创伤10例;术前膝关节活动度(0±0)°,HSS评分(38±13.80)分,膝关节功能Lysholm评分(15±13.29)分。结果:全部病例行膝关节置换,平均随访48.7

  18. 髋关节强直人工关节置换术治疗分析%Experience of hip artificial joint replacement in the treatment of ankylosis of hip joint

    Institute of Scientific and Technical Information of China (English)

    冯国英; 王心宽; 张辉; 刘铁军

    2014-01-01

    Objective To investigate the clinical curative effect and the technique of hip artificial joint replacement in the treatment of ankylosis of hip joint.Methods A retrospective data of 19 patients with hip joint ankylosis operated by artificial joint replacement was reviewed between July 2010 and June 2013 in our hospital.The hipfusion due to ankylosing spondylitis was in 15 cases; congenital acetabular dysplasia and osteoarthritis were in 3 cases; ischemic necrosis of femoral head was in 1 case.The history of all the cases was 5-40 years in which 15 cases of hip joint was complete rigidity and no activity with hip 10 °-45 ° of adduction and flexion.The preoperative,intraoperative and postoperative data were summarized.Results Totally 19 cases were all followed up and the follow-up time was 0.5-3.5 years.All the patients had no complications after operation,such as nerve,vascular injury,acute pulmonary embolism,acute renal and heart failure,pulmonary infection and deep vein thrombosis.During the follow-up period,all the patients had no dislocation,loosening prosthesis and delayed infection.The postoperative activity of hip joint was significantly improved after operation.There were 3 cases (15.8%) of heterotopic ossification.Conclusions Artificial joint replacement is an ideal method in the treatment of hip joint ankylosis,which can significantly improve the joint function and the quality of life.Intraoperative technology directly affects the effect after operation.The lateral approach of hip joint has a lot of advantages and can effectively prevent the dislocation after artificial joint replacement.%目的 探讨髋关节强直人工关节置换手术的临床疗效和技术要点.方法 回顾性分析自2010年7月至2013年6月在北京市通州区中西医结合医院住院的19例髋关节强直患者经过人工关节置换手术后的临床资料.其中强直性脊柱炎髋关节融合15例,先天性髋臼发育不良伴骨性关节炎3

  19. 哈萨克医药马脂治疗SD大鼠踝关节僵硬的效果%Effect of Horse-fat of Kazakh-medicine on SD-rat Ankle-join Ankylosis

    Institute of Scientific and Technical Information of China (English)

    尹作祯; 江阿古丽·艾山; 海拉提·阿力地阿尔汗; 加莎热特·杰力勒; 杨广忠; 江安努尔·这依肯

    2011-01-01

    目的 研究马脂对创伤后制动继发踝关节僵硬后踝关节功能的效果.方法 将SD大鼠随机分成7 d、14 d、21 d三组,每组10只,各组分为用药组与功能锻炼组,每组各5只,用药后用量角器分别测定其踝关节活动度.结果 7 d组用药大鼠关节活动度与功能锻炼组比较,差异无统计学意义(P>0.05);14 d用药组活动度与功能锻炼组比较,差异有统计学意义(P<0.05);21 d用药组活动度与功能锻炼组比较,差异有统计学意义(P<0.05).结论 马脂经皮渗透治疗大鼠创伤后制动继发踝关节僵硬的作用明显优于对照组.%Objective To investigate the effect of horse-fat on ankle-join ankylosis secondary to immobilization following trauma. Methods All rat models were divided into three groups: 7-day group, 14-day group and 21-day group, ten rats each. These groups were further divided into two subgroups: control group and experimental group, 5 rats each. The protractor was used to determine ankle-joint range of motion of every group after medication. Results There was no difference between control group and experimental group in 7-day group but there were significant differences in the 14-day and the 21-day groups. Conclusion Horse-fat can improve the ankle-joint range of motion compared with control group.

  20. Surgical treatment of traumatic temporomandibular joint ankylosis with medially displaced residual condyle%创伤性颞下颌关节强直伴内侧髁突残存的手术治疗

    Institute of Scientific and Technical Information of China (English)

    何冬梅; 杨驰; 陈敏洁; 杨秀娟; 李凌志; 蒋倩

    2011-01-01

    PURPOSE: A surgical method for the treatment of traumatic temporomandibular joint (TMJ) ankylosia with medially displaced residual condyle was described, and the long-term results were compared. METHODS: From 2001 to 2009, 60 patients and 82 joints diagnosed with traumatic TMJ ankylosis with medially displaced residual condyle were included in the present study. Lateral arthroplasty (LAP) was performed, and either the masseter muscle flap (MMF) or temporal fascial fat flap (TFF) were used as interpositional material to fill the lateral space. The long-term results of these treatments were compared by performing postoperative CT and clinical follow-up. SPSS 13.0 software package was used to analyze mouth opening improvement. RESULTS: In total, 22 joints were treated with LAP, 28 joints were treated with LAP and MMF, and 32 joints were treated with LAP and TFF. Thirty-eight patients with 48 joints were followed up for 1 to 4 years. Four of the 11 joints (36.4%) treated with LAP had reankylosis, 3 of the 17 (17.6%) joints treated with LAP and MMF had reankylosis, and 0 of the 20 (0%) joints treated with LAP and TFF had reankylosis. Compared with LAP treatment, LAP with TFF significantly improved the maximal incisal opening (MIO) in long -term follow -up. CONCLUSION: LAP can reserve the residual TMJ structure. TFF is a reliable interpositional material in LAP for prevention of reankylosis. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100).%目的:探讨创伤性颞下颌关节强直伴内侧髁突残存的手术治疗方法及疗效.方法:上海交通大学医学院附属第九人民医院口腔颌面外科关节组2001-2009年收治的内侧有髁突残存的创伤性颞下颌关节强直60例82侧关节纳入研究,分别采用外侧成形术、外侧成形+咬肌瓣和外侧成形+颢筋膜脂肪瓣进行治疗.通过临床和CT随访,评价3种治疗方法的疗效,采用SPSS13.0软件包对

  1. 颞下颌关节继发性强直与幼年期髁状突纵行骨折的关系%Relationship between secondary ankylosis of temporomandibular joint and childhood longitudinal fracture of mandibular condyle

    Institute of Scientific and Technical Information of China (English)

    姚军; 周继林; 胡敏; 洪民; 王燕一

    2005-01-01

    论:幼年期髁突纵行骨折对TMJ造成严重继发性损伤,髁突纵行骨折与关节强直关系密切.%BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological

  2. Analysis of the effect of short interval staged bilateral replacement in the treatment of ankylosing spondylitis combined with bilateral hip bony ankylosis%短间隔分期双侧置换治疗强直性脊柱炎伴双髋关节骨性强直的疗效分析

    Institute of Scientific and Technical Information of China (English)

    韩博闻; 殷力; 韩奇财; 娄超举; 李弘帅; 胡明鑫

    2015-01-01

    Objective To discuss the clinical effects of short interval staged bilateral replacement in the treatment of ankylo-sing spondylitis(AS)combined with bilateral hip bony ankylosis. Methods 21 cases(42 hips)of ankylosing spondylitis com-bined with bilateral hip bony ankylosis hospitalized from October of 2010 to October of 2014 were enrolled and received short in-terval(bilateral operation interval < 1 month)staged bilateral total hip arthroplasty. The Harris score,visual analogue score (VAS),total hip joint activity,short form health survey(SF - 36)were compared between pre - operation and the last follow -up,and the postoperative complications were observed. Results The Harris score,total hip joint activity and SF - 36 score on the last follow - up day were markedly increased than those before operation. The VAS score of the last follow - up day were markedly decreased than those before operation. 6 hips had mild heterotopic ossification,and 3 hips had femoral anterolateral in-termittent pain,but those had no obvious effect on the function. There were no femoral nerve injury. Conclusion SISBTHA can reconstruct the hip joint function,improve the quality of life,which is an effective and reliable method.%目的:探讨短间隔分期双侧置换治疗强直性脊柱炎(ankylosing spondylitis,AS)伴双髋关节骨性强直的临床疗效。方法回顾性研究2010年10月至2014年10月收治的21例(42髋)强直性脊柱炎双髋关节骨性强直患者,采用短间隔(双侧手术间隔<1个月)分期双侧人工全髋关节置换术(short interval staged bilateraltotal hip arthroplasty,SISBTHA)。比较患者术前及末次随访的 Harris 评分、疼痛视觉模拟评分(VAS)、髋关节总活动度、健康调查简表(SF -36),以及观察术后并发症发生情况。结果末次随访时 Harris 评分、髋关节总体活动度和 SF -36评分均较术前显著升高(P <0.05),VAS 评分较术前显著降低(P <0

  3. 人工全髋关节置换在骨性强直髋治疗中的临床及放射学评估%Clinical and radiographic evaluation for total hip arthroplasty in treatment of bony ankylosis of hips

    Institute of Scientific and Technical Information of China (English)

    冯卫; 刘建国; 齐欣; 李冬松; 杨晨; 李叔强; 付莉

    2012-01-01

    目的:对人工全髋关节置换(THA)在骨性强直髋治疗中的临床及放射学效果进行评估.方法:自2003年1月至2009年8月,20例(30髋)骨性强直的髋关节患者采用THA治疗,其中男12例,女8例;平均年龄36岁.术后临床随访根据Harris评分、患者疼痛缓解满意度、肢体长度差异、髋关节活动范围以及髋关节外展肌力进行评价.X线影像学随访包括对髋臼及股骨柄假体周围骨溶解、假体松动、透光线及异位骨化进行评价.术后平均随访时间为4年.结果:Harris评分由术前的平均(40.75±6.52)分提高至术后平均(86.40±5.42)分;邻近受累关节疼痛完全缓解13例,部分缓解7例;13例外展肌力量恢复满意,跛行症状明显缓解,肢体短缩下降至小于0.5 cm;髋关节活动范围较术前显著改善.放射学评估发现2例髋关节周围异位骨化,1例股骨假体周围透光线,无关节假体脱位及翻修的病例.结论:近期随访发现THA在治疗骨性强直的髋关节中可以获得满意的临床疗效,矫正髋关节畸形,恢复髋关节功能,减轻患髋邻近关节的疼痛,改善患者的生活质量.%Objective;To evaluate the clinical and radiographic effects of total hip arthroplasty (THA) in the treatment of bony ankylosis of hips. Methods: From January 2003 to August 2009,20 patients (30 hips) with bony ankylosis of hips were treated with THA. There were 12 males and 8 females,with an average age of 36 years old. After operation,the follow-up results were evaluated with clinical and radiographic criteria. The clinical follow-up results were evaluated with Harris score, satisfaction of pain relief, limb length discrepancy, ROM of hip and the strength of hip abductor. The X-ray imaging follow-up results were evaluated with acetabula and periprosthetic osteolysis, prosthesis loosening, radiolucent and hetcrotopic ossification. Re-SultS:The average following-up was 4 years. The mean preoperative Harris score was (40

  4. Anquilose intencional dos caninos decíduos como reforço de ancoragem para a tração reversa da maxila: estudo cefalométrico prospectivo Intentional ankylosis of the deciduous canines to enhance maxillary protraction: a prospective cephalometric analysis

    Directory of Open Access Journals (Sweden)

    Omar Gabriel da Silva Filho

    2006-12-01

    Full Text Available OBJETIVO: o presente trabalho de pesquisa analisou os efeitos da tração reversa da maxila associada à anquilose intencional dos caninos decíduos superiores, mediante o emprego da cefalometria. METODOLOGIA: o protocolo de tratamento incluiu: 1 anquilose intencional dos caninos decíduos superiores; 2 expansão rápida da maxila e 3 tração reversa da maxila, imediatamente após o término da fase ativa da expansão. A amostra foi composta de 18 crianças nos estágios de dentadura decídua e dentadura mista, com idade média inicial de 7 anos e 1 mês. O intervalo médio de tratamento com a tração reversa da maxila foi de 1 ano e 1 mês. As telerradiografias laterais foram obtidas na documentação inicial e após a correção da Classe III. RESULTADOS E CONCLUSÕES: os resultados demonstram que os ângulos representativos da convexidade facial, NAP e ANB, aumentaram de 0º para 6,6º e 3,5º, respectivamente. Isso significa dizer que a face transformou-se de reta ou côncava, peculiar na Classe III, para uma face convexa, característica de normalidade no estágio avaliado. Essa melhora na convexidade facial é atribuída ao avanço da maxila, registrado tanto na região alveolar (ângulo SNA e as distâncias Co-A e NPerp-A como na região basal (ângulo SN.ENA. A maxila deslocou-se para frente, enquanto a redução do ângulo SNB de 80,56º para 79,61º demonstrou um retroposicionamento mandibular. Além da mudança no sentido sagital, houve rotação da mandíbula no sentido horário, com aumento dos ângulos SN.GoGn e SN.Gn. Somado aos efeitos ortopédicos, houve inclinação vestibular dos incisivos superiores.AIM: the current article analyses the effects of maxillary protraction associated to the intentional ankylosis of the deciduous canines on the basis of cephalometric measurements. METHODS: the treatment protocol included: 1 intentional ankylosis of the upper deciduous canines; 2 rapid palatal expansion and 3 maxillary

  5. SECONDARY RETENTION OF PERMANENT MOLARS - AN ASSESSMENT OF ANKYLOSIS BY SCANNING ELECTRON AND LIGHT-MICROSCOPY

    NARCIS (Netherlands)

    RAGHOEBAR, GM; JANSEN, HWB; JONGEBLOED, WL; BOERING, G; VISSINK, A

    1992-01-01

    Secondary retention refers to the cessation of eruption of a tooth after emergence. This may be the result of pathological changes in the periodontal ligament. The aim of this study was to describe the morphological and histological aspects of the radicular surface of secondarily retained permanent

  6. Case 229: Burn-related Global Ankylosis of Interphalangeal Joints with Associated Acroosteolysis.

    Science.gov (United States)

    Davis, Derik L; Resnik, Charles S

    2016-05-01

    History A 50-year-old woman presented with a 6-month history of polyarthralgia involving the left and right hands, wrists, elbows, ankles, and knees. Her pain was not associated with morning stiffness but did worsen over the course of the day. She denied experiencing fevers, chills, or mouth ulcers. She did not report paresthesias or blue discoloration of her fingers when they were exposed to cold. Her family history was remarkable for an aunt who died of systemic lupus erythematosus and for a brother with arthritis. Her medical history was remarkable for vitamin D deficiency, hypertension, and rehabilitation for burns. At clinical examination, she had mild tenderness to palpation of her joints, without associated erythema, swelling, or crepitus. Healed skin grafts were also noted. Blood chemistry tests revealed a rheumatoid factor of 8.5 IU/mL (normal range, 0-13.9 IU/mL), an erythrocyte sedimentation rate of 2 mm/hr (normal range, 0-40 mm/hr), and a C-reactive protein value of 0.4 mg/L (3.8 nmol/L) (normal range, 0-4.9 mg/L [0-46.7 nmol/L]). Antinuclear antibodies test results were negative. Radiography of the right and left hands was performed. PMID:27089192

  7. 38 CFR 4.71 - Measurement of ankylosis and joint motion.

    Science.gov (United States)

    2010-07-01

    ... midpoint 0° between internal and external rotation of the shoulder; and (b) supination and pronation—the... pronation. Motion of the thumb and fingers should be described by appropriate reference to the joints...

  8. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Wichuk, Stephanie; Chiowchanwisawakit, Praveena;

    2014-01-01

    OBJECTIVE: Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging (MRI) scans may develop after resolution of inflammation in patients with ankylosing spondylitis (AS) and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated...

  9. Autosomal recessive mental retardation, deafness, ankylosis, and mild hypophosphatemia associated with a novel ANKH mutation in a consanguineous family

    NARCIS (Netherlands)

    Morava, E.; Kuhnisch, J.; Drijvers, J.M.; Robben, J.H.; Cremers, C.W.R.J.; Setten, P. van; Branten, A.J.W.; Stumpp, S.; Jong, A. de; Voesenek, K.E.J.; Vermeer, S.; Heister, A.; Claahsen-van der Grinten, H.L.; O'Neill, C.W.; Willemsen, M.H.; Lefeber, D.J.; Deen, P.M.T.; Kornak, U.; Kremer, J.M.J.; Wevers, R.A.

    2011-01-01

    CONTEXT: Mutations in ANKH cause the highly divergent conditions familial chondrocalcinosis and craniometaphyseal dysplasia. The gene product ANK is supposed to regulate tissue mineralization by transporting pyrophosphate to the extracellular space. OBJECTIVE: We evaluated several family members of

  10. Anquilose temporomandibular bilateral: aspectos fonoaudiológicos e procedimentos clinidos Bilateral ankylosis of the temporomandibular joint: oral miofunctional aspects and clinical procedure

    OpenAIRE

    Silvana Regina Marzotto; Esther Mandelbaum Gonçalves Bianchini

    2007-01-01

    OBJETIVO: apresentar uma proposta terapêutica miofuncional orofacial, os procedimentos utilizados e resultados em caso de anquilose temporomandibular bilateral, buscando ressaltar a importância do trabalho interdisciplinar e a contribuição da fonoaudiologia para a reabilitação do sistema estomatognático nesses casos. MÉTODOS: relato de caso de paciente adulto, gênero masculino, encaminhado para avaliação e procedimentos fonoaudiológicos após três meses da realização de cirurgia articular, ten...

  11. The Use of a Bioadhesive (BioGlue®) Secured Conchal Graft and Mandibular Distraction Osteogenesis to Correct Pediatric Facial Asymmetry as Result of Unilateral Temporomandibular Joint Ankylosis

    OpenAIRE

    Muhammad, Joseph Kamal; Al Hashimi, Bader Abdulla; Al Mansoor, Abu Bakr; Ali, Iqbal

    2013-01-01

    The rehabilitation of children affected by early traumatic facial deformity is a challenge for both the craniofacial team and the child's family. Although the immediate goals of surgery are to restore both form and function, the psychological needs of the growing child must also be addressed. Early surgery may be required to assist integration of the child into the community and thereby avert both social isolation and stigmatization of the child. Timed correctly, such surgery has the potentia...

  12. Disease: H00868 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00868 Stapes ankylosis with broad thumb and toes This syndrome is characterized by... conductive hearing loss due to congenital fixation of stapes, hyperopia, a hemicylindrical nose, broad thum...-Hofstee Y, Watkin PM, Hall CM, Baraitser M The autosomal dominant syndrome with congenital stapes ankylosis, broad...ce MM Autosomal dominant stapes ankylosis with broad thumbs and toes, hyperopia, and skeletal anomalies is c

  13. Surgical treatment of temporomandibular joint ankyloses: meniscus conservation and relocation.

    Science.gov (United States)

    Rinna, Claudio; Reale, Gabriele; Calvani, Francesco; Cascone, Piero

    2013-03-01

    Ankylosis of the temporomandibular joint is a serious complication, mainly after trauma and local or systemic infection. In rare cases, ankylosis is associated with systemic disease such as ankylosing spondylitis, rheumatoid arthritis, and psoriasis. According to the functional restriction and the provoked disturbances of facial growth in the youth, an early and effective therapy is desirable. There is a wide variety of surgical approaches to temporomandibular joint ankylosis, ranging from chondro-osseous grafts to prothesis. In the article the authors present the clinical case of a 60-year-old patient who, at the age of 6, accidentally fell from a height of about 2 m. In 60 years old, after removing the temporomandibular ankylosis with surgical technique, patient showed a marked improvement of mandibular kinetics. PMID:23524812

  14. Failures in the treatment of pseudoarthroses; Problem niepowodzen w leczeniu stawow rzekomych

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K.; Piotrowski, W.; Trubisz, L.; Michalski, S. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Failure analysis in the treatment of pseudoarthroses has been presented. It was noted that ankylosis within adjacent joints may lead to nonunion or refracture. Vascular disorders of various origins remain the dominant cause of failure. (author). 5 refs, 10 figs.

  15. 膝关节运动康复器与伸筋汤熏洗联合治疗股骨髁部骨折术后膝关节僵直的疗效观察%To Observe the Motion of Knee Joint Rehabilitation and Extensor Tendon Soup Fumigation Combined With Treatment of Femoral Condylar Fractures of Knee Ankylosis

    Institute of Scientific and Technical Information of China (English)

    赵明

    2015-01-01

    目的:探究股骨髁部骨折术后膝关节僵直采用膝关节运动康复器联合伸筋汤熏洗治疗的临床疗效。方法选取股骨髁部骨折术后膝关节僵直患者62例,随机分为对照组和观察组各31例,对照组采用膝关节运动康复器治疗,在此基础上,观察组采用伸筋汤熏洗治疗,比较其治疗效果。结果观察组患者治疗优良率高于对照组(P<0.05)。结论采用膝关节运动康复器与伸筋汤熏洗联合治疗股骨髁部骨折术后膝关节僵直,临床疗效显著。%ObjectiveTo explore clinical efficacy of femoral condylar fracture with postoperative stiffness of knee joint motion of knee joint rehabilitation combined with extensor tendon soup fumigation treatment.Methods 62 cases of knee joint stiffness in patients with femoral condylar fracture after operation, were randomly divided into control group and observation group with 31 cases in each group, the control group with rehabilitation treatment of knee joint motion, on the basis of this, the observation group with extensor tendon soup fumigation treatment. ResultsThe patients in the observation group was higher than the control group(P<0.05).Conclusion The knee joint rehabilitation and extension tendon soup fumigation treatment of femoral condylar fracture postoperative knee stiffness, clinical curative effect.

  16. Superficial temporal myofascial flap application in temporomandibular joint arthroplasty in a cat

    Directory of Open Access Journals (Sweden)

    Lisa A Mestrinho

    2015-07-01

    Full Text Available Case summary A 2-year-old, intact female domestic longhair cat was referred for surgical treatment after diagnosis of closed jaw locking secondarily to right temporomandibular joint ankylosis and left pseudoankylosis. The animal underwent successful surgical management with bilateral excision arthroplasty followed by interposition of a temporal superficial myofascial flap. Immediately after surgery, the full range of lower jaw movement was achieved and normal occlusion was maintained. Ankylosis did not recur in the 1 year postoperative follow-up period. Relevance and novel information A temporal myofascial flap could be considered as interposition material after temporomandibular joint arthroplasty to avoid postoperative re-ankylosis and mandibular drift. The main advantages of this flap are its autogenous origin, and the ability to maintain separation between the two bones, preserve mobility and disrupt new bone formation.

  17. Functional exercise after high temporomandibular joint plastic surgery%高位颞下颌关节成形术后的功能康复

    Institute of Scientific and Technical Information of China (English)

    洪霞; 羊玉荣; 赵丽

    2002-01-01

    Objective To investigate the impact of functional exercise following high temporomandibular joint plastic surgery on functional recovery.Methods High temporomandibular joint plastic surgery was performed on 31 patients suffered from temporomandibular ankylosis.Titanium fragment and pedicle fascia were inserted.Functional exercise as well as locally hot compress and healthy education were carried out after operation.Results 29 subjects showed favorable functional recovery.Results showed 2 subjects developed ankylosis again due to poor mouth opening training (2/31).Conclusion Functional exercise after high temporomandibular joint plastic surgery is effective for recovery of temporomandibular joint functional.

  18. Pfeiffer syndrome type 2 : Further delineation and review of the literature

    NARCIS (Netherlands)

    Plomp, AS; Hamel, BCJ; Cobben, JM; Verloes, A; Offermans, JPM; Lajeunie, E; Fryns, JP; de Die-Smulders, CEM

    1998-01-01

    We present 5 unrelated patients, 3 boys and 2 girls, with Pfeiffer syndrome (PS) type 2, They all had cloverleaf skull, severe proptosis, ankylosis of the elbows, broad thumbs and/or broad halluces and variable accompanying anomalies, We review the literature on all subtypes of PS, Most patients wit

  19. A novel nonsense mutation in the NOG gene causes familial NOG-related symphalangism spectrum disorder

    Science.gov (United States)

    Takano, Kenichi; Ogasawara, Noriko; Matsunaga, Tatsuo; Mutai, Hideki; Sakurai, Akihiro; Ishikawa, Aki; Himi, Tetsuo

    2016-01-01

    The human noggin (NOG) gene is responsible for a broad spectrum of clinical manifestations of NOG-related symphalangism spectrum disorder (NOG-SSD), which include proximal symphalangism, multiple synostoses, stapes ankylosis with broad thumbs (SABTT), tarsal–carpal coalition syndrome, and brachydactyly type B2. Some of these disorders exhibit phenotypes associated with congenital stapes ankylosis. In the present study, we describe a Japanese pedigree with dactylosymphysis and conductive hearing loss due to congenital stapes ankylosis. The range of motion in her elbow joint was also restricted. The family showed multiple clinical features and was diagnosed with SABTT. Sanger sequencing analysis of the NOG gene in the family members revealed a novel heterozygous nonsense mutation (c.397A>T; p.K133*). In the family, the prevalence of dactylosymphysis and hyperopia was 100% while that of stapes ankylosis was less than 100%. Stapes surgery using a CO2 laser led to a significant improvement of the conductive hearing loss. This novel mutation expands our understanding of NOG-SSD from clinical and genetic perspectives.

  20. 下肢骨折后膝关节的功能锻炼%Functional training of knee joint after fracture of lower limb

    Institute of Scientific and Technical Information of China (English)

    张超

    2003-01-01

    @@ BACKGROUND:In treatment of fracture of lower limb, clinical healing of fracture needs a long time after replace and immobilization. But clinical healing does not represent complete recovery of joint function.Knee ankylosis or stiffness could happen if not treated properly in this term.

  1. A novel nonsense mutation in the NOG gene causes familial NOG-related symphalangism spectrum disorder.

    Science.gov (United States)

    Takano, Kenichi; Ogasawara, Noriko; Matsunaga, Tatsuo; Mutai, Hideki; Sakurai, Akihiro; Ishikawa, Aki; Himi, Tetsuo

    2016-01-01

    The human noggin (NOG) gene is responsible for a broad spectrum of clinical manifestations of NOG-related symphalangism spectrum disorder (NOG-SSD), which include proximal symphalangism, multiple synostoses, stapes ankylosis with broad thumbs (SABTT), tarsal-carpal coalition syndrome, and brachydactyly type B2. Some of these disorders exhibit phenotypes associated with congenital stapes ankylosis. In the present study, we describe a Japanese pedigree with dactylosymphysis and conductive hearing loss due to congenital stapes ankylosis. The range of motion in her elbow joint was also restricted. The family showed multiple clinical features and was diagnosed with SABTT. Sanger sequencing analysis of the NOG gene in the family members revealed a novel heterozygous nonsense mutation (c.397A>T; p.K133*). In the family, the prevalence of dactylosymphysis and hyperopia was 100% while that of stapes ankylosis was less than 100%. Stapes surgery using a CO2 laser led to a significant improvement of the conductive hearing loss. This novel mutation expands our understanding of NOG-SSD from clinical and genetic perspectives. PMID:27508084

  2. 38 CFR 4.71a - Schedule of ratings-musculoskeletal system.

    Science.gov (United States)

    2010-07-01

    ..., substantiated by X-ray findings: Rate as arthritis, degenerative. 5011Bones, caisson disease of: Rate as... Spine Rating General Rating Formula for Diseases and Injuries of the Spine (For diagnostic codes 5235 to... in the area of the spine affected by residuals of injury or disease Unfavorable ankylosis of...

  3. Actis Total Hip System 2 Year Follow-up

    Science.gov (United States)

    2016-08-09

    Osteoarthritis; Traumatic Arthritis; Rheumatoid Arthritis; Congenital Hip Dysplasia; Avascular Necrosis of the Femoral Head; Acute Traumatic Fracture of the Femoral Head or Neck; Certain Cases of Ankylosis; Non-union of Femoral Neck Fractures; Certain High Sub-Capital and Femoral Neck Fractures in the Elderly

  4. The efficacy of early functional exercise in burns patients%烧伤病人早期功能锻炼体会

    Institute of Scientific and Technical Information of China (English)

    吴俊波; 孔繁英; 杨梅

    2002-01-01

    @@ Background:Scar and hyperplasia will lead to contracture malformation and dysfunction following severe burn of face,neck and joints of limbs.Functional exercise should be carried out in the early phase to prevent ankylosis,soften scar and reduce malformation positively.

  5. Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis)

    NARCIS (Netherlands)

    S. Ramiro; H. Radner; D. van der Heijde; A. van Tubergen; R. Buchbinder; D. Aletaha; R.B.M. Landewé

    2011-01-01

    Despite optimal therapy with disease-modifying antirheumatic drugs, many people with inflammatory arthritis (IA) continue to have persistent pain that may require additional therapy. To assess the benefits and safety of combination pain therapy for people with IA (rheumatoid arthritis (RA), ankylosi

  6. 颞下颌关节强直模型的研究进展

    Institute of Scientific and Technical Information of China (English)

    顾云凯(综述); 满城(审校)

    2014-01-01

    Temporomandibular joint ankylosis is a kind of disease seriously af ecting jaw movements.In order to explore its pathogenesis and treatment,animal experiment has been widely applied in this field.In this paper,a brief review is given about the research advances on animal models of temporomandibular joint ankylosis .%颞下颌关节强直是一类严重影响口腔下颌运动的疾病。为了更好的探究其发病机制及治疗方法,动物实验已被广泛应用于研究。本文就各种颞下颌关节强直模型相关研究做一简要综述。

  7. Apicotomy: surgical management of maxillary dilacerated or ankylosed canines.

    Science.gov (United States)

    Araújo, Eustáquio A; Araújo, Cristiana V; Tanaka, Orlando M

    2013-12-01

    This clinical article reports a technique, apicotomy, for managing dilacerated or ankylosed canines. The records of 3 patients successfully treated with apicotomy are presented. Orthodontists observe clinically significant incidences of impacted maxillary canines in their daily practices. Several procedures have been described to bring an ankylosed, impacted tooth into occlusion. Luxation is the most widely used solution, but there are risks involved with that approach, and the success rate is low. Surgical repositioning has also been used, but morbidity is high, and the aggressiveness of the procedure might also contraindicate it. Ankylosis might be related to the anatomic position of the canine's root apex and its adjacent anatomic structures. Apicotomy is a guided fracture of a canine root apex, followed by its orthodontic traction. It is a conservative surgical alternative for treating impacted canines with dilacerations or apical root ankylosis. PMID:24286914

  8. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects.

    Science.gov (United States)

    Giessler, Goetz A; Borsche, André; Lim, Paul K; Schmidt, Andreas B; Cornelius, C-Peter

    2012-02-01

    Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth.

  9. OPEN REDUCTION OF MANDIBULAR CONDYLE NECK FRACTURES: CASE REPORT AND LITERATURE REVIEW-Mandibular Kondil Boynu Kırıklarında Açık Redüksiyon: Olgu Raporu ve Kaynak Taraması

    OpenAIRE

    İŞLER, Sabri Cemil; CANSIZ, Erol; AKBAŞ, Emine; ÇEBİ, Zerrin

    2014-01-01

    ABSTRACTSince cases of mandibular condyle fractures may result in difficulty of recovery of functional and aesthetic disorders, their immobilization and reduction are very important. It may cause long-term complications as well as limited mandibular movement, pain, malocclusion, pathological changes in the TMJ, osteonecrozis, facial asymmetry, ankylosis, functional and growth disorders. Appropriatetreatment must enable the reconstruction of undamaged functional and natural form of mandibular ...

  10. 强直性脊柱炎胸腰段后凸畸形矫形设计的关键问题%Key points in the design of deformity correction of thoracolumbar kyphosis with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    张永刚

    2014-01-01

    For patients of thoracolumbar kyphosis with ankylosing spondylitis ( AS ), it is signiifcant to reconstruct the sagittal balance and the chin-brow vertical angle by spinal osteotomy. Relocation of the center of gravity to pelvic neutral positional line is the key to reconstruct sagittal balance. In addition, chin-brow vertical angle is also important for patients with cervical ankylosis. Better outcomes depend on the selection of optimal osteotomy level.

