Zugangswege und Fixation kindlicher Schenkelhalsfrakturen – transglutealer Zugang

Zusammenfassung Operationsziel Die Hüftkopfzirkulation schonende, anatomische Reposition und sichere Stabilisierung von Schenkelhalsfrakturen im Kindesalter über einen transglutealen Zugang. Indikationen Intra-extraartikuläre proximale Femurfrakturen (Schenkelhalsfrakturen) AO 31-M/2.1 I‑III; 31-M/3.1 I‑III; 31-M/3.2 I‑III. Kontraindikationen Keine. Operationstechnik Präparation eines Muskellappens durch Ablösen des proximalen M. vastus lateralis inklusive des anterolateralen Anteils des M. glutaeus medius vom proximalen Femur respektive Trochanter major. Ablösen des glutaeus minimus von der Gelenkkapsel und Weghalten nach dorsal, ohne die Insertion des Muskels vollständig abzulösen. Die anterolaterale Gelenkkapsel kann nun vollständig exponiert werden. Arthrotomie der Gelenkkapsel und Darstellen des Schenkelhalses. Unter Sicht nun vorsichtige, kontrollierte Reposition der Fraktur unter Schutz der retinakulären Gefäße. Weiterbehandlung Mobilisation an Gehstöcken. Abstellen des Fußes erlaubt. Zur vollständigen Anheilung der Hüftabduktoren sollte eine aktive Abduktion sowie passive Adduktion für 4 bis 6 Wochen (je nach Alter des Patienten) vermieden werden. Ergebnisse In der eigenen Klink zeigten sich in den letzten 10 Jahren exzellente Ergebnisse bei 29 Patienten nach Behandlung von kindlichen Schenkelhalsfrakturen mit diesem Operationszugang. Eine operationsbedingte Femurkopfnekrose trat nicht auf.

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Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100077529 ◽

1983 ◽

Vol 41 ◽

pp. 790-791

Author(s):

Melinda L. Estes ◽

Samuel M. Chou

Keyword(s):

Vastus Lateralis ◽

Inflammatory Myopathy ◽

Muscle Disease ◽

White Female ◽

Inflammatory Cell Infiltrate ◽

Limb Weakness ◽

Muscle Diseases ◽

History Of ◽

The Right ◽

Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

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Reduktion des Frakturrisikos unter Denosumab bei postmenopausalen Frauen in Abhängigkeit der Behandlungsbedürftigkeit nach DVO-Leitlinie 2009

Osteologie/Osteology ◽

10.1055/s-0038-1630100 ◽

2013 ◽

Vol 22 (01) ◽

pp. 39-45 ◽

Cited By ~ 4

Author(s):

O. Bock ◽

H. Resch ◽

M. Kraenzlin ◽

A Wang ◽

T. Steinle ◽

...

Keyword(s):

Proximale Femurfrakturen ◽

Post Hoc

ZusammenfassungIn der FREEDOM-Studie konnte gezeigt werden, dass Denosumab 60 mg s. c. alle sechs Monate vs. Placebo bei postmenopausalen Frauen mit Osteoporose nach 36 Monaten das relative Risiko für vertebrale und nonvertebrale Frakturen sowie proximale Femurfrakturen um 68 %, 20 % und 40 % senkt (1). In einer Post-hoc-Analyse wurden nun die Teilnehmerinnen der FREEDOM-Studie entsprechend DVO-Leitlinie als behandlungsbedürftig (81 %) bzw. nicht behandlungs-bedürftig (19 %) eingestuft. Für die behandlungsbedürftige Subgruppe ergaben sich hierbei mit 67 %, 23 % und 41 % vergleichbare relative Risikoreduktionen. Auch in der nicht behandlungsbedürftigen Subgruppe reduzierte Denosumab das relative Risiko für neue vertebrale Frakturen um 75 % vs. Placebo (p = 0,0004); die Zahl der nonvertebralen Frakturen und proximalen Femurfrakturen unterschied sich hier zwischen den Behandlungsarmen nicht signifikant. Diese Auswertung zeigt, dass mehr als 80 % der FREEDOM-Population auch nach DVO-Leitlinie behandlungsbedürftig war und die für Denosumab gezeigten Frakturreduktionen auch unter Anwendung der DVO-Leitlinie in der täglichen Praxis erwartet werden können. Die deutliche Reduktion des Risikos für neue vertebrale Frakturen unter Denosumab auch in der Gruppe der nicht behandlungsbedürftigen Patienten ist ein bemerkenswerter Befund, der im Hinblick auf mögliche Konsequenzen für den Schwellenwert der DVO-Leitlinie bzw. für einen frühzeitigen effektiven Einsatz von Denosumab näher analysiert werden sollte.

