scholarly journals Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

2020 ◽  
Vol 09 (04) ◽  
pp. 328-337
Author(s):  
Vicente Carratalá ◽  
Francisco Javier Lucas ◽  
Ignacio Miranda ◽  
Alfonso Prada ◽  
Eva Guisasola ◽  
...  
Keyword(s):  
Grip Strength ◽  
Soft Tissues ◽  
Primary Repair ◽  
Acute Injury ◽  
Prospective Clinical Study ◽  
Scapholunate Ligament ◽  
Dorsal Approach ◽  
Perilunate Dislocation ◽  
Acute Injuries ◽  
Aggressive Interventions

Abstract Objective To describe a technique for treating acute injuries of the scapholunate ligament (SLL) by performing an arthroscopic reinsertion of the SLL and dorsal capsulodesis and to present the results obtained. Methods The study deals with an analytical, prospective clinical study that included 19 consecutive patients with acute injury of the SLL. The range of joint motion, grip strength, pain according to the visual analog scale, functional outcomes according to the Mayo Wrist Score (MWS), and the QuickDASH Score were studied preoperatively and 6 and 12 months postoperatively. The complications and necessary reinterventions were recorded. Results Nineteen patients with acute injury of the SLL were studied; mean age was 44 ± 2 years, 74% males, 58% complete rupture, and 42% partial rupture, treated with the above-mentioned technique. Thirty-seven percent also had a distal radius fracture and there was one case of perilunate dislocation. Improvement in pain, grip strength, joint balance, and functionality was observed 6 and 12 months postoperatively, with 79% of the cases with good or excellent results Conclusion The arthroscopic reinsertion and dorsal capsular reinforcement of the SLL, allow a reliable and stable primary repair of the dorsal aspect of the ligament in acute or subacute SL injuries where there is tissue that can potentially be repaired, thus achieving an anatomical repair similar to that obtained with open surgery, but without the complications and stiffness secondary to aggressive interventions on the soft tissues that are inherent to the open dorsal approach.

scholarly journals Modern approaches to the treatment of scapholunate interosseous ligament injuries (literature review)

2020 ◽  
Vol 26 (4) ◽  
pp. 593-599
Author(s):  
O.G. Shershneva ◽  
◽  
I.V. Kirpichev ◽  
Keyword(s):  
Primary Repair ◽  
Clinical Manifestations ◽  
Tendon Graft ◽  
Open Approach ◽  
Scapholunate Ligament ◽  
Ligament Injuries ◽  
Chronic Instability ◽  
Interosseous Ligament ◽  
Acute Injuries ◽  
Arthroscopically Assisted

Introduction The scapholunate interosseous ligament binds the scaphoid and lunate together, and is the primary stabilising ligament between these two bones. Scapholunate injuries lead to chronic instability and degenerative arthritis of the wrist. Scapholunate injuries are graded based on the acuity and the severity of the injury. Purpose The paper is a review of various techniques used to repair or reconstruct the scapholunate ligament according to the clinical manifestations, anatomic and pathologic findings. Methods A review of the literature covering this topic is presented. Results Conservative treatment is primarily indicated in stable and partial ligament tears. Arthroscopic treatment is used when immobilization is unsuccessful. Arthroscopically assisted scapholunate reduction and K-wire fixation is commonly used for acute injuries. Primary repair of scapholunate injuries are performed in all tear types using an open approach. Surgical indications depend on the severity of the instability, time after trauma and the presence of degenerative changes. Acute repair of scapholunate ligament injuries remains the gold standard as an earlier intervention provides better results. Acute injuries to the scapholunate ligament require two-four weeks before surgery. Within this period the ligament is often still repairable itself both with or without supplementary capsulodesis procedures; ligament reconstruction is generally preferable in patients with chronic injures. There are many arthroscopic techniques to treat chronic scapholunate injures such as scapholunate ligament primary repair using various types of capsulodesis, tendon graft reconstruction, bone-ligament-bone procedure, various intercarpal fusions and proximal row carpectomy, total wrist fusion and arthroplasty. Conclusion Early diagnosis and management of scapholunate ligament tears are necessary to preserve wrist functions.

scholarly journals Injury patterns of South African provincial cricket players over two seasons