  11. Posttraumatic Temporomandibular Joint Disorders

    OpenAIRE

    Giannakopoulos, Helen E.; Quinn, Peter D.; Granquist, Eric; Chou, Joli C.

    2009-01-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding,...

  12. Ankylosing Spondylitis: a Reflection and a Question

    Directory of Open Access Journals (Sweden)

    Annia Deysi Hernández Martín

    2014-07-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease that affects the synovial membrane, joint entheses and para-articular structures of the spine, including the sacroiliac joints and limbs. We present a case of ankylosing spondylitis that had evolved for 12 years despite the relatively early diagnosis and treatment, showing flexion deformity and limitation of spinal movements. On radiological examination an early evolution to ankylosis was observed, which motivated us to make a reflection and a question.

  13. Successful management of a cervical fracture in a patient with ankylosing spondylitis by a posterior approach

    Directory of Open Access Journals (Sweden)

    Neeraj Patni

    2015-01-01

    Full Text Available Patients with ankylosing spondylitis (AS are at an increased risk of spinal fractures due to the altered spinal biomechanics. Moreover, it is difficult to treat these fractures due to the combination of ankylosis and osteoporosis. We report successful management of a C6-C7 vertebral fracture in a patient with AS. The patient improved in his neurological status and a good fusion was seen at a follow-up of 24 months.

  14. A functional variant in ERAP1 predisposes to multiple sclerosis

    OpenAIRE

    Guerini, F R; Cagliani, R.; De Forni, D; C. Agliardi; Caputo, D.; A. Cassinotti; Galimberti, D.; Fenoglio, C; M. Biasin; R. Asselta; Scarpini, E.; Comi, G P; Bresolin, N.; M. S. Clerici; Sironi, M

    2012-01-01

    The ERAP1 gene encodes an aminopeptidase involved in antigen processing. A functional polymorphism in the gene (rs30187, Arg528Lys) associates with susceptibility to ankylosying spondylitis (AS), whereas a SNP in the interacting ERAP2 gene increases susceptibility to another inflammatory autoimmune disorder, Crohn's disease (CD). We analysed rs30187 in 572 Italian patients with CD and in 517 subjects suffering from multiple sclerosis (MS); for each cohort, an independent sex- and age-matched ...

  15. Cartilage in facet joints of patients with ankylosing spondylitis (AS) shows signs of cartilage degeneration rather than chondrocyte hypertrophy: implications for joint remodeling in AS

    OpenAIRE

    Bleil, Janine; Sieper, Joachim; Maier, Rene; Schlichting, Uwe; Hempfing, Axel; Syrbe, Uta; Appel, Heiner

    2015-01-01

    Introduction In ankylosing spondylitis (AS), joint remodeling leading to joint ankylosis involves cartilage fusion. Here, we analyzed whether chondrocyte hypertrophy is involved in cartilage fusion and subsequent joint remodeling in AS. Methods We assessed the expression of chondrocyte hypertrophy markers runt-related transcription factor 2 (Runx2), type X collagen (COL10), matrix metalloproteinase 13 (MMP13), osteocalcin and beta-catenin and the expression of positive bone morphogenic protei...

  16. HETEROTOPIC OSSIFICATION OF HIP IN A RARE CASE OF MOYAMOYA DISEASE: A RARE CASE REPORT

    OpenAIRE

    Anita; Dimple; Pratima; Ravi

    2015-01-01

    A case of extensive ossification around the left hip joint involving lesser trochanter of the femur leading to ankylosis of left hip joint in a 60 years male is being reported. The diagnosis of moyamoya disease was made , which is a rare form of occlusive cerebrovasc ular disorder. Occlusion of an artery may present with Transient Ischemic Attacks , headaches , stroke and seizures. Surgical management is the only option...

  17. Pierre Robin Sequence: A Familial, Clinical, and Pathoanatomical Record of an Affected Dachshund.

    Science.gov (United States)

    Moura, Enio; Wagner, José L; Cirio, Silvana M; Pimpão, Cláudia T

    2015-01-01

    This study describes a spontaneous case of Pierre Robin sequence in a nonhuman animal species. A miniature dachshund with micrognathia developed glossoptosis, respiratory distress, dysphagia, temporomandibular ankylosis, and a misaligned upper jaw. The severity of this condition resulted in death by obstructive apnea at the age of 8 mo. Dogs with Pierre Robin sequence can provide further knowledge and a greater understanding of this abnormality, leading to better management of affected individuals and improvement of therapeutic methods.

  18. Use of Adult Fibreoptic Bronchoscope for Difficult Paediatric Intubation: A Case Report

    Directory of Open Access Journals (Sweden)

    Kundan Sandugir Gosavi

    2015-06-01

    Full Text Available Difficult airway management in paediatric patients may require a technique different from the standard one. We report the use of an adult fibreoptic bronchoscope and J tipped guidewire to intubate a child having temporo-mandibular joint ankylosis. Spontaneous respiration was maintained and local anaesthesia was provided to the upper airway during the procedure and the successful use of this technique avoided the requirement of surgical airway.

  19. Multidisciplinary approach in the management of absolute trismus with bilateral temporomandibular joint replacements for a patient with juvenile idiopathic arthritis.

    Science.gov (United States)

    Fanaras, Nikolaos; Parry, Nicholas S; Matthews, N Shaun

    2014-11-01

    Juvenile idiopathic arthritis (JIA) is an exclusion diagnosis that gathers together all forms of arthritis that begin before the age of 16 years, persist for more than 6 weeks and are of unknown origin. We present the case of a 42 year old woman with a 20 year history of absolute trismus, secondary to bilateral temporomandibular joint (TMJ) ankylosis caused by JIA. The trismus resulted in grossly compromised oral hygiene and limited the patient to a semi-solid diet. JIA also affected her neck leading to a severe cervico-thoracic kyphosis. The patient who had been wheelchair bound developed severe lymphoedema of both lower limbs, complicating the pre-operative work up further. This particularly challenging case required input from specialists in anaesthetics, neurosurgery, special care dentistry, intensive care and maxillofacial surgery. Treatment consisted of ankylosis release, dental clearance and bilateral alloplastic replacement of her TMJs with custom implants. A full range of hinge movement and good functional outcome was achieved. This case presents the multidisciplinary approach to a severely compromised patient and illustrates the pre-, intra- and postoperative management of bilateral TMJ ankylosis with bespoke implants. PMID:25085804

  20. Perosomus elumbis in a day old udah neonate lamb in Sokoto, Nigeria

    Directory of Open Access Journals (Sweden)

    A. Bello

    2013-02-01

    Full Text Available Perosomus elumbis is a rare congenital anomaly of unknown aetiology. It is characterized by errors of morphogenesis resulting in multi-organs malformations that produce a deformity of the caudal one third of the foetus. Spinal and pelvic malformations are evident, structural anomalies such as arthrogryposis of the hind limbs, ankylosis of joints, with associated malformations of the musculature. This is a case of a new born Uda lamb, with the Chief complaint of inability to stand two hours after lambing. History revealed that the dam delivered them as twins, one of which was normal. On clinical examination the lamb was recumbent but alert. The fore limbs were well developed and appeared normal. The lumbo-sacral area was excessively narrow, with a skin fold attaching the crus (Tibia and Fibula. There was an ankylosis of the stifle and hock joint and were maintained in a flexed position. The response to pin prick on the hind limb was poor. However, both anal and vulval openings were patent. Radiography revealed hypoplasia of the lumbar vertebrae, pelvic girdle, the iliac wing, the ischium and the pubis. There is a convergence of the lschial arches towards the public symphisis; the wing of the ischium is absent bilaterally. There is an ankylosis of the stifle and tarsal joints in flexed position. However, all the bones of the hind limbs are present.

  1. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-03-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  2. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-01-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  3. Post-traumatic bifid mandibular condyle: A case report and literature review.

    Science.gov (United States)

    Woo, Min-Ho; Yoon, Kyu-Ho; Park, Kwan-Soo; Park, Jae-An

    2016-09-01

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC. PMID:27672618

  4. Posttraumatic temporomandibular joint disorders.

    Science.gov (United States)

    Giannakopoulos, Helen E; Quinn, Peter D; Granquist, Eric; Chou, Joli C

    2009-05-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ. PMID:22110802

  5. Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture

    DEFF Research Database (Denmark)

    Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

    2016-01-01

    AIM: To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify.......3-3.5), P = 0.003), and age >30 years (HR: 2.3 (95% CI: 1.1-4.6), P = 0.02). The type of splint (rigid or flexible), the duration of splinting (more or less than 4 weeks), and the administration of antibiotics did not affect the risk of PN. CONCLUSION: Teeth involved in alveolar process fractures appear...

  6. Post-traumatic bifid mandibular condyle: A case report and literature review

    Science.gov (United States)

    Woo, Min-Ho; Yoon, Kyu-Ho; Park, Jae-An

    2016-01-01

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC. PMID:27672618

  7. 股骨髁上骨折应用L形加压钢板内固定后的早期康复治疗%The early rehabilitation intervention after internal fixation English Column with L-shaped compression armor plate for supracondylar fracture of femur

    Institute of Scientific and Technical Information of China (English)

    岳红卫; 李国顺

    2002-01-01

    Background: The thickness and width of L shaped armor plate can antagonize muscle traction with the ability of anti inflecting, anti torsion and anti shearing force, which overcomes the weakness of common armor plate and osseous pin that have weaker fixation force and need external fixation. The fixation can satisfy the request of early functional training. And the functional training can be performed on the continuous passive movement (CPM) instrument 1 week after operation to prevent adhesion of knee joint, elasticity losing in soft tissue around joint, ankylosis, osteoporosis and osteoarthritis.

  8. Management of a Severely Submerged Primary Molar: A Case Report

    Directory of Open Access Journals (Sweden)

    Iman Parisay

    2013-01-01

    Full Text Available Ankylosis is a condition frequently associated with primary molars, wherein the ankylosed primary teeth remain in a fixed position, while the adjacent teeth continue to erupt, moving occlusally. In this case report, a five-year-old boy, who had a retained and submerged left lower second primary molar, was presented. Luxation of ankylosed primary molar was considered as a treatment approach. After four months, the tooth erupted to the occlusal level, and there was evidence of further development of a permanent successor in radiographic evaluation. After one year, tooth mobility, bone formation, and development of a permanent successor were in good condition.

  9. Management of Mandibular Hypoplasia Using Distraction Osteogenesis Technique

    Institute of Scientific and Technical Information of China (English)

    陶学金; 樊敏; 凌翔; 陈卫民

    2004-01-01

    Summary: By using distraction osteogenesis technique, 3 cases of mandibular hypoplasia were treated by home-made and German-made jaw distractors: including one patient suffered from bilateral ankylosis of temporo-mandibular joint and 2 patients from deficiency of mandible. The duration of distraction osteogenesis was one month. The bone distractor was removed 3 months after operation. Satisfactory results were obtained in all 3 cases. Distraction osteogenesis can successfully be used in mandibular functional reconstruction and has much more advantages than traditional technique.

  10. Imaging the spine in arthritis-a pictorial review

    DEFF Research Database (Denmark)

    Jurik, Anne Grethe

    2011-01-01

    Spinal involvement is frequent in rheumatoid arthritis (RA) and seronegative spondyloarthritides (SpA), and its diagnosis is important. Thus, MRI and CT are increasingly used, although radiography is the recommended initial examination. The purpose of this review is to present the typical...... by vertebral squaring and condensation of vertebral corners, in later stages by slim ossifications between vertebral bodies, vertebral fusion, arthritis/ankylosis of apophyseal joints and ligamentous ossification causing spinal stiffness. The imaging features of the other forms of SpA can vary, but voluminous...

  11. THE RHEUMATOID HAND (Part I

    Directory of Open Access Journals (Sweden)

    Yuri Aleksandrovich Olyunin

    2009-01-01

    Progression of RA leads to articular cartilage and bone destruction and ligament and tendon damage over time. Incompetence of the ligamentous apparatus may cause dorsal subluxation of the radius. In late RA, bone erosions are detectable in practically all patients. This is the most characteristic X-ray symptom of polyarthritis. Extensive and multiple destructive changes in the joints are accompanied by the development of their multiple subluxations, dislocations, and contractures. In addition to destructive changes in the joints, most deformities are associated with their tendinous and liga-mentous looseness and ruptures and with the rearrangement of normal muscle tension around one joint or more. Articular ankylosis occurs in late RA

  12. Martin-Gruher anastomosis:a case report and review of the literature%正中神经与尺神经交通支1例报告及文献回顾

    Institute of Scientific and Technical Information of China (English)

    潘伟波; 陈海啸; 梁军波; 叶招明

    2011-01-01

    Objective:To investigate therapeutic effects of mini-incision assisted by arthroscope for the treatment of ankylosis of knee. Methods: From July 2007 to August 2009,18 patients with ankylosis of knee were treated with mini-incision assisted by arthroscope. Among the patients, 15 patients were male and 3 patients were female,ranging in age from 27 to 56 years, with an average of 33.6 years. Before operation, 5 patients had comminuted fractures in the distal end of femur (including 1 patient with open fracture),9 patients had comminuted fractures of tibial plateau,2 patients had comminuted fractures of patella, 1 patient had comminuted fractures of patella combined with comminuted fracture of capitulum fibulae and injuries of complex structure at lateral knee,and 1 patient had floating knee. The duration between the primary operation and the arthrolysis ranged from 6 to 31 months (averaged, 10.6 months). The therapeutic effects were evaluated according to Judet criteria. Results : All the patients were followed up,and the duration ranged from 3 to 25 months (averaged, 11.4 months). All the patients had incision healing at the first stage without infection,wound dehiscence and liquifaction necrosis. The preoperative knee flexed motion ranged from 30° to 80° ,with a mean of(44.72±l 1.60)° ;and postoperative knee flexed range of motion improved to an average of (109.17±10.31)° (ranged,95° to 135°). According to Judet evaluation, 16 patients got an excellent result,2 good. Conclusion:Treatment of ankylosis of the knee through a mini-incision assisted by arthroscope has advantages such as reducing the complications of incision on knee, little trauma and early recovery, which is a good operative mode to treat ankylosis of the knee after operation or trauma.%@@ 肘关节水平的尺神经损伤,常导致患者手内在肌的功能障碍.笔者遇到1例肘部尺神经沟内尺神经完全断裂的患者,手内在肌无明显功能障碍,后经肌电图检查证实

  13. The biomechanical role of periodontal ligament in bonded and replanted vertically fractured teeth under cyclic biting forces

    Institute of Scientific and Technical Information of China (English)

    Ya-Nan Zhu; Wei-Dong Yang; Paul V Abbott; Nicolas Martin; Wen-Jia Wei; Jing-Jing Li; Zhi Chen; Wen-Mei Wang

    2015-01-01

    After teeth are replanted, there are two possible healing responses:periodontal ligament healing or ankylosis with subsequent replacement resorption. The purpose of this study was to compare the fatigue resistance of vertically fractured teeth after bonding the fragments under conditions simulating both healing modes. Thirty-two human premolars were vertically fractured and the fragments were bonded together with Super-Bond C&B. They were then randomly distributed into four groups (BP, CP, CA, BA). The BP and CP groups were used to investigate the periodontal ligament healing mode whilst the BA and CA groups simulated ankylosis. All teeth had root canal treatment performed. Metal crowns were constructed for the CP and CA groups. The BP and BA groups only had composite resin restorations in the access cavities. All specimens were subjected to a 260 N load at 4 Hz until failure of the bond or until 23106 cycles had been reached if no fracture occurred. Cracks were detected by stereomicroscope imaging and also assessed via dye penetration tests. Finally, interfaces of the resin luting agent were examined by scanning electron microscope. The results confirmed that the fatigue resistance was higher in the groups with simulated periodontal ligament healing. Periodontal reattachment showed important biomechanical role in bonded and replanted vertically fractured teeth.

  14. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

    Science.gov (United States)

    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

  15. Vertebral deformities in hatchery-reared and wild-caught juvenile Japanese flounder, Paralichthys olivaceus

    Science.gov (United States)

    Lü, Hongjian; Zhang, Xiumei; Fu, Mei; Xi, Dan; Su, Shengqi; Yao, Weizhi

    2015-01-01

    The present study compared vertebral deformities of hatchery-reared and wild-caught juvenile Japanese flounder, Paralichthys olivaceus. A total of 362 hatchery-reared flounder (total length 122.5-155.8 mm) were collected from three commercial hatcheries located in Yantai, East China, and 89 wild fish (total length 124.7-161.3 mm) were caught off Yangma Island near Yantai City (37°27'N, 121°36'E). All the fish were dissected, photographed, and images of the axial skeleton were examined for vertebral deformities. Compared with wild-caught flounder in which no deformed vertebrae were detected, 48 (13.3%) hatcheryreared fish had deformed vertebrae. The deformities were classified as compression, compression-ankylosis, and dislocation-ankylosis. The vertebral deformities were mainly localized between post-cranial vertebra 1 and 3, with vertebrae number 1 as the most commonly deformed. The causative factors leading to vertebral deformities in reared Japanese flounder may be related to unfavorable temperature conditions, inflammation, damage, or rupture to the intervertebral ligaments under rearing conditions. Furthermore, no significant difference in the total number of vertebral bodies was observed between wild-caught (38.8±0.4) and hatchery-reared flounder (38.1±0.9) ( P>0.05). However, the number of vertebral bodies of hatchery-reared and wild-caught flounder ranged from 35 to 39 and from 38 to 39, respectively.

  16. Hyperplastic conditions of the mandibular condyles

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-12-15

    To evaluate the clinical and radiographic features of unilateral hyperplastic mandibular condyles for some useful preliminary diagnostic recommendations. Clinical records, radiographs and histologic diagnoses of 35 cases with asymmetric mandibular condyles due to apparent unilateral condylar hyperplasia were evaluated retrospectively. Among 35 cases, 28 were true hyperplastic conditions of condyles whereas the remaining 7 were unilateral internal derangement occurring on the short side. 17 of the 28 hyperplastic condyles showed a mass or irregular radiographic shadow with histologic diagnosis including osteochondroma and osteoma. Only 5 of these cases showed facial asymmetry. 2 out of ths 17 cases showed hyperplastic round shaped irregular condyles consistent with ankylosis and their histologic diagnoses were osteochondromas. 11 of the 28 cases showed smooth enlargement of condylar head with elongation of the neck causing facial asymmetry, but histologic diagnoses were not available because the surgical operation conserved the condyles. The hyperplastic conditions of the mandibular condyles include not only true hyperplasia, osteochondroma, osteoma, and ankylosis, but also unilateral internal derangement occurring on the short side.

  17. Pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities.

    Science.gov (United States)

    Mehrotra, D; Vishwakarma, K; Chellapa, A L; Mahajan, N

    2016-07-01

    The aim of this study was to evaluate the hard and soft tissue changes after pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities. This prospective study included 10 patients with unilateral temporomandibular joint (TMJ) ankylosis who presented with a facial deformity and a maxillary cant. Informed patient consent was obtained for participation. Simultaneous maxillomandibular distraction was planned based on clinical and radiographic examinations. A horizontal mandibular osteotomy was performed in the ramus and the distractor device was fixed. A bilateral Le Fort I osteotomy was then performed and a four-hole straight plate was fixed on the contralateral zygomatic buttress to act as a fulcrum. After a latency period of 5 days, the distractor was activated twice daily by 0.5mm until the required vertical lengthening was achieved. Intermaxillary fixation was maintained during the entire distraction period. After a consolidation period of 8-12 weeks, the distractor was removed. The TMJ ankylosis was released and a temporal fascia interpositional arthroplasty was performed as second surgery, along with a genioplasty if needed. All patients were followed up for a period of 12-24 months. A marked improvement in the facial asymmetry was noted in all cases. The occlusal cant and mandibular retrusion improved satisfactorily, and the average postoperative inter-incisal opening was 35.6mm. Pre-arthroplasty simultaneous maxillomandibular distraction offers a good treatment outcome, as it allows improvements in facial aesthetics as well as function. PMID:26780926

  18. [Decoronation: treatment protocol for ankylotic root resorption as a consequence of dental trauma].

    Science.gov (United States)

    Lin, S; Fuss, Z; Wigler, R; Karawani, M; Ashkenazi, M

    2013-10-01

    Severe dental traumatic injuries, such as the complete displacement of a tooth from its socket (Avulsion) or the displacement of a tooth within its socket (Intrusive Luxation), may result in extensive injury to the root surface. As a result, the root surface injury heals without cementum and there is fusion between the alveolar bone and the exposed dentin or anorganic exposed cementum, without any attachment apparatus between them. This phenomenon is known as "dento-alveolar ankylosis" and is accompanied by ankylotic resorption of the root. In a process that results subsequent to the ankylosis, the root surface resorbs, and this is part of the remodeling of the alveolar bone (ankylotic resorption). When the traumatic injury occurs at a young age, lateral and apical growth of the alveolar bone continues without continued physiological eruption of the tooth. As a result, the position of the ankylotic tooth does not change, and with time thetooth appears infra-occluded resulting in severe esthetic and functional consequences. Extraction of the ankylotic tooth is difficult and sometimes even impossible due to the rigid fusion between the bone and the tooth. In addition, attempted extraction of the ankylotic tooth may lead to fracture of the buccal plate and resorption of the alveolar bone. Retention of the ankylotic tooth may lead to damage in bone deposition in the verticaldimension, leading to difficulties in future prosthodonticrehabilitation, research-based information has been incorporated PMID:24660573

  19. Treatment of inflammatory root resorption using mineral trioxide aggregate: A case report

    Directory of Open Access Journals (Sweden)

    Roohollah Sharifi

    2014-01-01

    Full Text Available Introduction: This report presents a case to show inflammatory root resorption can be successfully treated by using mineral trioxide aggregate (MTA. Case Report: A central maxillary incisor of an eight-year-old boy was avulsed associated with crown fracture secondary to a fall. The tooth was stored in ice. Early attempts at pulpal revascularization of the replanted tooth proved unsuccessful. To stop inflammatory root resorption, long-term calcium hydroxide therapy was employed. Despite the use of calcium hydroxide, resorption continued. Subsequent to the failure of that treatment, MTA was used as a root canal filling material. At 20-month follow-up, the tooth was asymptomatic and had clinical signs of ankylosis but external inflammatory root resorption had stopped. Discussion: MTA may be considered as an alternative option for the treatment of continuous external inflammatory root resorption.

  20. Management of Temporomandibular Joint Reankylosis in Syndromic Patients Corrected with Joint Prostheses: Surgical and Rehabilitation Protocols

    Science.gov (United States)

    Clauser, Luigi C.; Consorti, Giuseppe; Elia, Giovanni; Tieghi, Riccardo; Galiè, Manlio

    2013-01-01

    Temporomandibular joint ankylosis (TMJA) is a severe disorder described as an intracapsular union of the disc-condyle complex to the temporal articular surface with bony fusion. The management of this disability is challenging and rarely based on surgical and rehabilitation protocols. We describe the treatment in two young adults affected by Goldenhar syndrome and Pierre Robin sequence with reankylosis after previous surgical treatments. There are three main surgical procedures for the treatment of TMJA: gap arthroplasty, interpositional arthroplasty, and joint reconstruction. Various authors have described reankylosis as a frequent event after treatment. Treatment failure could be associated with surgical errors and/or inadequate intensive postoperative physiotherapy. Surgical treatment should be individually tailored and adequate postoperative physiotherapy protocol is mandatory for success. PMID:24624260

  1. The radiological residua of healed diabetic arthropathies

    International Nuclear Information System (INIS)

    Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy. (orig.)

  2. Radiological changes of the symphysis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Jajic, Z.; Jajic, I.; Grazio, S. [Univ. Hospital Sestre Milosrdnice, Zagreb (Croatia). Dept. for Rheumatology, Physical Medicine and Rehabilitation

    2000-07-01

    Purpose: To evaluate the symphyseal changes in patients with ankylosing spondylitis. Material and Methods: Radiological-morphological changes of the symphysis were studied in 68 patients (66 men, 2 women) with ankylosing spondylitis whose age ranged from 21 to 75 years. The duration of the disease was from 2 to 50 years. Results and Conclusion: Changes in the symphysis were found in 16 patients (23.5%) and were less prominent than findings in the sacroiliac joints. We classified these changes into four stages: minimal changes, apparent destruction, reparation and ankylosis. The third and the fourth stages of the changes in the symphysis were found more frequently in patients who suffered from the disease for more than 15 years. Radiological evaluation of symphyseal changes can be helpful in the evaluation of disease progression as well as in establishing a differential diagnosis.

  3. Functional appliance treatment for bilateral condylar fracture in a pediatric patient.

    Science.gov (United States)

    Medina, Aida Carolina

    2009-01-01

    Trauma to the mandible may cause condylar fracture (CF). The prevalence of CF in children is low and treatment must focus on possible long-term effects on the growing facial skeleton and soft tissues. Consequences may include functional disturbances, facial asymmetry, mandibular retrusion, temporomandibular joint dysfunction and ankylosis. Conservative treatment, including close observation, soft diet, physiotherapy, and functional appliances, is advised in most cases. The purpose of this report was to describe the case of a pediatric female patient with bilateral condylar fracture. Treatment consisted of physiotherapy and hybrid functional appliances. Satisfactory remodeling of both condyles occurred and normal occlusion and jaw movements were obtained. Close monitoring will continue throughout the 6-year follow-up period and completion of growth. The conservative treatment approach proved successful in this case. PMID:19947140

  4. Septic arthritis of the distal interphalangeal joint in 12 horses.

    Science.gov (United States)

    Honnas, C M; Welch, R D; Ford, T S; Vacek, J R; Watkins, J P

    1992-01-01

    The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (one horse), intraarticular injection of antimicrobial drugs (five horses), curettage of the distal phalanx (one horse), and cancellous bone grafting to promote fusion (one horse). Five horses were euthanatized. Ankylosis of the affected joint developed in five horses, four of which are pasture sound. Two horses treated medically are sound although one underwent subsequent palmar digital neurectomy for treatment of navicular syndrome.

  5. The role of radiotherapy in the treatment of desmoid tumours

    International Nuclear Information System (INIS)

    From 1974 to 1983 in the Netherlands Cancer Institute, 21 patients with desmoid tumours were treated with radiation therapy. Nineteen patients were irradiated postoperatively (11 patients had micro- or macroscopic residual disease, 8 patients treated for recurrent disease had narrow surgical margins), 2 patients with inoperable tumours were treated with radiation alone. The entire involved muscle received a dose of 40 Gy, while a boost of 20 Gy was delivered to the tumour bed. Local control was achieved in 19 out of 21 patients, with an actuarial 5 year disease-free survival of 90%. No relation could be found between the amount of tumour present and local control. With careful set-up of treatment fields and long-term physical therapy, complications like fibrosis, ankylosis and oedema could be minimised. These excellent results with radiotherapy for minimal residual tumour, or even for macroscopic tumour, makes mutilating surgery unnecessary. (Auth.)

  6. The natural history of ankylosing spondylitis in the 21st century

    Directory of Open Access Journals (Sweden)

    C. Campana

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton and evolves in stiffnes followed by ankylosis and disability. However, it may be difficult to exactly establish the natural history of the disease and the influence of risk factors of progression, since most patients are treated with various pharmacologic or non-pharmacologic agents, which may potentially influence the natural progression of the disease. In this context, we report here a very interesting case of a 40 year old man, presented to our outpatient clinic, 28 years after the onset of AS. Previously for personal reasons, did not choose not to undergo any treatment. This case allows us to evaluate the natural radiological progression of the disease and the influence of predictive risk factors.

  7. Jaw locking after maxillofacial trauma

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2007-09-01

    Full Text Available The purpose of this report is to present two cases of jaw locking with two different etiologies. In case #1, jaw locking occured 5.5 months after a surgical reduction and internal fixation on the fractured maxilla and mandible. Some plain radiographic x-ray were made but failed to give adequate information in establishing the cause of trismus. The three dimensional computed tomography (3D-CT was finally made and able to help guide the pre-operative diagnosis and treatment. Two-steps gap arthroplasty were done comprising a gap arthroplasty leading to acceptable outcome. An adult patient in case #2 with a history of trauma at his childhood and bird-like face apprearance clinically, was unable to open the mouth since the time of accident. The patient was diagnosed with bilateral ankylosis of temporomandibular joints. One side (right gap arthroplasty was done and resulted in normal mouth opening.

  8. Temporomandibular Joint Septic Arthritis and Mandibular Osteomyelitis Arising From an Odontogenic Infection: A Case Report and Review of the Literature.

    Science.gov (United States)

    Gams, Kevin; Freeman, Phillip

    2016-04-01

    Septic arthritis of the temporomandibular joint (TMJ) has been infrequently reported in the literature. Some investigators believe that this condition is under-reported because it is underdiagnosed. Misdiagnosis or late diagnosis of this condition can lead to serious morbidity, including fistula formation, intracranial abscess, fibrous or bony ankylosis, temporal bone or condylar osteomyelitis, growth alteration, and several others. This report describes a case of septic TMJ arthritis arising from direct spread of an odontogenic infection with subsequent development of mandibular osteomyelitis. The purpose of this case report is to 1) increase awareness of an underdiagnosed condition, 2) establish the seriousness of this infection, 3) for the first time report on a case of TMJ septic arthritis caused by Bacteroides infection, and 4) provide a review of the relevant literature.

  9. Bilateral Temporomandibular Joint Replacement Using Computer-Assisted Surgical Simulation and Three-Dimensional Printing.

    Science.gov (United States)

    Ryu, Jaeyoung; Cho, Jinyong; Kim, Hyeon Min

    2016-07-01

    The dental occlusion is the important reference for replacement of the temporomandibular joint. If a patient does not have normal occlusion, few considerations are needed for temporomandibular joint replacement. The custom-made prosthesis, typically fabricated with a stereolithographic model, is probably the optimized solution currently available. However the ready-made stock from Biomet Microfixation System (Jacksonville, FL) is the only available product, which is authorized by the government ministry in South Korea, for replacement of the temporomandibular joint. This report presents a patient with the problems that were retrognathic "bird face" profile subsequent to severe bilateral condylar resorption and temporomandibular joint ankylosis without enough natural teeth for occlusion. Bilateral temporomandibular joint replacement using the ready-made prosthesis was done by reestablishing the mandibular position with new occlusion and improved facial profile via the virtual surgical planning and stereolithographic model simulation. PMID:27315318

  10. A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome.

    Science.gov (United States)

    Putnis, S E; Wartemberg, G K; Khan, W S; Agarwal, S

    2015-01-01

    Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications. PMID:26587066

  11. HETEROTOPIC OSSIFICATION OF HIP IN A RARE CASE OF MOYAMOYA DISEASE: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Anita

    2015-04-01

    Full Text Available A case of extensive ossification around the left hip joint involving lesser trochanter of the femur leading to ankylosis of left hip joint in a 60 years male is being reported. The diagnosis of moyamoya disease was made , which is a rare form of occlusive cerebrovasc ular disorder. Occlusion of an artery may present with Transient Ischemic Attacks , headaches , stroke and seizures. Surgical management is the only option in these cases. This 60 years male had an acute onset hemiplegia 4 ½ years back and at present came wit h complaints of pain and swelling over the left hip. Surgical excision was done and histopathological examination revealed extensive ossification of skeletal muscle. A diagnosis of Moyamoya disease complicated with heterotopic ossification was made. There was no recurrence after 8 months of follow up.

