scholarly journals Talar process fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 85-92 ◽  
Author(s):  
Haroon Majeed ◽  
Donald J. McBride
Keyword(s):  
Subtalar Joint ◽  
Avulsion Fracture ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Flexor Hallucis Longus ◽  
High Clinical Suspicion ◽  
Significant Disability ◽  
Missed Diagnosis ◽  
And Inversion

Fractures of the lateral and the posterior processes of the talus are uncommon and frequently missed because of a low level of suspicion and difficulty in interpretation on plain radiographs. Missed fractures can lead to persistent pain and reduced function. Lateral process fractures are usually a consequence of forced dorsiflexion and inversion of fixed pronated foot. These are also commonly known as snowboarder’s fractures. The posterior process of the talus is composed of medial and lateral tubercles, separated by the groove for the flexor hallucis longus tendon. The usual mechanism of injury is forced hyperplantarflexion and inversion causing direct compression of the posterior talus, or an avulsion fracture caused by the posterior talofibular ligament. CT scans are helpful in cases of high clinical suspicion. There is a lack of consensus regarding optimal management of these fractures; however, management depends on the size, location and displacement of the fragment, the degree of cartilage damage and instability of the subtalar joint. Non-operative treatment includes immobilization and protected weight-bearing for six weeks. Surgical treatment includes open reduction and internal fixation or excision of the fragments, depending on the size. Fractures of the lateral and the posterior processes of the talus are uncommon but important injuries that may result in significant disability in cases of missed diagnosis or delayed or inadequate treatment. Early diagnosis and timely management of these fractures help to avoid long-term complications, including malunion, nonunion or severe subtalar joint osteoarthritis. Cite this article: EFORT Open Rev 2018;3:85-92. DOI: 10.1302/2058-5241.3.170040

scholarly journals Three-Dimensional Gait Analysis Can Shed New Light on Walking in Patients with Haemophilia

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sébastien Lobet ◽  
Christine Detrembleur ◽  
Firas Massaad ◽  
Cedric Hermans
Keyword(s):  
Gait Analysis ◽  
Functional Performance ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Three Dimensional ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Gait Pattern ◽  
Metabolic Energy

In patients with haemophilia (PWH) (from Greek “blood love”), the long-term consequences of repeated haemarthrosis include cartilage damage and irreversible arthropathy, resulting in severe impairments in locomotion. Quantifying the extent of joint damage is therefore important in order to prevent disease progression and compare the efficacy of treatment strategies. Musculoskeletal impairments in PWH may stem from structural and functional abnormalities, which have traditionally been evaluated radiologically or clinically. However, these examinations are performed in a supine position (i.e., non-weight-bearing condition). We therefore suggest three-dimensional gait analysis (3DGA) as an innovative approach designed to focus on the functional component of the joint during the act of walking. This is of the utmost importance, as pain induced by weight-bearing activities influences the functional performance of the arthropathic joints significantly. This review endeavors to improve our knowledge of the biomechanical consequences of multiple arthropathies on gait pattern in adult patients with haemophilia using 3DGA. In PWH with arthropathy, the more the joint function was altered, the more the metabolic energy was consumed. 3DGA analysis could highlight the effect of an orthopedic disorder in PWH during walking. Indeed, mechanical and metabolic impairments were correlated to the progressive loss of active mobility into the joints.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

Three-Dimensional In Vivo Kinematics of the Subtalar Joint During Dorsi-Plantarflexion and Inversion-Eversion

2009 ◽  
Vol 30 (05) ◽  
pp. 432-438 ◽  
Author(s):  
Akira Goto ◽  
Hisao Moritomo ◽  
Tomonobu Itohara ◽  
Tetsu Watanabe ◽  
Kazuomi Sugamoto
Keyword(s):  
Subtalar Joint ◽  
Three Dimensional ◽  
In Vivo Kinematics ◽  
And Inversion

scholarly journals Supracondylar rotation osteotomy of the femur influences the coronal alignment of the ankle

