bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of recurrent lumbar disc herniation
Authors: Mariscal Gonzalo , Torres Elena , Barrios Carlos 
Published: June 2022

ABSTRACT

Background:
Recurrent disc herniation is a common condition that often results in months of disabling symptoms and additional costs.

Objective:
The objective of this study was to investigate the incidence of recurrent disc herniation in patients treated surgically.

Materials and Methods:
Clinical trials and prospective studies involving patients treated with different techniques, such as open, percutaneous, or microendoscopic discectomy, were included. The incidence of recurrence as well as the level and the time until the recurrent disc herniation was collected.

Results:
Thirteen studies were included. Recurrence of disc herniation ranged from 0% to 14% of patients. Most recurrences occurred at the same level of herniation and on the same side. The time to recurrence of disc herniation ranged from 1 to 5 years.

Conclusion:
This study answers the question of how much, when, and where in lumbar recurrent disc herniation.
Alternative approach to treatment of unusual site giant cell tumor at cervical spine
Authors: Mousavi Seyed Reza , Rezvani Alireza , Eghbal Keyvan , Motlagh Mohammadhadi Amir Shahpari , Dehghanian Amir Reza , Taherpour Sanaz , Farrokhi Majidreza 
Published: June 2022

ABSTRACT
Giant cell tumor (GCT) is an intermediate malignant bone tumor which mostly involves long extremity bones, less commonly involving the spine with sacral predominance. Cervical spine involvement is rare. According to literature, the selective approach for the treatment of GCT is en bloc resection with spinal reconstruction. For unusual sites, such as cervical region, which is a mobile spinal segment and critically proximate to the cervical spinal cord, great vessels, and vital organs, it is almost impossible to perform the selective approach for treatment. Alternative approaches in such situations are under investigations. We present a case of C2 vertebral body GCT, who was treated with polymethylmethacrylate intravertebral injection and was followed by adjuvant therapy with denosumab. A 16-year-old boy without any past medical history presented with progressive suboccipital and axial neck pain since 3 months earlier, which had not responded to conservative treatments. There was no neurologic deficit, and pain was significantly controlled. In the 1-year follow-up, no complication and tumor recurrence was seen. Vertebroplasty with bone cement for lytic spinal GCT lesions, followed by adjuvant therapy with denosumab, not only is a less invasive treatment but also has good results in spinal stability, patient recovery, and 12-month recurrence.
Ozone disc nucleolysis in cervical intervertebral disc herniation
Authors: Ghatge Sharad Balasaheb , Shah Rohit Pannalal , Surya Nirmal , Sankhala Suresh , Unadkat Chetan Jagjivandas , Khan Gulam M. , Modi Dhaval B. 
Published: June 2022

ABSTRACT

Background:
Inherent complications associated with surgery and limited success of percutaneous minimally invasive procedures make researches wanting for an ideal treatment for cervical disc herniation.

Objective:
We prospectively study the role of ozone disc nucleolysis in cervical intervertebral disc herniation.

Patients and Methods:
From January 2008 to December 2020, we prospectively study 246 consecutive patients of cervical disc herniation treated by a single session of intradiscal injection of ozone–oxygen mixture (ozone disc nucleolysis). There were 55% of females and 45% of males. Age ranged from 28 to 68 years with a mean of 47. The outcome was measured on visual analog scale (VAS) scale and neck disability index (NDI) along with Mcnab method.

Results:
The mean baseline VAS score was 7.87 which became 3.09 at 1 month, 1.42 at 3 months, 1.40 at 6 months, and 1.35 at 1 year. The mean NDI was 36.27 at baseline which improved to 9.24 at 1 month, 6.25 at 3 months, 6.20 at 6 months, and 6.22 at 1 year. This was found to be significant with P < 0.05. Modified McNab criterion showed excellent recovery in 138 (56.10%), good recovery in 50 (20.32%), and fair recovery in 22 (8.94%), resulting in a successful rate of 85.36%. Mediocre recovery was seen in the remaining 36 patients amounting to a 14.64% failure rate.