  12. A MODIFIED TECHNIQUE OF RETROGRADE INTUBATION IN A DIFFICULT INTUBATION CASE

    Directory of Open Access Journals (Sweden)

    Murthy

    2014-08-01

    Full Text Available Anaesthesiologists will be facing difficult intubating conditions, anticipated or unanticipated, quite frequently, whenever they anaesthetize patients with facio- maxillary injuries, temporo mandibular joint ankylosis, obesity, pregnancy, congenital air-way abnormalities, etc. A large number of aids are available now for intubating in such difficult situations and a lot of techniques have been described in literature for giving anaesthesia for such patients. (1 Use of Bullard laryngoscope in difficult air-way situation was described by Dullenkopf et al 2003, (2 Lighted Wand by Agro et al 2004, (3 Shikani flexible seeing stylet by Agro et al 2005(4 Blind nasal intubation, L M A, Fiber optic laryngoscope by Levitan et al1999. (5 Glydoscope by Lim et al 2005(6 . In this case report, we have given one more alternate solution for this problem

  13. Treatment of a Vertical Root Fracture Using Dual-Curing Resin Cement: A Case Report

    Directory of Open Access Journals (Sweden)

    Nima Moradi Majd

    2012-01-01

    Full Text Available Introduction. Vertical root fracture (VRF is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options. However, bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction. Methods. A vertically fractured left maxillary incisor was carefully extracted, fracture line was treated with adhesive resin cement, a retrograde cavity was produced and filled with calcium-enriched mixture (CEM cement, and tooth was replanted. Results. After 12 months the tooth was asymptomatic. The size of periapical radiolucency was noticeably reduced and there was no clinical sign of ankylosis. Conclusion. Using adhesive resin cement to bond the fracture lines extraorally in roots with VRF and intentional replantation of the reconstructed teeth could be considered as an alternative to tooth extraction, especially for anterior teeth.

  14. Management of the temporomandibular joint in rheumatoid disorders.

    Science.gov (United States)

    Sidebottom, A J; Salha, R

    2013-04-01

    This article summarises the rheumatoid diseases that particularly affect the temporomandibular joint (TMJ): psoriatic arthropathy, ankylosing spondylitis, and rheumatoid arthritis. Management is by a joint approach between rheumatologists and maxillofacial surgeons with a specific interest in diseases of the TMJ who give early surgical advice. Steroid injections, whilst useful in the short term, are not useful for long term or repeated treatment, and may lead to collapse of the joint and development of a deformed anterior open bite. These disorders should be managed primarily using standard conservative regimens, and failure to respond should lead to diagnostic or therapeutic arthroscopy and appropriate surgical treatment. When ankylosis develops or the joint collapses, a replacement joint should be considered and patients should be referred to an appropriately trained surgeon. PMID:22658606

  15. The unerupted maxillary canine - a post-surgical review.

    LENUS (Irish Health Repository)

    O'Dowling, Ian

    2009-10-01

    The orthodontic records of 685 patients referred for surgical exposure of an unerupted impacted maxillary canine tooth were examined. The condition was more common among females than males, slightly less than 2:1. The impacted teeth had a palatal-labial ratio of 3:1. All of the teeth were exposed using the open surgical technique and in 98% of cases the tooth erupted and was orthodontically aligned. In 2% of cases ankylosis occurred and the teeth were subsequently extracted. The presence of peg-shaped lateral incisors associated with the impacted maxillary canine tooth was 3.4% of the total number of impacted teeth and congenital absence was found in 1.7% of impacted teeth.

  16. Predictors of Switching Anti-Tumor Necrosis Factor Therapy in Patients with Ankylosing Spondylitis.

    Directory of Open Access Journals (Sweden)

    Jeong-Won Lee

    Full Text Available The aim of this study was to investigate the potential predictors of switching tumor necrosis factor (TNF-α inhibitors in Korean patients with ankylosing spondylitis (AS. The patients who had been treated with TNF-α inhibitors were divided into two groups depending on whether they had switched TNF-α inhibitors. Demographic, clinical, laboratory, and treatment data at the time of initiation of TNF-α inhibitor treatment were compared between switchers and non-switchers, and within switchers according to the reasons for switching. Of the 269 patients, 70 (23% had switched TNF-α inhibitors once; of these, 11 switched again. The median follow-up time was 52.7 months. Three- and five-year drug survival rates were 52%/48% for infliximab, 62%/42% for etanercept, and 71%/51% for adalimumab, respectively. Switchers were more likely to be prescribed disease-modifying anti-rheumatic drugs than non-switchers. A history of joint surgery and complete ankylosis of the sacroiliac joint was more frequent in switchers. Multivariate Cox's proportional hazard analysis showed that the use of adalimumab as the first TNF-α inhibitor was less likely to lead to switching and complete ankylosis of the sacroiliac joints was more likely to lead to switching. The principal reasons for switching were drug inefficacy and adverse events, but the differences in the clinical data of these two groups of switchers were not significant. In AS patients who are candidates for TNF-α inhibitor therapy, switching may improve the therapeutic outcome based on clinical information.

  17. Do costochondral grafts have any growth potential in temporomandibular joint surgery? A systematic review

    Science.gov (United States)

    Kumar, Praveen; Rattan, Vidya; Rai, Sachin

    2015-01-01

    Purpose of the study To assess the growth potential of costochondral graft in temporomandibular joint reconstruction in patients with temporomandibular ankylosis and hemifacial microsomia. Method Systematic review after inclusion of articles fulfilling the following criteria: (1) only human studies; (2) patients of temporomandibular joint ankylosis and hemifacial microsomia; and (3) studies with minimum of five cases and with a minimum follow-up for a period of 5 years. The primary outcome measure was the percentage of patients with optimum growth of costochondral graft. Secondary outcomes were any abnormal growth and restoration of function. Delphi's criteria were used for assessing the quality of the included studies. Result Only three studies satisfied all the inclusion criteria. A total of 96 costochondral grafts were placed in the included studies. Optimum growth was reported in 54 grafts, undergrowth in 1 graft, overgrowth in 7 grafts, lateral overgrowth in 1 graft and no growth in 1 graft. Graft resorption, reankylosis and sequestration were seen in 21, 8 and 3 cases, respectively. When the Delphi's criteria were applied to the case series for the assessment of quality, majority of the studies could be considered as satisfying at least 50% of the criteria. Conclusion There are no randomised clinical trials and the only evidence is in the form of case series that is considered as the lowest level of evidence for any study. No inference can be interpreted regarding growth potential of costochondral graft. Thus, on the basis of available evidence, it can be concluded that use of costochondral graft for temporomandibular joint reconstruction lacks scientific evidence. PMID:26605146

  18. Spinal arthritis and physical stress at Bronze Age Harappa.

    Science.gov (United States)

    Lovell, N C

    1994-02-01

    This study examines joint changes in the vertebral skeleton in human remains excavated in 1987 and 1988 at Bronze Age Harappa, an urban center of the Indus Valley civilization. The sample consists of 23 complete skeletons from primary burial context, the partial remains of more than 69 other individuals, and hundreds of skeletal elements from secondary context, totalling 3,084 vertebral joint margins and articular surfaces. Marginal bone proliferation, pitting of articular surfaces, eburnation, and ankylosis were scored macroscopically for vertebral body margins and surfaces and posterior apophyseal facet joints. Marginal lipping is far more prevalent on the vertebral bodies than on the apophyseal facets and surface pitting is also more frequent on vertebral bodies although its expression is relatively low overall. Cervical vertebrae in this sample exhibit the same amount of marginal new bone and much more surface pitting of the vertebral bodies than do either thoracic or lumbar vertebrae; the cervical segment also exhibits the most severe expressions of both types of lesions. In addition, although the frequencies of cervical and lumbar posterior facet involvement are similar, the cervical facets exhibit much more severe lipping as well as the only cases of eburnation and ankylosis. Pitting of the posterior facets is most common in the lumbar segment, but the cervical examples are the only severe cases. It is proposed that the severe joint changes in the cervical spine result from trauma, perhaps accumulated microtrauma from activity stresses. There are no age or sex associated patterns in the frequency of arthritis although this result may be influenced by the small proportions of the total sample for which age and sex could be determined. PMID:8147433

  19. Management of facial asymmetry due to overgrowing costochondral graft: A case report.

    Science.gov (United States)

    Razzak, Arif; Ahmed, Nabeela; Sidebottom, Andrew

    2016-01-01

    Costochondral grafts are used to replace the mandibular condyle in cases of TMJ ankylosis, and are generally viewed as a gold standard for autogenous reconstruction of the mandibular condyle (Güven, 2000; Posnick and Goldstein, 1993 [1,2]). We report a case where overgrowth of costochondral grafts is seen, resulting in asymmetric mandibular growth and dentofacial asymmetry (Posnick and Goldstein, 1993 [2]). A 17 year old male patient presented with an existing costochondral graft performed due to TMJ ankylosis during childhood. He fell from a height at the age of 4, and was lost to follow up through non-attendance until the age of 9, when he presented with a progressive reduction in maximal incisal opening (MIO). At this stage his maximal incisal opening was noted to be 11mm, and the CT showed a grossly deformed ankylosed left TMJ. This post traumatic ankyloses was managed with gap arthroplasty and costochondral graft reconstruction. This immediately improved his MIO to 22mm and at 1 year follow up was noted to be 30mm. At age 12 he was noted to have a clinically obvious overgrowth of the left ramus of the mandible, and deviation of the chin point to the right. MIO remained at 38mm. He declined orthognathic surgery and represented 2 years later requesting treatment without orthodontic intervention for his facial asymmetry. He subsequently underwent a Le Fort 1 impaction osteotomy, right BSSO and left condylar ostectomy, coronoidectomy and left lower border mandibulectomy. Regrowth of the CCG occurred during the 6 months of follow up. This case illustrates the problems that can occur after condylar trauma. It also highlights issues with costochondral grafts which can continue to grow. PMID:27475115

  20. Optimizing the MRI protocol of the sacroiliac joints in Spondyloarthritis: which para-axial sequence should be used?

    Energy Technology Data Exchange (ETDEWEB)

    Giraudo, Chiara; Weber, Michael; Platzgummer, Hannes; Kainberger, Franz; Schueller-Weidekamm, Claudia [Medical University of Vienna, Vienna General Hospital, Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Vienna (Austria); Magnaldi, Silvia [Fondazione Poliambulanza Istituto Ospedaliero, Dipartimento di Radiologia e Diagnostica per Immagini, Brescia (Italy); Puchner, Antonia [Medical University of Vienna, Vienna General Hospital, Division of Rheumatology, Department of Internal Medicine III, Vienna (Austria)

    2016-01-15

    To assess the diagnostic value of para-axial T2w-TSE (paT2) and fat-suppressed proton density (paPD-FS) MRI sequences for the evaluation of the sacroiliac joint (SIJ) of patients with axial Spondylarthritis (SpA). One hundred and six patients with clinical findings suggestive of SpA underwent an MR protocol of the SIJ with additional paPD-FS (41 patients) and paT2 (105 patients). Acute (bone marrow oedema [BME], enthesitis, capsulitis, synovitis) and chronic findings (erosions, ankylosis) were assessed by paPD-FS and compared with the gold standard post-contrast sequences, whereas chronic features (because of the lack of fat suppression) were evaluated on paT2 and compared with pcT1. paPD-FS demonstrated high sensitivity (98.9 %) and specificity (99.1 %) for BME; sensitivity and specificity for synovitis and enthesitis were 100 %; 85.7 % and 100 %, respectively, for capsulitis. paPD-FS and paT2 showed 100 % sensitivity and specificity for ankylosis; for erosions, paT2 demonstrated 85.3 % sensitivity and 100 % specificity, whereas paPD-FS, respectively, 98 % and 100 %. PaT2 and paPD-FS provided precious information enabling an accurate interpretation of the heterogeneous findings of SpA. paPD-FS showed good results in detecting acute and chronic lesions and its inclusion in a routine MR examination of the SIJ could increase the diagnostic performance of a pre-contrast protocol. (orig.)

  1. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis

    Directory of Open Access Journals (Sweden)

    Tsui FW

    2014-05-01

    Full Text Available Florence WL Tsui,1,2 Hing Wo Tsui,1 Ali Akram,1,3 Nigil Haroon,1–3 Robert D Inman1–3 1Genetics and Development Division, Toronto Western Research Institute, University Health Network, 2Department of Immunology, 3Institute of Medical Science, University of Toronto, Toronto, ON, Canada Abstract: Ankylosing spondylitis (AS is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage–bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD, fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS. It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. Keywords: ankylosing spondylitis, genome-wide association studies, risk loci, ankylosis, joint and gut inflammation, clinical subsets

  2. Achondroplasia manifesting as enchondromatosis and ossification of the spinal ligaments: a case report

    Directory of Open Access Journals (Sweden)

    Al Kaissi Ali

    2008-08-01

    Full Text Available Abstract Introduction A girl presented with achondroplasia manifested as mild knee pain associated with stiffness of her back. A skeletal survey showed enchondroma-like metaphyseal dysplasia and ossification of the spinal ligaments. Magnetic resonance imaging of the spine further clarified the pathological composites. Case presentation A 7-year-old girl presented with the classical phenotypic features of achondroplasia. Radiographic documentation showed the co-existence of metaphyseal enchondromatosis and development of spinal bony ankylosis. Magnetic resonance imaging showed extensive ossification of the anterior and posterior spinal ligaments. Additional features revealed by magnetic resonance imaging included calcification of the peripheral vertebral bodies associated with anterior end-plate irregularities. Conclusion Enchondromas are metabolically active and may continue to grow and evolve throughout the patient's lifetime; thus, progressive calcification over a period of years is not unusual. Ossification of the spinal ligaments has a specific site of predilection and often occurs in combination with senile ankylosing vertebral hyperostosis. Nevertheless, ossification of the spinal ligaments has been encountered in children with syndromic malformation complex. It is a multifactorial disease in which complex genetic and environmental factors interact, potentially leading to chronic pressure on the spinal cord and nerve roots with subsequent development of myeloradiculopathy. Our patient presented with a combination of achondroplasia, enchondroma-like metaphyseal dysplasia and calcification of the spinal ligaments. We suggest that the development of heterotopic bone formation along the spinal ligaments had occurred through an abnormal ossified enchondral mechanism. We postulate that ossification of the spinal ligaments and metaphyseal enchondromatous changes are related to each other and represent impaired terminal differentiation of

  3. Avaliação radiográfica e de função de vôo após fixação de osteotomias distais do úmero em pombas (Columba livia, com modelo de fixador externo articulado Radiologic and flight function evaluation after fixation of distal humeral osteotomies in pigeons, with model of articulated external fixator

    Directory of Open Access Journals (Sweden)

    Vanessa C.M. Ferraz

    2008-08-01

    viabilidade de músculos e tendões, e assim, garantindo a capacidade de vôo das aves tratadas, sendo um método adequado para a reparação de fraturas distais de úmero em aves quando se pretende a reabilitação destes animais.The treatment of distal humeral fractures in birds is very difficult, technically and for consolidation and maintenance of normal function of the wing, because theses bones are pneumatic, and its cortices very thin. The ankylosis of the humerus-radius-ulnar joint with external fixator is unviable for birds intended for rehabilitation and release. In all animals, the experimental fixator was placed over the humerus, with its articulation over the humerus-radial-ulnar joint e the extension of the fixator was placed over the ulna. The animals were divided in two groups: bilateral surgeries with ankylosis in one wing (static wing and maintenance of the joint function in the other (dynamic wing (Group 1, and unilateral surgery, with maintenance of the joint function (dynamic wing (Group 2. The bonny callus was evaluated with radiographs: post-surgical, at 3, 6 and 9 weeks. The birds in Group 2 were evaluated as of their flight abilities between 11 and 15 weeks after surgery. The wing amplitude and humeral length was evaluated in all animals, after euthanasia. At 6 weeks, all the animals in Group 2, that underwent unilateral surgery, without ankylosis, and four animals in Group 1, that underwent bilateral surgeries: ankylosis of one elbow (static wing and not of the other (dynamic wing, presented radiographic and clinical consolidation of the fractures. Two animals in Group 1 only presented consolidation of the dynamic wing at 9 weeks and of the static wing at 12 weeks. All the animals in Group 2 presented adequate flight capacity, in at least 13 weeks after surgery. There are few published papers on bird osteosynthesis, and therefore we studied the use of articulated external fixator for the stabilization of distal humeral fractures, avoiding ankylosis

  4. 下颌骨髁状突骨折56例疗效分析%Retrospective study of treatments for 56 condylar fractures

    Institute of Scientific and Technical Information of China (English)

    曲昌锋; 郭哲; 陆平; 周晓南; 汪崇

    2012-01-01

    [ Objective] To investigate the treatments and curative effects for different types of condylar fractures. [ Methods] There were 56 condylar fractures presented with expectant treatments, condylar removal, arthroplasty, rigid fixation and evaluated the clinical effects. [Results] The curative effects were satisfactory but some patients suffered with complications such as injury of facial nerve, limitation of mouth opening, ankylosis of temporo - mandibular joint and absorption of condyle. [ Conclusion ] Miniplate rigid fixation based on anatomical reduction is an effective procedure in treating condylar neck and subcondylar fractures. Post - mandibular approach could significantly reduce the probability of facial nerve injury. Ankylosis of temporo - mandibular joint could happen if the serious dislocation of articular disc and comminuted fractures of condyle head.%[目的]探讨不同类型髁状突骨折的治疗方法和临床效果.[方法]回顾性分析大连市中心医院56例髁状突骨折病例,分别采用保守治疗及髁状突摘除、关节成形和小型钛板坚固内固定,并评价其临床效果.[结果]随访47例,所有病例均一期愈合,无感染,无涎瘘.但部分病例出现面神经损伤(5例)、张口受限(3例)、颞下颌关节强直(1例)、髁状突吸收(2例)等并发症.[结论]切开复位及小型钛板坚固内固定是治疗髁颈和髁颈下骨折的有效方法,但应保留翼外肌附着.经颌后区入路可明显降低面神经损伤的几率.囊内粉碎性骨折和髁状突骨折伴关节盘明显移位如处理不当易发生颞下颌关节强直.

  5. MR imaging features of foot involvement in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  6. Arthrogryposis multiplex congenita - a rare congenital stiff joints syndrome

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2006-01-01

    Full Text Available Introduction: Arthrogryposis multiplex congenita is not a disease but a term describing multiple congenital contractures. Etiological factors include neurological and primary myogenic diseases. This rare syndrome is present at birth and is characterized by reduced mobility of many joints. The contractures involve two or more joints with ankylosis. The accompanying musculature is hypoplastic, but multiple pterygia are also present. Arthrogryposis multiplex congenita is a heterogeneous group of disorders with the incidence rate of 6.2/100000 liveborn infants. The true incidence cannot be established, because many cases result in spontaneous miscarriages or stillbirth. More than 90% of cases are associated with birth defects. The cause of this syndrome is unknown. Many forms are not hereditary, though there are hereditary forms as well. Case report. This paper presents a case with arthrogryposis multiplex congenita. The pregnancy was not controlled regularly. During the pregnancy, oligohydramnion was detected. Due to contractures, labor ended is cesarean section. The child was born in the 34th week of gestation. Flexion and extension joint contractures were observed. Active and passive mobility of the afflicted joints was reduced. There was a limited motor function in the shoulder, elbow and wrist joints with a slight internal rotation of the shoulder joint and lower arm joints during pronation. The hips were subluxated; the feet were in equinovarus position and the fingers in ulnar deviation with partial syndactyly of the 4th and 5th fingers on the left hand. The infant had abnormal dermatoglyphics. The neck was short, and the 2nd and 3rd cervical vertebrae were fused. There was also a slight left-sided thoracic scoliosis. Trismus was present due to the existing ankylosis of the temporomandibular joint. The karyotype was normal. The serum creatinine phosphokinase was slightly elevated. The electromyographic picture indicate non-specific signs of

  7. Imaging features of SAPHO syndrome%SAPHO综合征的影像表现

    Institute of Scientific and Technical Information of China (English)

    刘记存; 陈勇; 崔建岭

    2011-01-01

    Objective To explore the imaging features of patients with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods Imaging features of 20 patients with SAPHO syndrome were retrospectively analyzed. Results Nineteen patients had anterior chest wall involvement, which showed bone sclerosis, hyperostosis, costal cartilage sclerotic hyperostosis, joint destruction and ankylosis on plain X-ray films and CT images. The medial end of clavicle, ma-nubrium and the first costal cartilage were affected in 19 cases. Among them, bilaterally asymmetrical involvements were found in 8 cases, bilaterally symmetrical in 7 cases and unilateral in 4 cases, respectively. Manubriosternal junctions and the second costal cartilages were affected in 10 and 6 cases, respectively. Five patients had spinal involvement which showed endplate erosion, sclerosis, paravertebral ossification, narrowed disc space, wedged body on plain film and CT, in-homogeneous long Tl and long T2 signal intensities on MRI. Three patients also had sacroiliac joint involvement which showed joint destruction and ankylosis on plain film and CT. Conclusion Anterior chest wall lesions are the typical imaging features of SAPHO syndrome.%目的 探讨SAPHO综合征的影像学表现.方法 回顾性分析20例SAPHO综合征患者的影像学表现.结果 19例病变累及前上胸壁,X线、CT表现为骨及肋软骨硬化、肥厚,关节破坏、强直,胸骨柄、锁骨近端和第1肋软骨受累,其中双侧不对称受累8例,双侧对称性受累7例,单侧受累4例.10例柄胸联合受累,6例第2肋软骨受累.5例伴有脊柱病变,X线、CT表现为多发椎体终板侵蚀、硬化,椎旁骨化,椎间隙变窄,椎体楔形变;MRI表现为椎体不均匀长T1长T2信号.3例伴骶髂关节受累,X线和CT表现为关节破坏、强直.结论 前上胸壁病变是SAPHO综合征最具特征性的影像学表现.

  8. Current diagnosis and therapy of anterior mandibular fracture associated with condyle fractures%下颌骨前段骨折伴发髁突骨折的诊治现状

    Institute of Scientific and Technical Information of China (English)

    徐晓峰; 徐兵

    2014-01-01

    下颌骨前段骨折(包括正中联合及旁正中的骨折)是下颌骨骨折最常见的类型之一,且常常与髁突骨折同时发生。受解剖因素的影响,这类骨折一旦处理不当容易出现包括面下部增宽,咬合紊乱,甚至关节强直等多种并发症。本文就这类骨折的特点、常见并发症、诊断方法以及治疗过程中应注意的问题作一综述。%Anterior mandibular fracture, which includes symphyseal and parasymphyseal mandibular fractures, is one of the most common types of fracture in clinical work, and is usually associated with condyle fracture. This type of fracture predisposes the patients to facial widening, malocclusion, and ankylosis when not properly and timely treated because of the influence of its anatomic structure. This article reviews the characteristics, complication, diagnosis, and therapy of this type of fracture.

  9. Hereditary bone dysplasia with pathological fractures and nodal osteoarthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Arendse, Regan [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); University of Cape Town, Division of Rheumatology, Groote Schuur Hospital, Cape Town (South Africa); Brink, Paul [University of Stellenbosch, Department of Medicine, Tygerberg Hospital, Stellenbosch (South Africa); Beighton, Peter [University of Cape Town, Division of Human Genetics, Faculty of Health Sciences, Cape Town (South Africa)

    2009-12-15

    A father and daughter both had multiple pathological fractures and nodal osteoarthropathy. The father, aged 50 years, had at least 20 healed fractures of the axial and appendicular skeleton, sustained by minor trauma over his 50-year lifespan, many of which had been surgically fixed prior to his first presentation to us. Fractures of the clavicles, thoracic cage and long bones of the arms and legs, had healed with malalignment and deformity. Healed fractures were complicated by ankylosis of the cervical vertebrae and both elbows. He also had osteoarthritis of the hands, with exuberant osteophytosis, and profound perceptive deafness. His general health was good, his intellect and facies were normal, and his sclerae were white. The daughter, aged 27 years, had sustained at least seven fractures of the axial and appendicular skeleton following trivial injuries, in distribution similar to those of the father. She had also experienced painful swelling of the fingers, which preceded progressive development of nodal osteoarthropathy. Her hearing was normal. In both individuals, biochemical and immunological investigations yielded normal results. It was not possible for molecular studies to be undertaken. Pedigree data were consistent with autosomal dominant transmission, and this disorder appeared to be a previously undocumented heritable skeletal dysplasia. (orig.)

  10. Calcium hydroxide mixed with camphoric p-monochlorophenol or chlorhexidine in delayed tooth replantation.

    Science.gov (United States)

    Trevisan, Carolina Lunardelli; Panzarini, Sônia Regina; Brandini, Daniela Atili; Poi, Wilson Roberto; Luvizuto, Eloá Rodrigues; Dos Santos, Cláudia Letícia Vendrame; Saito, Célia Tomiko Hamada Matida

    2011-11-01

    This study evaluated the repair process after delayed replantation of rat teeth, using calcium hydroxide (Ca(OH)2) mixed with camphorated p-monochlorophenol (CMCP), chlorhexidine 2% (CHX), or saline as temporary root canal dressing to prevent and/or control inflammatory radicular resorption. Thirty Wistar rats (Rattus norvegicus albinos) had their right upper incisor extracted, which was bench-dried for 60 minutes. The dental papilla, the enamel organ, the dental pulp, and the periodontal ligament were removed. The teeth were immersed in 2% acidulated-phosphate sodium fluoride solution for 10 minutes. The root canals were dried with absorbent paper cones and divided into 3 groups of 10 animals according to root canal dressing used: group 1: Ca(OH)2 + saline, group 2: Ca(OH)2 + CMCP, and group 3: Ca(OH)2 + CHX 2%. Before replanting, the teeth sockets were irrigated with saline. Histological analysis revealed the presence of inflammatory resorption, replacement resorption, and ankylosis in all 3 groups. Statistical analysis showed a significant difference between group 3 and the other groups. The use of Ca(OH)2 mixed with CMCP or CHX did not show an advantage over the use of Ca(OH)2 mixed with saline in preventing and/or controlling inflammatory resorption in delayed replantation of rat teeth. PMID:22067873

  11. Treatment of root surface in delayed tooth replantation: a review of literature.

    Science.gov (United States)

    Panzarini, Sônia Regina; Gulinelli, Jéssica Lemos; Poi, Wilson Roberto; Sonoda, Celso Koogi; Pedrini, Denise; Brandini, Daniela Atili

    2008-06-01

    The time elapsed between a trauma and tooth replantation usually ranges from 1 to 4 h. The chances of root surface damage are higher when tooth replantation is not performed immediately or if the avulsed tooth is not stored in an adequate medium. This invariably leads to necrosis of pulp tissue, periodontal ligament cells and cementum, thus increasing the possibility of root resorption, which is the main cause of loss of replanted teeth. This paper presents a comprehensive review of literature on root surface treatments performed in cases of delayed tooth replantation with necrotic cemental periodontal ligament. Journal articles retrieved from PubMed/MedLine, Bireme and Scielo databases were reviewed. It was observed that, when there are no periodontal ligament remnants and contamination is under control, replacement resorption and ankylosis are the best results and that, although these events will end up leading to tooth loss, this will happen slowly with no loss of the alveolar ridge height, which is important for future prosthesis planning. PMID:18410388

  12. Extensive heterotopic ossification in patient with tubercular meningitis

    Directory of Open Access Journals (Sweden)

    Vijai Prakash Sharma

    2014-01-01

    Full Text Available Tubercular meningitis is a severe form of central nervous system tuberculosis with high morbidity and mortality. Apart from neurological deficits, musculoskeletal involvement is also seen in very few cases in the form of heterotopic ossification around immobile joints. A 35-year-old male case of tubercular meningitis with left hemiparesis presented with multiple joint restriction of range of motion. On clinical examination, palpable firm masses around multiple joints with painful restriction of movements were seen. X-ray films of multiple joints revealed heterotopic ossification over left shoulder, hip and knee joint with bony ankylosis of left hip and soft tissue contractures. Very few reports have been published in the literature for association of heterotopic ossification with tubercular meningitis with such extensive joint involvement which compels us to report this clinical association of tubercular meningitis. This report is intended to create caution among physicians and other caregivers for this debilitating complication of tubercular meningitis and in face of high prevalence of tuberculosis and tubercular meningitis, employ methods to prevent and treat.

  13. Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis. Correlation with anatomy and histology

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, K.G.A. [Charite Medical School, Campus Mitte, Berlin (Germany). Dept. of Radiology; Bollow, M. [Augusta Hospital, Bochum (Germany). Dept. of Diagnostic and Interventional Radiology and Nuclear Medicine

    2014-03-15

    Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. (orig.)

  14. [Intravenous regional sympathetic block with guanethidine. Retrospective study of 251 blocks of the upper limb in 68 patients].

    Science.gov (United States)

    Egloff, D V; Piaget, F

    1989-01-01

    68 patients have been treated by regional intravenous blocks with guanethidine. 251 blocks have been realized. The majority of the patients received 3 blocks of one week. Some of them got a second series of 3 blocks after a minimum interval of one month. The study included 3 groups of patients. The first group showed 12 patients in the first stage of Sudeck; the second group 22 patients in the second stage. The third group included 34 patients for which the indication to blockade had been a chronic painful stage (19 cases), an ankylosis (8 cases), a Dupuytren post-traumatic contracture (3 cases) a stage before the operation predisposing to dystrophy reflex (3 cases) and one case of hyperhidrosis of the hand. Considering the three groups it can be stated that the first one responded the best to the treatment with a success in 80% of the cases. This success confirms the necessity of intervening as soon as possible in case of an algoneurodystrophy. The third group reveals that this therapeutical method can be useful in other situations than the dystrophy reflexes. The indication herewith is more founded on a possible sympathetic origin of the troubles as on the comportment psycho-affective of the patient. PMID:2481373

  15. Computer-assisted surgical planning and intraoperative navigation in the treatment of condylar osteochondroma.

    Science.gov (United States)

    Yu, H B; Li, B; Zhang, L; Shen, S G; Wang, X D

    2015-01-01

    Mandibular condylar osteochondroma (OC) results in asymmetric prognathism with facial morphology and functional disturbances. The aim of this study was to explore the feasibility of computer-assisted surgical planning combined with intraoperative navigation in the treatment of condylar OC. Five patients with mandibular condylar OC were enrolled in this study. Surgical planning and simulation was performed based on a computed tomography reconstruction model using SurgiCase software. Under the guidance of navigation, a condylar OC resection and conservative condylectomy was carried out via intraoral approach. Simultaneous orthognathic surgery was used to correct the facial asymmetry and malocclusion. All patients healed uneventfully. No facial nerve injury or salivary fistula occurred. Facial symmetry and morphology were greatly improved and stable occlusion was obtained in all cases. Good matching between preoperative planning and postoperative results was achieved. Patients showed no signs of recurrence or temporomandibular joint ankylosis during follow-up of 12-30 months. Computer-assisted surgical planning and intraoperative navigation is a valuable option in the treatment of mandibular condylar OC. PMID:25442742

  16. Endoscope-assisted conservative condylectomy in the treatment of condylar osteochondroma through an intraoral approach.

    Science.gov (United States)

    Yu, H B; Sun, H; Li, B; Zhao, Z L; Zhang, L; Shen, S G; Wang, X D

    2013-12-01

    Mandibular condylar osteochondroma (OC) can result in morphological and functional disturbances, including facial asymmetry and temporomandibular joint (TMJ) dysfunction. The aim of this study was to explore the feasibility of endoscope-assisted tumour resection and conservative condylectomy via an intraoral approach. Seven patients with condylar OC were enrolled in this study. Endoscope-assisted tumour resection and conservative condylectomy were achieved intraorally, and no conventional extraoral incision was needed. Direct vision of the magnified and illuminated operative field was realized with the assistance of an endoscope. No facial nerve injury or salivary fistula occurred in any patient. Stable occlusion was realized through postoperative orthodontic treatment. The patients showed no signs of tumour recurrence or TMJ ankylosis during follow-up (range 18-43 months). Endoscope-assisted condylar OC resection and conservative condylectomy via intraoral approach offers great advantages with no significant complications compared with conventional extraoral incisions. The endoscope provides us with a valuable treatment option for this potentially complicated procedure. PMID:23790807

  17. [Immediate and long-term results of surgical treatment of patients for traumatic mandibular fracture].

