Iliac Crest Avulsion Fracture in a Young Sprinter

Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

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Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

Children ◽

10.3390/children7100173 ◽

2020 ◽

Vol 7 (10) ◽

pp. 173

Author(s):

Stefano Stallone ◽

Filippo Selleri ◽

Giovanni Trisolino ◽

Alberto Grassi ◽

Luca Macchiarola ◽

...

Keyword(s):

Avulsion Fracture ◽

Sport Activity ◽

Return To Sport ◽

Knee Laxity ◽

International Knee Documentation Committee ◽

High Rate ◽

Special Focus ◽

Early Return ◽

Complete Restoration ◽

Sport Activities

Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special focus on a return to sport activities. Skeletally immature patients with a TSA, treated in two orthopedic hospitals, were evaluated for range of motion and knee laxity using KT1000, KiRA and Rolimeter. The pediatric International Knee Documentation Committee score (Pedi-IKDC) and the Hospital for Special Surgery pediatric Functional Activity Brief Scale (Pedi-FABS) questionnaires were recorded during the latest visit. Forty-two children were included. Twenty-six were treated nonoperatively and 16 underwent surgery. At a mean follow-up of 6.9 ± 3.6 years, 36 patients completed the questionnaires and 23 patients were tested with arthrometers. Among them, 96% had normal knee laxity. The Pedi-IKDC score averaged 96.4 ± 5.7 points, while the mean Pedi-FABS was 22.2 ± 5.9 points, without statistically significant differences between groups. Twenty-eight patients (78%) returned to their previous level of sport activity (eight amateur, 13 competitive, seven elite athletes). Eight patients (22%) quit sport, mostly because of re-injury fear. If properly treated, pediatric TSAs achieve a high rate of successful healing, with complete restoration of knee stability and an early return to sport activities.

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Limitations of body mass index for counseling individuals with unilateral lower extremity amputation

Prosthetics and Orthotics International ◽

10.1177/0309364616650079 ◽

2016 ◽

Vol 41 (2) ◽

pp. 186-193 ◽

Cited By ~ 3

Author(s):

Alexandra P Frost ◽

Tracy Norman Giest ◽

Allison A Ruta ◽

Teresa K Snow ◽

Mindy Millard-Stafford

Keyword(s):

Body Mass Index ◽

Lower Extremity ◽

Health Risk ◽

Body Mass ◽

Body Fat ◽

Lower Limb ◽

Dual Energy ◽

Limb Loss ◽

Percent Body Fat ◽

X Ray

Background: Body composition is important for health screening, but appropriate methods for unilateral lower extremity amputees have not been validated. Objectives: To compare body mass index adjusted using Amputee Coalition equations (body mass index–Amputee Coalition) to dual-energy X-ray absorptiometry in unilateral lower limb amputees. Study design: Cross-sectional, experimental. Methods: Thirty-eight men and women with lower limb amputations (transfemoral, transtibial, hip disarticulation, Symes) participated. Body mass index (mass/height2) was compared to body mass index corrected for limb loss (body mass index–Amputee Coalition). Accuracy of classification and extrapolation of percent body fat with body mass index was compared to dual-energy X-ray absorptiometry. Results: Body mass index–Amputee Coalition increased body mass index (by ~ 1.1 kg/m2) but underestimated and mis-classified 60% of obese and overestimated 100% of lean individuals according to dual-energy X-ray absorptiometry. Estimated mean percent body fat (95% confidence interval) from body mass index–Amputee Coalition (28.3% (24.9%, 31.7%)) was similar to dual-energy X-ray absorptiometry percent body fat (29.5% (25.2%, 33.7%)) but both were significantly higher ( p < 0.05) than percent body fat estimated from uncorrected body mass index (23.6% (20.4%, 26.8%)). However, total errors for body mass index and body mass index–Amputee Coalition converted to percent body fat were unacceptably large (standard error of the estimate = 6.8%, 6.2% body fat) and the discrepancy between both methods and dual-energy X-ray absorptiometry was inversely related ( r = −0.59 and r = −0.66, p < 0.05) to the individual’s level of body fatness. Conclusions: Body mass index (despite correction) underestimates health risk for obese patients and overestimates lean, muscular individuals with lower limb amputation. Clinical relevance Clinical recommendations for an ideal body mass based on body mass index–Amputee Coalition should not be relied upon in lower extremity amputees. This is of particular concern for obese lower extremity amputees whose health risk might be significantly underestimated based on body mass index despite a “correction” formula for limb loss.