Conclusion:
This study showed that ozone disc nucleolysis significantly reduces the pain related to cervical disc herniation along with a significant reduction in disability.
Unilateral spacer distraction of the subaxial cervical facet joint for the treatment of fixed coronal malalignment of the craniovertebral junction
Authors: Carelli Luis E. , Girão Alderico , Cechin Ígor , Cabrera Juan P. 
Published: June 2022

ABSTRACT

Introduction:
The standard treatment for a fixed coronal malalignment of the craniovertebral junction is an anterior and/or posterior column osteotomy (PCO) plus instrumentation. However, the procedure is very challenging, carrying an inherently high risk of complications even in experienced hands. This case series demonstrates the usefulness of an alternative treatment that adds a unilateral spacer distraction (USD) to the subaxial cervical facet joint to promote coronal realignment and fusion.

Materials and Methods:
A single-center retrospective study of the patients with fixed coronal malalignment of the craniovertebral junction caused by different etiologies treated with USD in the concavity side with PCO in the convexity side of the subaxial cervical spine. Demographic characteristics and radiological parameters were collected with special emphasis on clinical and radiological measurements of coronal alignment of the cervical spine.

Results:
From 2012 to 2019, four patients were treated with USD of the subaxial cervical spine complementing an asymmetrical PCO at the same level. The causes of coronal imbalance were congenital, tuberculosis, posttraumatic, and ankylosing spondylitis. The level of USD was C2–C3 in three patients and C3–C4 in one patient. A substantial coronal realignment was achieved in all four. One patient had an iatrogenic vertebral artery injury during the dissection and facet distraction and developed Wallenberg's syndrome with partial recovery.

Conclusions:
USD of the concave side with unilateral PCO of the convexity side in the subaxial cervical spine is a promising alternative treatment for fixed coronal malalignment of the craniovertebral junction from different causes.
Health-Related Quality of Life of the Geriatric Population Living in Rural Areas of West Tripura District of India
Authors: Debnath Arpita , Bhattacharjya Himadri 
Published: June 2022

Background:
Growing life expectancy is challenging the quality of healthcare for elderly. Information regarding health-related quality of life (QOL) may help policymakers to design need-based health programs for this population.

Objectives:
The objective of this study is to estimate health-related QOL of the geriatric population living in rural areas of West Tripura district and to compare it between ethnic and nonethnic populations with respect to important domains.

Methodology:
This community-based cross-sectional study was conducted between February 1, 2019, and March 31, 2020, among 225 geriatric subjects of rural West Tripura district chosen by multistage sampling. The World Health Organization's QOL–BREF scale was used for data collection.

Results:
Among the study population, 46.2% had overall good health-related QOL. About 52.9% had good QOL in environment, and 37.3% had good QOL in social relationship domains. Marginally higher proportion of the subjects from ethnic origin had better QOL than the nonethnic, but it was not significant. A higher proportion of the Muslim subjects had better QOL than the rest, but it was also not significant. Bivariate analysis showed significant associations between QOL with age, sex, literacy, financial condition, socioeconomic status, and type of family. Multivariate analysis identified male sex, younger age, and living with spouse as the significant predictors of good QOL.

Conclusion:
Overall health-related QOL of the geriatric people living in rural areas of West Tripura district is poor, but younger male subjects of ethnic origin and living with spouses may enjoy relatively better QOL.
Lethologica in aging
Authors: Girija P. C. , Shahal N. P. , Narayanan Nayana 
Published: June 2022

Introduction:
Lethologica is a phenomenon that is an early sign of aging. Lethologica refers to the inability to retrieve a specific word as a response to a visual, auditory, or tactile presentation.

Need:
Even though it is known that aging has a strong impact on cognitive language functions, it is not yet clear which aspect is most affected. Since naming is an important element of language functions, analysis of this aspect would aid in understanding the nature of deterioration of cognitive-linguistic functions with age.

Aim:
The aim is to analyze the impact of aging on naming abilities in neurotypical individuals.

Methods:
One hundred and fifty neurotypical individuals of 30 individuals from each group between 30 and 80 years of age, i.e., 31–40 years, 41–50 years, 51–60 years, 61–70 years, and 71–80 years participated in the study. A tool was developed in Malayalam language to assess confrontation naming, responsive naming, generative naming, and contextual naming. A score of 1 was given for each correct response.