    Science.gov (United States)

    Kopchak, A V

    2014-01-01

    The analysis of immediate and long-term results of the surgical treatment of 286 patients, operated for traumatic mandibular fractures in the Department of Oral and Maxillofacial Surgery, National O. O. Bogomolets Medical University. In 67% of patients the anatomical shape of the bone was adequately restored. The presence of residual displacements in other cases was determined by the fracture type and localization, the technical complexity of the surgical intervention, lack of fixation rigidity under certain functional load conditions. In long terms of observation the infection and inflammatory complications were observed in 13.4% of patients, delayed unition and non-unition of bone fragments occurred--in 4.7%, arthosis with persistent dysfunction of the temporomandibular joint--in 6.7%, fibrous ankylosis--in 1.3%. Secondary displacement of fragments was observed in 23.5% of patients due to insufficient stiffness and reliaability of the bone-fixatorsystem. The non-precise reposition of fragments and secondary displacements in the early and late postoperative period were the main cause of occlusal disturbances of various severities, noted in 28% of operated patients, limitation of mouth opening (10%), TMJ disorders and changes in masticatory stereotype (33%), the sensation of pain and discomfort in tough food chewing (35%). A statistical analysis of the effectiveness of different osteosynthesis methods depending on the type and localization of the fracture was carried out and recommendations for usage of fixation devices in clinical practice were given. PMID:24923155

  18. The temporomandibular joint

    International Nuclear Information System (INIS)

    Whilst the temporomandibular joint is in many ways unique, it is subject to all the diseases and disorders found in joints in other parts of the human skeleton. By far the most common disorder is injury, followed by arthropathy, acute and chronic dislocations, ankylosis, and in rare instances, neoplasms. The diagnosis and management of the temporomandibular joint are the primary responsibility of the oral surgeon. Nevertheless, this anatomical region is an area in which the cooperation of medical and dental disciplines may be required for the satisfactory conclusion of treatment. The more so when the disease process involves either associated psychosomatic illness or malignancy. The mainstay of the diagnosis is a careful radiological examination of the joint. There exists a delicate relationship between the dentition, the muscles of mastication, and the temporomandibular articulation, which is controlled by arthrokinetic reflex activity of the branches of the 5th cranial nerve. Imbalance between one or more of the components of this integrated system frequently leads to disturbances in function. Pain-dysfunction disorders constitute the larger part of temporomandibular joint disturbances generally encountered

  19. The Role of MicroRNAS in Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Zheng; Wong, Sunny H; Shen, Jianxiong; Chan, Matthew T V; Wu, William Ka Kei

    2016-04-01

    Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of hip, sacroiliac joints and spine. Until now, there is no method for early diagnosis of AS and the effective treatment available for AS patients remain largely undefined.We searched articles indexed in PubMed (MEDLINE) database using Medical Subject Heading (MeSH) or Title/Abstract words ("microRNA" and "ankylosing spondylitis") from inception up to November 2015.Genetic polymorphisms of miRNAs and their targets might alter the risk of AS development whereas certain miRNAs exhibit correlation with inflammatory index.Let-7i and miR-124 were upregulated whereas miR-130a was downregulated in circulating immune cells of AS patients. These deregulated miRNAs could modulate key immune cell functions, such as cytokine response and T-cell survival.miRNA deregulation is key to AS pathogenesis. However, clinical utilization of miRNAs for management of AS patients requires further support from future translational studies.

  20. Overexpression of Shox2 Leads to Congenital Dysplasia of the Temporomandibular Joint in Mice

    Directory of Open Access Journals (Sweden)

    Xihai Li

    2014-07-01

    Full Text Available Our previous study reported that inactivation of Shox2 led to dysplasia and ankylosis of the temporomandibular joint (TMJ, and that replacing Shox2 with human Shox partially rescued the phenotype with a prematurely worn out articular disc. However, the mechanisms of Shox2 activity in TMJ development remain to be elucidated. In this study, we investigated the molecular and cellular basis for the congenital dysplasia of TMJ in Wnt1-Cre; pMes-stop Shox2 mice. We found that condyle and glenoid fossa dysplasia occurs primarily in the second week after the birth. The dysplastic TMJ of Wnt1-Cre; pMes-stop Shox2 mice exhibits a loss of Collagen type I, Collagen type II, Ihh and Gli2. In situ zymography and immunohistochemistry further demonstrate an up-regulation of matrix metalloproteinases (MMPs, MMP9 and MMP13, accompanied by a significantly increased cell apoptosis. In addition, the cell proliferation and expressions of Sox9, Runx2 and Ihh are no different in the embryonic TMJ between the wild type and mutant mice. Our results show that overexpression of Shox2 leads to the loss of extracellular matrix and the increase of cell apoptosis in TMJ dysplasia by up-regulating MMPs and down-regulating the Ihh signaling pathway.

  1. Molecular mechanisms of bone formation in spondyloarthritis.

    Science.gov (United States)

    González-Chávez, Susana Aideé; Quiñonez-Flores, Celia María; Pacheco-Tena, César

    2016-07-01

    Spondyloarthritis comprise a group of inflammatory rheumatic diseases characterized by its association to HLA-B27 and the presence of arthritis and enthesitis. The pathogenesis involves both an inflammatory process and new bone formation, which eventually lead to ankylosis of the spine. To date, the intrinsic mechanisms of the pathogenic process have not been fully elucidated, and our progress is remarkable in the identification of therapeutic targets to achieve the control of the inflammatory process, yet our ability to inhibit the excessive bone formation is still insufficient. The study of new bone formation in spondyloarthritis has been mostly conducted in animal models of the disease and only few experiments have been done using human biopsies. The deregulation and overexpression of molecules involved in the osteogenesis process have been observed in bone cells, mesenchymal cells, and fibroblasts. The signaling associated to the excessive bone formation is congruent with those involved in the physiological processes of bone remodeling. Bone morphogenetic proteins and Wnt pathways have been found deregulated in this disease; however, the cause for uncontrolled stimulation remains unknown. Mechanical stress appears to play an important role in the pathological osteogenesis process; nevertheless, the association of other important factors, such as the presence of HLA-B27 and environmental factors, remains uncertain. The present review summarizes the experimental findings that describe the signaling pathways involved in the new bone formation process in spondyloarthritis in animal models and in human biopsies. The role of mechanical stress as the trigger of these pathways is also reviewed. PMID:26838262

  2. Clinical and histopathological evaluation of MDP/collagen induced arthritis rat model (MCIA) after treatment with Urtica dioica, plantago major and Hypericum perforatum L herbal mixture.

    Science.gov (United States)

    Khalifeh, Mohammad S; Hananeh, Wael; Al-Rukibat, Raida; Okour, Omar; Boumezrag, Assia

    2008-04-01

    This study was done to assess the effects of Urtica dioica, Plantago major and Hypericum perforatum L herbal mixture in the MCIA rat model. In addition, a new pathological and clinical arthritis lesion assessment was developed. Sprague-Dawley (SD) rats were immunized with bovine type II collagen and muramyl dipeptide (MDP). Commercial herbal extracts were administered daily to the rats after the immunization for the course of experiment (90 days). Rats were boosted with a second collagen-MDP emulsion 60 days after the first immunization. Paws were daily evaluated macroscopically for redness, swelling, distortion, or ankylosis of the joints. On the day of sacrifice, rat paws were assessed for histopathologic changes. Herbal mixture administration decreased the clinical lesion manifestation in the MCIA rat model and led to development of similar or slightly more severe histopathological lesions compared to rats that did not receive the treatment. The clinical arthritis signs appeared as early as 13 days after the first MDP/collagen injection and with peak incidence at 20 days post-immunization. Histopathologically, animals showed changes ranging from mild to very severe. Administration of the herbal mixture used in this study had a clinical therapeutic effect on the course of the clinical manifestations in the MCIA model, but the herbal treatment had no such effect on the histopathological lesion development and even led to slightly more severe lesions. Rats in the MCIA model developed prominent clinical and histopathological changes that were comparable to rheumatoid arthritis (RA) lesions in humans. PMID:18421172

  3. Psoriatic arthritis: imaging techniques

    Directory of Open Access Journals (Sweden)

    E. Lubrano

    2012-06-01

    Full Text Available Imaging techniques to assess psoriatic arthritis (PsA include radiography, ultrasonography (US, magnetic resonance imaging (MRI, computed tomography (CT and bone scintigraphy. The radiographic hallmark of PsA is the combination of destructive changes (joint erosions, tuft resorption, osteolysis with bone proliferation (including periarticular and shaft periostitis, ankylosis, spur formation and non-marginal syndesmophytes. US has an increasing important role in the evaluation of PsA. In fact, power Doppler US is useful mainly for its ability to assess musculoskeletal (joints, tendons, entheses and cutaneous (skin and nails involvement, to monitor efficacy of therapy and to guide steroid injections at the level of inflamed joints, tendon sheaths and entheses. MRI allows direct visualization of inflammation in peripheral and axial joints, and peripheral and axial entheses, and has dramatically improved the possibilities for early diagnosis and objective monitoring of the disease process in PsA. MRI has allowed explaining the relationships among enthesitis, synovitis and osteitis in PsA, supporting a SpA pattern of inflammation where enthesitis is the primary target of inflammation. CT has little role in assessment of peripheral joints, but it may be useful in assessing elements of spine disease. CT accuracy is similar to MRI in assessment of erosions in sacroiliac joint involvement, but CT is not as effective in detecting synovial inflammation. Bone scintigraphy lacks specificity and is now supplanted with US and MRI techniques.

  4. Detectability for Nondeterministic Discrete Event Systems and Its Applications in Medical Diagnosis

    Institute of Scientific and Technical Information of China (English)

    舒少龙; 林峰

    2008-01-01

    In this paper,we extend our previous results on detectability to nondeterministic discrete event systems.Many practical systems are nondeterministic,especially those in biomedicine.Disease models of patients are usually nondeterministic because hardly anything is deterministic in biological systems.The goal is to determine or estimate the current and subsequent states of a system based on a sequence of observations when the initial state of the system is unknown.We say that a system is detectable if one can determine its state after observing some outputs.The observation includes partial event observation and/or partial state observation.We define four types of detectabilities:strong detectability,(weak) detectability,strong periodic detectability,and (weak) periodic detectability.We derive necessary and sufficient conditions for these detectabilities.These conditions can be checked by constructing an observer,which models the estimation of states under different observation.Furthermore,we apply the results to medical diagnosis by considering a realistic example of diagnosing whether a patient suffers from one of the following five similar diseases:(1) rheumatoid arthritis,(2) rheumatic arthritis,(3) systemic lupus eruthematosus,(4) bony ankylosis,or (5) spondylitis ankylopoietica.

  5. Histology of tooth attachment tissues and plicidentine in Varanus (Reptilia: Squamata), and a discussion of the evolution of amniote tooth attachment.

    Science.gov (United States)

    Maxwell, Erin E; Caldwell, Michael W; Lamoureux, Denis O; Budney, Lisa A

    2011-10-01

    Few recent studies have examined the histological basis for tooth attachment in squamates. In the past few years, a surge of interest in this topic has led to the intriguing suggestion that the major tissues derived from the tooth germ (enamel, dentine, cementum and alveolar bone), are conservative and are present in all amniotes. In this study, we describe the histology and development of the tooth attachment complex in Varanus rudicollis, the rough-neck monitor. We provide the first published evidence for the role of cementum and alveolar bone in tooth attachment in varanoid lizards. In Varanus, cementum is deposited on the external surface of the tooth root as well as at the base of the tooth, where it plays a role in the attachment of the tooth to the jawbone. Alveolar bone is also involved in tooth ankylosis. Our results support the hypothesis that the major tooth germ tissues are found in all amniotes. We provide insights into the structure and development of plicidentine, defined as infolding of the dentine around the tooth base. This feature is unique to varanoids among extant tetrapods and is the third tissue implicated in tooth attachment in Varanus. Plicidentine develops asymmetrically along the labial-lingual axis of a tooth. Varanus is characterized by the presence of both primary and higher-order lamellae, which anastomose to form a honeycomb-like surface that then interacts with the more basal attachment tissues.

  6. Magnetic resonance imaging of sacroiliitis in patients with spondyloarthritis: correlation with anatomy and histology.

    Science.gov (United States)

    Hermann, K-G A; Bollow, M

    2014-03-01

    Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group. Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings.

  7. The contemporary imaging methods of arthritis of the knee: algorithm of radiological examination

    International Nuclear Information System (INIS)

    Arthritis is a common term used for over 50 different joint diseases. Arthritis of the knee from the data of traumatologists takes about 16-22% of all arthritis. The precise diagnosis in early stage is very important to prevent such severe complications of arthritis as ankylosis and others because certain problems require immediate attention and prompt treatment. The aim of the study was to create an algorithm for precise diagnosis of arthritis in early stage taking in account clinics, possible cause of the arthritis and potentialities and informatively of the new radiological equipment. There were analysed 43 conventional radiograms, 10 ultra sonograms, 5 computer tomograms, 3 magnetic resonance and 7 radionuclide images of the patients with different stages and causes of the arthritis of the knee. The findings were correlated with literature data. From data of the study authors conclude that in the early stage of the arthritis the conventional radiology findings can be negative. If arthritis goes with excess fluid or cysts in the joint and also in paediatric praxis it might be more convenient to start examinations with ultrasonography. If there is clinical suspicion of bone marrow, tendon or cartilage structures involvement must be used magnetic resonance. To detect more precise destructive cavities or localisation of squirmiest the computer tomography should be performed. According to analysis for precise early radiological diagnosis and for follow up of the arthritis of the knee its treatment, authors made up algorithm for the patients with arthritis of the knee depending of the clinics and radiological findings

  8. Donor's age and replicative senescence favour the in-vitro mineralization potential of human fibroblasts.

    Science.gov (United States)

    Boraldi, Federica; Bartolomeo, Angelica; Di Bari, Caterina; Cocconi, Andrea; Quaglino, Daniela

    2015-12-01

    Aberrant mineralization of soft connective tissues (ectopic calcification) may occur as a frequent age-related complication. Still, it remains unclear the role of mesenchymal cell donor's age and of replicative senescence on ectopic calcification. Therefore, the ability of cells to deposit in-vitro hydroxyapatite crystals and the expression of progressive ankylosis protein homolog (ANKH), ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), tissue non specific alkaline phosphatase (TNAP) and osteopontin (OPN) have been evaluated in human dermal fibroblasts derived from neonatal (nHDF) and adult (aHDF) donors (ex-vivo ageing model) or at low and high cumulative population doublings (CPD) up to replicative senescence (in-vitro ageing model). This study demonstrates that: 1) replicative senescence favours hydroxyapatite formation in cultured fibroblasts; 2) donor's age acts as a major modulator of the mineralizing potential of HDF, since nHDF are less prone than aHDF to induce calcification; 3) donor's age and replicative senescence play in concert synergistically increasing the calcification process; 4) the ANKH+ENPP1/TNAP ratio, being crucial for pyrophosphate/inorganic phosphate balance, is greatly influenced by donor's age, as well as by replicative senescence, and regulates mineral deposition; 5) OPN is only modulated by replicative senescence.

  9. Osteogenesis imperfecta type V: clinical and radiographic manifestations in mutation confirmed patients.

    Science.gov (United States)

    Kim, Ok-Hwa; Jin, Dong-Kyu; Kosaki, Keisuke; Kim, Jung-Wook; Cho, Sung Yoon; Yoo, Won Joon; Choi, In Ho; Nishimura, Gen; Ikegawa, Shiro; Cho, Tae-Joon

    2013-08-01

    Osteogenesis imperfecta (OI) type V is a specific OI phenotype with interosseous membrane calcification of the forearm and hyperplastic callus formation as typical features. The causative gene mutation for OI type V has been recently discovered. The purpose of this report is to review the clinical and radiographic characteristics of mutation confirmed OI type V in detail. Sixteen (nine familial and seven sporadic) patients were enrolled in the study. Blue sclera and dentinogenesis imperfecta were not evident in any patient. However, hypodontia in the permanent teeth, ectopic eruption, and short roots in molars were additionally observed in 11 patients. Of the radiographic abnormalities, cortical thickening and bony excrescence of interosseous margin of the ulna was the most common finding, followed by overgrowth of the olecranon and/or coronoid process of the ulna. Slender ribs and sloping of the posterior ribs with or without fractures were also a consistent finding. Hyperplastic callus was detected in 75% of patients and was commonly encountered at the femur. Heterotopic ossification in the muscles and tendon insertion sites were noted in four patients, which resulted in bony ankylosis or contracture of joints. The current study confirms common clinical and radiographic findings of OI type V and reports additional phenotypic information. These observations provide clues to recognize OI type V more promptly and guide to direct targeted molecular study. © 2013 Wiley Periodicals, Inc.

  10. A STUDY ON THE INCID ENCE OF PLEUROPULMON ARY MANIFESTATIONS OF RH EUMATOID ARTHRITIS I N A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Purushottam Rao

    2015-03-01

    Full Text Available INTRODUCTION: Rheumatoid arthritis is a chronic systemic inflammatory disorder that affects many tissue organs such as skin, blood vessels, heart, lungs and muscles but principally affects joints producing synovitis that often progress to tissue destruction of articular cartilage and ankylosis of joints. Pulmonary manifestations in rheumatoid arthritis are varied as the pleura, lung, parenchyma, airways and pulmonary vasculature all can be involved. AIM AND OBJECTIVES : To study the incidence of pleuropulmonary manifestations of Rheumatoid Arthritis in patients who were confirmed to have rheumatoid arthritis by 2010 ACR criteria . 6 METHODOLOGY : This prospective study was carried out at King George Hospital, Visakhapatnam, Andhra Pradesh. It is a Tertiary Care Hospital. The study was conducted from January 2013 to December 2014. RESULTS: A total of sixty patients who were confirmed to have rheumatoid arthritis were included in this study. Of these, female patients were 34 (56.66% and males were 26 (43.33%. In this study, out of sixty patients of rheumatoid arthritis 24 patients (40% had pleuropulmonary manifestations. CONCLUSION : Rheumatoid Arthritis is prevalent in females but pleuropulmonary manifestations are common in males. Prevalence of pleuropulmonary manifestations is independent of duration of rheumatoid arthritis. But presence of pleuropulmonary manifestations indicate the severity of disease process

  11. Arthroscopic tibiotalar and subtalar joint arthrodesis.

    Science.gov (United States)

    Roussignol, X

    2016-02-01

    Arthroscopy has become indispensable for performing tibiotalar and subtalar arthrodesis. Now in 2015, it is the gold-standard surgical technique, and open surgery is reserved only for cases in which arthroscopy is contraindicated: material ablation after consolidation failure, osteophytes precluding a work chamber, excentric talus, severe malunion, bone defect requiring grafting, associated midfoot deformity, etc. The first reports of arthroscopic tibiotalar and subtalar arthrodesis date from the early 1990s. Consolidation rates were comparable to open surgery, but with significantly fewer postoperative complications: infection, skin necrosis, etc. Arthroscopy was for many years reserved to moderate deformity, with frontal or sagittal deviation less than 10°. The recent literature, however, seems to extend indications, the only restriction being the surgeon's experience. Tibiotalar arthrodesis on a posterior arthroscopic approach remains little used. And yet the posterior work chamber is much larger, and initial series showed consolidation rates similar to those of an anterior approach. The surgical technique for posterior tibiotalar arthrodesis was described by Van Dijk et al., initially using a posterior para-Achilles approach. This may be hampered by posterior osteophytes or ankylosis of the subtalar joint line (revision of non-consolidated arthrodesis, sequelae of calcaneal thalamus fracture) and is now used only by foot and ankle specialists. Posterior double tibiotalar-subtalar arthrodesis, described by Devos Bevernage et al., is facilitated by transplantar calcaneo-talo-tibial intramedullary nailing. PMID:26797006

  12. Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Fryns Jean-Pierre

    2006-06-01

    Full Text Available Abstract Pfeiffer syndrome is a rare autosomal dominantly inherited disorder that associates craniosynostosis, broad and deviated thumbs and big toes, and partial syndactyly on hands and feet. Hydrocephaly may be found occasionally, along with severe ocular proptosis, ankylosed elbows, abnormal viscera, and slow development. Based on the severity of the phenotype, Pfeiffer syndrome is divided into three clinical subtypes. Type 1 "classic" Pfeiffer syndrome involves individuals with mild manifestations including brachycephaly, midface hypoplasia and finger and toe abnormalities; it is associated with normal intelligence and generally good outcome. Type 2 consists of cloverleaf skull, extreme proptosis, finger and toe abnormalities, elbow ankylosis or synostosis, developmental delay and neurological complications. Type 3 is similar to type 2 but without a cloverleaf skull. Clinical overlap between the three types may occur. Pfeiffer syndrome affects about 1 in 100,000 individuals. The disorder can be caused by mutations in the fibroblast growth factor receptor genes FGFR-1 or FGFR-2. Pfeiffer syndrome can be diagnosed prenatally by sonography showing craniosynostosis, hypertelorism with proptosis, and broad thumb, or molecularly if it concerns a recurrence and the causative mutation was found. Molecular genetic testing is important to confirm the diagnosis. Management includes multiple-staged surgery of craniosynostosis. Midfacial surgery is performed to reduce the exophthalmos and the midfacial hypoplasia.

  13. General anesthesia in fibrodysplasia ossificans progressive: a case report and clinical review.

    Science.gov (United States)

    Liu, Jin-Xing; Hu, Rong; Sun, Yu; Jiang, Hong

    2014-01-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare and devastating genetic disorder of connective tissue characterized by heterotopic bone formation and progressive musculoskeletal disability. Soft-tissue trauma may exacerbate this condition and lead to further ossification. We described the anesthetic and perioperative management of a 23-year-old male with FOP scheduled for dental extraction requiring general anesthesia. Preoperative examination revealed multisystem involvement including cranial and cervical ankylosis and severe restrictive lung disease. Nasal fiber-optic endotracheal intubation was chosen in our patient. Anesthesia was maintained with total intravenous anesthesia and ventilation was controlled throughout the surgery. Endotracheal tube was remained for mechanical ventilation until the second postoperative day and aggressive respiratory physiotherapy was performed after extubation. Additionally, extreme caution was taken to a femoral vascular access and an arterial catheter. Positioning of the patient was meticulous and air warming blanket was used to minimize soft tissue trauma. No significant documented intraoperative and postoperative adverse events appeared attributable to the anesthesia. PMID:24995115

  14. Mucopolysaccharidosis VI in a Siamese/short-haired European cat.

    Science.gov (United States)

    Macrì, B; Marino, F; Mazzullo, G; Trusso, A; De Maria, R; Amedeo, S; Divari, S; Castagnaro, M

    2002-10-01

    A 3-year-old Siamese/short-haired European cat was referred for clinical disease characterized by dwarfism, facial dysmorphia, paralysis, small and curled ears, corneal clouding and large areas of alopecia. X-ray examination showed multiple bone dysplasia. On the basis of clinical features a form of mucopolysaccharidosis was suspected. The cat, killed at the owner's request, presented several severe skeletal deformities such as long caudal limbs, enlarged thorax with sunken breastbone, vertebral ankylosis in many spinal segments and visceral involvement. Histologically, the cat showed diffuse vacuolization and enlargement of cells in cartilage, bone and visceral organs. Ultrastructurally, membrane-bound vacuoles were filled with fibrillar and fluffy-material or concentrically whorled lamellae. Arylsulphatase B activity was 3.24 nm/mg/h in the affected cat and 30.6 in a normal age-matched control (NC). The L-iduronidase activity was slightly increased. Quantitation of total glycosaminoglycans (GAGs) revealed a 4.5-fold increase in the affected cat as compared with NC, while electrophoretic run of specific GAGs [chondroitin sulphate (CA); hyaluronan (HA); heparan sulphate (HS); dermatan sulphate (DS); keratan sulphate (KS)] performed on a cellulose acetate sheet, showed a striking increase in the DS band. On densitometric analysis of the electrophoretic run stained with Alcian Blue 8GX, the absorption of DS was eight-fold increased as compared with NC. The clinical and morphological features, and the biochemical findings, were consistent with the diagnosis of feline mucopolysaccharidosis VI.

  15. Enduring fluoride health hazard for the Vesuvius area population: the case of AD 79 Herculaneum.

    Directory of Open Access Journals (Sweden)

    Pierpaolo Petrone

    Full Text Available BACKGROUND: The study of ancient skeletal pathologies can be adopted as a key tool in assessing and tracing several diseases from past to present times. Skeletal fluorosis, a chronic metabolic bone and joint disease causing excessive ossification and joint ankylosis, has been only rarely considered in differential diagnoses of palaeopathological lesions. Even today its early stages are misdiagnosed in endemic areas. METHODOLOGY/PRINCIPAL FINDINGS: Endemic fluorosis induced by high concentrations of fluoride in water and soils is a major health problem in several countries, particularly in volcanic areas. Here we describe for the first time the features of endemic fluorosis in the Herculaneum victims of the 79 AD eruption, resulting from long-term exposure to high levels of environmental fluoride which still occur today. CONCLUSIONS/SIGNIFICANCE: Our observations on morphological, radiological, histological and chemical skeletal and dental features of this ancient population now suggest that in this area fluorosis was already endemic in Roman times. This evidence merged with currently available epidemiologic data reveal for the Vesuvius area population a permanent fluoride health hazard, whose public health and socio-economic impact is currently underestimated. The present guidelines for fluoridated tap water might be reconsidered accordingly, particularly around Mt Vesuvius and in other fluoride hazard areas with high natural fluoride levels.

  16. Matrix stiffness promotes cartilage endplate chondrocyte calcification in disc degeneration via miR-20a targeting ANKH expression.

    Science.gov (United States)

    Liu, Ming-Han; Sun, Chao; Yao, Yuan; Fan, Xin; Liu, Huan; Cui, You-Hong; Bian, Xiu-Wu; Huang, Bo; Zhou, Yue

    2016-05-04

    The mechanical environment is crucial for intervertebral disc degeneration (IDD). However, the mechanisms underlying the regulation of cartilage endplate (CEP) calcification by altered matrix stiffness remain unclear. In this study, we found that matrix stiffness of CEP was positively correlated with the degree of IDD, and stiff matrix, which mimicked the severe degeneration of CEP, promoted inorganic phosphate-induced calcification in CEP chondrocytes. Co-expression analysis of the miRNA and mRNA profiles showed that increasing stiffness resulted in up-regulation of miR-20a and down-regulation of decreased ankylosis protein homolog (ANKH) during inorganic phosphate-induced calcification in CEP chondrocytes. Through a dual luciferase reporter assay, we confirmed that miR-20a directly targets 3'-untranslated regions of ANKH. The inhibition of miR-20a attenuated the calcium deposition and calcification-related gene expression, whereas the overexpression of miR-20a enhanced calcification in CEP chondrocytes on stiff matrix. The rescue of ANKH expression restored the decreased pyrophosphate efflux and inhibited calcification. In clinical samples, the levels of ANKH expression were inversely associated with the degeneration degree of CEP. Thus, our findings demonstrate that the miR-20a/ANKH axis mediates the stiff matrix- promoted CEP calcification, suggesting that miR-20a and ANKH are potential targets in restraining the progression of IDD.

  17. The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis.

    Science.gov (United States)

    Tsui, Florence Wl; Tsui, Hing Wo; Akram, Ali; Haroon, Nigil; Inman, Robert D

    2014-01-01

    Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage-bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD), fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS). It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS. PMID:24971029

  18. A functional variant in ERAP1 predisposes to multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Franca Rosa Guerini

    Full Text Available The ERAP1 gene encodes an aminopeptidase involved in antigen processing. A functional polymorphism in the gene (rs30187, Arg528Lys associates with susceptibility to ankylosying spondylitis (AS, whereas a SNP in the interacting ERAP2 gene increases susceptibility to another inflammatory autoimmune disorder, Crohn's disease (CD. We analysed rs30187 in 572 Italian patients with CD and in 517 subjects suffering from multiple sclerosis (MS; for each cohort, an independent sex- and age-matched control group was genotyped. The frequency of the 528Arg allele was significantly higher in both disease cohorts compared to the respective control population (for CD, OR = 1.20 95%CI: 1.01-1.43, p = 0.036; for RRMS, OR = 1.26; 95%CI: 1.04-1.51, p = 0.01. Meta-analysis with the Wellcome Trust Cases Control Consortium GWAS data confirmed the association with MS (p(meta = 0.005, but not with CD. In AS, the rs30187 variant has a predisposing effect only in an HLA-B27 allelic background. It remains to be evaluated whether interaction between ERAP1 and distinct HLA class I alleles also affects the predisposition to MS, and explains the failure to provide definitive evidence for a role of rs30187 in CD. Results herein support the emerging concept that a subset of master-regulatory genes underlay the pathogenesis of autoimmunity.

  19. Occult radiological effects of lipomatosis of the lumbosacral plexus

    Energy Technology Data Exchange (ETDEWEB)

    Mahan, Mark A. [Barrow Neurological Institute, Phoenix, AZ (United States); Howe, B.M.; Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Spinner, Robert J. [Mayo Clinic, Department of Neurosurgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States); Mayo Clinic, Rochester, MN (United States)

    2014-07-15

    Lipomatosis of nerve (LN) is a condition of massive peripheral nerve enlargement frequently associated with hypertrophy within the distribution of the nerve, and most commonly affecting the distal limbs. We sought to understand if LN of the lumbosacral plexus would be associated with the trophic effects of LN on surrounding tissue within the pelvis, which may be clinically occult, but present on MRI. Fifty-one cases of LN, confirmed by pathology or pathognomonic appearance on MRI, were reviewed. Patients with LN of the sciatic nerve were investigated for radiological signs suggestive of overgrowth. Five patients had involvement of the sciatic nerve, 4 of whom had MR imaging of the pelvis. Three patients had LN involving the lumbosacral plexus, and one patient had isolated involvement of the sciatic nerve. All patients with involvement of the lumbosacral plexus demonstrated previously unrecognized evidence of nerve territory overgrowth in the pelvis, including: LN, profound adipose proliferation, muscle atrophy and fatty infiltration, and bone hypertrophy and ankylosis. The patient with LN involving the intrapelvic sciatic nerve, but not the lumbosacral plexus did not demonstrate any radiological evidence of pelvic overgrowth. LN is broader in anatomical reach than previously understood. Proximal plexal innervation may be involved, with a consequent effect on axial skeleton and intrapelvic structures. (orig.)

  20. Fibroblast-Like Synoviocytes Induce Calcium Mineral Formation and Deposition

    Directory of Open Access Journals (Sweden)

    Yubo Sun

    2014-01-01

    Full Text Available Calcium crystals are present in the synovial fluid of 65%–100% patients with osteoarthritis (OA and 20%–39% patients with rheumatoid arthritis (RA. This study sought to investigate the role of fibroblast-like synoviocytes (FLSs in calcium mineral formation. We found that numerous genes classified in the biomineral formation process, including bone gamma-carboxyglutamate (gla protein/osteocalcin, runt-related transcription factor 2, ankylosis progressive homolog, and parathyroid hormone-like hormone, were differentially expressed in the OA and RA FLSs. Calcium deposits were detected in FLSs cultured in regular medium in the presence of ATP and FLSs cultured in chondrogenesis medium in the absence of ATP. More calcium minerals were deposited in the cultures of OA FLSs than in the cultures of RA FLSs. Examination of the micromass stained with nonaqueous alcoholic eosin indicated the presence of birefringent crystals. Phosphocitrate inhibited the OA FLSs-mediated calcium mineral deposition. These findings together suggest that OA FLSs are not passive bystanders but are active players in the pathological calcification process occurring in OA and that potential calcification stimuli for OA FLSs-mediated calcium deposition include ATP and certain unidentified differentiation-inducing factor(s. The OA FLSs-mediated pathological calcification process is a valid target for the development of disease-modifying drug for OA therapy.