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NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

Journal of the Grodno State Medical University ◽

10.25298/2221-8785-2020-18-6-710-715 ◽

2020 ◽

Vol 18 (6) ◽

pp. 710-715

Author(s):

N. N. Ioskevich ◽

◽

L. F. Vasilchuk ◽

P. E. Vankovich ◽

S. P. Antonenko ◽

...

Keyword(s):

Lower Limb ◽

Type I Diabetes ◽

Lower Extremities ◽

Limb Ischemia ◽

Type I ◽

Critical Ischemia ◽

Lower Limb Ischemia ◽

X Ray ◽

Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

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Avulsion fracture of the iliac crest in a child

Revista Brasileira de Ortopedia (English Edition) ◽

10.1016/j.rboe.2014.03.010 ◽

2014 ◽

Vol 49 (3) ◽

pp. 309-312 ◽

Cited By ~ 1

Author(s):

Rafael Borghi Mortati ◽

Lucas Borghi Mortati ◽

Matheus Silva Teixeira ◽

Marcelo Itiro Takano ◽

Richard Armelin Borger

Keyword(s):

Iliac Crest ◽

Avulsion Fracture

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Anatomical axis validation of lower extremity for different deformities: A radiological study

SAGE Open Medicine ◽

10.1177/2050312120923822 ◽

2020 ◽

Vol 8 ◽

pp. 205031212092382

Author(s):

Meric Unal ◽

Sabriye Ercan ◽

Aydin Budeyri ◽

Uğur Toprak ◽

Abdülkerim Şalkaci

Keyword(s):

Lower Limb ◽

Mechanical Axis ◽

Correlation Coefficients ◽

Strong Positive Correlation ◽

Knee Alignment ◽

Intra Class Correlation ◽

X Ray ◽

The Past ◽

Radiology Assistant ◽

Anatomical Axis

Aim: The aim of this study was to derive a pure, unbiased, reliable and accurate objective relationship between the local knee axis measurements through a short knee anteroposterior roentgenogram and the lower limb axis measurement through an orthoroentgenogram. Patients and Methods: Radiographs of 114 patients (114 knees) were evaluated by two independent raters for measurement of lower limb axis on an orthoroentgenogram and the local knee axis on short knee anteroposterior X-ray, which was derived by cropping the orthoroentgenogram by a blinded radiology assistant. The raters measured at two different time-points separated by an interval of 30-day period. Intra-rater and inter-rater reliabilities were calculated by intra-class correlation coefficients and three models were built to establish the relationships of X-ray anatomical axis with orthoroentgenogram anatomical axis, orthoroentgenogram anatomical axis with orthoroentgenogram mechanical axis and X-ray anatomical axis with orthoroentgenogram mechanical axis. Results: For three different measurements, intra-class correlation coefficients of Rater 2 were higher than 0.90 which shows perfect reliability, while that for Rater 1 was low. Furthermore, first measurements were more consistent than the second measurement. There was a strong positive correlation in all the three models except for varus cases in the last. Conclusion: The standardized correlation derived between the two different techniques for measuring knee alignment is fairly comparable with the studies in the past and would serve as a reliable template for future studies concerning relationships between the two, in addition to helping knee surgeons make more reliable and accurate interpretations through local knee axis measurements.

