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Sanda II, Hosin S, Vermesan D, Deleanu B, Pop D, Crisan D, Al-Qatawneh M, Mioc M, Prejbeanu R, Rosca O. Impact of Syndesmotic Screw Removal on Quality of Life, Mobility, and Daily Living Activities in Patients Post Distal Tibiofibular Diastasis Repair. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2048. [PMID: 38138151 PMCID: PMC10744725 DOI: 10.3390/medicina59122048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: While numerous studies have been conducted on syndesmotic screw management following distal tibiofibular diastasis repair, a clear consensus remains unclear. This research aims to evaluate whether the postoperative removal of syndesmotic screws leads to improved patient outcomes, specifically in quality of life, mobility, and daily living activities, and whether it offers a cost-effective solution. Materials and Methods: Patients with a history of unimalleolar or bimalleolar ankle fractures, classified according to the Danis-Weber and Lauge-Hansen systems, were included. Comprehensive evaluations were made via standardized questionnaires like the SF-36 Health Survey, HADS, and WHOQOL-BREF, distributed approximately 2 months post surgery. A total of 93 patients underwent syndesmotic screw removal while 51 retained the screws (conservative approach). Results: Patients who underwent screw removal reported superior satisfaction in mobility, with a score of 7.8, compared to 6.7 in the conservative approach (p = 0.018). Similarly, their ability to perform daily activities scored 8.1, higher than the 6.5 from the conservative cohort (p < 0.001). Pain levels were also more favorable in the screw removal group, with a score of 5.3 against 6.8 in the conservative group (p = 0.003). On the SF-36 physical domain, the screw removal group achieved a mean score of 55.9 versus 53.3 for the conservative group (p = 0.027). Notably, the HADS anxiety subscale highlighted reduced anxiety levels in the screw removal cohort with a mean score of 5.8 against 7.3 in the conservative group (p = 0.006). However, overall quality of life and recommendations to others showed no significant difference between the groups. Conclusions: Syndesmotic screw removal postoperatively leads to marked improvements in patients' mobility, daily activity abilities, and reduced postoperative pain and anxiety levels. However, overall quality of life was similar between the two approaches. The findings offer valuable insights for orthopedic decision making and patient-centered care concerning the management of syndesmotic screws after distal tibiofibular diastasis repair.
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Affiliation(s)
- Isabella-Ionela Sanda
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
- Department of Laboratory Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Samer Hosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Dinu Vermesan
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Bogdan Deleanu
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Daniel Pop
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Dan Crisan
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Musab Al-Qatawneh
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Mihai Mioc
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Radu Prejbeanu
- Department of Orthopedics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.V.); (B.D.); (D.P.); (D.C.); (M.A.-Q.); (M.M.); (R.P.)
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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Ramos O, de Arco L, Cifuentes CA, Moazen M, Wurdemann H, Múnera M. Mechanical assessment of novel compliant mechanisms for underactuated prosthetic hands. Front Bioeng Biotechnol 2023; 11:985901. [PMID: 37901838 PMCID: PMC10602892 DOI: 10.3389/fbioe.2023.985901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
This paper proposes novel compliant mechanisms for constructing hand prostheses based on soft robotics. Two models of prosthetic hands are developed in this work. Three mechanical evaluations are performed to determine the suitability of the two designs for carrying out activities of daily living (ADLs). The first test measures the grip force that the prosthesis can generate on objects. The second determines the energy required and dissipated from the prosthesis to operate. The third test identifies the maximum traction force that the prosthesis can support. The tests showed that the PrHand1 prosthesis has a maximum grip force of 23.38 ± 1.5 N, the required energy is 0.76 ± 0.13 J, and the dissipated energy is 0.21 ± 0.17 J. It supports a traction force of 173.31 ± 5.7 N. The PrHand2 prosthesis has a maximum grip force of 36.13 ± 2.3 N, the required energy is 1.28 ± 0.13 J, the dissipated energy is 0.96 ± 0.12 J, and it supports a traction force of 78.48 ± 0 N. In conclusion, the PrHand1 prosthesis has a better performance in terms of energy and tensile force supported. The difference between the energy and traction force results is related to two design features of the PrHand2: fully silicone-coated fingers and a unifying mechanism that requires more force on the tendons to close the prosthesis. The grip force of the PrHand2 prosthesis was more robust than the PrHand1 due to its silicone coating, which allowed for an improved grip.
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Affiliation(s)
- Orion Ramos
- School of Engineering, Science and Technology, Universidad Del Rosario, Bogota, Colombia
| | - Laura de Arco
- Telecommunications Laboratory (LABTEL), Electrical Engineering, Federal University of Espirito Santo (UFES), Vitória, Brazil
| | - Carlos A. Cifuentes
- School of Engineering, Science and Technology, Universidad Del Rosario, Bogota, Colombia
- Bristol Robotics Laboratory, University of the West of England, Bristol, United Kingdom
| | - Mehran Moazen
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Helge Wurdemann
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Marcela Múnera
- Bristol Robotics Laboratory, University of the West of England, Bristol, United Kingdom
- Biomedical Engineering Department, Colombian School of Engineering Julio Garavito, Bogota, Colombia
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