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Feng Y, Ding Q, Meng C, Wang W, Zhang J, Lian H. Combining CT Images and Clinical Features of Four Periods to Predict Whether Patients Have Rectal Cancer. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2021; 2021:4662061. [PMID: 34917137 PMCID: PMC8670968 DOI: 10.1155/2021/4662061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/19/2021] [Indexed: 01/30/2023]
Abstract
In this paper, we mainly use random forest and broad learning system (BLS) to predict rectal cancer. A total of 246 participants with computed tomography (CT) image records were enrolled. The total model in the training set (combined with imaging and clinical indicators) has the best prediction result, with the area under the curve (AUC) of 0.999 (95% confidence internal (CI): 0.996-1.000) and the accuracy of 0.990 (95%CI: 0.976-1.000). Model 3, the general model in the test set, has the best prediction result, with the AUC of 0.962 (95%CI: 0.915-1.000) and the accuracy of 0.920 (95%CI: 0.845-0.995). The results of the model using random forest prediction are compared with those using BLS prediction. It can be found that there is no statistical difference between the two results. Our prediction model combined with image features has a good prediction result, and this image feature is the most important among all features. Consequently, we can successfully predict rectal cancer through a combination of the clinical indicators and the comprehensive indicators of CT image characteristics in four different periods (plain scan, vein, artery, and excretion).
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Affiliation(s)
- Yingyin Feng
- Department of Radiology, Tianjin Fourth Central Hospital, Tianjin 300140, China
| | - Qi Ding
- Department of Radiology, Tianjin Fourth Central Hospital, Tianjin 300140, China
| | - Chen Meng
- Hemodialysis Room, Tianjin Fourth Central Hospital, Tianjin 300140, China
| | - Wenfeng Wang
- School of Science, Shanghai Institute of Technology, Shanghai 201418, China
| | - Jingjing Zhang
- School of Science, Shanghai Institute of Technology, Shanghai 201418, China
| | - Huixiu Lian
- Department of Medical Imaging, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, China
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Qazi S, Graham D, Regal S, Tang P, Hammarstedt JE. Distal Radioulnar Joint Instability and Associated Injuries: A Literature Review. J Hand Microsurg 2021; 13:123-131. [PMID: 34539128 PMCID: PMC8440053 DOI: 10.1055/s-0041-1730886] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The distal radioulnar joint (DRUJ) allows supination and pronation of the distal forearm and wrist, an integral motion in everyday human activity. DRUJ injury and chronic instability can be a significant source of morbidity in patients' lives. Although often linked with distal radius fractures, DRUJ injury may occur in a variety of other upper extremity injuries, as well as an isolated pathology. Diagnosis of this injury requires the clinician to have a high index of suspicion and low threshold for clinical testing and further imaging of the DRUJ. The purpose of this article is to provide a review on DRUJ anatomy and biomechanics, to discuss common diagnostic and treatment modalities, and to identify common injuries associated with DRUJ instability.
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Affiliation(s)
- Sohail Qazi
- Department of Orthopaedic Surgery, Temple University Hospital, Philadelphia, Pennsylvania, United States
| | - David Graham
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Steven Regal
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Peter Tang
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Jon E. Hammarstedt
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
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Peter K, Luzian H, Markus G, Ansgar R, Andrea K, Arora R. Mid-term outcome (11-90 months) of the extensor retinaculum flap procedure for extensor carpi ulnaris tendon instability. Arch Orthop Trauma Surg 2019; 139:1323-1328. [PMID: 31222435 PMCID: PMC6687678 DOI: 10.1007/s00402-019-03227-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of our study was the assessment of the mid-term outcome of patients treated with a pediculated extensor retinaculum flap for extensor carpi ulnaris (ECU) tendon subluxation including postoperative tendon stability control. MATERIALS AND METHODS Twelve patients treated with an extensor retinaculum flap for symptomatic ECU tendon instability were retrospectively evaluated. Follow-up examinations included functional and radiologic assessment. The range of motion, grip strength, DASH score, PRWE score, Krimmer score and subjective satisfaction were recorded. A rotation-movie MRI was conducted before and after surgery to visualize tendon displacement. RESULTS Wrist extension was 65.8° (SD 10.0°), flexion 64.2° (SD 12.2°), radial deviation 15.8° (SD 6.0°), ulnar deviation 32.1° (SD 7.2°), pronation 82.5° (SD 9.4°) and supination 85.0° (SD 9.0°). Mean grip strength was 30.5 kg (SD 8.9 kg). Six patients presented an excellent, four a good, one a fair and one a poor result on the Krimmer score. The DASH and PRWE scores showed a mean of 24.2 (SD 25.1) and 32.2 (SD 29.4) points. MRI showed a dislocation (n = 7) or subluxation (n = 5) of the ECU tendon preoperatively. Five patients showed an unchanged displacement pattern postoperatively. CONCLUSION The pediculated extensor retinaculum flap as a treatment for a symptomatic ECU instability shows good to excellent results and a high subjective satisfaction independent of postoperative ECU tendon displacement.