2009 ◽  
Vol 21 (4) ◽  
Author(s):  
RA Stretch ◽  
RP Raffan ◽  
N Allan
Keyword(s):  
Soft Tissues ◽  
Lower Limbs ◽  
Acute Injury ◽  
Anatomical Site ◽  
Injury Incidence ◽  
Training Time ◽  
Acute Injuries ◽  
Gradual Onset ◽  
Fast Bowler ◽  
Fitness Training

Objective. To determine the incidence and nature of injury patternsin elite cricketers over two seasons.Methods. Physiotherapists and/or doctors working with 4 provincial teams completed a questionnaire for each cricketer who presented with an injury during the 2004 - 2005 (S1) and 2005 - 2006 (S2) cricket seasons. This was done to determine: (i) the anatomical site of injury; (ii) the month of injury during the season; (iii) the diagnosis using the OSCIS injury classification system; (iv) the mechanism of injury; (v) whether it was a recurrence of a previous injury; (vi) whether the injury had recurred again during the season; and (vii) biographical data.Results. The results showed that 180 injuries (S1 – 84; S2 – 96)were sustained. On average the teams spent 2 472 hours on matches, 4 148 on practices and 1 612 on fitness training during the two-season period. The injury prevalence was 8% per match, while the injury incidence was 30/10 000 hours of match, practice and training time, with the match incidence being 74 injuries/ 10 000 hours and the training incidence 15 injuries/10 000 hours. Bowling (29%), fielding and wicket-keeping (27%) and batting (19%) accounted for the majority of injuries. The occurrence of injuries was predominantly to the lower limbs (S1 – 45%; S2 – 42%),back and trunk (S1 – 19%; S2 – 19%), upper limbs (S1 – 19%; S2 – 22%), head and neck (S1 – 6%; S2 – 3%), and related to illnesses (S1 – 11%; S2 – 14%). The injuries occurred primarily during first-class matches (39%), limited-overs matches (22%), and practices (17%), and some were of gradual onset (20%). Acute injuries comprised 78% of injuries. The majority of injuries were first-time injuries (76%), with 11% and 14% recurrent injuries from the previous and current seasons, respectively. The major injuries during S1 were haematomas (19%), muscle strains(17%) and other trauma (14%), while during S2 the injuries were primarily muscle strains (16%), other trauma (20%), tendinopathy (16%) and acute sprains (15%). The primary mechanisms of injury occurred in the delivery stride when bowling (19%) and overbowling (7%), on impact by the ball when batting (11%), and on sliding to field the ball (6%).Conclusion. The results indicate a pattern of cause of injury, withthe fast bowler most likely to sustain an acute injury to the soft tissues of the lower limb while participating in matches and practices during the early part of the season.

scholarly journals DETERMINATION OF THE STRUCTURE OF ACUTE INJURY OF TEMPORARY AND PERMANENT FRONTAL TEETH IN CHILDREN, ANALYSIS OF DIAGNOSTIC AND TREATMENT MEASURES AND THEIR EFFECTS

2020 ◽  
Vol 73 (4) ◽  
pp. 737-742
Author(s):  
Valentina P. Trufanova ◽  
Olha V. Sheshukova ◽  
Natalia A. Lyakhova ◽  
Tetiana V. Polishchuk ◽  
Sofia S. Bauman ◽  
...  
Keyword(s):  
Self Regulation ◽  
Pediatric Dentistry ◽  
Permanent Tooth ◽  
Acute Injury ◽  
Permanent Teeth ◽  
Traumatic Injuries ◽  
Acute Injuries ◽  
Jaw Apparatus ◽  
Treatment Measures

The aim: To determine the structure of acute injuries of temporary and permanent frontal teeth in children, to analyze the applied diagnostic and treatment measures for acute tooth trauma and to investigate their effectiveness. Materials and methods: The subject of the study were 31 children aged 2-12 years with acute temporary and permanent tooth trauma. Methods: clinical (radiological, thermodiagnosis), medical and statistical. Results: The number of injured permanent teeth was greater than the number of injured temporary teeth. The pattern of temporary and permanent tooth injuries differed, so in temporary teeth dislocations were observed, and in permanent teeth fractures prevailed over dislocations. In our opinion, this is due to the peculiarities of the anatomy of the temporary teeth. Usually, the therapeutic tactics of acute temporary teeth injuries is to remove them, despite their important role in the growth and development of jaws, physiological formation and eruption of permanent teeth. The therapeutic tactics of dynamic observation in the case of intrusive dislocation of the temporary tooth were selected in the clinic of the Department of Pediatric Dentistry. In some cases, with a slight change in the position of the temporary tooth, self-regulation of its position was observed, in other cases the tooth remained dystopic, but its viability remained in 50% of cases. Therapeutic tactics of acute injuries of permanent teeth were selected according to the type of trauma. In the case of permanent tooth dislocation, with a slight change in its position, tooth immobilization was carried out by splinting with fiberglass tape and photopolymer composite material. Conclusions: Our observations have shown that the complex of modern specialized medical care for the affected children with acute traumatic injuries of the teeth should be guided by their preservation, which ensures the subsequent normal formation of the dental-jaw apparatus. To ensure these conditions, a long, reliable immobilization of the damaged tooth is required as soon as possible after injury.

