Acute Traumatic Tear of Gluteus Medius and Minimus Tendons in a Patient Without Antecedant Peritrochanteric Hip Pain.

Acute traumatic tear of gluteus medius and minimus tendons in a patient without antecedant peritrochanteric hip pain.

Geriatr Orthop Surg Rehabil. 2012 Jun; 3(2): 84-8
Stanton MC, Maloney MD, Dehaven KE, Giordano BD

Morphologic similarities between the abductor mechanisms of the hip and shoulder have given rise to the term rotator cuff tear of the hip. Although the true incidence of gluteus medius and minimus tears in the general population is unknown, the association between these tears and recalcitrant lateral hip pain has been described as greater trochanteric pain syndrome. Historically, tears of the gluteus medius and minimus have been thought to be attritional, and associated with chronic peritrochanteric pain, found incidentally during fracture fixation or hip arthroplasty, or with failure of abductor repair following arthroplasty utilizing the anterolateral approach. The literature supports favorable clinical outcomes with operative repair utilizing either endoscopic or open techniques. To our knowledge, there has never been a reported case of an acute traumatic tear of the gluteus medius and minimus that occurred without antecedant peritrochanteric hip pain. In this case, the patient was treated with acute open repair of the gluteus medius and minimus tendons within 3 weeks of injury and excellent clinical results were obtained at 6-month follow-up. Of note, the patient was notified and gave consent for his case to be used in publication. HubMed – rehab

Barriers to implementation of an organized geriatric fracture program.

Geriatr Orthop Surg Rehabil. 2012 Mar; 3(1): 8-16
Kates SL, O’Malley N, Friedman SM, Mendelson DA

There has been a recent increase in interest in implementing organized geriatric fracture programs for care of older adults with fragility fractures in order to improve both the quality and costs of care. Because such programs are relatively new, there are no standardized methods for implementation and no published descriptions of barriers to implementation.An online survey tool was sent to 185 surgeons and physicians practicing in the United States, who are involved with geriatric fracture care. Sixty-eight responses were received and evaluated.Barriers identified included lack of medical and surgical leadership, need for a clinical case manager, lack of anesthesia department support, lack of hospital administration support, operating room time availability, and difficulty with cardiac clearance for surgery. Other issues important to implementation included quality improvement, cost reductions, cost to the hospital, infection prevention, readmission prevention, and dealing with competing interest groups and competing projects mandated by the government. Physicians and surgeons felt that a site visit to a functioning program was most important when considering implementing a hip fracture program.This study provides useful insights into barriers to implementing an organized hip fracture program. The authors offer suggestions on ways to mitigate or overcome these barriers. HubMed – rehab

Pelvic floor muscle exercise for chronic low back pain.

J Int Med Res. 2013 Feb; 41(1): 146-52
Bi X, Zhao J, Zhao L, Liu Z, Zhang J, Sun D, Song L, Xia Y

To assess the effect of pelvic floor muscle exercise in patients with chronic low back pain.Adults (aged ?18 years) with chronic low back pain (with or without radiculopathy) were randomized to undergo either routine treatment (ultrasonography, short wave diathermy and lumbar strengthening exercises; control group) or routine treatment with pelvic floor exercises (intervention group) for 24 weeks. Pain, disability (Oswestry Disability Index [ODI] score) and trunk muscle function were assessed at baseline and after completion of treatment.The study included 47 patients (control group n?=?24; intervention group n?=?23). Pain severity and ODI scores were significantly lower in the intervention group than in the control group after 24 weeks. There were no significant between-group differences in trunk muscle function.Pelvic floor exercise in combination with routine treatment provides significant benefits in terms of pain relief and disability over routine treatment alone. HubMed – rehab

Strategic targeted exercise for preventing falls in elderly people.

J Int Med Res. 2013 Mar 7;
Zheng J, Pan Y, Hua Y, Shen H, Wang X, Zhang Y, Fan Y, Yu Z

OBJECTIVE: Randomized, controlled, blinded trial to evaluate the effectiveness of strategic targeted exercise for preventing falls in elderly people. METHODS: Elderly people were randomly allocated to either a control group that received conventional exercise, or a training group that received conventional exercise plus proprioception and cognitive exercises. Subjects were asked to exercise three times a week (40?min per session) for 8 weeks. In the pre- and post-training sessions, all participants were assessed using a static postural control test with eyes open and closed, the Berg Balance Scale (BBS) and the joint position sense test of the lower limbs. RESULTS: After 8 weeks, there were statistically significant improvements in the training group (n?=?50) compared with the control group (n?=?50) for mediolateral sway distance with eyes open and eyes closed, anteroposterior sway distance with eyes open but not with eyes closed, BBS scores and joint position sense test for the left but not the right knee. CONCLUSION: This study demonstrated that strategic targeted exercise could produce more beneficial effects on balance and proprioception function than conventional exercise alone, in elderly people. HubMed – rehab