OBJECTIVE: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. METHODS: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. RESULTS: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). CONCLUSION The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.
Humans ; Spinal Fusion/psychology* ; Intervertebral Disc Displacement/psychology* ; Lumbar Vertebrae/surgery* ; Male ; Female ; Middle Aged ; Phobic Disorders/etiology* ; Surveys and Questionnaires ; Adult ; Risk Factors ; Aged ; Fear ; Kinesiophobia

BACKGROUND: Increased intra-abdominal pressure during laparoscopic surgery causes cephalad displacement of the diaphragm, resulting in the formation of atelectasis, which can be overcome by positive end-expiratory pressure (PEEP). The aim of this prospective study was to investigate the level of optimal PEEP to maintain adequate arterial oxygenation and hemodynamics during robot-assisted laparoscopic radical prostatectomy (RLRP). METHODS: One hundred patients undergoing RLRP were randomly allocated to one of five groups (n = 20) (0, 3, 5, 7 and 10 cmH2O of PEEP). Hemodynamic variables and respiratory parameters were measured at baseline with the patient in the supine position; at 30 min, 1, 2, 3 and 4 h during CO2 insufflation with the patient in the post-Trendelenburg position; and after deflation in the supine position with increasing PEEP. RESULTS: The PaO2 levels and alveolar-arterial difference in oxygen tension (AaDO2) were improved in patients with PEEPs compared with patients in whom PEEP was not used. The application of PEEP (10 cmH2O) resulted in higher PaO2 levels compared to those with lower PEEP levels, but excessive peak airway pressure (PAP) was sometimes observed. The application of a PEEP of 7 cmH2O resulted in similar PaO2 levels without causing excessive PAP. There was a significant difference in central venous pressure between the groups, but there were no significant differences in heart rate, mean arterial pressure or minute ventilation between the groups. CONCLUSIONS: A PEEP of 7 cmH2O is associated with the greater improvement of PaO2 and AaDO2 without causing excessive PAP during RLRP.
Arterial Pressure ; Central Venous Pressure ; Diaphragm ; Displacement (Psychology) ; Heart Rate ; Hemodynamics ; Humans ; Insufflation ; Laparoscopy ; Oxygen ; Positive-Pressure Respiration ; Prospective Studies ; Prostatectomy ; Pulmonary Atelectasis ; Robotics ; Supine Position ; Ventilation

OBJECTIVE: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. METHODS: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. RESULTS: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). CONCLUSIONS: Due to its simplicity, this method may be feasible and useful for repositioning condyles.
Adult ; Bites and Stings ; Centric Relation ; Displacement (Psychology) ; Humans ; Joints ; Mandibular Condyle ; Orthognathic Surgery ; Temporomandibular Joint

PURPOSE: To evaluate the effect of intravitreal expansile gas (C3F8) with anti-VEGF injection for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (ARMD). METHODS: In this report, 18 eyes of 18 patients with large SMH secondary to ARMD were treated with a simultaneous injection of 0.3 cc C3F8 and 0.05 ml anti-VEGF intravitrealy. RESULTS: The mean age was 64.89 +/- 5.68 years and the mean size of SMH was 4.44 +/- 1.25 disc diameters (DD). The minimum follow-up period was 12 months (range: 12-17 months). Mean preoperative best corrected visual acuity (BCVA) was 1.72 +/- 0.56 log MAR which improved significantly to 1.01 +/- 0.68 log MAR at 12 months (p = 0.002). SMH displacement occurred in all eyes. BCVA improved 2 or more lines in 11 eyes (61.1%) and deteriorated in 1 eye (5.6%). CONCLUSIONS: In this report, intravitreal injection of an expansible gas (C3F8) with anti-VEGF produced successful results in anatomical displacement of SMH and early visual improvement.
Displacement (Psychology) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Intravitreal Injections ; Macular Degeneration ; Visual Acuity

PURPOSE: To compare the clinical and radiologic outcomes of various surgical techniques for an isolated fracture of greater tuberosity of the humerus. MATERIALS AND METHODS: From February 2001 to December 2008, 31 patients, who underwent an operation for isolated greater tuberosity fracture and were followed up for more than 1 year, were enrolled in this study. The mean age at the time of operation was 49.3 years (range, 23-73 years). The operation methods included in this study were as follows: a transosseous suture using nonabsorbable suture material (16 cases), a fixation by cannulated screws (10 cases), tension band wiring (2 cases), bony fragment excision with rotator cuff repair (2 cases), and percutaneous pinning (1 case). RESULTS: At the last follow-up, the average Constant score was 79.4 and Korean Shoulder Score (KSS) was 81.2. Among the various operation methods used in this study, the transosseous suture had the highest scores with 82.5 in Constant score and 89.3 in KSS. Bone union was achieved at average 10.3 weeks (range, 7-15 weeks), and there were 2 cases in which the reoperation was required due to internal fixation failure. Postoperative shoulder stiffness occurred in 3 cases, and all the cases were done with the deltopectoral approach. CONCLUSION: Clinically and radiologically satisfactory results were obtained using various operation techniques for an isolated greater tuberosity fracture of the humerus. The transosseous suture showed relatively better results than the other methods used in this study. To achieve favorable clinical and radiologic results, it is important to select an appropriate surgical approach and fixation method according to the fracture site, degree of displacement, and size of fragment.
Displacement (Psychology) ; Follow-Up Studies ; Humans ; Humerus ; Reoperation ; Rotator Cuff ; Shoulder ; Sutures