Shin-splints: Common exercise-related syndromes affecting the lower leg

2014 ◽  
Vol 100 (3) ◽  
pp. 272-276
Author(s):  
BL Williamson ◽  
CHC Arthur
Keyword(s):  
Soft Tissues ◽  
Lower Leg ◽  
Leg Pain ◽  
Shin Splints ◽  
Common Complaint ◽  
Acute Injuries ◽  
Exertional Compartment Syndrome ◽  
As Stress ◽  
Lower Leg Pain ◽  
The Military

AbstractLower leg pain is a common complaint of athletically active individuals, often limiting physical activities. As such, the group of lower leg conditions related to athletic pursuits and physical exercise confer considerable operational implications for the military. Whilst acute injuries to the lower limb are commonly encountered and are clearly of significance, this article focuses instead on chronic conditions related to physical activity. These include insults to bone such as stress fractures and medial tibial stress syndrome, and those related to the soft tissues such as chronic exertional compartment syndrome. In this article we will examine the presentation and management of these conditions.

scholarly journals Injuries and illnesses among competitive Norwegian rhythmic gymnasts during preseason: a prospective cohort study of prevalence, incidence and risk factors

2020 ◽  
pp. bjsports-2020-102315
Author(s):  
Marte Charlotte Dobbertin Gram ◽  
Benjamin Clarsen ◽  
Kari Bø
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Self Report ◽  
Acute Injury ◽  
Overuse Injuries ◽  
Early Age ◽  
Trauma Research ◽  
Lower Back ◽  
Acute Injuries ◽  
Rhythmic Gymnasts

ObjectivesRhythmic gymnastics is an Olympic sport that demands high training volume from early age. We investigated the extent of, and risk factors for, injuries among competitive Norwegian rhythmic gymnasts.MethodsOne hundred and seven of 133 (80.5%) female rhythmic gymnasts (mean age: 14.5 years (SD 1.6), mean body mass index: 18.9 (SD 2.2)) participated. All gymnasts completed a baseline questionnaire and the ‘Triad-Specific Self-Report Questionnaire’. Injuries, illnesses and training hours were recorded prospectively for 15 weeks during preseason using the ‘Oslo Sports Trauma Research Center Questionnaire on Health Problems’ (OSTRC-H2).ResultsResponse rate to OSTRC-H2 was 97%. Mean overuse and acute injury prevalence were 37% (95% CI: 36% to 39%) and 5% (95% CI: 4% to 6%), respectively. Incidence was 4.2 overuse injuries (95% CI: 3.6 to 4.9) and 1.0 acute injuries (95% CI: 0.5 to 1.6) per gymnast per year. Overuse injuries in knees, lower back and hip/groin represented the greatest burdens. Previous injury increased the odds of injury (OR 30.38, (95% CI: 5.04 to 183.25)), while increased age (OR 0.61 per year, (95% CI: 0.39 to 0.97)) and presence of menarche (OR: 0.20, (95% CI: 0.06 to 0.71)) reduced the odds of all injuries and substantial injuries, respectively.ConclusionsOveruse injuries were common among Norwegian rhythmic gymnasts. Younger gymnasts had higher all-injury risk. Gymnasts who were not menstruating had higher substantial injury risk. Injury prevention interventions should start at an early age and focus on preventing knee, lower back and hip/groin injuries.