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Agreement between anthropometric and dual-energy X-ray absorptiometry assessments of lower-limb volumes and composition estimates in youth-club rugby athletes

Applied Physiology Nutrition and Metabolism ◽

10.1139/h2012-027 ◽

2012 ◽

Vol 37 (3) ◽

pp. 463-471 ◽

Cited By ~ 7

Author(s):

Humberto M. Carvalho ◽

Manuel J. Coelho-e-Silva ◽

Sérgio Franco ◽

António J. Figueiredo ◽

Óscar M. Tavares ◽

...

Keyword(s):

Young Adult ◽

Free Volume ◽

Body Mass ◽

Reference Values ◽

Lower Limb ◽

Dual Energy ◽

Limb Volume ◽

X Ray ◽

Volume Estimates ◽

Rugby Players

The purpose of this study was to assess the agreement of lower-limb volume estimates based on anthropometry and dual-energy X-ray absorptiometry (DXA) as a reference method in male rugby athletes. Predictive models using body mass and skinfolds were tested to improve the relative agreement between protocols (anthropometry, DXA). Rugby players (n = 41; 19.9 ± 2.2 years) volunteered for the study. Lower-limb total and fat-free volumes were estimated by anthropometry and also derived using DXA. Cross-validation between the anthropometry technique and DXA was then performed. Lower-limb volume estimates by anthropometry overestimated reference values and tended to be further from the reference values with the increase of scale. For the total sample, standard errors of measurement for volume estimates by anthropometry were 1.99 L and 1.34 L for total and fat-free volumes, respectively. Correlations with reference values were 0.81 for lower-limb volume and 0.90 for lower-limb fat-free volume. Correlations between estimated prediction equations and reference values showed higher correlations (r = 0.96 for lower-limb volume and r = 0.93 for lower-limb fat-free volume) compared with anthropometric estimates. Overall, the agreement of anthropometry method to quantify lower-limb volumes with DXA as a reference in young adult rugby players is acceptable and is a practical method when more expensive and complex techniques are not available. The consideration of body mass and lower-limb skinfolds increases the precision of lower-limb volume estimates using anthropometry in the young adult rugby players.

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Return to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-016-4360-2 ◽

2016 ◽

Vol 26 (3) ◽

pp. 892-896 ◽

Cited By ~ 8

Author(s):

F. G. Usuelli ◽

C. A. Di Silvestri ◽

R. D’Ambrosi ◽

C. Maccario ◽

E. W. Tan

Keyword(s):

Return To Sport ◽

Flexor Digitorum Longus ◽

Calcaneal Osteotomy ◽

Sport Activities ◽

Flexor Digitorum

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Triceps tendon rupture: repair and rehabilitation

Shoulder & Elbow ◽

10.1177/1758573217706358 ◽

2017 ◽

Vol 10 (1) ◽

pp. 62-65 ◽

Cited By ~ 3

Author(s):

Cezary Kocialkowski ◽

Rebecca Carter ◽

Chris Peach

Keyword(s):

Surgical Technique ◽

Tendon Repair ◽

Return To Sport ◽

Rehabilitation Programme ◽

Range Of Movement ◽

Triceps Tendon Rupture ◽

Sport Activities ◽

Tendon Ruptures ◽

Five Phases ◽

Triceps Tendon

Triceps tendon ruptures are rare injuries and are frequently missed on initial presentation to the emergency department. In cases of complete rupture, surgical repair is recommended but no guidelines exist on the optimum reconstructive technique or rehabilitation. We present a surgical technique and rehabilitation programme for the management of these injuries. A midline posterior incision is performed, the ruptured triceps tendon is identified and mobilized, and the tendon footprint is prepared. The tendon is then repaired using bone suture anchors, with a parachute technique, and held in 40° of flexion. The rehabilitation programme is divided into five phases, over a period of 12 weeks. Range of movement is gradually increased in a brace for the first 6 weeks. Rehabilitation is gradually increase in intensity, progressing from isometric extension exercises to weight-resisted exercises, and finally plyometrics and throwing exercises. Our surgical technique provides a solid tendon repair without the need for further metalwork removal. The graduated rehabilitation programme also helps to protect the integrity of the repair at the same time as enabling patients to gradually increase the strength of the triceps tendon and ultimately return to sport activities.