Distal radius fractures are one of the most common types of fractures in the elderly. It is well documented that increased risk of a distal radius fracture in older patients is associated with decreased bone mineral density. Also, low bone mineral density increased severity of fracture and instability of fracture after reduction. Fracture displacement in the elderly does not necessarily result in functional impairment. Therefore, conservative treatment has been a mainstay treatment even in unstable fracture in the elderly. However, there is an increasing trend toward operative treatment recently, because functional demand increased in the elderly due to active life style and volar locking plate fixation enables the elderly early return to daily activity even in osteoporotic distal radius fracture.
Aged ; Bone Density ; Displacement (Psychology) ; Humans ; Life Style ; Osteoporosis ; Radius ; Radius Fractures

PURPOSE: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. MATERIALS AND METHODS: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. RESULTS: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. CONCLUSION: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.
Arthralgia ; Displacement (Psychology) ; Hallux ; Hallux Valgus ; Humans ; Inflammation ; Metatarsal Bones ; Osteotomy ; Skin ; Sutures

PURPOSE: We evaluated the results of arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window along with any additional bone grafts. MATERIALS AND METHODS: From March 2006 to March 2009, twelve patients with arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures over 5 mm in depression and displacement on the articular surface in computed tomography (CT) were enrolled in this study. We reduced or removed the depressed fracture fragment using freer without making a cortical window. Then, we accomplished internal fixation by a cannulated screw. All cases have not received bone graft. Both the postoperative clinical and radiological results were evaluated by the Rasmussen system. RESULTS: The fractures were healed completely in an average of 9 (range from 7 to 12) weeks. According to Rasmussen classification, we obtained satisfactory clinical results as excellent in 8 cases, good in 3 cases, and fair in 1 case; and radiological results were excellent in 7 cases and good in 5 cases. CONCLUSION: We consider that arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window and any additional bone grafts is are a useful methods for attaining satisfactory results.
Arthroscopy ; Depression ; Displacement (Psychology) ; Humans ; Knee Joint ; Tibia ; Tibial Fractures ; Transplants

PURPOSE: To evaluate the radiological and clinical outcomes of intrapelvic anterior plate fixations for Day Classification Type II crescent fracture-dislocations of sacroiliac joints. MATERIALS AND METHODS: Ten patients who had undertaken the surgical treatment for the sacroiliac joint from 2006 to 2012 were enrolled in this study. All cases fell into Type II by Day Classification for sacroiliac joint injuries. For surgical treatments, the plate fixation through the intra-pelvic anterior approach was first performed for all cases and anterior ring fixation was performed in 4 cases with more severely displaced anterior pelvic ring injuries. Then, radiological and clinical evaluation was implemented. RESULTS: The bone union was observed from all patients whom performed the surgical fixation. In the radiological results, 9 cases with the anatomic and nearly-anatomic reductions were observed. Out of the 10 cases which performed the rotational displacement analysis, there were 3 excellent cases, 6 good cases and 1 fair case. The 10 cases that performed the deformity index and vertical displacement analysis, less variations were observed in the anterior ring fixations after intra-pelvic anterior plate fixation group. According to the clinical results, 4 excellent cases, 3 good cases, and 3 moderate cases were observed. CONCLUSION: In the Type II crescent fracture-dislocation of sacroiliac joint, the intrapelvic anterior plate fixation achieved satisfactory anatomical reductions, radiological stabilities and clinical results.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Sacroiliac Joint

OBJECTIVE: To evaluate the psychosocial impact of malocclusion, determine its relationship with the severity of malocclusion, and assess the influence of gender and social class on this relationship in adolescents. METHODS: A random sample of 627 Spanish adolescents aged 12 - 15 years underwent intraoral examinations by 3 calibrated examiners (intraexaminer and interexaminer kappa > 0.85) at their schools. Psychosocial impact was measured through a self-rated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The severity of malocclusion was measured by the Index of Orthodontic Treatment Need (IOTN). Gender and social class were also recorded. RESULTS: The total PIDAQ score and those of its 4 subscales, social impact, psychological impact, aesthetic concern, and dental self-confidence, presented significant differences (p < or = 0.05 by analysis of variance) and linear relationships with the IOTN grades (p < or = 0.05 by linear regression). Stepwise linear regression models showed that the IOTN dental health component was a predictive variable of the total and subscale PIDAQ scores. Neither gender nor social class was an independent predictive variable of this relationship, except the linear model for psychological impact, where gender was a predictive variable. The occlusal conditions responsible for higher PIDAQ scores were increased overjet, impeded eruption, tooth displacement, and increased overbite. CONCLUSIONS: Malocclusion has a psychological impact in adolescents and this impact increases with the severity of malocclusion. Social class may not influence this association, but the psychological impact seems to be greater among girls.
Adolescent ; Aged ; Displacement (Psychology) ; Esthetics ; Humans ; Index of Orthodontic Treatment Need ; Linear Models ; Malocclusion ; Public Health ; Surveys and Questionnaires ; Social Change ; Social Class ; Tooth Eruption