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A Systematic Review of the Effect of Open and Closed Kinetic Chain Exercises on the Vastus Medialis Oblique and Vastus Lateralis Muscles of Patients with Patellofemoral Pain Syndrome

MOJ Yoga & Physical Therapy ◽

10.15406/mojypt.2017.02.00014 ◽

2017 ◽

Vol 2 (1) ◽

Author(s):

Adel Almangoush

Keyword(s):

Systematic Review ◽

Vastus Lateralis ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Vastus Medialis ◽

Kinetic Chain ◽

Closed Kinetic Chain

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Ideal body position for epinephrine autoinjector administration

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.42.200108) ◽

2020 ◽

Author(s):

Qing Wang ◽

Luke Pittman ◽

Andrew Healey ◽

James Chang ◽

T. Ted Song

Keyword(s):

Body Position ◽

Vastus Lateralis ◽

The United States ◽

Thigh Muscle ◽

First Line ◽

Medical Treatment Facility ◽

First Line Therapy ◽

Epinephrine Autoinjector ◽

Ideal Body ◽

The Ideal

Background: Epinephrine is the first-line therapy for patients with anaphylaxis, and intramuscular (IM) delivery is shownto be superior to subcutaneous (SC) delivery. There currently is no consensus on the ideal body position for epinephrine autoinjector (EAI) administration.Objective: We designed this study to investigate whether SC tissue depth (SCTD) is affected by body position (e.g., standing, sitting, supine), which can potentially impact delivery of EAI into the IM space.Methods: Volunteer adults (ages >/= 18 years) from a military medical treatment facility in the United States were recruitedto participate in this study. SCTD of the vastus lateralis was measured via ultrasound at standing, sitting, and supine bodypositions. Subjects’ age, sex, and body mass index (BMI) were collected. Statistical analysis was performed to compare averageSCTD between body positions, sex, and BMI.Results: An analysis of variance of 51 participants (33 men and 18 women) did not reveal statistically significant differencein SCTD among standing, sitting, and supine body positions. It did show a significantly greater SCTD in women than in men (2.72 +/- 1.36 cm versus 1.10 +/- 0.38 cm; p < 0.001). There was no significant association observed between BMI and SCTD in this study.Conclusion: Body position did not seem to significantly change the distance between skin and thigh muscle in adults. Thiswould suggest that there might not be an ideal body position for EAI administration. Therefore, in case of anaphylaxis, promptadministration of epinephrine is recommended at any position.

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Ayurvedic management of Myositis Ossificans of Vastus Lateralis Muscle (Urusthamba) - A Case Study

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i1.7523 ◽

2017 ◽

Vol 2 (1) ◽

Author(s):

Vishnu Mohan ◽

Gopikrishna BJ ◽

Avnish Pathak ◽

Mahesh Kumar ES ◽

Duradundi G

Keyword(s):

Heterotopic Ossification ◽

Myositis Ossificans ◽

Vastus Lateralis ◽

Treatment Protocol ◽

Vastus Lateralis Muscle ◽

Satisfactory Treatment ◽

Lateralis Muscle ◽

Ayurvedic Treatment

Myositis ossificansis characterized by heterotopic ossification (calcification) of muscle of various etiologies. It is most commonly affected in the quadriceps of the thighs. There are many tools available for diagnosis of Myositis ossificans, but lack of satisfactory treatment. So the development of a treatment protocol for Myositis ossificans is the need of today`s era. In Ayurveda, the same can be understood as Urusthamba. The present paper discusses a case of Myositis ossificans of right vastus lateralis muscle and its Ayurvedic treatment.

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Knee Muscle Force Estimating Model Using Machine Learning Approach

The Computer Journal ◽

10.1093/comjnl/bxaa160 ◽

2020 ◽

Author(s):

Anurag Sohane ◽

Ravinder Agarwal

Keyword(s):

Machine Learning ◽

Random Forest ◽

Muscle Force ◽

Vastus Lateralis ◽

Input Parameter ◽

Research Work ◽

Cost Effective ◽

Coefficient Of Determination ◽

Muscle Forces ◽

Knee Muscle

Abstract Various simulation type tools and conventional algorithms are being used to determine knee muscle forces of human during dynamic movement. These all may be good for clinical uses, but have some drawbacks, such as higher computational times, muscle redundancy and less cost-effective solution. Recently, there has been an interest to develop supervised learning-based prediction model for the computationally demanding process. The present research work is used to develop a cost-effective and efficient machine learning (ML) based models to predict knee muscle force for clinical interventions for the given input parameter like height, mass and angle. A dataset of 500 human musculoskeletal, have been trained and tested using four different ML models to predict knee muscle force. This dataset has obtained from anybody modeling software using AnyPyTools, where human musculoskeletal has been utilized to perform squatting movement during inverse dynamic analysis. The result based on the datasets predicts that the random forest ML model outperforms than the other selected models: neural network, generalized linear model, decision tree in terms of mean square error (MSE), coefficient of determination (R2), and Correlation (r). The MSE of predicted vs actual muscle forces obtained from the random forest model for Biceps Femoris, Rectus Femoris, Vastus Medialis, Vastus Lateralis are 19.92, 9.06, 5.97, 5.46, Correlation are 0.94, 0.92, 0.92, 0.94 and R2 are 0.88, 0.84, 0.84 and 0.89 for the test dataset, respectively.