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Affiliation(s)
- Kaiser Peter
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Haug Luzian
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
- Department for Plastic, Reconstructive and Hand Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Gabl Markus
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Rudisch Ansgar
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klauser Andrea
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Rohit Arora
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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Quadlbauer S, Pezzei C, Hintringer W, Hausner T, Leixnering M. Klinische Untersuchung des distalen Radioulnargelenks. DER ORTHOPADE 2018; 47:628-636. [DOI: 10.1007/s00132-018-3584-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW The goal of this manuscript is to review key historic and recent literature regarding extensor carpi ulnaris (ECU), triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) injuries, particularly in athletes. RECENT FINDINGS Many recent studies examining the ECU focus on clinical and radiographic diagnosis. Several physical exam findings are described in addition to the use of MRI and US. Imaging studies must be clinically correlated due to high incidence of findings in asymptomatic patients. In regard to the TFCC/DRUJ, there are numerous recent studies that support the use of MRA as an adjunctive diagnostic study. There are also a number of repair constructs that are described for the various different kinds of TFCC pathology reviewed here. In summary, there are a number of options for the diagnosis and treatment of ulnar-sided wrist pain. Patient factors, especially in the athletic population, must be taken into account when approaching any patient with these pathologies.
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Iannuzzi NP, Kollitz KM, Huang JI. Acute Distal Radioulnar Joint Instability in Adults: A Critical Analysis Review. JBJS Rev 2016; 2:01874474-201407000-00002. [PMID: 27490058 DOI: 10.2106/jbjs.rvw.m.00110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nicholas P Iannuzzi
- Department of Orthopaedics and Sports Medicine, University of Washington, 4245 Roosevelt Way N.E., Box 354740, Seattle, WA 98105
| | | | - Jerry I Huang
- Department of Orthopaedics and Sports Medicine, University of Washington, 4245 Roosevelt Way N.E., Box 354740, Seattle, WA 98105
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Spies CK, Hahn P, Müller LP, Unglaub F. [In Process Citation]. Unfallchirurg 2015; 118:719-23. [PMID: 26242547 DOI: 10.1007/s00113-015-0055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C K Spies
- Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland,
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Clinical experience with arthroscopically-assisted repair of peripheral triangular fibrocartilage complex tears in adolescents—technique and results. INTERNATIONAL ORTHOPAEDICS 2015; 39:2087. [DOI: 10.1007/s00264-015-2879-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/08/2015] [Indexed: 10/23/2022]
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Kirchberger MC, Unglaub F, Mühldorfer-Fodor M, Pillukat T, Hahn P, Müller LP, Spies CK. Update TFCC: histology and pathology, classification, examination and diagnostics. Arch Orthop Trauma Surg 2015; 135:427-37. [PMID: 25575720 DOI: 10.1007/s00402-015-2153-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Indexed: 02/09/2023]
Abstract
The TFCC is a crucial stabilizer of the DRUJ. Based on its superficial and deep fibers, the TFCC guarantees unrestricted pronation and supination which is essential for performing sophisticated tasks. The ability to perform complex movements is of uppermost importance for hand function. Therefore, a functional intact TFCC is a prerequisite in this context. The articular disc of the TFCC is a fibrocartilaginous extension of the superficial zone of hyaline articular cartilage which arises from the radius. The peripheral 10-40 % of the TFC is vascularized. Degeneration of the articular disc is common with increasing age. Even though the central part of the articular disc is avascular, potential regeneration of lesions could be detected. The Palmer and Atzei classifications of TFCC lesions are complementary. TFCC innervation is based on different nerves. There is a high variability. A diligent clinical examination facilitates specific tests which help to allocate symptoms to the pathology. Therefore, a thorough clinical examination is not dispensable. Wrist arthroscopy remains the "gold standard" for diagnosing TFCC pathologies despite technical progress in imaging modalities. MR arthrography may have the potential to become a real alternative to wrist arthroscopy for diagnosing TFCC pathologies with technical progress in the future.
