Osteotomy

Researchers are evaluating the safety and effectiveness of the Symani Surgical System in microsurgical anastomosis during free tissue transfer surgery and lymphovenous anastomosis surgery. This observational study aims to assess the device's performance in real-world settings, focusing on the rate of successful vessel connection in the first surgical attempt and the absence of device-related adverse events. Participants will receive standard surgical care using the Symani Surgical System, which offers articulated, interchangeable instruments designed for open microsurgery procedures. The study includes patients undergoing free tissue transfer of the breast or extremities and those having lymphovenous anastomosis surgery for lymphedema. During the trial, participants will have their surgical procedures assessed and may complete questionnaires if undergoing lymphedema procedures. Throughout the study, researchers will monitor the safety and effectiveness of the device by evaluating intraoperative vessel patency and tracking any adverse events up to 30 days after surgery. Participants will be asked to allow access to their medical information, attend follow-up visits, and complete all study procedures and questionnaires. The total participation covers the surgery period and a 30-day post-surgery follow-up to ensure comprehensive safety and outcome monitoring.

Researchers are investigating the accuracy of using two customized titanium plates compared to four customized titanium plates for transferring the virtual surgical plan in orthognathic surgery cases. The study aims to improve the precision of maxillary repositioning in three dimensions during these surgeries by minimizing the hardware used in fixation. Participants will receive either two or four customized 3D titanium miniplates designed to transfer the virtual plan accurately to the surgical field. The study is randomized and evaluates these two approaches as procedures during orthognathic surgery. During the study, researchers will assess the accuracy of the plan transfer within one week after surgery and measure patient satisfaction at six months. The study involves close monitoring of surgical outcomes and participant feedback over this period, with participants aged 18 to 40 years taking part.

This research aims to evaluate how well patients with various musculoskeletal conditions follow personalized home-based exercise programs prescribed by their physicians. It focuses on patients with degenerative, orthopedic, or neurological disorders undergoing rehabilitation. The study seeks to identify differences in adherence across these groups and explore factors such as demographics, clinical status, psychosocial elements, and physical function that might influence exercise compliance. Participants will receive customized home exercise programs designed by physical therapy and rehabilitation physicians based on their specific clinical needs. These exercises complement clinic-based treatments and are tailored to individual conditions within three subgroups: chronic degenerative disorders, post-operative orthopedic rehabilitation, and neurological rehabilitation following conditions like stroke or hemiplegia. The home programs will last six weeks, with clear instructions and printed materials provided to support correct performance. During the study, patients' adherence and clinical progress will be assessed at the beginning and end of the six-week program using standardized tools such as the Exercise Adherence Rating Scale, Beck Depression Index, Visual Analog Scale for pain, Barthel Index for daily living activities, Tampa Kinesiophobia Scale, and Health Assessment Questionnaire. Researchers will monitor mood, functional status, pain levels, and fear of movement to understand adherence patterns. The study will also evaluate patients' satisfaction and factors influencing their commitment to the home exercises, aiming to improve future rehabilitation strategies.

Researchers are evaluating facial symmetry outcomes in patients undergoing mandibular reconstruction using fibula free flaps. This study compares two surgical fixation techniques: placing the fibula flap at the prosthetically favorable alveolar level versus the conventional inferior border level. The trial involves patients needing mandibular reconstruction due to tumors, trauma, or osteomyelitis with defects larger than 9 cm. Participants are randomly assigned to one of two groups. One group receives fibula free flap fixation at the inferior border level, while the other group's flap is fixed at the alveolar level, leaving 15-17 mm space to the opposing teeth. The study follows patients for 12 months after surgery to assess the outcomes of these techniques. Throughout the study, patients are monitored at baseline, 3 days, 1 week, 1 month, 6 months, and 12 months postoperatively. Researchers measure facial symmetry as the primary outcome and patient satisfaction as a secondary outcome during the 6 to 12 month follow-up. This helps evaluate the effectiveness of the two fixation positions in mandibular reconstruction.

Researchers are evaluating the skeletal, dental, and soft tissue effects of two orthodontic treatments—Mandibular advancement aligners (Invisalign MA) and the Herbst appliance—in growing patients with Class II malocclusion. The study focuses on children aged 9 to 15 years who have a Class II skeletal malocclusion with specific dental and skeletal characteristics. The goal is to compare how each device stimulates mandibular growth and affects jaw alignment and facial structure. Participants will receive treatment with either the Invisalign MA system or the Herbst appliance. Before treatment, dental impressions and 3D optical scans will be used to create the devices. Some preparatory dental adjustments may be made, such as leveling teeth or expanding the palate when needed. Active mandibular advancement will continue until a Class I molar relationship is achieved, followed by a 2-month period without advancement to allow jaw stabilization. The study includes two CBCT scans taken before and after this phase, spaced at least one year apart, to measure changes precisely. Throughout the study, patients will undergo initial and follow-up dental assessments, including cephalometric X-rays and ultra-low dose CBCT scans. These scans help measure mandibular lengthening, jaw movement, and rotation. After the main treatment phase, orthodontic care will continue until completion, followed by retention and regular post-treatment check-ups. The total study duration per participant is at least one year plus the retention period, ensuring careful monitoring of treatment effects and jaw development.