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Reliability of Corticospinal Excitability Estimates for the Vastus Lateralis: Practical Considerations for Lower Limb TMS Task Selection

Brain Research ◽

10.1016/j.brainres.2021.147395 ◽

2021 ◽

pp. 147395

Author(s):

F. Proessl ◽

M.E. Beckner ◽

A.M. Sinnott ◽

S.R. Eagle ◽

A.D. LaGoy ◽

...

Keyword(s):

Lower Limb ◽

Vastus Lateralis ◽

Corticospinal Excitability ◽

Task Selection

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Prevalence of the additional head of quadriceps femoris in the South Indian population: a cadaveric and radiological study

Scientific Reports ◽

10.1038/s41598-021-95374-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Femina Sam ◽

Madhavi Kandagaddala ◽

Ivan James Prithishkumar ◽

Koyeli Mary Mahata ◽

Mahasampath Gowri ◽

...

Keyword(s):

Indian Population ◽

Vastus Lateralis ◽

Femoral Nerve ◽

Quadriceps Femoris ◽

Lower Limbs ◽

South Indian Population ◽

The South ◽

South Indian ◽

Circumflex Femoral Artery ◽

Vastus Intermedius

AbstractQuadriceps femoris is an extensor muscle in the anterior compartment of thigh and is traditionally taught to be composed of four heads. Recently, there is an increased interest in the occurrence of an additional muscle head of quadriceps femoris. But scientific knowledge regarding its incidence is lacking in the South Indian population. This study was done to confirm the presence of the additional head by routine anatomic dissection and radiological imaging techniques. Forty-one formalin fixed human cadaveric lower limbs were dissected and the morphology of the additional head was noted. Retrospective analysis of 88 MRI images of patients was done. The additional muscle head was present in 43.9% of the cadaveric lower limbs and was consistently located between the vastus lateralis and vastus intermedius. It originated from variable portions of the greater trochanter, intertrochanteric line, lateral lip of linea aspera and lateral surface of the shaft of femur and inserted either as a muscle belly or as an aponeurosis into the vastus intermedius (55.6%), vastus lateralis (22.2%) or directly into the base of the patella. It received its vascular supply from branches of the lateral circumflex femoral artery and was innervated by branches from the posterior division of the femoral nerve. In addition, the additional muscle head was identified by MRI and its incidence was reported to be 30.68% for the first time in living subjects. The result of this study provides additional information in understanding the morphology of the quadriceps femoris muscle.

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Preliminary Functional Outcomes and Quality of Life after Tongue Reconstruction with the Vastus Lateralis Myofascial Free Flap

Facial Plastic Surgery ◽

10.1055/s-0041-1726445 ◽

2021 ◽

Author(s):

Armando De Virgilio ◽

Andrea Costantino ◽

Raul Pellini ◽

Gerardo Petruzzi ◽

Giuseppe Mercante ◽

...

Keyword(s):

Quality Of Life ◽

Head And Neck ◽

Free Flap ◽

Functional Outcomes ◽

Vastus Lateralis ◽

Life Questionnaire ◽

Donor Area ◽

Tongue Reconstruction ◽

Eortc Qlq

AbstractThe aim of the present study is to report our preliminary experience with the vastus lateralis myofascial free flap (VLMFF) for tongue reconstruction according to tongue and donor site functional outcomes. Twelve consecutive patients (F: 5; median age: 54.0 years, interquartile range or IQR 42.75–69.0) were included. The validated European Organization for Research and Treatment of Cancer of the Head and Neck 35 Quality of Life Questionnaire (EORTC QLQ-H&N35) and the performance status scale for head and neck cancer (PSS-HN) questionnaires were used to assess the health-related quality of life (HRQOL). The lower extremity functional scale (LEFS) was used to self-report the donor area function. All patients were successfully treated, and no VLMFF failure was detected during a median follow-up period of 10.5 months (IQR: 6.5–33.0). The HRQOL showed a median EORTC QLQ-H&N35 score of 56.0 (IQR: 50.0–72.5). The median PSS-HN score was 80.0 (IQR: 45.0–95.0), 75.0 (IQR: 62.5–100.0), 75.0 (IQR: 62.5–100.0) for “Normalcy of Diet,” “Public Eating,” and “Understandability of Speech,” respectively. The self-reported function of the lower extremities (donor area) showed a median LEFS of 59.0 (IQR: 32.5–74.0). This study reports optimistic data regarding the functional and quality of life outcomes after tongue reconstruction using VLMFF. Prospective controlled studies are needed to demonstrate advantages and disadvantages when compared with other reconstructive techniques.

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