Results:
As age advances, all the naming abilities deteriorated. The effect was most prominent in the generative naming task as it demands the most cognitive involvement. The neuronal areas governing these cognitive aspects mainly include the prefrontal cortical regions which are highly susceptible to the aging process. Responsive naming and contextual naming were least affected as it gained the advantage of crystallized intelligence. The age-related decline is more prominent after the age of 60 years.

Conclusion:
Naming skills, even though being a language element also have strong foundations within the cognitive domain. Hence, any age-related neurobiological alterations can impact naming functions.
Risk Factors for Falls in Older Adults with Cognitive Impairment
Authors: Saini Mamta , Subramanian Manicka Saravanan , Soni Nidhi , Singh Vishwajeet , Chakrawarty Avinash , Chatterjee Prasun , Dey Aparajit Ballav 
Published: June 2022

Background:
Falls are one of the leading causes of disability among older people. The risk factors of falls widely vary among the older populations, including the different stages of cognitive impairment. We aim to identify the risk factors for falls among cognitively impaired older adults.

Materials and Methods:
In a cross-sectional study, older adults attending the memory clinic were screened for falls and their risk factors. A total of 112 subjects who satisfied the inclusion criteria and provided informed consent were subjected to a semi-structured interview and comprehensive geriatric assessment. Cognitive impairment was graded by the Clinical Dementia Rating (CDR). Subjects were divided into fallers and nonfallers. A multivariable logistic regression analysis was done to identify the independent risk factors of falls.

Results:
The prevalence of falls was 39.28% in the study population. Gender (adjusted odds ratio [aOR] [95% confidence interval (CI)]: 2.21 [0.690–7.117]), body mass index (aOR [95% CI]: 0.89 [0.773–1.028]), socioeconomic status (middle-class aOR [95% CI]: 0.34 [0.077–1.526], lower-class aOR [95% CI]: 2.44 [0.349–17.160]), multimorbidity (aOR [95% CI]: 19.39 [1.043–360.373]), depression (mild aOR [95% CI]: 2.90 [0.896–9.429] and moderate aOR [95% CI]: 4.77 [0.967–23.597]), and impairment in hobbies and home (aOR [95% CI]: 24.78 [6.251–98.294]) part of CDR were the independent predictors of falls.

Conclusion:
Older adults with cognitive impairment are at high risk of falling with definitive risk factors. Regular screening will help to identify older adults at risk of falls and enable fall prevention to reduce morbidity and dependency.
Management of Extra Articular Distal Femoral Fractures with Nail Plate Combination
Authors: Sharma Ashok , Varma Deepak , Vyas Umesh , Bohra Arvind Kumar , Sharma Shiv Bhagwan 
Published: June 2022

Background:
Junctional distal femur fractures are considered difficult to unite and often can led to a degree of disability. The incidence of malunion, nonunion, and infection is relatively high in many reported series. In elderly patients, low-energy distal femur fractures can cause devastating injuries, carrying high rates of morbidity and mortality. Operative fixation can be more challenging in comminuted fractures of osteoporotic bones. The management of junctional fractures of the distal femur by using the nail plate combination (NPC) technique can provide stable, well-balanced fixation, allowing for immediate weight-bearing and early mobilization and improve quality of life.

Materials and Methods:
A prospective randomized study including 16 patients with distal femur extraarticular and junctional fractures, was conducted in the department of orthopedic surgery Jhalawar medical college and SRG hospital Jhalawar, from May 2019 to June 2021. There were 9 male and 7 female patients, age range from 43 years to 70 years, with a mean age being 53 years. The average length of follow-up was 18.5 months (12 months to 24 months).

Results:
Patients followed up at 1 month, 3 months, 6 months, annually thereafter. Regular fracture healing was observed in 15 cases. Delayed union seen in 1 case who had infection postoperatively, which was treated with debridement and antibiotics as culture and sensitivity. mild rotational misalignment (~5°) seen in one case and there was no axial misalignment (Varus/valgus angulations) was found in any case. There were no implant failures.