Researchers are evaluating the effects and safety of dexamethasone palmitate compared to traditional dexamethasone for preventing postoperative nausea and vomiting (PONV) after open surgery. Although dexamethasone is commonly used to reduce PONV, some patients still experience symptoms within 24 hours after surgery. Dexamethasone palmitate has a longer-lasting anti-inflammatory effect and fewer side effects, making it a promising option for managing PONV. Participants will be randomly assigned to one of two groups. One group will receive an intravenous injection of dexamethasone palmitate 8 mg (containing 5 mg dexamethasone) after anesthesia induction and before surgical incision. The other group will receive an intravenous injection of dexamethasone 5 mg at the same time. The trial compares these treatments in patients undergoing elective open surgeries such as spinal, chest, or abdominal surgery. During the study, researchers will monitor participants for the incidence and severity of PONV at multiple time points within 72 hours after surgery. They will also track the use of rescue antiemetic medications, participant satisfaction with PONV management, pain levels using the VAS scale, quality of postoperative recovery, length of hospital stay, and safety outcomes up to one month after surgery. The main outcome is the occurrence of PONV within the first 24 hours postoperatively. Participation lasts through the surgery and follow-up periods as described.

This trial investigates whether intravenous dexamethasone can prevent low blood pressure after spinal anesthesia in older adults having orthopedic surgeries on their lower limbs. Researchers aim to see if giving dexamethasone before surgery reduces post-spinal hypotension compared to a placebo. The study focuses on geriatric patients aged 65 to 85 years undergoing these procedures. Participants are randomly assigned to one of two groups. One group receives an 8 mg dose of intravenous dexamethasone about 20 minutes before spinal anesthesia. The other group receives a placebo intravenously at the same time before the spinal anesthesia. This is a phase 4, single-blind, randomized study conducted at a tertiary care hospital. During the trial, participants' blood pressure is monitored from enrollment until 30 minutes after spinal anesthesia to assess the occurrence of hypotension. Researchers will compare the effects of dexamethasone versus placebo on this outcome. The total participation duration includes preoperative administration and monitoring immediately after spinal anesthesia. Safety and other assessments are performed as part of routine care during this period.

Researchers are investigating how orthognathic surgery, which changes the three-dimensional position of the jaws, affects head and neck posture along with overall body posture. The study focuses on how these postural changes influence plantar pressure distribution. By comparing patients who undergo orthognathic surgery with non-operated individuals, the study aims to understand the direction and magnitude of these changes and their implications for postoperative evaluation and rehabilitation. The study includes 60 participants divided into two groups: 30 patients scheduled for orthognathic surgery and 30 control patients who have completed orthodontic treatment without surgery. The surgical group will undergo static and dynamic computerized plantar pressure analyses using specialized pedobarography systems before surgery and at a 6-month postoperative follow-up. Total body posture will be analyzed with a mobile application using four-directional photographs. Body height, weight, and lateral cephalometric radiographs will also be collected preoperatively and at the 6-month follow-up. The control group will receive comparable assessments during routine follow-up visits. Participants will be evaluated through posture and plantar pressure measurements before and after surgery or at corresponding times for controls. Data collected include body measurements, radiographs, and computerized pressure analyses to measure changes over time. Researchers will compare baseline and follow-up results to assess postural and plantar pressure changes. The study will help identify important parameters for patient rehabilitation after orthognathic surgery, with total participation lasting at least six months post-surgery or follow-up.

Researchers are evaluating the effects of murottal (recitations of Islamic verses) and classical music on reducing postoperative pain intensity and levels of interleukin 6, an inflammatory marker, in patients undergoing lower extremity orthopedic surgery with spinal anesthesia. The study aims to understand if these non-drug therapies can help manage pain and the body's inflammatory response after surgery. Participants are randomly assigned to one of three groups: listening to murottal during surgery recovery, listening to classical music, or receiving standard postoperative care without additional interventions. Pain intensity and interleukin 6 levels will be measured before surgery and 30 minutes after surgery to assess the impact of the interventions. Throughout the study, participants will undergo routine checkups to ensure safety and treatment success. Pain will be measured using a numeric rating scale, and blood samples will be collected to track interleukin 6 levels. The study will monitor participants closely during the postoperative period to evaluate the effects of these therapies compared to standard care.

Researchers are monitoring the ongoing safety and performance of various Arthrex foot and ankle medical devices. These include implants and screws for treating hyperpronated foot, reconstructive surgeries, fracture fixation, arthrodeses, osteotomies, and joint stabilization. The study also evaluates devices like the ArthroFLEX dermal allograft and the DualCompression Hindfoot Nail for specific foot and ankle conditions. This registry collects data from patients undergoing procedures with these products to better understand their outcomes. The devices studied include the ProStop implant, Bio-Compression Screw, TRIM-IT Drill and Spin Pin systems, Headless and Compression FT Screws, DynaNite nitinol staple, BioComposite SutureTak anchor, Beveled FT Screws, KreuLock screws, ArthroFLEX dermal allograft, and DualCompression Hindfoot Nail. Patients receive surgical treatments using these products as indicated. The study tracks device-related adverse events at 3, 6, 12, and 24 months after surgery to assess safety. Performance is evaluated through physical exams and range of motion measurements, particularly for the ArthroFLEX allograft. Participants complete patient-reported outcome surveys including the Foot and Ankle Ability Measures, Visual Analogue Scale, Single Assessment Numeric Evaluation, and Veterans Rand 12-Item Health Survey at various times up to two years post-surgery. Imaging such as X-rays and CT scans are used to monitor specific devices at set intervals. The study requires follow-up visits to assess recovery, device function, and safety. Participation may last for at least two years after surgery, with scheduled assessments throughout this period.