Proximal Scaphoid Costo-Osteochondral Replacement Arthroplasty

1998 ◽  
Vol 23 (2) ◽  
pp. 201-208 ◽  
Author(s):  
M. J. SANDOW
Keyword(s):  
Grip Strength ◽  
Proximal Pole ◽  
Function Score ◽  
Scapholunate Ligament ◽  
Medium Term ◽  
Wrist Motion ◽  
Osteochondral Autograft ◽  
Replacement Arthroplasty ◽  
Wrist Function

Deficiency of the proximal pole of the scaphoid due to fracture or necrosis was treated by costo-osteochondral replacement arthroplasty using rib bone/cartilage autografts in 22 patients who were followed prospectively and assessed at a median 24 month follow-up (range, 12–72 months). Improvement of wrist function occurred in all patients with increased motion, improved grip strength and less pain. The average modified Green and O’Brien Wrist Function Score improved from 53 out of 100 preoperatively to 80 at the most recent review. All patients were graded fair or poor at initial review and all but three improved to good or excellent at the most recent assessment. Despite the absence of the scapholunate ligament, carpal alignment did not deteriorate in any patient and there were no graft non-unions or significant complications. In the short and medium term a costo-osteochondral autograft can satisfactorily restore mechanical integrity of the scaphoid proximal pole and maintain wrist motion while avoiding the potential complications of alternative replacement arthroplasty techniques.

scholarly journals Epidemiology of Overuse and Acute Injuries Among Competitive Collegiate Athletes

2012 ◽  
Vol 47 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Jingzhen Yang ◽  
Abigail S. Tibbetts ◽  
Tracey Covassin ◽  
Gang Cheng ◽  
Saloni Nayar ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Female Athletes ◽  
Injury Rate ◽  
Collegiate Athletes ◽  
Sports Injury ◽  
Epidemiologic Studies ◽  
Acute Injury ◽  
Overuse Injuries ◽  
Male And Female ◽  
Acute Injuries

Context: Although overuse injuries are gaining attention, epidemiologic studies on overuse injuries in male and female collegiate athletes are lacking. Objective: To report the epidemiology of overuse injuries sustained by collegiate athletes and to compare the rates of overuse and acute injuries. Design: Descriptive epidemiology study. Setting: A National Collegiate Athletic Association Division I university. Patients or Other Participants: A total of 1317 reported injuries sustained by 573 male and female athletes in 16 collegiate sports teams during the 2005–2008 seasons. Main Outcome Measure(s): The injury and athlete-exposure (AE) data were obtained from the Sports Injury Monitoring System. An injury was coded as either overuse or acute based on the nature of injury. Injury rate was calculated as the total number of overuse (or acute) injuries during the study period divided by the total number of AEs during the same period. Results: A total of 386 (29.3%) overuse injuries and 931 63.1 per 10000 AEs. The rate ratio (RR) of acute versus overuse injuries was 2.34 (95% confidence interval [CI] = 2.05, 2.67). Football had the highest RR (RR = 8.35, 95% CI = 5.38, 12.97), and women's rowing had the lowest (RR = 0.75, 95% CI = 0.51, 1.10). Men had a higher acute injury rate than women (49.8 versus 38.6 per 10000 AEs). Female athletes had a higher rate of overuse injury than male athletes (24.6 versus 13.2 per 10000 AEs). More than half of the overuse injuries (50.8%) resulted in no time loss from sport. Conclusions: Additional studies are needed to examine why female athletes are at greater risk for overuse injuries and identify the best practices for prevention and rehabilitation of overuse injuries.

Trans-Triquetral Dorsal Perilunate Fracture Dislocation

2007 ◽  
Vol 32 (6) ◽  
pp. 647-648 ◽  
Author(s):  
Y. F. LEUNG ◽  
S. P. S. IP ◽  
A. WONG ◽  
W. Y. IP
Keyword(s):  
Rare Case ◽  
Soft Tissues ◽  
Carpal Bones ◽  
Fracture Dislocation ◽  
Perilunate Dislocation ◽  
Perilunate Fracture Dislocation

A rare case of trans-triquetral dorsal perilunate dislocation is described. It differs from the Mayfield and Johnson theory of progressive perilunar instability in greater arc injuries which states that the injury passes from the radial to the ulnar carpal bones and soft tissues in stages. This injury supports the concept of a reverse greater arc injury from ulnar to radial being possible with the radial carpal bones being spared in some cases.