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Christian Konrads ◽  
Marc-Daniel Ahrend ◽  
Myriam R. Beyer ◽  
Ulrich Stöckle ◽  
Sufian S. Ahmad
Keyword(s):  
Subtalar Joint ◽  
Distal Femur ◽  
External Rotation ◽  
Weight Bearing ◽  
Orientation Angle ◽  
Osteotomy Site ◽  
Limb Alignment ◽  
Coronal Alignment ◽  
Rotational Osteotomy ◽  
Rotation Osteotomy

Abstract Purpose Osteotomies represent well-established treatment-options for the redistribution of loads and forces within and around the knee-joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal-femoral-rotation-osteotomy on the coronal alignment of the ankle. It was hypothesized that supracondylar-external-rotation-osteotomy of the distal femur leads to a change in the coronal orientation of the ankle joint. Methods Long-leg standing radiographs and CT-based torsional measurements of 27 patients undergoing supracondylar-rotational-osteotomy of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy-site. The hip-knee-ankle-angle (HKA), the mechanical-lateral-distal-femur-angle (mLDFA), and Tibia-Plafond-Horizontal-Orientation-Angle (TPHA) around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann–Whitney test. Results Twenty-seven patients with high femoral antetorsion (31.3° ± 4.0°) underwent supracondylar-external-rotation-osteotomy. The osteotomy led to a reduced antetorsion (17.4 ± 5.1; p < 0.001) and to a valgisation of the overall limb-alignment. The HKA decreased by 2.4° ± 1.4° (p < 0.001). The TPHA decreased by 2.6° (p < 0.001). Conclusions Supracondylar external rotation osteotomy of the femur leads to lateralization of the weight bearing line at the knee and ankle due to valgisation of the coronal limb alignment. The mobile subtalar joint has to compensate (inversion) for the resulting valgus orientation of the ankle to ensure contact between the foot and the floor. When planning a rotational osteotomy of the lower limb, this should be appreciated – especially in patients with a preexisting valgus alignment of the lower extremities or restricted mobility in the subtalar joint.

scholarly journals Long term results after transepiphysal ACL reconstruction in children and adolescent

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0001
Author(s):  
Christian Eberle ◽  
Wolfgang Schopf ◽  
Andree Ellermann
Keyword(s):  
Acl Reconstruction ◽  
Cartilage Damage ◽  
Long Term Results ◽  
Angular Deformity ◽  
Leg Length ◽  
Growth Disturbance ◽  
Children And Adolescent ◽  
The Mean

The aim of our study was to review the long term clinical and radiological (MRI) outcomes of adult patients who underwent ACL reconstruction as children or adolescent with emphasize to the features of growth disturbance, angular deformity, meniscal and cartilage damage and revision rate We retrospectively evaluated patient who underwent ACL reconstruction in our clinic with arthroscopic transepiphyseal technique using hamstrings graft in childhood or adolescence between the years 1997 and 2009. A total of 43 Patients were assessed. 25 male and 18 female. The average age at time of surgery was 13,5 years (8 - 16 y.), at time of assessement 22,4 years (18 - 30 y.) . The mean follow up was 10 years (4 - 16 years). The physical development of the patients was assessed with the Lysholm score and the Cincinnati Knee score scale, their satisfaction was recorded on the basis of the IKDC subjective knee evaluation form and the Tegner activity score . Leg deformity or leg length discrepancy was evaluated clinically by the observers. The instrumented Lachman test using KT1000 and manual Pivot shift test was performed to assess knee stability. MRI was used to detect graft integrity, cartilage and meniscal damages. No significant leg deformities or leg length discrepancy had been detected. The average Lysholm score was 91 points (83 - 100), the Cincinnati Knee Score was 90,4 (79 - 100) points on average . The mean IKDC score was 92 points (82 -100). The Tegner-Activity-Score changed from preop 6,8 (2-10) to post op 5,8 (2-9). 2 Patient underwent revision ACL reconstruction due to rerupture (3 and 9 years post op). 2 Patients underwent meniscal surgery during follow up (1 resection and one refixation). KT1000 evaluation showed 67% excellent, 21% good and in 12% bad results. The MRI scan showed 42 intact grafts and one unverifiable graft. One patient with cartilage damage up to 3° (ICRS), 3 patients with meniscal degeneration up to grade 2. Each patient showed a free range of motion Our data underlines that transepiphyseal ACL reconstruction in children and adolescent with hamstrings is a save procedure leading to good long term results without causing angular deformity or growth disturbance

scholarly journals Glucocorticoid-Induced Avascular Bone Necrosis: Diagnosis and Management