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Affiliation(s)
- Michael C Kirchberger
- Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany
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Spies CK, Hahn P, Unglaub F. Letter to the editor: how does ulnar shortening osteotomy influence morphologic changes in the triangular fibrocartilage complex? Clin Orthop Relat Res 2015; 473:397-8. [PMID: 25373937 PMCID: PMC4390974 DOI: 10.1007/s11999-014-4041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/27/2014] [Indexed: 01/31/2023]
Affiliation(s)
- Christian Karl Spies
- Department of Hand Surgery, Vulpius Klinik, Vulpiusstr. 29, 74906 Bad Rappenau, Baden-Württemberg Germany
| | - Peter Hahn
- Department of Hand Surgery, Vulpius Klinik, Vulpiusstr. 29, 74906 Bad Rappenau, Baden-Württemberg Germany
| | - Frank Unglaub
- Department of Hand Surgery, Vulpius Klinik, Vulpiusstr. 29, 74906 Bad Rappenau, Baden-Württemberg Germany
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Spies CK, Müller LP, Unglaub F, Hahn P, Klum M, Oppermann J. Anatomical transosseous fixation of the deep and superficial fibers of the radioulnar ligaments. Arch Orthop Trauma Surg 2014; 134:1783-8. [PMID: 25380839 DOI: 10.1007/s00402-014-2103-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The triangular fibrocartilage complex is in conjunction with the interosseous membrane the most important stabilizer of the distal radioulnar joint. Lesions of the triangular fibrocartilage complex may cause instability of the distal radioulnar joint with serious consequences. Therefore, the goal is to reconstruct and provide stability to prevent further harm. SURGICAL TECHNIQUE Based on the anatomical configuration of the radioulnar ligaments, we present a technique which addresses both the deep and the superficial fibers of the radioulnar ligaments. This surgical procedure can be performed either openly or arthroscopically assisted. Two osseous 2-mm tunnels starting from the ulnar neck to the foveal surface are created. A nonabsorbable suture is passed through the tunnels and the triangular fibrocartilage using a 20-gauge venipuncture needle in order to attach the deep fibers. Then a third osseous tunnel starting from the lateral base of the styloid process to the medial aspect is created. The suture is passed through this tunnel and through the triangular fibrocartilage and around the styloid process palmarily using the same needle as before in order to anchor the superficial fibers anatomically. After reducing the ulna head the sutures are tightened. CONCLUSION This technique is quite simple and addresses the anatomical configuration of the radioulnar ligaments.
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Affiliation(s)
- Christian K Spies
- Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany,
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Midterm functional outcome after dorsal capsular imbrication for posttraumatic instability of the distal radioulnar joint. Arch Orthop Trauma Surg 2014; 134:1633-9. [PMID: 25288029 DOI: 10.1007/s00402-014-2092-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The dorsal capsular imbrication of the distal radioulnar joint (DRUJ) which was performed because of posttraumatic dorsal instability showed promising functional results after the first postoperative years. Therefore, we hypothesized that patients after capsular imbrication are characterized by good subjective and functional outcome measurements after a midterm period. MATERIALS AND METHODS Eleven patients (range 21-50 years of age; median 35 years of age) were examined after capsular imbrication of the DRUJ because of posttraumatic instability with a mean follow-up time of 72 months (range 46-114 months; median 66 months). Examination parameters included the determination of range of motion (ROM), grip strength, pain and functional outcome scores (modified Mayo wrist score (MMWS); Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score)). RESULTS A mean DASH score of 6.7 (range 0-22.5) and mean MMWS of 91.8 (range 75-100) were measured. Grip strength reached 96.7 % of the contralateral hand. Range of motion reached at least 93.1 % of the contralateral hand. Eight of 11 patients regarded functional outcome and pain reduction as excellent. Six of 11 patients did not recognize a diagnosed instability of DRUJ as such. Ulnar-sided wrist pain was the apparent symptom in these cases. CONCLUSIONS Capsular imbrication of the DRUJ is a reliable and sufficient treatment option in case of posttraumatic dorsal instability. Since DRUJ instability is seldom recognized by the patients as such, a standardised diagnostic algorithm is mandatory to guarantee reliability and efficacy for identifying DRUJ instability.
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Push-off needle test for traumatic triangular fibrocartilage complex lesions. J Hand Surg Am 2014; 39:1448-9. [PMID: 24969501 DOI: 10.1016/j.jhsa.2014.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 02/04/2014] [Accepted: 03/24/2014] [Indexed: 02/02/2023]
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Spies CK, Hahn P, Unglaub F. Comments on: Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna (J Wrist Surg 2013;2(2):168-175). J Wrist Surg 2014; 3:155-6. [PMID: 25032081 PMCID: PMC4078119 DOI: 10.1055/s-0034-1373732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Peter Hahn
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frank Unglaub
- Hand Surgery, Vulpius Klinik, Bad Rappenau, Germany
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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