The study of consequences of acute injuries by agents of pulmonotoxic action

2018 ◽  
pp. 71-76
Author(s):  
М.А. Юдин ◽  
Ю.О. Коньшаков ◽  
Н.Г. Венгерович ◽  
О.О. Владимирова ◽  
И.И. Алексеева ◽  
...  
Keyword(s):  
Nitrogen Dioxide ◽  
Lung Tissue ◽  
Tissue Injury ◽  
Bronchial Tube ◽  
Lung Parenchyma ◽  
Male Rats ◽  
Acute Injury ◽  
Functional Changes ◽  
Acute Injuries ◽  
Injury Progression

Цель исследования - изучение особенностей развития последствий острого поражения веществами пульмонотоксического действия. Методика. Исследование выполнено на 160 белых нелинейных крысах-самцах массой 180-220 г. Для оценки развития последствий острого поражения пульмонотоксикантами использовали модели отравления фосгеном, диоксидом азота и паракватом. Проводили оценку гравиметрических показателей легочной ткани и изменений толерантности к физической нагрузке по показателю продолжительности плавания «до отказа» с грузом 7% от массы тела животного. Также проводилась морфологическая оценка тяжести поражения ткани легких. Результаты. Установлено, что однократное поражение крыс пульмонотоксикантами в дозе 1LCt в остром периоде сопровождается развитием комплекса морфологических и функциональных изменений, характерных для токсического отека лёгких. У части животных наблюдалось выраженное снижение функциональных возможностей, патологоанатомическим субстратом которых являлось нарушение структуры легочной паренхимы с деструкцией и фиброзированием бронхов и сосудов, развитием выраженной панацинарной эмфиземы, которая в 35% случаев сочетается с хроническими гнойно-деструктивными изменениями в легочной ткани. Заключение. Частота развития необратимых последствий поражений веществами пульмонотоксического действия составила: 60% случаев при отравлении паракватом, 40 и 20% при поражении фосгеном и диоксидом азота соответственно. The purpose is to study features of an acute injury progression in case of poisoning by agents of pulmonotoxic action. Experimental work was done in a model of 160 white non-linear male rats weighing 180-220 g. For the assessment of an acute injury development after poisoning by agents of pulmonotoxic action the models of phosgene, nitrogen dioxide and paraquat poisoning were used. The assessment of gravimetric characteristics of lung tissue and changes of physical activity tolerance according to the rate of swimming duration to the full with 7%-load of body mass was carried out. The morphological assessment of severity of lung tissue injury was carried out as well. Results. It was found out that a single exposure of rats with pulmonotoxicants in 1LCt during its acute period was accompanied by the development of a range of morphological and functional changes which were typical for the course of toxic pulmonary edema. As a consequence of poisoning in a half of animals an evident decrease of functional abilities was observed. Pathologicoanatomic substrate of these abilities was the abnormality of lung parenchyma with destruction and bronchial tube and vessel fibrosis, that in 35% of cases matched with chronical purulent-destructive changes in lung tissue. Conclusion. The rate of consequences development after pulmonotoxic agents exposure was the following: 60% cases after paraquate exposure, 40% and 20% after phosgene and nitrogen dioxide respectively.

scholarly journals Influence of different types of surgical suture materials on mehanical damage of oral mucosa

2011 ◽  
Vol 64 (3-4) ◽  
pp. 157-160 ◽  
Author(s):  
Sinisa Mirkovic ◽  
Tatjana Djurdjevic-Mirkovic
Keyword(s):  
Oral Mucosa ◽  
Soft Tissues ◽  
Tissue Reaction ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Suture Materials ◽  
Surgical Suture ◽  
Surgical Wounds ◽  
Synthetic Monofilament ◽  
Basic Characteristics

Introduction. Throughout history many kinds of different suture materials have been used for closing and suturing surgical wounds. Medical literature describes four basic characteristics of suture material: knot safety, tensile strength, tissue reaction and wound safety. The tissue reaction is reflected in an inflammatory response, which, though minimal, occurs during first two to seven days after implanting suture into the tissue. The aim of this research was to investigate whether different suture materials affect the development of decubital damage of oral mucosa, which to a great extent can compromise the process of wound healing. Material and methods. The investigation was designed as a prospective clinical study including 150 patients of both genders, aged between 25 and 60. The patients were distributed into three groups of 50 persons. The suture Black Silk was used in the first group, designated as a control group. Nylon and Vicril were used in the second and third group, i.e. experimental groups, respectively. Decubital damage of the surrounding soft tissues was the main parameter for monitoring the effects of selected suture materials on the oral mucosa. Conclusion. The comparison of results obtained for the investigated suture materials after suturing oral mucosa revealed that certain advan?tage could be given to synthetic monofilament suture materials

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