  1. Advances of Chinese and Western Medicine on Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Na-na HE

    2015-03-01

    Full Text Available Rheumatoid arthritis (RA is a kind of chronic general immunological disease with primary clinical characteristic being joint synovitis, and no specific treatment has been found at present. In China, its morbidity is in an increasing trend, and also shows a trend of getting younger. RA is complicated in symptoms and chronic disease course, leading to joint ankylosis, deformity and even disability, which seriously threaten patients' psychological and physical health as well as the quality of life (QOL. RA, which belongs to “ Bi” symdrome, is termed as “arthroncus of knee” or “severe and migratory arthralgia” in traditional Chinese medicine (TCM, for which TCM focuses on expelling wind to remove cold, tonifying qi to activate blood and dispelling dampness to smooth collaterals while the western medicines mainly based on the principles of anti-inflammation, analgesia and inhibiting autoimmune response. However, both Chinese and western medicines have certain advantages in treating RA. Therefore, this study primarily reviewed the advances of Chinese and western medicines in RA treatment in the hope of providing theoretical basis for the clinical treatment of RA.

  2. Advances of Chinese and Western Medicine on Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    HE Na-na; WU Zhi-sen; XING Zhen-long; ZHANG Zhi-gang; SUN Shi-xuan; LIN Fa-cai

    2015-01-01

    Rheumatoid arthritis (RA) is a kind of chronic general immunological disease with primary clinical characteristic being joint synovitis, and no speciifc treatment has been found at present. In China, its morbidity is in an increasing trend, and also shows a trend of getting younger. RA is complicated in symptoms and chronic disease course, leading to joint ankylosis, deformity and even disability, which seriously threaten patients’ psychological and physical health as well as the quality of life (QOL). RA, which belongs to“Bi”symdrome, is termed as“arthroncus of knee”or“severe and migratory arthralgia”in traditional Chinese medicine (TCM), for which TCM focuses on expelling wind to remove cold, tonifying qi to activate blood and dispelling dampness to smooth collaterals while the western medicines mainly based on the principles of anti-inflammation, analgesia and inhibiting autoimmune response. However, both Chinese and western medicines have certain advantages in treating RA. Therefore, this study primarily reviewed the advances of Chinese and western medicines in RA treatment in the hope of providing theoretical basis for the clinical treatment of RA.

  3. A clinical perspective on common forms of acquired heterotopic ossification

    Energy Technology Data Exchange (ETDEWEB)

    Garland, D.E. (Rancho Los Amigos Medical Center, Downey, CA (USA))

    1991-02-01

    The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. Approximately 10% of the HO is massive and causes severe restriction in joint motion or ankylosis. The most common sign and symptom are decreased range of motion and pain. The locations are the proximal limbs and joints. Sites of HO about a joint may vary according to the etiology of the HO. Roentgenographic evolution of HO occurs during a six-month period in the majority of patients. Treatment modalities include diphosphonates, indomethacin, radiation, range of motion exercises, and surgical excision. Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 years. A small number of patients have progression of HO with medicinal treatment and recurrence after resection. The patients seem recalcitrant to present treatment methods regardless of the HO etiology. 117 refs.

  4. Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

    Directory of Open Access Journals (Sweden)

    Nima Moradi Majd

    2014-01-01

    Full Text Available Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

  5. Biphasic calcium phosphate ceramic combined with fibrillar collagen with and without citric acid conditioning in the treatment of periodontal osseous defects.

    Science.gov (United States)

    Nery, E B; Eslami, A; Van Swol, R L

    1990-03-01

    The purpose of this study is to determine whether the combination of biphasic calcium phosphate ceramic (BCP) and collagen and citric acid root conditioning would promote accelerated new attachment of periodontal tissue to the root surface in dogs. Intrabony defects were surgically produced for each animal and were made chronic for 16 weeks. These defects were assigned to two study treatment and one control group: ceramic-collagen without citric acid (CO-CE); ceramic-collagen with citric acid (CO-CE-CA); and control (surgical debridement and root planing only). Results showed that all groups gained new attachment level as demonstrated both clinically and histometrically. The treatment groups showed a significant mean gain greater than the control (P less than .005), but no significant difference was found between treatment groups. Small areas of ankylosis was also found in both treatments but there was no evidence of active root resorption. It is concluded that the use of combined BCP and fibrillar collagen is beneficial in promoting new attachment of periodontal tissues to the root surface in dogs. Although citric acid root conditioning did as well or better than ceramic and collagen alone, its benefits are still speculative and need further experimentation.

  6. [Numerical variants and congenital fusions of carpal bones].

    Science.gov (United States)

    Senecail, B; Perruez, H; Colin, D

    2007-03-01

    The number of carpal bones may be increased or decreased by the fact of anatomical variants or true congenital anomalies. Numerical increment arises from additional or from split bones. Over twenty accessory carpal bones have been described but the commonest are the os centrale carpi, the os radiale externum, the triangular bone and the styloideum bone. Additional carpal bones usually result from a failure of fusion of their ossification centers. A congenital origin is not clearly established for all these ossicles. The scaphoid and lunate may split into two or three bones and several cases of bipartite hamulus of the hamatum have been reported. A carpus with only seven bones results from the congenital absence of a normal bone, which mainly affects the scaphoid, lunate and triquetrum, or from a synostosis between two carpal bones, usually the lunate and triquetrum. Congenital fusions originate from an absence of joint cavitation into the embryo and chondrification of the joint interzone. Numerical carpal variants are uncommon as independent entities but occur with a relative high frequency in association with complex malformations of the hand. These anomalies are detectable on plain radiographs of the wrist, but CT-scan and MR-Imaging are useful to differentiate bipartite and accessory bones from carpal fractures or posttraumatic injuries, carpal fusions having to be distinguished from bony ankylosis.

  7. Increased risk of temporomandibular joint closed lock: a case-control study of ANKH polymorphisms.

    Directory of Open Access Journals (Sweden)

    Boyen Huang

    Full Text Available OBJECTIVES: This study aimed to carry out a histological examination of the temporomandibular joint (TMJ in ank mutant mice and to identify polymorphisms of the human ANKH gene in order to establish the relationship between the type of temporomandibular disorders (TMD and ANKH polymorphisms. MATERIALS AND METHODS: Specimens from the TMJ of ank mutant and wild-type mice were inspected with a haematoxylin and eosin staining method. A sample of 55 TMD patients were selected. Each was examined with standard clinical procedures and genotyping techniques. RESULTS: The major histological finding in ank mutant mice was joint space narrowing. Within TMD patients, closed lock was more prevalent among ANKH-OR homozygotes (p = 0.011, OR = 7.7, 95% CI 1.6-36.5 and the elder (p = 0.005, OR = 2.4, 95% CI 1.3-4.3. CONCLUSIONS: Fibrous ankylosis was identified in the TMJ of ank mutant mice. In the human sample, ANKH-OR polymorphism was found to be a genetic marker associated with TMJ closed lock. Future investigations correlating genetic polymorphism to TMD are indicated.

  8. Signs and Symptoms of Temporomandibular Joint Disorders Related to the Degree of Mouth Opening and Hearing Loss

    Directory of Open Access Journals (Sweden)

    Kanavaros Panagiotis

    2011-05-01

    Full Text Available Abstract Background The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders (TMD have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms, and hearing loss. Methods The study involved 464 healthy Greek university students (156 men and 308 women with a mean age of 19.6 years. Age, gender and maximum mouth opening was recorded. Mouth opening was measured using Vernier calipers. An anamnestic questionnaire was used to stratify the subjects into four groups based on TMD severity. Aural symptoms and an audiogram were recorded for each subject too. Data were analyzed using multifactor ANOVA, chi-square, t-test, Mann-Whitney and Kruskal-Wallis tests. Results The overall incidence of TMD signs and symptoms was 73.3%. The incidence and severity was greater in females than males (p-value 0.0001 Conclusions TMD signs and symptoms were more common and severe in females than males. TMD severity is correlated with the degree of mouth opening and the number of aural symptoms. The absence or presence of mild TMD are associated with normal audiograms while moderate and severe TMD are related to hearing loss in median and low tones respectively. Bruxism, joint ankylosis, joint pain and ear itching were more common in TMD than non-TMD patients.

  9. Spine imaging after lumbar disc replacement: pitfalls and current recommendations

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    Sandén Bengt

    2009-07-01

    Full Text Available Abstract Background Most lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging (MRI. Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures. Methods Possible complications of lumbar total disc replacement (TDR are reviewed from the available literature and imaging recommendations given with regard to implant type. Two illustrative cases are presented in figures. Results Access-related complications, infections, implant wear, loosening or fracture, polyethylene inlay dislodgement, facet joint hypertrophy, central stenosis, and ankylosis of the operated segment can be visualised both in titanium and stainless steel implants, but require different imaging modalities due to magnetic artifacts in MRI. Conclusion Alternative radiographic procedures should be considered when evaluating patients following TDR. Postoperative complications following lumbar TDR including spinal stenosis causing radiculopathy and implant loosening can be visualised by myelography and radionucleotide techniques as an adjunct to plain film radiographs. Even in the presence of massive stainless steel TDR implants lumbar radicular stenosis and implant loosening can be visualised if myelography and radionuclide techniques are applied.

  10. Novel biologics in treatment of psoriatic arthritis%新型生物制剂在关节病型银屑病中的应用

    Institute of Scientific and Technical Information of China (English)

    周炯; 郑敏

    2009-01-01

    Psoriatic arthritis is an inflammatory joint disease associated with psoriasis.Due to difficulty for early diagnosis and lack of effective therapy,the disease leads to chronic course and frequent relapse.Patients may suffer from ankylosis,disability and even death.The past treatments neither can control the disease effectively,nor be capable of inhibiting the development of structural joint damage.Based on the current psoriasis pathogenesis,novel biologics have been developed,which can aim the specific targets,resulting in more effective and safer management for psoriatic arthritis.%关节病型银屑病是一种与银屑病相关的炎性关节病.该疾病早期诊断困难,而且缺乏有效药物;晚期患者可出现关节强直而致残,甚至死亡.传统药物在阻止关节损害方面效果不佳,毒副作用大.新型生物制剂作为一种基于银屑病发病机制中的免疫关键步骤而研发的新药,为关节病型银屑病的治疗提供了较为有效的方案.

  11. Dupuytren’s disease. State of the art and therapeutic perspectives

    Directory of Open Access Journals (Sweden)

    F.P. Cantatore

    2011-09-01

    Full Text Available Dupuytren’s disease is a benign fibroproliferative disorder characterised by the sclerosis and the retractile thickening of the medial palmar aponeurosis and digital aponeurosis, which can lead to the progressive and irreversible finger flexion. Genetic, metabolic and environmental factors are involved in the pathogenesis of Dupuytren’s disease, but their role is not clearly established. Different medical therapies have been proposed for Dupuytren’s disease treatment, but their real effectiveness has not been shown. Surgical therapy (fasciectomy is the most used treatment, whose purpose is to correct finger deformity and to avoid joint ankylosis. A team of French rheumatologists has developed a non-surgical approach, the percutaneous needle fasciotomy (PNF, whose results in less aggressive forms of Dupuytren’s disease are comparable to traditional surgery. PNF can be rapidly performed, presents a low cost and a low rate of complications and represents a valid alternative to surgical treatment of Dupuytren’s disease. In this review we report our results on 24 patients treated with PNA for Dupuytren’s contracture.

  12. Profunda Femoris Artery Perforator Propeller Flap: A Valid Method to Cover Complicated Ischiatic Pressure Sores.

    Science.gov (United States)

    Scalise, Alessandro; Tartaglione, Caterina; Bolletta, Elisa; Pierangeli, Marina; Di Benedetto, Giovanni

    2015-08-01

    We report the case of a 50-year-old paraplegic man with a complicated grade III/IV ischiatic pressure sore treated with a propeller flap based on the first perforator of the profunda femoris artery. Our aim was to surgically reconstruct an ischiatic pressure sore in a patient with ankylosis using a fasciocutaneous perforator propeller flap obtained from the posterior region of the thigh. Our decision to perform a profunda femoris artery perforator propeller flap reconstruction was mainly due to the anatomical contiguity of the flap with the site of the lesion and the good quality of the skin harvested from the posterior region of the thigh. The use of the perforator fasciocutaneous flap represents a muscle-sparing technique, providing a better long-term result in surgical reconstruction. The choice of the 180-degree propeller flap was due to its ability to provide a good repair of the pressure ulcer and to pass over the ischiatic prominence in the patient in the forced decubitus position. The operatory course did not present any kind of complication. Using this reconstructive treatment, we have obtained complete coverage of the ischiatic pressure sore. PMID:26495200

  13. Talonavicular joint abnormalities and walking ability of patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Miyamoto N

    2004-04-01

    Full Text Available Rheumatoid arthritis (RA is often associated with deformities of the feet, and foot pain often arises in the talonavicular joint of patients with RA. The object of this study was to assess the relationship between magnetic resonance imaging (MRI findings of the talonavicular joint and walking ability. The subjects were 35 RA patients (10 feet in 5 males and 56 feet in 30 females aged 34-87 years (mean: 70 years +/- 12.1, with a disease duration from 1-54 years (mean: 14 years +/- 12.1. MRI findings were classified as follows: Grade 1, almost normal; Grade 2, early articular destruction; Grade 3, moderate articular destruction; Grade 4, severe articular destruction; and Grade 5, bony ankylosis dislocation. Walking ability was classified into one of 9 categories ranging from normal gait to bedridden status according to the system of Fujibayashi. As the grade of MRI images became higher the walking ability decreased, and these parameters showed a correlation by Spearman's rank correlation coefficient analysis (P = 0.003. Thus, in the present cohort group of patients with RA, the deterioration of walking ability increased with the severity of destruction of the talonavicular joint.

  14. Description of spinal findings and determining the MR positive spondylitis

    International Nuclear Information System (INIS)

    Full text: Spondyloarthritis (SpA) is an umbrella term applied to a family of rheumatic diseases that have both features in common with, as well as being distinct from, other inflammatory arthritides, particularly rheumatoid arthritis (RA). Recently, the ASAS working group established classification criteria to distinguish 2 broad categories of SpA: peripheral SpA and axSpA (Rudwaleit, 2011; Rudwaleit, 2010; Rudwaleit, 2009c). This division is based on the body part predominantly involved in the inflammatory process and those areas of the body that may respond similarly well to medication. Therefore, peripheral SpA includes diseases affecting mainly peripheral joints, such as reactive arthritis and psoriatic arthritis (PsA), whereas axSpA comprises those diseases with mainly axial involvement (sacroiliac joints and spine), including ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA). Patients with AS have definitive evidence of structural changes in the sacroiliac joint (sacroiliitis) on x-ray, fulfilling the Modified New York classification criteria (mNY-positive) (van der linden, 1984), whereas in those with nr-axSpA structural changes on conventional radiographs do not meet the mNy criteria (mNY-negative) (Rudwaleit, 2005; Dougados, 1991). Axial SpA is a chronic inflammatory disease that impacts a substantial proportion of the population. Limited evidence exists regarding the exact prevalence of axSpA. In the US, however, recent data suggest that the prevalence is similar to that of RA (axSpA: 0.7% to 1.4%; RA: 0.5% to 1.0%) (Reveille; 2012; Myasoedova, 2010; Helmick, 2008). In patients with axSpA, the disease typically originates in the sacroiliac joints, then progresses to the spine. In the sacroiliac joints and the spine, active inflammation results in erosions, sclerosis, and fatty lesions. However, the most characteristic feature is new bone formation leading to ankylosis of the sacroiliac joints and syndesmophytes attached to the vertebral

  15. Comprehensive outpaitent treatment for advanced stage patients with ankylosing spondylitis%进展期强直性脊柱炎患者的门诊综合治疗

    Institute of Scientific and Technical Information of China (English)

    李永军; 刘明勋

    2015-01-01

    Objective:To explore the efficacy and comprehensive outpatient treatment progression in patients with ankylosing spondyli-tis. Methods:From 2000 March to 2012 March, 365 cases of ankylosing spondylitis patients in outpatient treatment mandatory progress pe-riod, of which 264 cases were male, 101 female;age 15 ~ 42 years, average 29 years;the course of disease was 5 to 9 years, average 6. 3 years;to give psychological counseling education, pay attention to functional exercise, the necessary physical therapy, standard drug treatment, with small needle knife used for treatment. By using visual analogue scale ( Visual Analogue Scale, VAS) , curative effect was evaluated. Results:All cases were followed up, the follow-up time ranged from 24 to 120 months, 17 patients developed fibrous ankylo-sis, 2 patients had bilateral hip bony ankylosis, femoral head necrosis, bilateral total hip arthroplasty. The rest of the patients showed no deformity and dysfunction, VAS first diagnosed by averaging 6. 13 points down to the last follow-up 3. 16 points. Conclusion:Advanced ankylosing spondylitis patients can effectively control the progression of the disease through reasonable comprehensive outpatient treatment.%目的::探讨进展期强直性脊柱炎患者的门诊综合治疗方法及疗效。方法:自2000年3月~2012年3月,门诊治疗进展期强直脊柱炎患者365例,其中男264例,女101例;年龄15~42岁,平均29岁;病程5~9年,平均6.3年;给予心理辅导教育,重视功能锻炼,必要物理治疗,规范药物治疗,配合小针刀应用进行治疗。采用视觉模拟评分法( Visual Analogue Scale,VAS)评价疗效。结果:所有病例均得到长期随访,随访时间24~120个月,17例患者发展为纤维性强直,2例患者出现双侧髋关节骨性强直,股骨头坏死,行双侧人工全髋置换术。其余患者未出现畸形及功能障碍, VAS由初次确诊平均得分6.13分降为末次随访3.16分。结论:进展期强直性

  16. Evaluation of the topical effect of alendronate on the root surface of extracted and replanted teeth. Microscopic analysis on rats' teeth.

    Science.gov (United States)

    Lustosa-Pereira, Adriana; Garcia, Roberto Brandão; de Moraes, Ivaldo Gomes; Bernardineli, Norberti; Bramante, Clovis Monteiro; Bortoluzzi, Eduardo Antunes

    2006-02-01

    The treatment of choice for tooth avulsion is replantation. The ideal replantation should be realized as quickly as possible, or at least, the avulsed tooth should be kept in an adequate solution to preserve the periodontal ligament attached to the root. If that is not possible, treatment of the radicular surface should be done in order to prevent radicular resorption. The purpose of this study was to test sodium alendronate as a substance for topical treatment of the radicular surface of avulsed teeth in an attempt to prevent the occurrence of dental resorptions. Fifty-four rat maxillary right central incisors were extracted and replanted. Group I--extra-alveolar dry period of 15 min, intracanal dressing with calcium hydroxide (CALEN, S.S. White, Artigos Dentários LTDA, Rio de Janeiro, Brazil) and replantation; Groups II and III - extra-alveolar dry periods of 30 and 60 min, respectively, immersion in 1% sodium hypochlorite for 30 min for removal of the periodontal ligament, washing in saline solution for 5 min, and treatment of the radicular surface with 3.2 mg/l sodium alendronate solution for 10 min. Intracanal dressing with calcium hydroxide and replantation followed. At 15, 60, and 90 days post-reimplantation, the animals were killed and the samples obtained and processed for microscopic analysis. The results indicated that sodium alendronate was able to reduce the incidence of radicular resorption, but not of dental ankylosis. No significant differences were observed regarding variations in the extra-alveolar periods among the groups. PMID:16422756

  17. 严重僵硬型颈椎后凸畸形的手术入路选择%Surgical approach of severe fixed cervical kyphosis

    Institute of Scientific and Technical Information of China (English)

    李方财; 陈其昕; 陈维善

    2015-01-01

    Objective To investigate the radiographic features and surgical approach of severe fixed cervical kyphosis.Methods Seventeen cases of severe fixed cervical kyphosis from January 2007 to January 2012 were studied retrospectively.There were 8 males and 9 females,with an average age of 49.7 years.The etiologies were 3 cases of infection,3 cases of degeneration,3 cases of neurofibromatosis,3 cases of prior laminectomy,2 cases of idiopathic,2 cases of trauma and 1 case of neuromuscular disease.The average length of kyphosis was 4.3 ± 1.2 segments.All patients complained of severe neck pain (visual analogue scale,VAS,7.6±1.5) or progressive cervical kyphosis.There were 4 cases with myelopathy,2 with radiculopathy,3 with difficulty of forward gaze and 1 with difficulty of swallowing.All patients were underwent dynamic flexion-extension radiographs and traction views.CT scans were carried out to identify the sites of fixed kyphosis.Continuous traction was performed after general anesthesia,and the surgical approach was decided according to spinal cord compression,length of kyphosis and the cause of fixed kyphosis.Surgical outcomes were assessed in terms of correction of Cobb angle and Odom criteria.Results All patients were followed-up for 2 to 5 years.According to the CT scans,the sites of fixed kyphosis were identified:anterior bony ankylosis in 7 cases,posterior in 6 cases and both anterior and posterior in 4 cases.The surgical approach were as following:anterior only in 4 cases,posterior only in 2 cases,anterior-posterior in 5 cases,posterior-anterior in 3 cases,anterior-posterior-anterior in 1 case and posterior-anterior-posterior in 2 cases.The Cobb angle was corrected from 49.3°± 14.6° preoperation to 2.1 °±6.8° at the latest follow-up,with an average correction of 47.2°.According to Odom criteria,there were 7 excellent outcome,8 good,2 fair and none poor outcome.Revision surgery was performed in 1 case due to proximal junctional kyphosis.At the latest

  18. Indications and outcome of mandibular condylar and ramus surgeries

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    Babatunde O Akinbami

    2014-01-01

    Full Text Available Background: Different surgical procedures are utilized for treatment of various diseases of the posterior mandible depending on the type of disease, site, duration and age of the patient. A thorough knowledge of the anatomical relations of structures and adequate surgical skills are needed to minimize complications. The purpose of this study was to evaluate the indications and outcome of surgical techniques for diseases affecting the condyle and ramus of the mandibles. Patients and Methods: Data were retrieved from the case files of patients who had surgeries for diseases involving the ramus/condylar area of the mandible. The diagnosis/indications for surgery, procedure and postoperative outcomes were documented. Outcomes assessed were related to mouth opening, esthetics (appearance of scar and jaw symmetry and function (occlusion, Jaw movements. Complications such as nerve dysfunction were documented. Paresthesia was tested by simple tactile stimulations. Results: There were a total of 27 procedures done either on the condyle or ramus in 23 (100% patients between May 2006 and October, 2013. 16 procedures were done for tumors in 16 (69.6% patients, 14 (60.9% patients had Ameloblastoma, 1 (4.3% had central neurofibroma and one had keratocystic odontogenic tumor, two procedures for unilateral condylar fractures in 2 (8.6% patients, five procedures for ankylosis in 3 (13.0% patients and four procedures were done for dislocation in 2 (8.6% patients. There was no permanent nerve dysfunction; mouth opening, jaw movements and mastication were remarkably satisfactory. Conclusion: Esthetic and functional outcome were quite satisfactory when compared with the preoperative status.

  19. Tuberculosis of hip in children: A retrospective analysis

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    Myung-Sang Moon

    2012-01-01

    Full Text Available Background: Tuberculosis (TB of hip constitutes nearly 15% of all cases of osteoarticular tuberculosis. We report a retrospective study carried out on 43 children with hip TB. Materials and Methods: Forty-three children of TB hip treated between 1971 and 2000 were analysed. Twenty-four children of the early series were treated with streptomycin (S, isoniazid (H and PAS (Pa for 18 months (3HPaS, 15 HPa, while 19 children in the later series were treated with isoniazid (H, rifampicin (R and ethambutol (E or pyrazinamide (Z for 12 months [(12 RHE(Z]. Five out of 18 children with radiologically normal appearing type hip TB were treated with chemotherapy alone and 38 children were subjected to surgery; simple synovectomy alone in 31 hips, joint debridement in six hips, and proximal femoral varisation osteotomy in one. After surgery hips were immobilized in cast for one to three months according to the severity of the disease and patients pain tolerance, and then were mobilized under leg traction in bed gradually till pain subsided completely. Results: TB of hip healed with minimum sequelae in all children. In 18 Type one hip TB, normal hip (synovial form anatomy was maintained, and in 25 patients with advanced lesions some defect in the femoral head and acetabulum was noticed, though painless good hip motion was maintained. Excellent to good results were obtained in 31 children (73.1%, fair in eight (18.6%, and poor in four (9.3%. In four patients with poor results, there was some residual morphological defect in the hip. None developed ankylosis of hip. Conclusion: We achieved good outcome with minimum sequelae in this series. The management goal should be aimed not only to heal the disease but also to maintain a painless mobile hip and anatomical cephalocotyloid relationship until maturity, and retard the development of secondary osteoarthritis.

  20. Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population

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    Y. Ragab

    2015-09-01

    Full Text Available Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6% and 32 females (44.4] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3% cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%, septic arthritis in 10 (13.9%, tuberculous arthritis in 4 (5.6%, sickle-cell disease in 7 (9.7%, complicated with septic arthritis in 3 (4.2%, transient bone marrow edema (BME in 3 (4.2%, osteomyelitis in 2 (2.8%, osteosarcoma in 2 (2.8%, sciatic nerve injury in 1 (1.4%, leukemia with BME in 1 (1.4%, coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%, and a benign bone cyst in 1 (1.4%. MRI studies showed hip effusion in a total of 51 patients (70.8%, joint space narrowing in 9 (12.5%, and BME in 15(20.8%. MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology.

  1. Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population.

    Science.gov (United States)

    Ragab, Y; Nabih, M; Aly, I; Kamal, A; Abd-Allah, M A; El-Refai, R; Emad, Y; El-Naggar, A; El-Shaarawy, N; Rasker, J J

    2015-01-01

    Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI) in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6%) and 32 females (44.4)] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3%) cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%), septic arthritis in 10 (13.9%), tuberculous arthritis in 4 (5.6%), sickle-cell disease in 7 (9.7%), complicated with septic arthritis in 3 (4.2%), transient bone marrow edema (BME) in 3 (4.2%), osteomyelitis in 2 (2.8%), osteosarcoma in 2 (2.8%), sciatic nerve injury in 1 (1.4%), leukemia with BME in 1 (1.4%), coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%), and a benign bone cyst in 1 (1.4%). MRI studies showed hip effusion in a total of 51 patients (70.8%), joint space narrowing in 9 (12.5%), and BME in 15(20.8%). MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology. PMID:26492965

  2. Arthrogryposis Multiplex: A Case Report La artrogriposis múltiple: a propósito de un caso

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    Diego Alexis Blanco Manso

    2012-11-01

    Full Text Available Congenital muscular dystrophies appear from birth or early infancy with hypotonia and loss of proximal or generalized muscle strength. Contractures at birth are called arthrogryposis. Arthrogryposis multiplex is a disorder that is identified by congenital stiffness of one or more joints, caused by hypoplasia of the muscles in the region and also by an incomplete fibrous ankylosis. Some experts have attributed the disease to a prolonged intrauterine compression, but others propose that it is more likely that the syndrome originates from an early period of embryonic life. We report a case of arthrogryposis multiplex with walking impossibility due to a broken kneecap. Through rehabilitation in the Specialized Outpatient Center, the patient achieves locomotion.Las distrofias musculares congénitas se presentan desde el nacimiento o los primeros meses de vida con hipotonía y pérdida de la fuerza muscular proximal o generalizada. A las contracturas presentes al nacer se les denomina artrogriposis. La artrogriposis múltiple es un trastorno que se identifica por la rigidez congénita de una o más articulaciones, causada por la hipoplasia de los músculos ubicados en la región y también por una anquilosis fibrosa incompleta. Algunos especialistas han atribuido esta enfermedad a una compresión intrauterina prolongada, en cambio otros plantean, que es mucho más viable que el síndrome se origine en un periodo temprano de la vida embrionaria. Se presenta un caso de artrogriposis múltiple con imposibilidad para la marcha producto de una fractura de rótula que a por medio de la rehabilitación en el Centro Especializado Ambulatorio logra la locomoción.

  3. Magnetic resonance imaging for ankylosing spondylitis

    International Nuclear Information System (INIS)

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.)

  4. Periodontal ligament, cementum, and alveolar bone in the oldest herbivorous tetrapods, and their evolutionary significance.

    Science.gov (United States)

    LeBlanc, Aaron R H; Reisz, Robert R

    2013-01-01

    Tooth implantation provides important phylogenetic and functional information about the dentitions of amniotes. Traditionally, only mammals and crocodilians have been considered truly thecodont, because their tooth roots are coated in layers of cementum for anchorage of the periodontal ligament, which is in turn attached to the bone lining the alveolus, the alveolar bone. The histological properties and developmental origins of these three periodontal tissues have been studied extensively in mammals and crocodilians, but the identities of the periodontal tissues in other amniotes remain poorly studied. Early work on dental histology of basal amniotes concluded that most possess a simplified tooth attachment in which the tooth root is ankylosed to a pedestal composed of "bone of attachment", which is in turn fused to the jaw. More recent studies have concluded that stereotypically thecodont tissues are also present in non-mammalian, non-crocodilian amniotes, but these studies were limited to crown groups or secondarily aquatic reptiles. As the sister group to Amniota, and the first tetrapods to exhibit dental occlusion, diadectids are the ideal candidates for studies of dental evolution among terrestrial vertebrates because they can be used to test hypotheses of development and homology in deep time. Our study of Permo-Carboniferous diadectid tetrapod teeth and dental tissues reveal the presence of two types of cementum, periodontal ligament, and alveolar bone, and therefore the earliest record of true thecodonty in a tetrapod. These discoveries in a stem amniote allow us to hypothesize that the ability to produce the tissues that characterize thecodonty in mammals and crocodilians is very ancient and plesiomorphic for Amniota. Consequently, all other forms of tooth implantation in crown amniotes are derived arrangements of one or more of these periodontal tissues and not simply ankylosis of teeth to the jaw by plesiomorphically retaining "bone of attachment", as

  5. Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications.