Conclusion:
In our study, functional results trended toward better outcomes in nails plates combinations in terms of knee flexion, early weight-bearing, less union time, and better alignment. NPC system could take the challenges such as poor bone stock, severe comminution both metaphyseal and diaphyseal region.
Predicting Short-Term Outcome of Metal-on-Metal Hip Resurfacing (MOMHR)
Authors: Goyal Amrit , Macaulay William , Geller Jeffrey A , Wang Wenbao , Nyce Jonathon D 
Published: June 2022

Introduction:
The aim of this study was to research factors affecting the short-term outcome of metal-on-metal hip resurfacing (MOMHR) and develop a multivariate regression model that may predict outcome.

Materials and Methods:
This was a prospective study of 154 patients who underwent MOMHR and were followed for a minimum of 1 year. Fourteen independent variables (age, gender, diagnosis, co-morbidities, body mass index (BMI), pr-operative Western Ontario and McMaster Universities Osteoarthritis (WOMAC) physical component/stiffness (S)/pain (P), short form 12 (SF-12) physical (SP), SF-12 mental (SM), acetabular and femoral component sizes, operative time, and estimated blood loss) were analyzed using correlation and multivariate regression analyses. Multivariate regression model was tested by using an independent cohort for validation.

Results:
Correlation analyses found four variables that significantly influence short term MOMHR outcome. These include comorbidities (C, P = 0.0001), preoperative SF-12 mental (SM, P = 0.0004), BMI (P = 0.0006), and gender (G, P = 0.0454). By multivariate analysis, the subsequent regression model was obtained with an R
2 value of 0.3816: Outcome = G*4.72 [FIGURE DASH] BMI*0.70 [FIGURE DASH] C*0.11 + SM*0.31 + 87.44. The average predicted outcome using this equation did not differ significantly from the observed WOMAC physical function outcome at a minimum of 1 year postoperatively.

Conclusion:
To the best of our knowledge, this study is the first reported multivariate analysis of factors affecting MOMHR and confirms the correlation of some of the previously proposed factors such as gender, BMI, comorbidities, and preoperative function. The multivariate regression equation can be used to predict the short-term outcome of MOMHR.
Combining Proximal Fibular Osteotomy with High Tibial Osteotomy – Is It Better than High Tibial Osteotomy Alone? Comparative Evaluation of Early Outcome
Authors: Baliga Sunil , Tunglut Pausiam , Arya Prashant , Mallick Manabendra Nath Basu 
Published: June 2022

Introduction:
Valgisation high tibial osteotomy (HTO) is a widely performed procedure for patients with medial compartment unicompartmental osteoarthrosis knee with varus malalignment of lower limbs. Over the last two decades, medial open-wedge HTO has been more popular than lateral closed-wedge techniques due to multiple advantages. Recently, isolated proximal fibular osteotomy/fibulectomy (PFO) has been advocated as a treatment for medial tibiofemoral osteoarthrosis in young patients. The role of fibulectomy as an adjunct to medial open-wedge HTO has been scarcely reviewed in the literature.

Materials and Methods:
This study is a retrospective comparative evaluation of clinical outcomes between patients undergoing PFO + HTO versus HTO alone. Functional outcome of ten patients in either group was assessed by Oxford Knee Score and Western Ontario and McMaster Universities score.

Results:
Patients undergoing PFO + HTO had a larger degree of angular correction. There were lesser complications related to HTO (no delayed union and nonunion). Furthermore, there was no loss of limb alignment. However, peroneal nerve (transient) palsy was reported in this group. Overall, patients had better pain relief and improved scores in the PFO + HTO group.

Conclusion:
PFO seems to be beneficial (albeit statistically insignificant in our cohort) in medial open-wedge osteotomy by allowing compression and promoting union at osteotomy site, maintaining limb alignment for longer period, and providing bone graft for osteotomy site. We recommend a larger prospective study to study the benefits of PFO + HTO for correction greater than 10°, osteoporosis, iatrogenic fracture of lateral cortex of tibia, and slope correction osteotomies. Care should be exercised while handling the common peroneal nerve during PFO.
Functional Outcome of Delayed Surgical Fixation of Capitellar Fractures Treated by Open Reduction and Internal Fixation with Herbert Screw
Authors: Keshkar Sanjay , Barman Riddhideb , Akhtar Mohammad Nasim 
Published: June 2022

Introduction:
Capitellar fractures are rare injuries and difficult to manage, especially so if the patient presents late. Treatment is almost always operative. The purpose of this study is to evaluate the functional outcome of capitellar fractures in adults treated by open reduction and internal fixation (ORIF) with cannulated compression headless screws (Herbert screw) with an inadvertent delay of 2 weeks or more.