2012 ◽  
Vol 6 (1) ◽  
pp. 449-457 ◽  
Author(s):  
KL Chan ◽  
CC Mok
Keyword(s):  
Early Recognition ◽  
Early Stage ◽  
Weight Bearing ◽  
Plain Radiograph ◽  
Core Decompression ◽  
Bone Necrosis ◽  
Avascular Bone Necrosis ◽  
Magnetic Resonance Imaging Mri ◽  
High Index Of Suspicion

Glucocorticoid use is one of the most important causes of avascular bone necrosis (AVN). The pathogenesis of glucocorticoid-induced AVN is not fully understood but postulated mechanisms include fat hypertrophy, fat emboli and intravascular coagulation that cause impedance of blood supply to the bones. Data regarding the relationship between AVN and dosage, route of administration and treatment duration of glucocorticoids are conflicting, with some studies demonstrating the cumulative dose of glucocorticoid being the most important determining factor. Early recognition of this complication is essential as the prognosis is affected by the stage of the disease. Currently, there is no consensus on whether universal screening of asymptomatic AVN should be performed for long-term glucocorticoid users. A high index of suspicion should be exhibited for bone and joint pain at typical sites. Magnetic resonance imaging (MRI) or bone scintigraphy is more sensitive than plain radiograph for diagnosing early-stage AVN. Conservative management of AVN includes rest and reduction of weight bearing. Minimization of glucocorticoid dose or a complete withdrawal of the drug should be considered if the underlying conditions allow. The efficacy of bisphosphonates in reducing the rate of collapse of femoral head in AVN is controversial. Surgical therapy of AVN includes core decompression, osteotomy, bone grafting and joint replacement. Recent advances in the treatment of AVN include the use of tantalum rod and the development of more wear resistant bearing surface in hip arthroplasty.

Long-Term Results of Osteoarticular Allografts in Weight-Bearing Joints

1989 ◽  
pp. 275-283 ◽  
Author(s):  
B. A. Waber ◽  
W. W. Tomford ◽  
H. J. Mankin ◽  
L. A. Butterfield
Keyword(s):  
Weight Bearing ◽  
Long Term Results

scholarly journals Andrographis paniculata Extract Relieves Pain and Inflammation in Monosodium Iodoacetate-Induced Osteoarthritis and Acetic Acid-Induced Writhing in Animal Models

Processes ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. 873
Author(s):  
Donghun Lee ◽  
Chae Yun Baek ◽  
Ji Hong Hwang ◽  
Mi-Yeon Kim
Keyword(s):  
Acetic Acid ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Degenerative Joint Disease ◽  
Andrographis Paniculata ◽  
Joint Disease ◽  
Tnf Α ◽  
Monosodium Iodoacetate ◽  
History Of

Osteoarthritis (OA), being the most prominent degenerative joint disease is affecting millions of elderly people worldwide. Although Andrographis paniculata is an ethnic medicine with a long history of being used as analgesic agent, no study using a monosodium iodoacetate (MIA) model has investigated its potential activities against OA. In this study, experimental OA was induced in rats with a knee injection of MIA, which represents the pathological characteristics of OA in humans. A. paniculata extract (APE) substantially reversed the loss of hind limb weight-bearing and the cartilage damage resulted from the OA induction in rats. Additionally, the levels of serum pro-inflammatory cytokines, such as IL-1β, IL-6, and TNF-α as well as the concentration of matrix metalloproteinases, including MMP-1, MMP-3, MMP-8, and MMP-13 were decreased by APE administration. Acetic acid-induced writhing responses in mice which quantitatively measure pain were significantly reduced by APE. In vitro, APE inhibited the generation of NO and downregulated the expression of IL-1β, IL-6, COX-2, and iNOS in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The above results suggest the potential use APE as a therapeutic agent against OA.