    Science.gov (United States)

    Westerveld, L A; Verlaan, J J; Oner, F C

    2009-02-01

    The ankylosed spine is prone to fracture after minor trauma due to its changed biomechanical properties. Although many case reports and small series have been published on patients with ankylosing spondylitis (AS) suffering spine fractures, solid data on clinical outcome are rare. In advanced diffuse idiopathic skeletal hyperostosis (DISH), ossification of spinal ligaments also leads to ankylosis. The prevalence of AS is stable, but since DISH may become more widespread due to its association with age, obesity and type 2 diabetes mellitus, a systematic review of the literature was conducted to increase the current knowledge on treatment, neurological status and complications of patients with preexisting ankylosed spines sustaining spinal trauma. A literature search was performed to obtain all relevant articles concerning the outcome of patients with AS or DISH admitted with spinal fractures. Predefined parameters were extracted from the papers and pooled to study the effect of treatment on neurological status and complications. Ninety-three articles were included, representing 345 AS patients and 55 DISH patients. Most fractures were localized in the cervical spine and resulted from low energy impact. Delayed diagnosis often occurred due to patient and doctor related factors. On admission 67.2% of the AS patients and 40.0% of the DISH patients demonstrated neurologic deficits, while secondary neurological deterioration occurred frequently. Surgical or nonoperative treatment did not alter the neurological prospective for most patients. The complication rate was 51.1% in AS patients and 32.7% in DISH patients. The overall mortality within 3 months after injury was 17.7% in AS and 20.0% in DISH. This review suggests that the clinical outcome of patients with fractures in previously ankylosed spines, due to AS or DISH, is considerably worse compared to the general trauma population. Considering the potential increase in prevalence of DISH cases, this condition may

  6. Effects of concomitant use of fibroblast growth factor (FGF)-2 with beta-tricalcium phosphate ({beta}-TCP) on the beagle dog 1-wall periodontal defect model

    Energy Technology Data Exchange (ETDEWEB)

    Anzai, Jun, E-mail: anzai_jun@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Kitamura, Masahiro, E-mail: kitamura@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Nozaki, Takenori, E-mail: tnozaki@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan); Nagayasu, Toshie, E-mail: nagayasu_toshie@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Terashima, Akio, E-mail: terashima_akio@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Asano, Taiji, E-mail: asano_taiji@kaken.co.jp [Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co., Ltd., 14, Shinomiya, Minamigawara-cho, Yamashina-ku, Kyoto 607-8042 (Japan); Murakami, Shinya, E-mail: ipshinya@dent.osaka-u.ac.jp [Department of Periodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 (Japan)

    2010-12-17

    Research highlights: {yields} Concomitant use of FGF-2 and {beta}-TCP (an osteo-conductive scaffold) significantly promotes periodontal regeneration in the severe periodontitis model (1-wall defect model) of beagle dog. {yields} FGF-2 enhanced new bone formation via {beta}-TCP at the defects. {yields} In particular, FGF-2 dramatically regenerated new periodontal ligament and cementum formations at the defects, that is one of the most important healing outcomes during the process of periodontal regeneration. {yields} Epithelial downgrowth (undesirable wound healing) was decreased by administration of FGF-2. {yields} This manuscript indicates for the first time that concomitant use of FGF-2 and {beta}-TCP is efficacious in regenerating periodontal tissue following severe destruction of the tissue by progression of periodontitis. -- Abstract: The effects of concomitant use of fibroblast growth factor-2 (FGF-2) and beta-tricalcium phosphate ({beta}-TCP) on periodontal regeneration were investigated in the beagle dog 1-wall periodontal defect model. One-wall periodontal defects were created in the mesial portion of both sides of the mandibular first molars, and 0.3% FGF-2 plus {beta}-TCP or {beta}-TCP alone was administered. Radiographic evaluation was performed at 0, 3, and 6 weeks. At 6 weeks, the periodontium with the defect site was removed and histologically analyzed. Radiographic findings showed that co-administration of FGF-2 significantly increased bone mineral contents of the defect sites compared with {beta}-TCP alone. Histologic analysis revealed that the length of the regenerated periodontal ligament, the cementum, distance to the junctional epithelium, new bone height, and area of newly formed bone were significantly increased in the FGF-2 group. No abnormal inflammatory response or ankylosis was observed in either group. These findings indicate the efficacy of concomitant use of FGF-2 and {beta}-TCP as an osteoconductive material for periodontal

  7. Central role of pyrophosphate in acellular cementum formation.

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    Brian L Foster

    Full Text Available BACKGROUND: Inorganic pyrophosphate (PP(i is a physiologic inhibitor of hydroxyapatite mineral precipitation involved in regulating mineralized tissue development and pathologic calcification. Local levels of PP(i are controlled by antagonistic functions of factors that decrease PP(i and promote mineralization (tissue-nonspecific alkaline phosphatase, Alpl/TNAP, and those that increase local PP(i and restrict mineralization (progressive ankylosis protein, ANK; ectonucleotide pyrophosphatase phosphodiesterase-1, NPP1. The cementum enveloping the tooth root is essential for tooth function by providing attachment to the surrounding bone via the nonmineralized periodontal ligament. At present, the developmental regulation of cementum remains poorly understood, hampering efforts for regeneration. To elucidate the role of PP(i in cementum formation, we analyzed root development in knock-out ((-/- mice featuring PP(i dysregulation. RESULTS: Excess PP(i in the Alpl(-/- mouse inhibited cementum formation, causing root detachment consistent with premature tooth loss in the human condition hypophosphatasia, though cementoblast phenotype was unperturbed. Deficient PP(i in both Ank and Enpp1(-/- mice significantly increased cementum apposition and overall thickness more than 12-fold vs. controls, while dentin and cellular cementum were unaltered. Though PP(i regulators are widely expressed, cementoblasts selectively expressed greater ANK and NPP1 along the root surface, and dramatically increased ANK or NPP1 in models of reduced PP(i output, in compensatory fashion. In vitro mechanistic studies confirmed that under low PP(i mineralizing conditions, cementoblasts increased Ank (5-fold and Enpp1 (20-fold, while increasing PP(i inhibited mineralization and associated increases in Ank and Enpp1 mRNA. CONCLUSIONS: Results from these studies demonstrate a novel developmental regulation of acellular cementum, wherein cementoblasts tune cementogenesis by modulating

  8. JNK phosphorylation promotes degeneration of cervical endplate chondrocytes through down-regulation of the expression of ANK in humans

    Institute of Scientific and Technical Information of China (English)

    XU Hong-guang; SONG Jun-xing; CHENG Jia-feng; ZHANG Ping-Zhi; WANG Hong; LIU Ping; L(U) Kun

    2013-01-01

    Background C-Jun N-terminal kinase (JNK) signaling pathway and ankylosis gene (ANK) play a critical role in endplate chondrocytes degeneration.The purpose of this study was to investigate whether the expression levels of ANK was associated with the activation of JNK.Methods Cartilage endplates of 49 patients were divided into the control group (n=19) and the experimental group (n=30).The patients in the control group were graded 0 and those in the experimental group were graded Ⅰ-Ⅲ according to Miller's classification.Endplate chondrocytes were isolated by enzyme digestion and cultured in vitro.The inverted phase contrast microscope,teluidine blue staining,HE staining,real time RT-PCR,and MTT were used to observe morphological appearances,biological characteristics,and growth curve of endplate chondrocytes from the cartilage endplate of the two groups.Real time RT-PCR and Western blotting were used to analyze the mRNA and protein expression levels of associated factors in the degeneration process in the cultured endplate chondrocytes with or without subjected SP600125.Results The expression levels of type Ⅱ collagen,aggrecan,and ANK in endplate chondrocytes of experimental group were lower than that of control group and phosphorylation level of JNK in the experimental group which was higher than that in the control group.Application of JNK phosphorylation inhibitor to degeneration chondrocytes resulted in a marked decrease in the phosphorylation level of JNK and a significant increase in the expression levels of type Ⅱ collagen,aggrecan,and ANK.Conclusion The degeneration of the human cervical endplate chondrocytes might be promoted by JNK phosphorylation by down-regulating the expression of ANK

  9. Identification of the inorganic pyrophosphate metabolizing, ATP substituting pathway in mammalian spermatozoa.

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    Young-Joo Yi

    Full Text Available Inorganic pyrophosphate (PPi is generated by ATP hydrolysis in the cells and also present in extracellular matrix, cartilage and bodily fluids. Fueling an alternative pathway for energy production in cells, PPi is hydrolyzed by inorganic pyrophosphatase (PPA1 in a highly exergonic reaction that can under certain conditions substitute for ATP-derived energy. Recombinant PPA1 is used for energy-regeneration in the cell-free systems used to study the zymology of ATP-dependent ubiquitin-proteasome system, including the role of sperm-borne proteasomes in mammalian fertilization. Inspired by an observation of reduced in vitro fertilization (IVF rates in the presence of external, recombinant PPA1, this study reveals, for the first time, the presence of PPi, PPA1 and PPi transporter, progressive ankylosis protein ANKH in mammalian spermatozoa. Addition of PPi during porcine IVF increased fertilization rates significantly and in a dose-dependent manner. Fluorometric assay detected high levels of PPi in porcine seminal plasma, oviductal fluid and spermatozoa. Immunofluorescence detected PPA1 in the postacrosomal sheath (PAS and connecting piece of boar spermatozoa; ANKH was present in the sperm head PAS and equatorial segment. Both ANKH and PPA1 were also detected in human and mouse spermatozoa, and in porcine spermatids. Higher proteasomal-proteolytic activity, indispensable for fertilization, was measured in spermatozoa preserved with PPi. The identification of an alternative, PPi dependent pathway for ATP production in spermatozoa elevates our understanding of sperm physiology and sets the stage for the improvement of semen extenders, storage media and IVF media for animal biotechnology and human assisted reproductive therapies.

  10. Progress of Mesenchymal Stem Cells in Treating Rheumatoid Arthritis%间充质干细胞治疗类风湿性关节炎的进展

    Institute of Scientific and Technical Information of China (English)

    朱海杰

    2013-01-01

    Rheumatoid arthritis( RA ) is a chronic inflammatory autoimmune disease, and is usually accompanied by destruction of articular cartilage and subchondral bone,which leads to ankylosis,deformity and loss of function of joints.Mesenchymal stem cells( MSC ) have immunomodulatory properties and can differentiate into osteogenic and chondrogenic cells.Experiments on animal models and preliminary clinical researches indicated that MSCs not only can significantly reduce the incidence and severity of experimental arthritis after systemic infusion through their immunomodulatory properties, but also promote repair of os-teochondral lesions caused by RA.It is promising to treat RA using MSCs.%类风湿性关节炎(RA)是一种慢性炎症性自身免疫性疾病,可发生关节软骨及软骨下骨破坏,并导致关节强直畸形和功能丧失.间充质干细胞(MSC)具有免疫调节功能及向骨细胞与软骨细胞分化的能力.动物模型及初步临床研究表明,MSC不仅能够通过其免疫调节作用降低关节炎的发生率并减轻实验性关节炎的严重程度,亦能修复发生于RA的骨与软骨破坏,提示其用于治疗RA具有广阔的前景.

  11. It costs to be clean and fit: energetics of comfort behavior in breeding-fasting penguins.

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    Vincent A Viblanc

    Full Text Available BACKGROUND: Birds may allocate a significant part of time to comfort behavior (e.g., preening, stretching, shaking, etc. in order to eliminate parasites, maintain plumage integrity, and possibly reduce muscular ankylosis. Understanding the adaptive value of comfort behavior would benefit from knowledge on the energy costs animals are willing to pay to maintain it, particularly under situations of energy constraints, e.g., during fasting. We determined time and energy devoted to comfort activities in freely breeding king penguins (Aptenodytes patagonicus, seabirds known to fast for up to one month during incubation shifts ashore. METHODOLOGY/PRINCIPAL FINDINGS: A time budget was estimated from focal and scan sampling field observations and the energy cost of comfort activities was calculated from the associated increase in heart rate (HR during comfort episodes, using previously determined equations relating HR to energy expenditure. We show that incubating birds spent 22% of their daily time budget in comfort behavior (with no differences between day and night mainly devoted to preening (73% and head/body shaking (16%. During comfort behavior, energy expenditure averaged 1.24 times resting metabolic rate (RMR and the corresponding energy cost (i.e., energy expended in excess to RMR was 58 kJ/hr. Energy expenditure varied greatly among various types of comfort behavior, ranging from 1.03 (yawning to 1.78 (stretching times RMR. Comfort behavior contributed 8.8-9.3% to total daily energy expenditure and 69.4-73.5% to energy expended daily for activity. About half of this energy was expended caring for plumage. CONCLUSION/SIGNIFICANCE: This study is the first to estimate the contribution of comfort behavior to overall energy budget in a free-living animal. It shows that although breeding on a tight energy budget, king penguins devote a substantial amount of time and energy to comfort behavior. Such findings underline the importance of comfort

  12. Arthroscopic intervention in early hip disease.

    Science.gov (United States)

    McCarthy, Joseph C; Lee, Jo-Ann

    2004-12-01

    Advancement in diagnostic and therapeutic applications for hip arthroscopy have dispelled previous myths about early hip disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationship

  13. Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report

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    Luca Guarda-Nardini

    2014-04-01

    Full Text Available Background: The literature on total alloplastic temporomandibular joint (TMJ reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint prosthesis, which occurred several years after the implant. Methods: The present manuscript describes a case of heterotopic bone formation around a total TMJ prosthesis, which occurred several years after the implant in patients, who previously underwent multiple failed TMJ surgeries. Results: Ten years after the surgical TMJ replacement to solve an ankylotic bone block, the patient came to our attention again referring a progressive limitation in mouth opening. A computerized tomography showed evidence of marked heterotopic bone formation in the medial aspects of the joint, where a new-born ankylotic block occupied most part of the gap created by resecting the coronoid process at the time of the TMJ prosthesis insertion. Conclusions: Despite this adverse event has been sometimes described in the literature, this is the first case in which its occurrence happened several years after the temporomandibular joint replacement. It can be suggested that an accurate assessment of pre-operative risk factors for re-ankylosis (e.g., patients with multiple failed temporomandibular joint surgeries and within-intervention prevention (e.g., strategies to keep the bone interfaces around the implant separated should be better standardized and define in future studies.

  14. Replantation after extended dry storage of avulsed permanent incisors: report of a case.

    Science.gov (United States)

    Cobankara, Funda Kont; Ungor, Mete

    2007-08-01

    A 15-year-old boy lost his maxillary right and left central incisor teeth in a bicycle accident. He was referred to our clinic 1 week after the injury. The crown-root integrities of both the teeth were not damaged. Although the teeth were stored under dry conditions for 1 week, reimplantation of the teeth was planned to retain the teeth in the mouth for as long a period as possible because of the patient's age. Following the debridement and sterilization of root surfaces in 2.5% NaOCl, root canals were prepared and filled with calcium hydroxide. Then, about 2 mm of the apexes were resected to ensure that the roots easily seated in the alveolar socket and the prepared cavities in root ends were obturated with the amalgam. The teeth were placed into their respective sockets and splinted temporarily. The root canal therapy was completed 5 weeks later. Ankylosis was observed radiographically after 10 months. The patient is now 23 years old and he is still able to use both the central incisors functionally. However, there is a pink appearance on the cervical buccal surface of left central incisor because of progressive replacement resorption. In this case, the new treatment plan is to perform a permanent restoration with dental implants following the extraction of both teeth. Even though the long-term prognosis is uncertain, this treatment technique has provided an advantage for the patient in his adolescent period by maintaining the height of alveolar bone and making the provision of an aesthetically acceptable permanent restoration at a later age possible.

  15. Observation on the Therapeutic Effect of Shu Feng Huo Luo Pian for Treatment of Osseous Arthritis

    Institute of Scientific and Technical Information of China (English)

    吴晓松; 周毅

    2002-01-01

    Objective: To evaluate the therapeutic effect of Chinese patent drug Shu Feng Huo Luo Pian (疏风活络片 Pill for Dispelling Wind and Activating Collaterals) for the treatment of osseous arthritis. Method: 50 cases of osseous arthritis were divided randomly into two groups, the Shu Feng Huo Luo Pian group (the experimental group), including 30 cases (aged 63.5±4 years), treated with 2 such pills, po, bid; and the control group, including 19 cases (aged 63±5 years), treated with Sulindac 0.2g, po, bid. The two groups were all supplemented by medication of calcium Caltrate D 0.6g, po, qd. The above-mentioned medications were administered for 2 courses, 2 weeks constituting a course. Result: The total effective rate of the experimental group evaluated by the doctors was 83.3%, and that evaluated by the patients was 90%, with mild side effects. Conclusion: Shu Feng Huo Luo Pian is an effective Chinese patent drug for treating osseous arthritis, with less and mild side effects. Osseous arthritis is characterized mainly by chronic arthralgia, ankylosis, and arthroncus accompanied with dysfunction of the joint. It affects predominantly the movable joints of the human body, such as the joint of the hip, knee, ankle, elbow, and finger. It is a commonly seen disease, which mostly affects the life activities of the aged people. Its morbidity rises along with age. X-ray mass survey has shown that the morbidity of this disease among people aged 15-24 years is about 10%, while that among people aged 55 years is about 80%1. As China is entering an aged society, due attention should be paid to this kind of disease. This article offers a clinical observation on the therapeutic effect of Shu Feng Huo Luo Pian (疏风活络片 Pill for Dispelling Wind and Activating Collaterals) for 50 cases of osseous arthritis as reported below.

  16. The value of {sup 99m}Tc-HDP scan in the diagnosis of tibial avascular necrosis caused by thermal injury: a case with multi-image correlation analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee [Sung-Ae General Hospital, Seoul (Korea, Republic of)

    2007-10-15

    Basic pathology in thermal injury is coagulative soft tissue necorsis that may occasionally be complicated by infection and later by scarring and vascular changes. Radiological features were discussed in detail by Resnick. The early changes consist of soft tissue defect, porosis and periostitis and the late changes include osteophytosis, periarticular calcification or ossification and arthropathy with ankylosis. Acromutilation can occur when small bones of the hand and foot are burned and scarred. This communication describes {sup 99m}Tc-HDP pnhole bone scan manifestations of thermal bone injuries observed in a case of skin-bone burns of the mid-tibial shaft that was complicated by infection, soft tissue scarring and osteonecrosis. Patient was a 49-year-old female thermal burn involving a mid-tibial shaft segment along with overlying skin. The injury was accidental to medullary rimming to fit intramedullary nail to fix fracture. The heat produced during drilling spread to burn the pretibial skin that is sparse in subcutaneous buffer tissue and vessels. The soft tissue burn was infected and healed by repeated skin grafts and scar over a period of 2 years. Concomitantly, the underlying bone was infected locally and treated but ensued in osteonecrosis that was accompanied by osteolysis. Indeed. pinhole {sup 99m}Tc-HDP scan played a unique role in this case in detecting that live lateral cortex had sustained the large dead bone that involved the main volume of the mid-tibial shaft. Importantly, the scan could confirm live cortex to have sustained dead bone uncollapsed. Anatomical and metabolic data gained from bone scanning prompted us to systematically scrutinize radiograph and CT to specifically identify the preserved lateral cortex. As mentioned the existence of healthy cortex is biomechanically and tactically vital to surgically replace and restore the devitalized bone.

  17. Effects of concomitant use of fibroblast growth factor (FGF)-2 with beta-tricalcium phosphate (β-TCP) on the beagle dog 1-wall periodontal defect model

    International Nuclear Information System (INIS)

    Research highlights: → Concomitant use of FGF-2 and β-TCP (an osteo-conductive scaffold) significantly promotes periodontal regeneration in the severe periodontitis model (1-wall defect model) of beagle dog. → FGF-2 enhanced new bone formation via β-TCP at the defects. → In particular, FGF-2 dramatically regenerated new periodontal ligament and cementum formations at the defects, that is one of the most important healing outcomes during the process of periodontal regeneration. → Epithelial downgrowth (undesirable wound healing) was decreased by administration of FGF-2. → This manuscript indicates for the first time that concomitant use of FGF-2 and β-TCP is efficacious in regenerating periodontal tissue following severe destruction of the tissue by progression of periodontitis. -- Abstract: The effects of concomitant use of fibroblast growth factor-2 (FGF-2) and beta-tricalcium phosphate (β-TCP) on periodontal regeneration were investigated in the beagle dog 1-wall periodontal defect model. One-wall periodontal defects were created in the mesial portion of both sides of the mandibular first molars, and 0.3% FGF-2 plus β-TCP or β-TCP alone was administered. Radiographic evaluation was performed at 0, 3, and 6 weeks. At 6 weeks, the periodontium with the defect site was removed and histologically analyzed. Radiographic findings showed that co-administration of FGF-2 significantly increased bone mineral contents of the defect sites compared with β-TCP alone. Histologic analysis revealed that the length of the regenerated periodontal ligament, the cementum, distance to the junctional epithelium, new bone height, and area of newly formed bone were significantly increased in the FGF-2 group. No abnormal inflammatory response or ankylosis was observed in either group. These findings indicate the efficacy of concomitant use of FGF-2 and β-TCP as an osteoconductive material for periodontal regeneration following severe destruction by progressive

  18. Analysis of meniscal degeneration and meniscal gene expression

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    Norton James H

    2010-01-01

    Full Text Available Abstract Background Menisci play a vital role in load transmission, shock absorption and joint stability. There is increasing evidence suggesting that OA menisci may not merely be bystanders in the disease process of OA. This study sought: 1 to determine the prevalence of meniscal degeneration in OA patients, and 2 to examine gene expression in OA meniscal cells compared to normal meniscal cells. Methods Studies were approved by our human subjects Institutional Review Board. Menisci and articular cartilage were collected during joint replacement surgery for OA patients and lower limb amputation surgery for osteosarcoma patients (normal control specimens, and graded. Meniscal cells were prepared from these meniscal tissues and expanded in monolayer culture. Differential gene expression in OA meniscal cells and normal meniscal cells was examined using Affymetrix microarray and real time RT-PCR. Results The grades of meniscal degeneration correlated with the grades of articular cartilage degeneration (r = 0.672; P HLA-DPA1, integrin, beta 2 (ITGB2, ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1, ankylosis, progressive homolog (ANKH and fibroblast growth factor 7 (FGF7, were expressed at significantly higher levels in OA meniscal cells compared to normal meniscal cells. Importantly, many of the genes that have been shown to be differentially expressed in other OA cell types/tissues, including ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS5 and prostaglandin E synthase (PTGES, were found to be expressed at significantly higher levels in OA meniscal cells. This consistency suggests that many of the genes detected in our study are disease-specific. Conclusion Our findings suggest that OA is a whole joint disease. Meniscal cells may play an active role in the development of OA. Investigation of the gene expression profiles of OA meniscal cells may reveal new therapeutic targets for OA therapy and also may uncover novel

  19. Update on calcium pyrophosphate deposition.

    Science.gov (United States)

    Abhishek, Abhishek; Doherty, Michael

    2016-01-01

    Calcium pyrophosphate crystal deposition (CPPD) associates with ageing, osteoarthritis (OA), uncommon metabolic diseases, mutations and polymorphisms in the ankylosis human gene (ANKH). CPPD is frequently polyarticular, occurs due to a generalised articular predisposition, and the association between CPPD and OA is joint specific, for example CPPD associates with knee OA, but not with hip OA. Other recently identified associations include knee malalignment (knee CC), low cortical BMD and soft-tissue calcification. CPPD is generally asymptomatic. A recent study reported that knees with OA plus CC at the index joint, or at distant joints (in absence of index joint CC), were more likely to have attrition. CPPD can cause acute CPP crystal arthritis, chronic CPP crystal inflammatory arthritis, and is frequently present in joints with OA. Joint aspiration remains the gold standard for diagnosing CPPD, although other promising techniques are emerging. Patients with polyarticular or young onset CPPD should be screened for underlying metabolic abnormalities, however, such testing can be unrewarding. The treatment of CPPD is symptomatic. Acute CPP crystal arthritis is treated with rest, local application of ice-packs, joint aspiration, colchicine and/or intra-articular corticosteroid injection (once infection is excluded). Colchicine, low-dose corticosteroids, hydroxychloroquine and radiosynovectomy are recommended for the treatment of chronic or recurrent acute CPP crystal arthritis. Recent RCTs did not confirm any benefit from methotrexate, and although there is increasing interest in the use of anti-IL1 agents for acute or chronic CPP crystal arthritis, their efficacy has not been formally examined. Unlike gout, currently there are no treatments to eliminate CPP crystal deposits. PMID:27586801

  20. 单螺钉内固定法在髁突矢状骨折治疗中的应用%Clinical comparsion of single screw-fixation treatment and conservative treatment in sagittal fracture of the madibular condyle

    Institute of Scientific and Technical Information of China (English)

    李健; 张智星; 柳江太; 邓末宏; 龙星

    2014-01-01

    目的:探讨单螺钉内固定治疗下颌骨髁突矢状骨折的临床效果和应用价值。方法:对27例髁突矢状骨折病例进行回顾研究,根据治疗方式分为单螺钉内固定组和保守治疗组,比较术后3个月两组患者术后并发症、咬合关系、最大开口度、颞下颌关节功能障碍指数(DI)和肌肉压痛指数(PI)等情况,进行统计学分析。结果:单螺钉内固定组术后未出现关节区疼痛、张口受限和关节强直等严重并发症,DI和PI各指标均优于保守治疗组,两组的差异具有显著统计学意义。结论:单螺钉内固定手术方法是一种行之有效的髁突矢状骨折治疗手段,疗效确切。%Objective:To compare the effects of single screw-fixation treatment and conservative treatment in sagittal fracture of the madibular condyle(SFMC). Method:Patients with SFMC were single-screw fixation(SSF) group and the con-servative treatment (CON) group. Index,such as occlusion, maximum opening,and function of temporomandibular joint, were recorded and analyzed. Result:All patients in the SSF group had favorable results,including good occlusion,satisfying function and without serious complications or ankylosis,etc. Conclusion:Single screw-fixation surgery is an effective treat-ment used in sagittal fracture of the mandibular condyle.

  1. Autocrine stimulation of osteoblast activity by Wnt5a in response to TNF-α in human mesenchymal stem cells

    Energy Technology Data Exchange (ETDEWEB)

    Briolay, A. [ICBMS, UMR CNRS 5246, University of Lyon 1, Bâtiment Raulin, 43 Bd du 11 novembre 1918, 69622 Villeurbanne Cedex (France); Lencel, P. [Physiopathology of Inflammatory Bone Diseases, EA4490, ULCO. Quai Masset, Bassin Napoléon BP120, 62327 Boulogne/Mer (France); Bessueille, L. [ICBMS, UMR CNRS 5246, University of Lyon 1, Bâtiment Raulin, 43 Bd du 11 novembre 1918, 69622 Villeurbanne Cedex (France); Caverzasio, J. [Service of Bone Diseases, Department of Internal Medicine Specialties, University Hospital of Geneva, CH-1211 Geneva 14 (Switzerland); Buchet, R. [ICBMS, UMR CNRS 5246, University of Lyon 1, Bâtiment Raulin, 43 Bd du 11 novembre 1918, 69622 Villeurbanne Cedex (France); Magne, D., E-mail: david.magne@univ-lyon1.fr [ICBMS, UMR CNRS 5246, University of Lyon 1, Bâtiment Raulin, 43 Bd du 11 novembre 1918, 69622 Villeurbanne Cedex (France)

    2013-01-18

    Highlights: ► Ankylosing spondylitis (AS) leads to bone fusions and ankylosis. ► TNF-α stimulates osteoblasts through growth factors in AS. ► We compare the involvement of canonical vs non-canonical Wnt signaling. ► Canonical Wnt signaling is not involved in TNF-α effects in differentiating hMSCs. ► TNF-α stimulates osteoblasts through Wnt5a autocrine secretion in hMSCs. -- Abstract: Although anti-tumor necrosis factor (TNF)-α treatments efficiently block inflammation in ankylosing spondylitis (AS), they are inefficient to prevent excessive bone formation. In AS, ossification seems more prone to develop in sites where inflammation has resolved following anti-TNF therapy, suggesting that TNF-α indirectly stimulates ossification. In this context, our objectives were to determine and compare the involvement of Wnt proteins, which are potent growth factors of bone formation, in the effects of TNF-α on osteoblast function. In human mesenchymal stem cells (MSCs), TNF-α significantly increased the levels of Wnt10b and Wnt5a. Associated with this effect, TNF-α stimulated tissue-non specific alkaline phosphatase (TNAP) and mineralization. This effect was mimicked by activation of the canonical β-catenin pathway with either anti-Dkk1 antibodies, lithium chloride (LiCl) or SB216763. TNF-α reduced, and activation of β-catenin had little effect on expression of osteocalcin, a late marker of osteoblast differentiation. Surprisingly, TNF-α failed to stabilize β-catenin and Dkk1 did not inhibit TNF-α effects. In fact, Dkk1 expression was also enhanced in response to TNF-α, perhaps explaining why canonical signaling by Wnt10b was not activated by TNF-α. However, we found that Wnt5a also stimulated TNAP in MSCs cultured in osteogenic conditions, and increased the levels of inflammatory markers such as COX-2. Interestingly, treatment with anti-Wnt5a antibodies reduced endogenous TNAP expression and activity. Collectively, these data suggest that increased

  2. Diversas modalidades de intervención temprana de caninos ectópicos.

    Directory of Open Access Journals (Sweden)

    Carlos Astorga

    2012-07-01

    Full Text Available RESUMEN La impactación del canino permanente se encuentra a menudo en la práctica ortodóncica y su etiología se asocia a factores locales de espacio y genéticos. El no intervenir a tiempo trae como consecuencia la reabsorción de raíces de dientes vecinos, desarrollo de quistes, anquilosis y necesidad de tratamientos ortodóncicos complejos y costosos. El objetivo de esta revisión fue recoger las distintas modalidades publicadas en los últimos años para prevenir este fenómeno. Son cuatro las más importantes: Intervención solo basadas en extracciones, extracción de caninos temporales más contención (arco de tracción cervical, intervención activa en dentición mixta tardía, intervención activa en dentición mixta temprana. Estos distintos tipos de intervención muestran un mayor porcentaje de éxito eruptivo del canino permanente maxilar (80 - 97%. La extracción del canino temporal sigue siendo un método efectivo para evitar la impactación palatina del canino, cuya tasa de éxito se vería aumentada sí además se complementa con otro método interceptivo. Abstract: Maxillary canine impactation is often encountered in orthodontic clinical practice and the aetiology is associated to genetic factors as well as local space factors. If preventive treatment is not started in ectopic maxillary canines, some possible consequences may occur, such as resorption of the roots of the neighboring permanent teeth, cysts, ankylosis and expensive surgical and orthodontic treatment. The aim of this review was to preset several early treatment modalities for ectopic maxillary canines based on recent scientific evidence. Four are the most important: Only extractions intervention, extraction of deciduous canines with cervical pull headgear, active intervention in late mixed dentition and active intervention in early mixed dentition. These different modalities showed a greater increasing the rate of normal eruption of ectopic canines ( 80- 97

  3. ANKYLOSING SPONDYLITIS IN THE VOLGA BULGARIA

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    D. I. Abdulganieva

    2015-01-01

    Full Text Available There is much evidence that ankylosing spondylitis (AS is a disease that is also much older than early human civilizations and man as a whole. Until now, the Russia's earliest (14th c ntury archaeological finding of such a patient remains a Volga Bulgaria inhabitant suffering with AS during his life. In the Republic of Tatarstan, at the site of an ancient Bulgar settlement appearing in the early ninth century, archaeologists have discovered an unusual grave: the deceased sitting with his back against the western wall of a tomb pitand having a bronze crosslet under his fingers. According to a historical source, it was the way of burying Christian hierarchs as pastors sitting on the altar and anticipating the great assize during which the destinies of human souls should be ruled. Anthropological analysis showed that the bones belonged to a 35–45-year-old man who was 158–163 cm tall. During the examination of the remains,attention was called to the following features of the spinal structure: ankylosis of the inferior cervical and superior thoracic vertebrae (СV–ThI and inferior thoracic and lumbar spine (ThIV–LII predominantly due to ossification of the anterior longitudinal ligament. Facet vertebral joints and costotransverse joints were also ankylosed at the same levels. The man's neck was fixed in a bent-over position with the head down, the chin touching the breast bone – the socalled soliciting posture. By and large, the vertebral changes are characteristic of late (X-ray stage III spondylitis. Spinal and pelvic photos and X-films are given for demonstration. The studies conducted by historical scientists and forensic medical experts suggest that the found remains are most likely to belong to Christian Theodore nicknamed Jerusaleman, also further known as Holy Theodore philosopher Kamsky (Bulgarian, who was mentioned in the Nikon chronicle in 1323.

  4. OTOSCLEROSI S - AN EVALUATION OF CLINICAL AND AUDIOLOGIC FINDINGS; OUTCOME AND COMPLICATIONS OF SMALL FENESTRA STAPEDOTOMY

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2015-05-01

    Full Text Available INTRODUCTION: Otosclerosis is one of the commonest non infective causes of acquired deafness in adults’. ‘Otosclerosis’ literally means hardening of the ear. It is a primary and exclusive disease of otic capsule of human temporal bone. Otosclerosis is characterised by alternate phases of bone resorption and formation. If the location of bony changes produces evident clinical manifestations term “C linical Otosclerosis” is used. If bony changes are not translated into clinical manifestations, the term used is “histologica l Otosclerosis”. Antonio Valsalva in 1735 gave first description of ankylosis of stapes to margins of oval window. Von Troltsch in 1881 coined the term ‘Otosclerosis’. Politzer in 1893 first described Otosclerosis as a primary disease of otic capsule. Alth ough the clinical course of the disease is well documented, its aetiology remains unclear; thus, multiple theories are available. But none of them has established a definite cause. Otosclerosis usually manifests as a progressive conductive or mixed hearing loss occurring clinically to varying degrees in 0.5% - 1% of the general population. The clinical diagnosis of Otosclerosis, as clarified by Bezold in 1908, requires a careful history, physical examination, tuning fork evaluation and audiometric testing. Radiographic examinations can be done as adjuncts when needed. Therapeutic options for Otosclerosis include medical, surgical and use of hearing aids, alone or in combination. Stapes surgery is an effective treatment for hearing loss and tinnitus of Otoscl erosis and stapedectomy is the current treatment of choice for conductive component of Otosclerosis. The first stapes mobilization was employed by Kessel in 1878. The procedure of extracting the stapes for Otosclerosis was first performed by Jack of Boston in 1892 but was beset with obvious difficulties because he lacked proper magnification and antibiotic coverage. In 1956 Dr. John Shea revived the

  5. Higher bone turnover is related to spinal radiographic damage and low bone mineral density in ankylosing spondylitis patients with active disease: a cross-sectional analysis.