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Analyse Du Rebut Des Cliches Radiographiques Dans Le Service De Radiologie Et Imagerie Médicale Du Chu Campus De Lomé Au Togo

European Scientific Journal ESJ ◽

10.19044/esj.2017.v13n33p244 ◽

2017 ◽

Vol 13 (33) ◽

pp. 244

Author(s):

P. Gbande ◽

L. Sonhaye ◽

K. Adambounou ◽

K. Lambon ◽

B. N’timon ◽

...

Keyword(s):

Medical Imaging ◽

Prospective Study ◽

Lower Limb ◽

University Hospital ◽

X Rays ◽

Financial Loss ◽

X Ray ◽

Chest X Ray ◽

Almost All

Purpose: To analyze the waste factors of rejected X-rays films. Methodology: Descriptive and analytical prospective study from 1 January to 30 June 2017 carried out in the department of radiology and medical imaging of the Campus University Hospital of Lomé in Togo. Results: 4912 patients had received 5630 radiographic incidences, including 3288 (58.4%) on the analogy and 2342 (41.5%) on the digital. The reject rate was 12.5%. The vast majority of the X-rays films, 682 (96.9%) were rejected by the radiographers themselves just after development. The resumption frequency ranged from one repeat (550 X-rays films, or 78%) to 4 repeats (8 X-rays films, or 1%). Almost all of the rejected films, 702 (99.7%) came from the analogical room. Chest X-ray was the incidence with more rejection in 33.9% followed by pelvic and lower limb incidences in 21% of cases. More than 2/3 of the rejected films, 473 (67.2%), came from the students' act. The causes of the rejection were mainly centering (25.5%), underexposure (20.17%) and overexposure (12.93). The financial loss caused by the scrap of X-rays films amounted to about 418800F CFA or 638.5 €. Conclusion: Strengthening communication between radiographers and radiologists is necessary to avoid unnecessary repeats of patient’s radiographs.

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Structure of human RNA Polymerase III

10.1101/2020.06.29.177279 ◽

2020 ◽

Author(s):

Ewan Phillip Ramsay ◽

Guillermo Abascal-Palacios ◽

Julia L. Daiß ◽

Helen King ◽

Jerome Gouge ◽

...

Keyword(s):

Rna Polymerase ◽

Rna Polymerase Iii ◽

Cellular Growth ◽

Loss Of Function ◽

Critical Determinant ◽

Saxs Data ◽

X Ray ◽

X Ray Crystallography ◽

The Stability ◽

Pol Iii

ABSTRACTIn eukaryotes, RNA Polymerase (Pol) III is the enzyme specialised for the transcription of the entire pool of tRNAs and several other short, essential, untranslated RNAs. Pol III is a critical determinant of cellular growth and lifespan across the eukaryotic kingdom. Upregulation of Pol III transcription is often observed in cancer cells and causative Pol III mutations have been described in patients affected by severe neurodevelopmental disorders and hypersensitivity to viral infection.Harnessing CRISPR-Cas9 genome editing in HeLa cells, we isolated endogenous human Pol III and obtained a cryo-EM reconstruction at 4.0 Å. The structure of human Pol III allowed us to map the reported genetic mutations and rationalise them. Mutations causing neurodevelopmental defects cluster in hotspots that affect the stability and/or biogenesis of Pol III, thereby resulting in loss-of-function of the enzyme. Mutations affecting viral sensing are located in the periphery of the enzyme in proximity to DNA binding regions, suggesting an impairment of Pol III cytosolic viral DNA-sensing activity.Furthermore, integrating x-ray crystallography and SAXS data, we describe the structure of the RPC5 C-terminal extension, which is absent in lower eukaryotes and not visible in our EM map. Surprisingly, experiments in living cells highlight a role for the RPC5 C-terminal extension in the correct assembly and stability of the human Pol III enzyme, thus suggesting an added layer of regulation during the biogenesis of Pol III in higher eukaryotes.

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