scholarly journals Muscle Fatigue-Alleviating Effects of a Prescription Composed of Polygonati Rhizoma and Notoginseng Radix et Rhizoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ya-Qin Yang ◽  
Yan-Qin Li ◽  
Li-Ping Yu ◽  
Xue Li ◽  
Jian-Kang Mu ◽  
...  
Keyword(s):  
Energy Metabolism ◽  
Muscle Fatigue ◽  
Weight Bearing ◽  
Herbal Medicines ◽  
Liver Glycogen ◽  
Serum Creatine Kinase ◽  
Oxidative Status ◽  
Major Research ◽  
Research Focus

Long-term muscle fatigue is a major cause of injury. Drugs/nutrients from herbal medicines that prevent fatigue remain a major research focus. In China, a prescription composed of Polygonati Rhizoma and Notoginseng Radix et Rhizoma has been commonly used as a herb and food nutrient, providing protection against fatigue in the clinic. To date, the mechanisms through which this prescription prevented fatigue are unknown. Here, we identified the effects of this prescription on muscle fatigue based on energy and oxidation regulation. Fatigue mouse models were produced through weight-bearing exhaustive swimming. Mice were intragastrically administered prescription extracts (1 and 2 g/kg) for four weeks. Changes in exhaustive swimming times, antifatigue biochemical indicators, oxidative status, and energy metabolism were investigated. The prescription prolonged the exhaustive swimming time of the mice. The content of lactic acid and blood urea nitrogen in the serum was also markedly reduced by the prescription. The content of liver glycogen and lactate dehydrogenase in the serum increased. The prescription also significantly reduced malondialdehyde levels and increased the levels of superoxide dismutase and glutathione peroxidase. The levels of ATPase, complexes I and II in the mitochondria of hind-leg skeletal muscle, and serum creatine kinase also increased in response to the prescription. Our results indicated that the prescription could effectively alleviate muscle fatigue status by promoting energy metabolism and antioxidation ability. The prescription therefore represents a useful drug/nutrient strategy to alleviate muscle fatigue.

scholarly journals A study of the approaches used to retrieve aerosol extinction, as applied to limb observations made by OSIRIS and SCIAMACHY

2018 ◽  
Vol 11 (6) ◽  
pp. 3433-3445 ◽  
Author(s):  
Landon A. Rieger ◽  
Elizaveta P. Malinina ◽  
Alexei V. Rozanov ◽  
John P. Burrows ◽  
Adam E. Bourassa ◽  
...  
Keyword(s):  
Particle Size ◽  
Radiative Transfer ◽  
A Priori ◽  
Stratospheric Aerosol ◽  
Aerosol Extinction ◽  
Transfer Modelling ◽  
Inversion Techniques ◽  
And Inversion ◽  
Good Agreement

Abstract. Limb scatter instruments in the UV–vis spectral range have provided long-term global records of stratospheric aerosol extinction important for climate records and modelling. While comparisons with occultation instruments show generally good agreement, the source and magnitude of the biases arising from retrieval assumptions, approximations in the radiative transfer modelling and inversion techniques have not been thoroughly characterized. This paper explores the biases between SCIAMACHY v1.4, OSIRIS v5.07 and SAGE II v7.00 aerosol extinctions through a series of coincident comparisons as well as simulation and retrieval studies to investigate the cause and magnitude of the various systematic differences. The effect of a priori profiles, particle size assumptions, radiative transfer modelling, inversion techniques and the different satellite datasets are explored. It is found that the assumed a priori profile can have a large effect near the normalization point, as well as systematic influence at lower altitudes. The error due to particle size assumptions is relatively small when averaged over a range of scattering angles, but individual errors depend on the particular scattering angle, particle size and measurement vector definition. Differences due to radiative transfer modelling introduce differences between the retrieved products of less than 10 % on average, but can introduce vertical structure. The combination of the different scenario simulations and the application of both algorithms to both datasets enable the origin of some of the systematic features such as high-altitude differences when compared to SAGE II to be explained.

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