    Directory of Open Access Journals (Sweden)

    Suzanne Arends

    Full Text Available INTRODUCTION: Ankylosing spondylitis (AS is characterized by excessive bone formation and bone loss. Our aim was to investigate the association of bone turnover markers (BTM with spinal radiographic damage and bone mineral density (BMD in AS patients with active disease. METHODS: 201 consecutive AS outpatients of the Groningen Leeuwarden AS (GLAS cohort were included. Serum markers of bone resorption (C-telopeptides of type-I collagen, sCTX and bone formation (procollagen type-I N-terminal peptide, PINP; bone-specific alkaline phosphatase, BALP were measured. Z-scores were used to correct for the normal influence that age and gender have on bone turnover. Radiographs were scored by two independent readers according to modified Stoke AS Spinal Score (mSASSS. The presence of complete bridging (ankylosis of at least two vertebrae was considered as measure of more advanced radiographic damage. Low BMD was defined as lumbar spine and/or hip BMD Z-score ≤ -1. RESULTS: Of the 151 patients with complete data, 52 (34% had ≥ 1 complete bridge, 49 (33% had ≥ 1 syndesmophyte (non-bridging, and 50 (33% had no syndesmophytes. 66 (44% had low BMD. Patients with bridging had significantly higher sCTX and PINP Z-scores than patients without bridging (0.43 vs. -0.55 and 0.55 vs. 0.04, respectively. Patients with low BMD had significantly higher sCTX Z-score than patients with normal BMD (-0.08 vs. -0.61. After correcting for gender, symptom duration, and CRP, sCTX Z-score remained significantly related to the presence of low BMD alone (OR: 1.60, bridging alone (OR: 1.82, and bridging in combination with low BMD (OR: 2.26. CONCLUSIONS: This cross-sectional study in AS patients with active and relatively long-standing disease demonstrated that higher serum levels of sCTX, and to a lesser extent PINP, are associated with the presence of complete bridging. sCTX was also associated with low BMD. Longitudinal studies are needed to confirm that serum levels of s

  6. The Results of Fetal Chondrocytes Transplantation in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Natalya Krivoruchko

    2014-12-01

    .03. Furthermore, patients in the second group had 2.7 times higher risk of ankylosis compared to the first group. We did not observe any complications of fetal chondrocytes transplantation.Conclusions. Application of fetal chondrocytes therapy had the desired clinical effect, which was confirmed by reduction of the RA activity and decrease of cartilage and bone destruction. 

  7. Complications after tibia plateau fracture surgery%胫骨平台骨折术后并发症

    Institute of Scientific and Technical Information of China (English)

    卢志强; 杜胜利(通讯作者)

    2013-01-01

    High-energy tibial plateau fractures is often result of blunt trauma and is associated with severe soft-tissue injury. Fixation techniques demand considerable surgical skill and mature judgment. The available surgical options do not always guarantee a favourable outcome. Operative treatment includes internal and external fixation, hybrid fixation and arthroscopically assisted techniques. Operative management of high-energy fractures remains difficult and challenging and may be associated with serious complications, such as knee stiffness, ankylosis, deep infection, post-traumatic arthritis, malunion and nonunion. Prevention of the complications can optimise the clinical outcome in these patients. This paper is according to the fracture of tibial plateau postoperative complications do a system review.%  高强度的胫骨平台骨折往往是由于顿挫伤引起的,同时伴有严重的软组织的损伤。固定技术需要临床医师具备熟练的手术技巧和准确的判断力。有效的外科手术并不一定总能达到良好的临床效果。手术治疗的方法包括内固定、外固定、混合固定和关节镜辅助技术。有效的高强度骨折术后管理仍然是困难的,富有挑战性的,因为术后会伴有严重的并发症,例如:关节僵硬、关节强直、深部的感染、创伤性关节炎、骨的畸形愈合和骨不连。对这些高强度胫骨平台骨折的病人及早的预防并发症的出现能够优化临床治疗效果。本文就是针对胫骨平台骨折术后的并发症做一系统的综述。

  8. Al-Aqeel Sewairi Syndrome, a new autosomal recessive disorder with multicentric osteolysis, nodulosis and arthropathy. The first genetic defect of matrix metalloproteinase 2 gene

    International Nuclear Information System (INIS)

    We report a distinctive autosomal recessive multicentric osteolysis in Saudi Arabian families with distal arthropathy of the metacarpal, metatarsal and interphalangeal joints, with ultimate progression to the proximal joints with decreased range of movements and deformities with ankylosis and generalized osteopenia. In addition, they had large, painful to touch palmar and plantar pads. Hirsutism and mild dysmorphic facial features including proptosis, a narrow nasal bridge, bulbous nose and micrognathia. Using a genome-wide search for microsatellite markers from 11 members of the family from the Armed Forces Hospital and King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia, localized the disease gene to chromosome 16q12-21. Haplotype analysis with additional markers narrowed the critical region to 1.2cM and identified the matrix metalloproteinase 2 (MMP-2), (gelatinase A, collagenase type IV, EC 3.4, 24,24) gene as a disease candidate at Mount Sinai School of Medicine, New York, United States of America in April 2000. Some affected individuals were homoallelic for a nonsense mutation (TCA>TAA) in codon 244 of exon 5, predicting the replacement of a tyrosine residue by a stop codon in the first fibronectin type II domain (Y244X). Other affected members had a missense mutation in exon 2 arginine 101-histidine (R101H) leading to no MMP-2 enzyme activity in serum or fibroblast or both of affected individuals. In other affected members, a non-pathogenic homoallelic GT transversion resulted in the substitution of an aspartate with a tyrosine residue in codon 210 of exon 4 (D210Y). The MMP-2-null mouse has no developmental defects, but are small, which may reflect genetic redundancy. The discovery that deficiency of this well-characterized gelatinase/collagenase results in an inherited form of an osteolytic and arthritic disorder provides an invaluable insights for the understanding of osteolysis and arthritis and is the first genetic

  9. Clinical effects of total knee arthroplasty in the treatment of ankylosed knee%全膝关节置换术治疗膝关节强直的临床研究

    Institute of Scientific and Technical Information of China (English)

    冷重光; 李忠强; 陈崇民; 刘灿祥; 赵江涛; 范树枫; 张红娜; 常鸣

    2008-01-01

    Objective To investigate the clinical effects of total knee arthroplasty in treatment ofankylosed knee caused by various reasons. Methods Four patients with 7 ankylosed knees, caused byankylosing spondylitis in 1 case, septic arthritis with bony ankylosis in 1 case, and rheumatoid arthritis in 2cases, underwent artificial knee replacement. Before the operation joint activity was 0°, Knee Society score(KSS) was 42 (11 - 63), and the function score was 17. Follow-up was conducted for 5 - 27months. Results Follow-up showed that the average joint activity was raised to 83° (60° - 110°) ,KSSscore to 83 (64 -91) points,and function score to 77 points. No infectious case was found. Conclusion Totalknee arthroplasty has a satisfactory effect in treatment of ankylosed knee. Computer assisted navigationsystem is helpful in femoro-tibial osteotomy and soft tissue balance. Individualized and directed rehabilitationis a pivotal factor.%目的 探讨各种原因引起膝关节强直采用人工全膝关节置换治疗的手术技巧和临床效果.方法 2005年2月至2007年3月对4例(7膝)膝关节强直的患者施行人工膝关节置换术,其中1例化脓性关节炎骨性强直,2例类风湿性关节炎,1例强直性脊柱炎.术前记录关节活动度均为0°,KSS评分平均为42分(11~63分),功能评分平均17分(0~45分).结果 术后随访5~27个月,术后平均活动度83°(60°~110°),KSS评分平均为83分(64~91分)功能评分平均77分(60~90分),感染例数为0.结论 人工全膝关节置换手术治疗膝关节强直近期随访取得满意疗效,计算机导航辅助下进行股骨胫骨的截骨和软组织松解平衡,术后个体化功能康复训练是关键因素.

  10. A PROSPECTIVE STUDY TO ASSESS EFFICACY OF DIRECTLY OBSERVED TREATMENT SHORT - COURSE INTERMITTENT REGIME IN DIFFERENT STAGES OF SPINAL TUBERCULOSIS

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    Manoj Kumar

    2015-02-01

    Full Text Available STUDY DESIGN: A Prospective non - randomised study . INTRODUCTION: Management of Tuberculosis spine still possesses many challenges. Availability of anti - tubercular drugs has changed the outcome. However, present recommendation by the WHO of Directly Observed Treatment Short - course (DOTS has sound scientific basis, but the optimum duration is still controversial. We conducted a prospective study on a consecutive series of patients with spinal tuberculosis treated with Category I Revised National Tuberculosis Control Programme (RNTCP regime based on DOTS strategy from June 2012 to Sep 2014 to evaluate the efficacy and come to conclusion regarding optimum duration of treatment. MATERIALS AND METHODS: A prospective study of 30 consecutive patients of spinal tuberculosis treated with Category I RNTCP based on DOTS strategy. All the patients were followed for minimum of 2 year. Surgical intervention was done in patients presenting with significant neurological deficits. Patients diagnosed clinicoradiologically and histopathologically (n=3 were enrolled in the study. Outcome was graded into excelle nt, good, fair and poor based on clinical, laboratory including return of ESR to normal and correction of lymphocytosis and radiological outcome showing - return to normal bone density and sclerosis, bony ankylosis and disappearance of marrow edema on MRI. RESULTS: In 30 cases, 63.4% (n=19 were males and 36.7% (n=11 were females. 10% (n=3 were with pre - destructive lesion, 53.3% (n=16 were in the early destructive phase, 30% (n=9 with mild angular kyphosis and 6.67% (n=2 with moderate angular kyphosis. Outcome of our study were excellent in 46.67% (n=14, good in 36.67% (n=11, fair in 10% (n=3 and poor in 6.67% (n=2. Duration to cure spinal TB 6 months 30% (n=9, 9 months 56.67% (n=17 and 12months 13.33% (n=4. CONCLUSIONS: Outcome of our study were excellent in 46.67% (n=14, good in 36.67% (n=11, fair in 10% (n=3 and poor in 6.67% (n=2. The duration of

  11. Gömülü süt ikinci azı dişine bağlı olarak meydana gelen perikoronitis vakası

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    Fatih Sari

    2011-10-01

    Full Text Available

    Primary tooth impaction has been reported to be very rare and studies report prevalence rates of impaction to be form 1:10.000. Primary tooth impactions can occur because of various reasons, including ankylosis, congenitally missing permanent teeth, defects in periodontal membrane, trauma, injury of the periodontal ligament, precocious eruption of the first permanent molar, defective eruptive force, or a combination of these factors. In this article we present a case of impacted mandibular second deciduous molar tooth with pericoronitis and discuss the etiology and its management by surgical intervention in an 8 year old girl.

     

    ÖZET

    Gömülü süt dişlerine ait çok az sayıda rapor vardır ve bu çalışmalarda süt dişlerinin gömülü kalma insidansı 10.000’de 1 olarak belirtilmiştir. Çeşitli nedenler süt dişlerinin gömülü kalmasına neden olabilmektedir. Bunlar; ankiloz, konjenital olarak daimi diş eksikliği, periodontal membranda defekt, travma, periodontal ligamentte yaralanma, erken süren daimi birinci molar, hatalı sürme kuvvetleri ya da bu faktörlerin kombinasyonlarıdır. Bu raporda 8 yaşındaki bir kız çocuğunun gömülü süt alt ikinci azı dişine bağlı olarak gelişen perikoronitis vakası sunulmuş, etyolojik faktörler ve cerrahi tedavi seçeneği tartışılmıştır.

    Anahtar Kelimeler: Gömülü süt dişi, perikoronitis, ankiloz

  12. Diversas modalidades de intervención temprana de caninos ectópicos.

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    Carlos Astorga

    2012-12-01

    Full Text Available RESUMEN La impactación del canino permanente se encuentra a menudo en la práctica ortodóncica y su etiología se asocia a factores locales de espacio y genéticos. El no intervenir a tiempo trae como consecuencia la reabsorción de raíces de dientes vecinos, desarrollo de quistes, anquilosis y necesidad de tratamientos ortodóncicos complejos y costosos. El objetivo de esta revisión fue recoger las distintas modalidades publicadas en los últimos años para prevenir este fenómeno. Son cuatro las más importantes: Intervención solo basadas en extracciones, extracción de caninos temporales más contención (arco de tracción cervical, intervención activa en dentición mixta tardía, intervención activa en dentición mixta temprana. Estos distintos tipos de intervención muestran un mayor porcentaje de éxito eruptivo del canino permanente maxilar (80 - 97%. La extracción del canino temporal sigue siendo un método efectivo para evitar la impactación palatina del canino, cuya tasa de éxito se vería aumentada sí además se complementa con otro método interceptivo . ABSTRACT Maxillary canine impactation is often encountered in orthodontic clinical practice and the aetiology is associated to genetic factors as well as local space factors. If preventive treatment is not started in ectopic maxillary canines, some possible consequences may occur, such as resorption of the roots of the neighboring permanent teeth, cysts, ankylosis and expensive surgical and orthodontic treatment. The aim of this review was to preset several early treatment modalities for ectopic maxillary canines based on recent scientific evidence. Four are the most important: Only extractions intervention, extraction of deciduous canines with cervical pull headgear, active intervention in late mixed dentition and active intervention in early mixed dentition. These different modalities showed a greater increasing the rate of normal eruption of ectopic canines ( 80- 97

  13. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

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    A. D. Kaprin

    2015-01-01

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  14. Surgical outcome after spinal fractures in patients with ankylosing spondylitis

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    Brilakis Emmanuel

    2009-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a rheumatic disease in which spinal and sacroiliac joints are mainly affected. There is a gradual bone formation in the spinal ligaments and ankylosis of the spinal diarthroses which lead to stiffness of the spine. The diffuse paraspinal ossification and inflammatory osteitis of advanced Ankylosing spondylitis creates a fused, brittle spine that is susceptible to fracture. The aim of this study is to present the surgical experience of spinal fractures occurring in patients suffering from ankylosing spondylitis and to highlight the difficulties that exist as far as both diagnosis and surgical management are concerned. Methods Twenty patients suffering from ankylosing spondylitis were operated due to a spinal fracture. The fracture was located at the cervical spine in 7 cases, at the thoracic spine in 9, at the thoracolumbar junction in 3 and at the lumbar spine in one case. Neurological defects were revealed in 10 patients. In four of them, neurological signs were progressively developed after a time period of 4 to 15 days. The initial radiological study was negative for a spinal fracture in twelve patients. Every patient was assessed at the time of admission and daily until the day of surgery, then postoperatively upon discharge. Results Combined anterior and posterior approaches were performed in three patients with only posterior approaches performed on the rest. Spinal fusion was seen in 100% of the cases. No intra-operative complications occurred. There was one case in which superficial wound inflammation occurred. Loosening of posterior screws without loss of stability appeared in two patients with cervical injuries. Frankel neurological classification was used in order to evaluate the neurological status of the patients. There was statistically significant improvement of Frankel neurological classification between the preoperative and postoperative evaluation. 35% of patients showed improvement

  15. 微型钛板植入体可坚强内固定修复下颌骨骨折%Mini-titanium plate implant can enhance internal fixation for mandibular fracture

    Institute of Scientific and Technical Information of China (English)

    姚红磊; 纳应坤; 陈涌; 刘华

    2012-01-01

    背景:下颌骨折越来越多的采用口内切开小型钛板张力带内固定治疗,那么微小型钛板在颌骨骨折中起怎样的作用?目的:评价下颌骨骨折骨缺损重建微型钛板坚固内固定的重要性.方法:以 "钛板,下颌骨,骨折,坚固内固定"为关键词.采用计算机检索1995-01/2011-10 PubMed数据库,维普数据库有关坚固内固定技术在下颌骨骨折中的临床应用的文章.排除重复研究,以20篇为重点进行探讨.结果与结论:采用钛板在下颌角上缘张力带内固定辅以颌间固定治疗下颌角骨折,临床操作简单,易掌握,缩短颌间固定的时间,固定稳固性有了可靠的保证,创伤较小,患者能早期张口训练,避免关节强直.有利于内固定后骨折愈合及恢复正常咬合关系.%BACKGROUND: Intraoral incision and mini-plate fixation as tension band have been used to treat for mandibular fracture. The effect of mini-plate has not been fully investigated. OBJECTIVE: To assess the importance of mini-plate fixation during bone defect reconstruction following mandibular fracture. METHODS: With “titanium plate, mandible, fracture, and rigid internal fixation” as key words, a computer-based online search of PubMed and VIP database was performed for articles published between January 1995 and October 2011 related to clinical application of rigid internal fixation in mandibular fracture. Repetitive articles were excluded, and 20 were included and further discussed. RESULTS AND CONCLUSION: Titanium plate has been used as tension band in the superior margin of the mandibular angle, assisted with intermaxillary fixation to treat mandibular angle fracture. This method is simple, convenient, and can shorten duration for intermaxillary fixation, ensuring stability of the fixation. In addition, the incision is minimal, allowing early mouth open training and preventing ankylosis. This method benefits fracture healing and recovery of normal occluding relation

  16. Kaks luustikku Tartu toomkirikust: arheoloogia ja osteoloogia andmed / Two skeletons from the Tartu Cathedral Cemetery: archaeological and osteological data

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    Martin Malve

    2011-01-01

    from slight forms of various spinal diseases, which include Schmorl’s nodes, spondyloarthrosis, and spondylosis. The fourth and fifth cervical vertebrae had ankylosis, the cause of which is unknown. Signs of osteoartrosis, a joint disease, were also noticed. Traumas recorded in the skeleton include a healed fracture of a rib and vertebral compression. The man’s head was decapitated with a sharp blade between the sixth and seventh cervical vertebrae (fig. 7.

  17. Reconstrucción de la articulación temporomandibular postraumática con prótesis a medida: Planificación quirúrgica virtual Post-traumatic reconstruction with custom prosthesis of the temporomandibular joint: Computerized surgical planning

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    Aitor García Sánchez

    2011-06-01

    surgical execution of three cases of bilateral articular ankylosis (6 joints is presented with simulation of osteotomies, maxillomandibular movements and custom total alloplastic prosthesis design for the temporomandibular joint. Conclusions: A comprehensive approach to articular biomechanics, intermaxillary relations and dental occlusion is necessary to obtain predictable and satisfactory results. Computer modeling and the use of custom alloplastic devices allows exact, safe total articular reconstruction.

  18. Hemophilic arthropathy. A scoring system for magnetic resonance imaging

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    Soler, R.; Rodriguez, E.; Marini, M. [Department of Radiology, Hospital Juan Canalejo, Coruna (Spain); Lopez-Fernandez, F. [Department of Hematology, Hospital Juan Canalejo, Coruna (Spain)

    2002-04-01

    The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

  19. Application of Exercise Therapy in Ankylosing Spondylitis (review)%运动疗法在强直性脊柱炎治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    周亚美; 茹晋丽; 赵华明

    2013-01-01

    Ankylosing spondylitis (AS) is a systemic disease, which mainly causes to axial joint chronic inflammation. Spine, thoracic and peripheral joints may have varying degrees of activity limitation, and somatic activity is also likely to decline. Ankylosis of the spine and movement disorder of hip are the mainly causes of AS patients' disability, which not only affect the patients' motor function, and but al-so affect their social interaction, role affordability, mental state and daily living skills. Exercise therapy is the treatment unarmed or with equipment, for injuries, disease, residual patients, to restore or improve dysfunction. There are a number of studies about exercise therapy for joint function of patients with AS, confirmed that exercise therapy plays a crucial role in the treatment of AS patients, on the basis of the medications control.%强直性脊柱炎(AS)是以中轴关节慢性炎症为主的全身性疾病,脊柱、胸廓及外周关节可有不同程度的活动受限,躯体活动能力亦可能下降。而脊柱的骨性强直和髋关节的活动障碍是AS患者致残的主要原因,不仅影响患者的运动功能,而且影响患者的社会交往能力、角色承担能力、心理状态和日常生活能力等。运动疗法是以徒手及应用器械进行运动训练来治疗伤、病、残患者,恢复或改善功能障碍的方法。已有多项运动疗法对AS患者关节功能影响的研究证实,在药物治疗控制病情的基础上,运动疗法在AS患者的治疗中起到至关重要的作用。

  20. Psoriatic arthritis: immunologic mechanisms and biological therapy%银屑病性关节炎免疫机制及生物制剂治疗的进展

    Institute of Scientific and Technical Information of China (English)

    赵伟; 龚瑜; 史玉玲

    2015-01-01

    银屑病性关节炎是一种与银屑病相关的炎症性关节病,病程迁延反复,晚期可致关节强直甚至致残,严重影响患者的生活质量.因此,早期诊断,早期干预以及制定有效的治疗方案改善患者的关节症状,缓解其心身的双重压力是银屑病性关节炎面临的挑战.银屑病性关节炎的发病机制十分复杂,有多种免疫细胞和免疫分子参与,异常T细胞的活化、增殖、分化是发病的主要原因.此外,肿瘤坏死因子α和白细胞介素12、23、17等为主要的炎症介质靶点.针对发病机制中不同炎症因子的靶向治疗药物,为银屑病性关节炎的治疗带来了革命性的变化.目前,一些新型的生物靶向药物正在研究中,有希望成为银屑病性关节炎患者未来治疗的新选择.%Psoriatic arthritis (PsA),a psoriasis-associated inflammatory arthropathy with a chronic and recurrent clinical course,may lead to ankylosis and even disability at late stage,and seriously affects the quality of life in patients.It remains a challenge to improve joint symptoms and relieve physical and mental stress by early diagnosis,early intervention and effective therapeutic strategies.The pathogenesis of PsA is very complicated with the involvement of various immunocytes and immune molecules,in which the abnormal activation,proliferation and differentiation of T-lymphocytes may play a key role.Additionally,tumor necrosis factor alpha (TNF-α),interleukin 12 (IL-12),IL-23 and IL-17 are the main targets for inflammatory mediators.Aiming directly at different inflammatory cytokines in the pathogenesis of PsA,targeted drugs have brought revolutionary changes for the treatment of PsA.At present,some novel targeted biological drugs are under investigation,and may bring novel choices for the treatment of PsA.

  1. The posttraumatic proximal cross-union of the forearm in childhood: what is recommended?

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    Marcel Dudda

    2013-06-01

    Full Text Available The posttraumatic proximal cross-union of the forearm in childhood is a rare complication after radial head, neck or proximal forearm fractures and elbow dislocations. There is no standardized treatment. Several surgical procedures with or without interposition techniques are described in the literature. The aim of this study was to analyze all children with cross-unions who underwent surgery over the last 15 years. From 1998 to 2013, 8 children with a posttraumatic proximal cross-union of the forearm (Type 3 according to Vince and Miller received surgical treatment with resection of the cross-union or radial head. Mean age at the time of initial trauma was 9.0±2.56 years (range 6-14 years, age at the time of surgery was 11.9±3.09 years (range 7-16 years. Mean time of resection of the cross-union was 23.2 months. Follow-up time was 10.6 months (range 1-36 months. Five patients had a resection of the cross-union without any interposition techniques, in 2 cases with an additional arthrolysis of the elbow. One patient had an interposition of a local fascia flap. In 2 cases, a primary excision of the radial head, six and seven years, respectively, after trauma, was performed. All patients, except one, had non-steroidal anti-inflammatory drugs therapy after surgery. A post-operative irradiation was performed in 3 cases. The mean postoperative range of motion for pronation/supination was 36/0/53°. Controversy remains about the best procedure to adopt for posttraumatic cross-union in childhood. After analysis of our data and the literature, we recommend the resection of the cross-union within 6-24 months of occurrence without necessarily using any interposition techniques. All patients reported an improvement with regard to ordinary activities. In cases of long-term cross-union for several years with ankylosis of the elbow and bony deformities of the proximal radius, an excision of the radial head as salvage procedure is recommended.

  2. Complex Fractures of the Facial Skeleton%颌面部多发骨折临床特点的探讨

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    管仪芳

    2013-01-01

    were single linear fracture,102 cases were multiple linear,46 cases were comminuted fractures.Among them,38 cases were associated with maxillary fracture,12 cases with zygoma fracture,13 cases with fracture of the nasal bone,48 cases with fractures of tympanic plate,10 cases with condylar fracture and retrodisplacement.There was significant difference between incidence of sagittal fracture of the condyle accompanying with anterior wall fracture of external auditory canal and that of other types (P<0.01),there was significant difference between incidence of mentum and condyle sagittal fracture accompanying with anterior wall fracture of external auditory canal and that of fracture of mentum or condylar process (P<0.01).3 cases complicated with obstruction of external auditory canal.2 cases resulted in ankylosis of the temporomandibular joint,3 cases occurred dislocation of temporomandibular joint.Conclusion:The mandibular fractures manifested as single linear fracture,multiple fracture and comminuted fracture,in association with fractures of other facial skeletons.The proportion of mandibular mentum and condyle sagittal fracture accompanying with fractures of anterior wall of external auditory canal was significantly increased.Attention should be paid on the prevention of complications as stenosis of external auditory canal,ankylosis and posterior dislocation of the temporomandibular joint.

  3. Animal experimental study on the role of the lateral pterygoid muscles in healing process of the sagittal fracture of mandibular condyles%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建影响的动物实验研究

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    刘昌奎; 胡开进; 刘平; 邓天阁; 江欣; 程鹏

    2012-01-01

    目的 观察翼外肌在髁突矢状骨折愈合过程中对髁突形态的改建是否有影响以及是否会进一步导致关节强直的发生.方法 将12只健康成年绵羊随机分为2组,均以右侧颞下颌关节作为手术实验侧,人为手术造成髁突矢状骨折.一组保留翼外肌在髁突内极的附丽,行使其功能,另一组切断翼外肌在髁突内极的附丽,阻断其功能,术后即刻行MRI检查,确定翼外肌是否离断.术后1周对动物模型行CT三维检查,测量髁突骨折块的移位距离及髁突内外径的改变,术后4周、12周及24周时处死动物,再次行CT检查,多平面重建后对髁突形态相关参数测量,以观察髁突的形态变化.结果 通过CT三维测量,两组髁突内外径的改变有明显的差异(P<0.05),证实翼外肌对髁突游离骨折端有牵拉作用,保留翼外肌功能组,对髁突矢状骨折后髁突形态的影响更明显.结论 此动物模型的建立,证实翼外肌对髁突矢状骨折后髁突形态改建的确有影响,为进一步研究“翼外肌牵张成骨在创伤性颞下颌关节强直发生中的作用研究”提供研究平台.%Objective To examine whether they may further cause joint ankylosis lateral pterygoid muscles influence the condyle morphology in the healing process of sagittal fracture of mandibular condyles ( SFMC ) . Methods Twelve healthy adult sheep were included in our study, and all the animals were treated with surgery to make the condyles fracture on the right side of the temporomandibu-lar joint. The animals were randomly divided into two groups: the pterygoids of sheep in one group were cut and not able to function. The others in the other group were not cut. They were still on the internal poles of the fractured condyles and their functions remained. We immediately examined whether the pterygoid muscles were cut ( or not) by MRI after the operation. 3D computed tomograms ( CT) were taken 1,4,12 and 24 weeks after the operation

  4. Reimplante intencional en diente geminado con lesión endoperio tipo IV: Reporte de caso Intentional replantation gemina injured in tooth type IV endoperio: Case report

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    R.S. Rodríguez Rodríguez

    2012-10-01

    , persistent fistula, large periapical lesions, periodontal pocket, root anatomy of the tooth organ palate (palatine canal alleged and that the anatomy tooth is favorable to perform the procedure. The extraction and intentional replantation is the treatment in cases where the endodontic treatment fails and the anomaly dental periapical surgery also fail because only temporarily remove the lesion but not the cause it is the communication between the oral cavity and apical area. However, it is known that this treatment option can have risks and benefits, including tooth loss or possible ankylosis and with a success rate of 42.9%. The present case report describes the extraction and intentional replantation geminate tooth with a persistent periapical lesion of periodontal origin, with symptoms and fistula, after endodontic treatment complex, its evolution and success.

  5. Magnetic resonance imaging for ankylosing spondylitis; Magnetresonanztomographie bei ankylosierender Spondylitis (Morbus Struempell-Marie-Bechterew)

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    Bollow, M. [Augusta-Kranken-Anstalt, Inst. fuer Radiologie, Bochum (Germany)

    2002-12-01

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German

  6. 交锁髓内钉固定治疗胫骨干骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵英杰; 张如国

    2013-01-01

    目的:探讨交锁髓内钉治疗胫骨干骨折的适应症及优点。方法:回顾性分析笔者所在医院2008年以来应用交锁髓内钉固定治疗60例胫骨干骨折患者,其中开放性骨折18例(GustiloⅠ度10例,Ⅱ度8例),闭合性骨折42例,采用Johner-wruh 评分评价其治疗效果。结果:术后所有患者均获得随访,骨折均获愈合,无断钉,无伤口感染和骨髓炎发生、未发生脂肪栓塞综合征、骨筋膜间室综合征、关节僵硬等并发症。本组病例平均愈合时间为6个月,根据Johner-wruh 评分:优50例,良7例,差3例,优良率95%。结论:交锁髓内钉内固定治疗胫骨干骨折有术式简单、手术损伤小、固定可靠、可早期功能锻炼、骨折愈合率高、并发症少等优点,可作为治疗胫骨干骨折较理想的固定方式。%Objective Explore into interlocking intramedullary nails in the treatment of tibial fracture dry indications and advantages. Methods The writer's hospital were retrospectively analyzed since 2008 in application of interlocking intramedullary nail fixed treatment sixty cases of tibial fractures were treated with dry, including open fractures and cases (Gustilo degrees of 10 cases, 8 cases), closed fracture 42 patients, the Johner - wruh score evaluate its therapeutic effect. Results All the patients were followed up for postoperative, fracture have been healing, no broken nail, no wound infection and osteomyelitis happen not happen fat embolism syndrome bone fascia compartment syndrome ankylosis complications, such as the average healing time, all the cases for 6 months, according to Johner-wruh rating:optimal fifty cases, good in 7 cases, difference in 3, was 95%. Conclusion Pay interlocking intramedullary nails in the treatment of tibial fractures fixed do a simple surgical operation injury small fixed reliable early functional exercise can fracture healing rate less complications advantages, such as a treatment for tibial

  7. Progress of temporomandibular joint prosthesis%人工颞下颌关节的研究进展

    Institute of Scientific and Technical Information of China (English)

    孙荃; 李恺得; 刘磊

    2014-01-01

    颞下颌关节结构和功能的复杂性使得其重建成为外科医生所面临的最大挑战之一。人工颞下颌关节是颞下颌关节重建的重要方式之一,主要适用于颞下颌关节强直、无法复位固定的髁突粉碎性骨折、颞下颌关节肿瘤、晚期关节内紊乱及一些先天性颅面综合征等所致的颞下颌关节发育不良等。人工颞下颌关节旨在改善颞下颌关节的功能、减少疼痛并防止严重的并发症。在口腔颌面外科,人工颞下颌关节具有能模仿正常的解剖形态、与宿主贴合、不需另行取材、术后能立即进行功能训练等优点。假体材料在人工颞下颌关节的发展中起着至关重要的作用,优良的设计、牢靠的固定都是人工颞下颌关节能够行使其功能必不可少的条件,当然关节生物力学的研究也是必不可少的。随着材料学、关节生物力学及制作工艺等相关学科的飞速发展,人工颞下颌关节在关节假体的植入材料、假体的设计等方面取得了不少进展。随着人工颞下颌关节的发展,其应用也越来越广泛。本文对人工颞下颌关节的发展及其临床应用作一综述。%The anatomically and functionally complex nature of the temporomandibular joint (TMJ) makes its reconstruction one of the most challenging tasks faced by surgeons who operate in the head and neck. TMJ prosthesis is one of the important techniques in the reconstruction of TMJ. The main indications for TMJ prosthesis include ankylosis, fractures of condylar that can’t be fixed, trauma or tumor, end-stage TMJ disturbance, and TMJ dysplasia caused by Hallermann-Streiff syndrome. TMJ replacement aims to enhance the function of TMJ, alleviate pain, and prevent serious complications. TMJ prosthesis is advantageous in oral and maxillofacial surgery because it can imitate normal anatomic morphology and adhere to the host. Moreover, the use of other materials is no longer

  8. Stability of dual-incision double-plate fixation versus locking plate fixation for tibial plateau fracture%双切口双钢板及锁定钢板内固定修复胫骨平台骨折的稳定性比较

    Institute of Scientific and Technical Information of China (English)

    李世芳; 孙健; 周道政

    2014-01-01

    背景:Schazker Ⅴ、Ⅵ型骨折常造成交叉韧带、侧副韧带及半月板等部位的损伤,且塌陷移位严重,若仅采用一侧锁定钢板,则较难支撑及满意复位。目的:比较双切口双钢板内固定与膝前正中切口锁定钢板内固定修复Schatzker Ⅴ、Ⅵ型胫骨平台骨折后的效果及稳定性评价。方法:纳入76例Schazker Ⅴ、Ⅵ型胫骨平台骨折患者,分别采用锁定钢板内固定(n=38)和双切口双钢板内固定(n=38)进行治疗,通过X射线正、侧位片评估骨折复位及愈合情况,并对胫骨平台内翻角、胫骨平台内侧后倾角进行生物力学测试。结果与结论:双切口双钢板内固定组住院时间、内固定后开始负重时间显著少于锁定钢板内固定组(P0.05);关节强直、骨折延迟愈合、针道感染、骨折延迟愈合、膝内翻畸形多项并发症比较,双切口双钢板内固定组显著少于锁定钢板内固定组,差异均有显著性意义(P 0.05);双切口双钢板内固定组内固定后Rasmussen分级明显优于锁定钢板内固定组,差异均有显著性意义(P0.05). The number of complications, such as ankylosis, fracture delayed union, pin tract infection, delayed union, varus deformity, was significantly fewer in the dual-incision double-plate fixation group than in the locking plate fixation group (P0.05). Postoperative Rasmussen classification was significantly better in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). Experimental results indicated that the clinical efficacy of the dual-incision double-plate fixation is superior to that of the anterior cruciate midline incision locking plate fixation in the treatment of Schatzker V, VI type tibial plateau fractures. The dual-incision double-plate fixation has more biomechanical stability.