Materials and Methods:
Twelve patients (4 males and 8 females) of capitellum fracture who were reported after an inadvertent delay of at least 2 weeks, with near-normal elbow range of motion, operated by ORIF with Herbert screw, were studied retrospectively from April 2013 to March 2019. All cases were operated between 2 to 3 weeks of injury. All patients had a follow-up for a mean period of 34 months, and the final functional outcome was assessed using Mayo Elbow Performance Index (MEPI) and by radiology.

Results:
The mean MEPI score was 92.9 points, and as per this evaluation of the functional rating, all but one patient had excellent results. The mean range of elbow flexion/extension was 125 (90–140), while the range of movement in supination/pronation was 170 (130–180).

Conclusion:
ORIF of capitellum fractures with Herbert screw was found to be superior and gives excellent result, even with a delay of around 2 weeks. Preoperative computed tomography is helpful not only to know clear picture of fracture configuration but also to choose right surgical approach and right implant. Apart from stable internal fixation, early mobilization and rehabilitation are the keys for optimum functional outcome.
Bilateral Bunionette in Rheumatoid Arthritis
Authors: Agrawal Alok Chandra , Garg Ankit Kumar , Garg Deepak Kumar , Ranjan Rahul 
Published: June 2022

Introduction:
Tailor's bunion or Bunionette deformities were described by Davies et al. as abnormal, painful bony prominence on the lateral aspect of the fifth metatarsal head. This prominence, though present in many individuals, seldom causes symptoms. Most deformities can be managed conservatively, and surgical interventions will be needed only for refractory cases presenting with chronic pain. Various surgical interventions (percutaneous, mini-open, open), including osteotomies at different level, has been described in the literature.

Case:
A thirty-three-year-old female house-maker presented with swelling over the bilateral fifth metatarsal lateral aspect and pain while walking for the last six months. The patient is a known case of Rheumatoid arthritis controlled on medication. The patient underwent Lateral exostectomy resection for bilateral swelling, At one year follow up, the patient had good functional outcome with no recurrence.

Conclusion:
Tailor's bunion deformity, although morphologically common, is rarely symptomatic. Its management involves identifying the cause, thorough clinical and radiographic evaluation of the deformity, and deciding the best surgical procedure to obtain optimal results.
Prevalence of Osteoporosis in Eastern Odisha – A Cross-Sectional Study of Bone Mineral Density
Authors: Pattnaik Madhuchhanda , Mohanty Tanmoy , Jena Sunil Kumar 
Published: June 2022

Introduction:
Osteoporosis is a common metabolic disease of the bone characterized by decreased bone mass and micro-architectural deterioration in bone tissues that results in increased susceptibility to fractures. Osteoporosis is a significant public health problem in many parts of the world, also in India. The primary purpose of the article is to find out the prevalence of osteoporosis in Eastern Odisha through the cross-sectional study of bone mineral density (BMD).

Materials and Methods:
Two thousand and one hundred individuals within the age range of 20–82 years were included in the study. It was conducted between February 2016 and August 2017. The instrument to measure BMD was the Achilles Express Bone Ultradensitometer. Their average BMD was calculated according to T score by using the World Health Organization guidelines for the classification into normal, osteopenic, and osteoporotic. The findings were statistically analyzed. The results were compared with the results of other authors. Statistical analysis was performed using the SPSS software version 16 (IBM Corporation, Armonk, New York USA).

Results:
Prevalence of osteoporosis was found to be 22.4% and osteopenia 37.9%. There was a significant difference in the prevalence of osteoporosis between premenopausal and postmenopausal women.

Conclusion:
In India, no centralized data are available to show the prevalence of osteoporosis. This study was an effort to find out the prevalence of osteoporosis in Eastern part of Odisha, India. Ultrasonic heel densitometry is a safe and noninvasive method for the assessment of BMD to diagnose and assess the osteoporotic individuals so that adequate steps can be taken in them to prevent fracture and other complications of osteoporosis.