  9. HIPEROSTOSIS ESQUELÉTICA DIFUSA IDIOPÁTICA EN UNA COLECCIÓN OSTEOLÓGICA CONTEMPORÁNEA (LA PLATA, BUENOS AIRES, ARGENTINA / Difusse Idiopathic Skeletal Hyperostosis in a contemporary osteological collection (La Plata, Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Marcos Plischuk

    2015-06-01

    Full Text Available La Hiperostosis Esquelética Difusa Idiopática (DISH es una enfermedad caracterizada por provocar anquilosis entre cuerpos vertebrales, sumada a la osificación masiva de ligamentos y tendones en el resto del sistema esqueletal. El objetivo del presente trabajo es establecer la prevalencia de DISH en una colección osteológica documentada contemporánea y discutir rasgos patognomónicos y factores de riesgo asociados. A fin de establecer un diagnóstico se relevó, en 100 individuos adultos, la formación de bloques óseos de al menos tres vertebras fusionadas por la osificación de ligamento vertebral anterior. Se consideró además que no estuvieran comprometidos los espacios intervertebrales y la articulación sacroilíaca. En la zona extra espinal se registraron como evidencia complementaria la presencia de entesopatías. Como resultado del análisis se observaron seis individuos con DISH, sin diferencias significativas entre ambos sexos. El segmento vertebral principalmente afectado fue el torácico, los espacios intervertebrales no se vieron comprometidos en ningún caso y la articulación sacroilíaca tampoco presentó señales de osificación patológica; a la vez que se relevaron numerosas entesopatías. Las prevalencias observadas se deberían a la avanzada edad de los individuos analizados y las características nutricionales de la población de referencia.  Abstract  The diffuse idiopathic skeletal hyperostosis (DISH is a disease characterized by vertebral ankylosis, with massive ligaments and tendons ossification in the rest of the skeletal system. The aim of this study is to establish the prevalence of DISH in a well-documented and contemporary osteological collection, and to discuss pathognomonic features and associated risk factors. In order to establish the diagnosis, we registered, in 100 adults, the formation of bone blocks, with at least three fused vertebrae by ossification of the anterior vertebral ligament. It was

  10. Role of the Lateral Pterygoid Muscle in the Sagittal Fracture of Mandibular Condyle (SFMC) Healing Process%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响

    Institute of Scientific and Technical Information of China (English)

    刘平; 刘昌奎; 邓天阁; 江欣; 程鹏; 胡开进

    2012-01-01

    Objective: To examine the effect of the lateral peterygoid muscle in the reconstruct the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process. Methods: Twenty梖our adult sheep were divided into 2 groups . All sheep had a unilateral operation on the right side of cuting anterior and posterior attachments of the the discs, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. One group (groupl) of twelve sheep's lateral pterygoid muscle were cut. The other group (group2) weren't cut the lateral pterygoid muscle. Each group sheep was sacrificed at 4 weeks (2 sheep) , 12 weeks (4 sheep), and 24 weeks (4 sheep) after surgery. Computed tomograms (CT) were taken after sacrificed, and the three imensional compute tomographic reconstruction was used to observe condylar shape. Results: In the group without cut the lateral peterygoid muscle, the joints showed greater overgrows of new bone and more advanced ankylosis. Conclusion: This study shows that the lateral pterygoid muscle plays an important part in reconstructing the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process.%目的:本实验的目的是检查翼外肌在髁突矢状骨折愈合过程中,对髁突形态改建的影响.方法:20只1岁龄成年绵羊,随机分为两组,每组10只动物,所有绵羊都用超声骨刀造成髁突矢状骨折,剪断关节盘前后附着并将其推向内侧,其中组1动物切断翼外肌,组2动物保留翼外肌功能.每组动物分别在术后4周(各2只)、12周(各4只)、24周(各4只)处死.处死后行CT检查,CT三维重建观察髁突形态,并解剖颞颌关节(TMJ)以观察髁突形态.结果:组2即保留翼外肌功能组,较组1髁突有更多新骨形成,髁突形态改变更严重.结论:翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响起非常重要的作用.

  11. Association of therapeutic occasion, gross motor function grading and developmental level with gross motor functional recovery in children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: The abnormal posture and motor pattern have not stabilized in children with cerebral palsy at early period, thus timely treatment can establish normal postural reflex and motor pattern, and prevent complications of muscle contracture, ankylosis, skeletal deformity, etc. The clinical factors affecting the rehabilitative efficacy of gross motor function in children with cerebral palsy should be observed.OBJECTIVE: To observe the effects of therapeutic occasion, grading of gross motor function and developmental level on the rehabilitative efficacy in children with cerebral palsy.DESIGN: A case-controlled analysis.SETTING: Qilu Children's Hospital of Shandong University.PARTICIPANTS: Totally 138 children with cerebral palsy, who were hospitalized for 12 months in the Rehabilitation Center of Qilu Children's Hospital, Shandong University, were selected from April 2004 to September 2006, and all the children were diagnosed to be accorded with the standard set by the national seminar on cerebral palsy in 2004. There were 97 males and 41 females, including 55 cases of 0 - 2 years old,47 cases of 2 - 4 years and 36 cases of 4 - 6 years. Informed contents were obtained from relatives of all the children.METHODS: ① Comprehensive rehabilitation treatment: Vojta method was to induce the children to turn over the body and crawl by stimulating reflective turn over and crawling on belly. Bobath method including trainings of head control, turning over body, keeping sitting position, keeping balance, crawling, keeping standing position, and walking, etc.; The children were massaged by using the maneuvers of push, press, rub,pull, wave, etc. according to the sites and types of palsy. Acupuncture was performed mainly at bilateral motor areas, the needle was retained for 1 hour per time, 6 days continuously every week, and followed by a 1-day interval. ② Prognosis assessment: The gross motor functional grading of the children with cerebral palsy at admission was

  12. Tratamento ortodôntico em pacientes com dentes reimplantados após avulsão traumática: relato de caso Orthodontic treatment in patients with reimplanted teeth after traumatic avulsion: a case report

    Directory of Open Access Journals (Sweden)

    Simone Requião Thá Rocha

    2010-08-01

    Full Text Available INTRODUÇÃO: a alta prevalência de indivíduos com traumatismo dentário prévio ao tratamento ortodôntico justifica os cuidados a serem observados antes e durante o tratamento, considerando todas as implicações do movimento ortodôntico sobre os dentes traumatizados. Entre as lesões traumáticas dentárias, a avulsão com posterior reimplantação do dente é a que apresenta maior risco de complicações - como necrose pulpar, reabsorção radicular e anquilose -, sendo também a que inspira maiores cuidados pelo ortodontista. OBJETIVO: este trabalho busca, através do relato de um caso clínico, analisar as implicações do reimplante dentário após avulsão traumática, em pacientes que requerem tratamento ortodôntico. CONCLUSÕES: a movimentação ortodôntica de um dente reimplantado, após sua avulsão traumática, é possível desde que não ocorra qualquer sinal de anormalidade. Porém, dentes que sofrem anquilose não são passíveis de movimentação ortodôntica, mas devem ser preservados como mantenedores de espaço, até a reabsorção total da raiz, desde que não apresentem infraposição severa. Ocorrendo infraposição severa do dente anquilosado, é indicada a amputação da coroa e o sepultamento da raiz, como meio de favorecer a manutenção do osso alveolar na região, pois ocorrerá reabsorção por substituição da raiz sepultada, como ocorreu no caso clínico apresentado.INTRODUCTION: The high prevalence of individuals with dental trauma prior to orthodontic treatment justifies the precautions that should be followed before and during treatment, considering all possible effects of orthodontic movement on traumatized teeth. Among the major traumatic dental injuries, avulsion with subsequent tooth reimplantation entails a higher than average risk of complications, such as pulp necrosis, root resorption and ankylosis. Therefore, it gives orthodontists several reasons for concern. OBJECTIVE: This case report sought

  13. All-arthroscopic rotator cuff repair versus mini-open for the treatment of rotator cuff injury:aMeta-analysis%全关节镜与小切口修复肩袖撕裂损伤的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王毅; 赵其纯

    2016-01-01

    BACKGROUND:There are controversies about the efficacy of al-arthroscopic rotator cuff repairversus mini-open for the treatment of rotator cuff injury. OBJECTIVE:To evaluate the efficacy of al-arthroscopic rotator cuff repairversusmini-open for the treatment of rotator cuff injury by conducting a meta-analysis. METHODS:A computer-based online search was conducted in PubMed, Embase, Cochrane Library and CBM databases from January 1966 to November 2015 to screen the relevant articles usingthe key words of“rotator cuff, arthroscopy, mini-open”. Meta-analysis was performed using Revman5.3 software. RESULTS AND CONCLUSION:A total of 11 studies, including 6randomized controled trialsand 5 cohort studies,were selected. The meta-analysis results showed that there were no significant differences in the function and strength of the shoulder joint, pain, motor range, recurrence of rotator cuff avulsion, the incidence rate of ankylosis between both two groups (P> 0.05). These results suggest that the efficacy of al-arthroscopic rotator cuff repair does not differ from those of mini-open for the treatment of rotator cuff injury. However arthroscopic rotator cuff repair induces less soft tissue injury and early incision pain, but better function recovery.%背景:对于全关节镜及小切口两种修复式的疗效比较,国内外尚有许多争议。  目的:对全关节镜及小切口两种方法治疗肩袖损伤的疗效进行荟萃分析。  方法:以“肩袖”、“关节镜”、“小切口”为检索词,计算机检索1966年1月至2015年11月PubMed, Embase,Cochrane图书馆和CBM,搜集所有的有关论研究。筛选并提取数据,采用Revman5.3软件进行荟萃分析。  结果与结论:共纳入11例研究,其中6例随机对照研究,5例队列研究,荟萃分析显示这两组肩关节功能、疼痛、活动范围、肩袖再撕裂率、关节僵硬发生率以及肩关节力量差异均无显著性意义(P>0

  14. Storage media for avulsed teeth: a literature review.

    Science.gov (United States)

    Poi, Wilson Roberto; Sonoda, Celso Koogi; Martins, Christine Men; Melo, Moriel Evangelista; Pellizzer, Eduardo Pizza; de Mendonça, Marcos Rogério; Panzarini, Sônia Regina

    2013-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a

  15. 全面部陈旧性骨折回顾性分析与临床分类研究%Delayed pan-facial fractures-injury patterns associated with deficient treatment results and clinical classification

    Institute of Scientific and Technical Information of China (English)

    张益

    2008-01-01

    Objective To analyze the injury patterns in pan-facial fractures(PFF) which potentially lead to deficient treatment outcomes and then to propose a clinical classification.Methods Thirty-nine patients,31 male and 8 female,with an average age of 33,treated from 1998 to 2007 in the Center of Maxillaofacial Trauma,Peking University School and Hospital of Stomatology,were included.Zygomatic complex,maxilla and mandible were involved in the extensive fracture concomitant with nosalorbital-ethmoid(NOE)fracture or not.All cases experienced a delay of over 4 weeks after iniury.An analysis was made to display the relationship between facial architecture demolition and disfigurement and disability.Treatment results were assessed with facial appearance,opening range,occlusion and regional deformities.The associated iniury patterns most frequently leading to deftcient outcomes were summarized as references to scheme a clinical classification.Resuits Facial deformities presented in 90% of the patients and mostly related to condylar fracture/dislocation and zygomatic complex fracture.Limited mouth opening occurred in 59% of patients and were caused most frequently by displacement of zygomatic complex and joint ankylosis.Malocclusion was found in 100% of cases and there were the associated optical signs in 46%.Thirty-nine cases were divided into two types.Zygomatic,maxillary and mandibular fractures all together constituted type Ⅰ,which accounted for 46% of patients.Type Ⅰ plus NOE fracture was type Ⅱ,which accounted for 54% of patients.Furthermore,A,B and C sub-types were recognized in corresponding to involvement of condylar dislocation/fracture and zygomatic complex fracture.In treatment outcomes,a difference between type Ⅰ and type Ⅱ fractures remained with NOE fractures.The outcomes of term "moderate"and"worse"in subtype C group were attributed to severe soft tissue injuries and trauma-induced ankylosis.Conclusions NOE fracture,condylar fracture and dislocation

  16. Repairing of fingertip defect with topographical anterograde flap pedicled with digital artery trunk or branch%带指掌侧固有动脉或其分支局部顺行皮瓣修复指端缺损

    Institute of Scientific and Technical Information of China (English)

    林宏伟; 吴杰; 江标; 连素文; 邹育才; 肖瑛; 赵资坚; 林丽贤

    2015-01-01

    branch flaps and 5 digital artery V-Y flaps occurred arterial crisis, 9 digital artery dorsal branch flaps and 5 digital artery volar branch flaps occurred venous crisis within 24 hours of the surgery. Based on the reasons which caused cyclic crisis, such as removing some stitches around and/or in the pedicle of the flap, small incision bleeding, flap massage, changing finger position, braking and so on were used. 4 flaps survived and 8 partial necrosis occurred due to arterial crisis. 8 flaps survived and 6 partial necrosis occurred because of venous crisis. There were 57 in 62 fingers (91.9%) with skin grafts at the donor sites survived completely. 99 fingers in 67 cases were followed-up from 3 to 12 months, average 5.5 months. The color, texture and contour of the flaps were good. There were no bulkiness, no painful scar, no tenderness and no ankylosis. Tow-point discrimination was 8 to 12 mm. Joint movement of the fingers were normal. The patients could adapt to normal work and life. They were satisfied with the exterior and the sensation of the fingertip post-operatively. Based on the upper limb functional assessment criteria issued by the Chinese Medical Association Hand Surgery Society, the results were rated as excellent in 63 fingers, good in 20 finger and fair in 16 finger. The overall satisfactory rate was 83.8%. Conclusion Repairing of fingertip defect with topographical anterograde flap pedicled with digital artery trunk or branch, the surgery operation is simple and safe, does not need complex microsurgical technique. It does little harm to the donor. That is to say, it is an effective, scientific and reliable method worthy of clinical application.

  17. 经皮电刺激治疗外伤性外周神经损伤40例的效果分析%Analysis of the results of percutaneous electrostimulation in 40 cases of traumatic peripheroneural Injury treated

    Institute of Scientific and Technical Information of China (English)

    张力

    2012-01-01

    Objective To investigate the effect of percutaneous electrostimulation on paraneural mi-crocirculation by analyzing the clinical therapeutic effects of percutaneous neuromuscular electrostimulation (PNMES) on peripheral nerve injury. Methods Forty patients with incomplete injury of peripheral nerves in the upper limbs were treated by PNMES with the use of EMG of Dantec Keypoint type (DKT), complemented with kinesitherapy to observe the functional recovery of the injured nerves. During the treatment, laser Doppler flowmetery (LDF) was employed to detect changes in the bloodstream of paraneural micro-circulation before and after the electrostimulation, and to analyze the effect of electrostimulation on micro-circulation. Before and after treatment, comparative analysis of electro-neurophysiology was performed. The comparative analysis of the post-therapeutic effects in patients with different disease durations was also carried out. Results In the 40 patients with insufficiency of brachial plexus nerves, radial nerves, median nerves and ulnar nerves, the curative rate of their injured nerve functions was 63% (25/40), and the effective rate was 90% (36/40) after 2 to 10 therapeutic courses. LDF demonstrated that the bloodstream volume of paraneural microcirculation was increased by 23. 3% to 26. 96%, compared with that before electrostimulation. The local microcirculation of the injured nerves was improved. In the comparison between patients with different disease durations, the shorter the duration, the better the therapeutic effect. Conclusion PNMES can increase the injured neuromuscular excitability, improve the blood circulation in the injured nerve areas, and promote the regrowth of the peripheral nerves. With the supplement of kinesitherapy, it can stop muscular atrophy (myoatrophy), strengthen muscular balance, prevent joint stiffness (ankylosis), keep the activities of the joints, and finally obtain satisfactory therapeutic effect in the treatment of traumatic

  18. The application of internal distraction osteogenesi s of ja ws in correction of difficult and complicated dento-gnatho-facial deformities (report of 88 cases)%内置式颌骨牵引成骨 在疑难牙颌面畸形矫治中的应用 --附88例报告

    Institute of Scientific and Technical Information of China (English)

    王兴; 林野; 伊彪; 周彦恒; 梁成; 王晓霞; 李自力; 张震康

    2001-01-01

    secondary to cleft palate, 11 cases of hemifacial microsomia, l7 cases of severe micrognathia accompanie d with obstructive sleep apnea syndrome, l4 cases of TMJ ankylosis, 8 cases of r econstruction of jaw defects, 17 cases of alveolar-bone defect treated by verti c al distraction, and 12 cases with upper and lower dental arch constriction for expansion. The youngest patient was 4.5 years of age, and the oldest 54 year s, with a mean of 22.5 years. The Germany Medicon Co. and Martin Co. produced distr actors were used in 22 cases. In other cases, 7 types of distractors designed an d cooperatively developed by the first author were used. The mode of osteotomy, t he selection and placement of distractor, and the modality of distraction depend ed on the types of deformity, the degree of severity, and the sites of the jaws. Results: The distraction distances in maxilla were 7-l5 mm, and 1 2-50 mm in man dible. 3 cases had local chronic infection leading to resorption of a part of th e new bone; other 3 cases had fracture of the mandibular inferior border and the troubles of the distractor; they had had addi tional operations to complete the distraction. The other cases went on with dist racti on osteogenesis smoothly obtaining good bone formation, their dento-gnatho-fac ia l deformities were corrected satisfactorily. Conclusion: The intraor al distract ion osteogenesis for jaws provides a new and effective means for those difficult and complicated dento-gnatho- facial deformities which are hard to be treated b y conventional measures. This is a technique of wide application value and worth y to be spread.

  19. 前交叉韧带重建失败后的首次翻修%Primary revision after failure of anterior cruciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    孔颖; 王国栋; 张元民; 赵晓伟; 张玉革

    2014-01-01

    , invalid fixation, adhesion, compound ligament injuries, and ankylosis. The functional results and objective stability could be obtained through revision folowing anterior cruciate ligament reconstruction.%背景:前交叉韧带重建失败可由多种因素引起,需要进行翻修手术治疗。国内关于前交叉韧带翻修的报道较少。目的:分析前交叉韧带重建失败后行翻修治疗的主要原因、适应证、方法及效果。方法:前交叉韧带重建后失稳需要接受翻修患者30例,均在关节镜下行探查与翻修治疗。翻修后应用KT-2000、国际膝关节评分委员会评分标准(IKDC)、Lysholm及Tegner评分系统进行评价。结果与结论:30例患者中,初次手术选用自体骨-髌腱-骨移植物9例,自体半腱股薄肌腱14例,同种异体腘绳肌腱7例,翻修原因上、下两端骨道均偏前8例,上骨道偏前12例,下骨道偏前8例,其中1例合并关节强直;自体骨-髌腱-骨重建固定上骨道内骨块的挤压螺钉位置异常1例;内侧副韧带股骨止点撕脱骨折未予修复1例。翻修术中重建的前交叉韧带完全断裂和吸收12例,韧带有部分连接但已明显松弛失张力18例。无骨道骨质严重缺损,均一期行前交叉韧带翻修手术,重建移植物采用同侧腘绳肌腱(STG)10例,对侧腘绳肌腱14例,人工韧带6例。前交叉韧带翻修后KT-2000检查膝关节屈曲90°和30°平均差值,以及IKDC、Tegner和Lysholm评分均较翻修前有明显改善。前交叉韧带重建手术失败的原因较多,但主要与手术骨道位置异常、固定失效、复合韧带损伤处理不当、关节强直等有关。前交叉韧带翻修后膝关节的主观功能和客观稳定性可获得明显改善。

  20. 一期全膝关节置换治疗陈旧性股骨髁骨折合并膝关节骨关节炎%One-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    任姜栋; 张晓岗; 曹力; 郭文涛; 彭理斌

    2012-01-01

    目的 探讨陈旧性股骨髁骨折合并膝关节骨关节炎一期全膝关节置换(total knee arthroplasty,TKA)的可行性和疗效.方法 2003年1月至2010年12月对陈旧性股骨髁骨折合并膝关节骨关节炎患者11例行一期TKA手术,男4例,女7例;年龄38~77岁,平均58.3岁.股骨髁上骨折8例,髁间骨折3例.其中2例伴有膝纤维性强直及轻度肌肉萎缩,2例合并膝关节侧副韧带损伤,2例合并股骨髁上纤维性愈合,2例为感染性骨不愈合.结果 所有患者均获得随访,随访时间6~72个月,平均41.3个月.美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分从术前平均(6.65±7.01)分(0~13分)提高至末次随访时平均(88.5±6.18)分(81~95分).膝关节活动度由术前平均32.7°±17.6°(0°~50°)提高至末次随访时平均101.3°±9.8°(85°~115°).活动度平均增加77.7°.1例患者术后6年出现感染,反复清创失败后行膝关节离断术.其余患者均无感染、假体松动、下肢深静脉血栓形成、膝关节不稳及双下肢不等长等并发症.结论 陈旧性股骨髁骨折合并膝关节骨关节炎的一期TKA手术难度大,合理的手术方案是手术成功的关键.术后短期随访效果良好.%Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months

  1. Dolor osteomuscular y reumatológico Osteomuscular and rheumatic pain

    Directory of Open Access Journals (Sweden)

    J. L. Rodríguez-Hernández

    2004-03-01

    spondylitis is a chronic systemic inflammatory disease that affects in particular the axial skeleton and rarely the peripheral joints. Most patients are HLA-B27 positive and may present family aggregation. Its onset occurs mainly at the end of the adolescence and most frequently in men. The treatment aims to maintain the spine mobility, in order to avoid ankylosis, pain and inflammation. Gout is a metabolic disease characterized by the deposition of urate monosodium crystals from over-saturated extracellular liquids. Its clinical manifestations range from acute gouty arthritis to intercritical gout and chronic tophaceous gout. The diagnosis is based on the examination of joint fluid. The treatment is based on colchicine, to which NSAIDs and occasionally corticoids or ACTH may be added. Musculotendinous pain syndromes occur at shoulder, elbow, wrist, hip, knee, ankle and foot level. They present local clinical manifestations and the treatment is based in local infiltrations, iontophoresis and sometimes TENS and ultrasounds. Myofascial pain syndrome is a regional pain condition that frequently affects the scapular and pelvic waist. It presents pain triggering points and muscular contracture. Treatment is focused on pain management, recovery of the muscular force and mobility. Fibromyalgia is a chronic generalized non-articular painful condition with predominance of muscular involvement and sensitivity in multiple predefined points. It is more frequently seen in middle-aged women. Its physiopathology is not clear. Low levels of tryptophan and a significant increase of the S/S type of the 5 HT transporting gene have been found. N-methyl-D-aspartate receptors seem also to be involved in this syndrome when they are activated and family aggregation has also been found, probably due to genetic predisposition. Its diagnosis is based on the criteria published by the American College of Rheumatology. This disease requires a pharmacological, physical and rehabilitative treatment, also

  2. 组配型桡骨头假体置换治疗桡骨头粉碎性骨折%Modular prosthesis replacement for comminuted and unreconstructable radial head fractures

    Institute of Scientific and Technical Information of China (English)

    查晔军; 蒋协远; 公茂琪; 刘兴华; 李庭; 张力丹; 高志强; 王满宜

    2012-01-01

    treated with Acumed modular prosthesis replacement. Repair of collateral ligaments and associated elbow fractures was carried out simultaneously.They were 16 men and 6 women,with an average age of 41.5 years (from 21 to 62 years).The left side was involved in 9 cases and the right in 13.One patient was associated with posterior olecranon fracture-dislocation of Monteggia type Ⅱ,13 with elbow terrible triad,one with elbow dislocation but without coronoid process fracture,3 with Essex-Lopresti injury and 4 with medial collateral ligament injury.The coronoid process fracture was fixated with Kirschner wire and the proximal ulnar fracture with plate and screw.Hinged external fixators were used in 2 cases of elbow terrible triad.Patients were evaluated by the Mayo Elbow Performance Score (MEPS). Results The follow-ups averaged 12.95 months ( range,6 to 22 months ).One patient had disturbed elbow flexion of less than 90° due to prosthesis overstuffing,one patient had elbow instability in spite of full range of motion gained due to prosthesis understuffing,and one patient had elbow ankylosis at elbow flexion of 70° with a heterotopic ossification bridge.The results in the other 19 patients were good to excellent. Their average flexion was 131.5°±4.4° (from 130° to 140°),average extension 5.4°±6.3° (from 0 to 20°),average range of extension-flexion motion 126.1 ° ± 7.7° ( from 120° to 140°),average pronation 81.6° ± 6.4° ( from 70°to 90°),average supination 85.6° ± 3.1° (from 80° to 90°),and average range of rotation 167.2° ± 8.2°(from 150° to 180°).Their mean postoperative MEPS score was 94.2 ± 5.1 points (from 85 to 100points). Conclusions The Acumed modular radial head prosthesis offers 200 standard combinations (10left and 10 right stem options with 5 diameters and 4 collar height options) to accommodate different sizes and provide proper restoration of the overall length of the radius,replicates natural radial head geometry,provides improved

  3. An investigation of concerns of Chinese patients and their families before total knee arthroplasty%膝关节置换术前患者及家属关注问题调查

    Institute of Scientific and Technical Information of China (English)

    李杨; 蔡宏; 张克

    2013-01-01

    Objective To learn about the degree of concerns of Chinese patients and their family about the upcoming total knee arthroplasty ( TKA ), postoperative rehabilitation, expectation and other relevant diagnosis and treatment procedures. Methods 128 patients who were scheduled to undergo TKA and their family members were inquired about preoperative concerns with a 61-question questionnaire. The degree of concerns was assessed by assigning a score on a scale of 1-4 ( 1=not concerned, 2=somewhat concerned, 3=very concerned and 4=extremely concerned ). Collected data were then statistically analyzed. Results The mean score of the degree of concerns of all the patients about all the items was 3.11. The top 5 concerns of Chinese patients were the ability to walk with no difficulties postoperatively ( 3.78 ), surgeons’ experience ( 3.73 ), the risk of failure in the surgery ( 3.68 ), the lifespan of joint prostheses ( 3.63 ) and the ability to take care of oneself postoperatively ( 3.63 ). The mean score of the degree of concerns of their family members was 3.18. The top 5 concerns of family members were surgeons’ experience ( 3.86 ), the ability to walk with no difficulties postoperatively ( 3.82 ), the postoperative pain relief rate ( 3.74 ), the postoperative occurrence of ankylosis ( 3.72 ), pain existing or not after discharge ( 3.72 ). The patients under 65 years old were evidently more concerned about the 6 items than those aged greater than or equal to 65 years old, including the ability to look after children postoperatively, the ability to enjoy recreations postoperatively, the lifespan of joint prostheses, the ability to ride a bike postoperatively, the ability to lift weights postoperatively and the occurrence of fractures around artificial prostheses after TKA. The scores of the degree of concerns of elderly and young patients about the occurrence of anesthetic accident were 3.71 and 3.38 respectively ( P=0.036 ). The scores of the degree of concerns of

  4. 复杂肱骨远端骨折手术治疗的临床探讨%Clinical evaluation of operative treatment of complicated distal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    赵龙; 宋有鑫; 崔成喜; 张宇轩; 张宝琦; 龚平; 武云鹤; 尚瑞松; 陈宾

    2014-01-01

    Background Distal humeral fracture is a severe damage around the elbow joint,and is often seen in young adults.It accounts for 2% of all adult fractures and about 50% of all humerus fractures.It′s one of the fractures that is difficult to deal with.The types of distal humeral fracture are divergent. Distal humerus fractures are often comminuted which make operative reduction difficult.Secondary loss of reduction and elbow ankylosis are common postoperative complications. All these difficulties make the distal humerus fracture one of the unresolved problems in fracture treatment.This study is to evaluate the clinical outcome of complex distal humeral fractures treated by operation.Methods (1)General data:twenty-four cases of operative treated distal humerus fractures in author′s hospital from January 2004 to December 2013 were included in this study.There were 1 5 males and 9 females,aging from 1 7 to 73,averaged 41.AO/OTA Classification:A3:9 cases;B1, B2:6 cases;C3:9 cases.Two cases were combined with nerve injury.Two cases had histories of high blood pressure and diabetes.(2 ) Operative method:The patient was placed in the supine position,and the elbow to be operated on was positioned at 90°of abduction and supported on a lucent operating table.A pneumatic tourniquet was placed as proximally as possible on the arm.With the elbow flexed at about 60°,the first incision was made about 7 cm proximal to the tip of the medial epicondyle.In the initial cases,the ulnar nerve was isolated,released from the ulnar nerve groove, and protected carefully.In later cases,the nerve was only exposed.The medial and anteromedial side of the distal humerus was exposed through the opening between the brachial muscle and the medial intermuscular septum.The common origin of the flexor muscles was partially dissected and reflected distally,leaving a 5-mm strut to be re-sutured in situ at completion of surgery.The anterior capsule was incised.The articular surface of the trochlea was