Acute Paraplegia

1985 ◽  
Vol 6 (10) ◽  
pp. 303-304
Keyword(s):  
Plantar Flexion ◽  
Tibialis Posterior ◽  
Peroneus Longus ◽  
Posterior Tibial ◽  
Acute Paraplegia ◽  
And Inversion

With regard to the article "Diagnosis and Evaluation of Acute Paraplegia" by J. M. Freeman in the April 1983 issue (PIR 1983;4:327), a reader has noted that Table 2 (page 328) lists the anterior and posterior tibial muscles as responsible for `dorsiflexion inversion.' In the same table, the peroneals were listed as being responsible for `dorsiflexion eversion.' However, the action of the tibialis posterior is plantar flexion and inversion. In addition, the action of the peroneus longus is plantar flexion and eversion. Dr Freeman answers: The reader is indeed correct. In an effort to condense the table, I did lump dorsiflexion and eversion together.

Development of a Rehabilitation and Training Device Considering the Ankle Degree of Freedom

2020 ◽  
Vol 32 (3) ◽  
pp. 673-682
Author(s):  
Asaki Akagi ◽  
Satoki Tsuichihara ◽  
Shinichi Kosugi ◽  
Hiroshi Takemura ◽  
◽  
...  
Keyword(s):  
Degrees Of Freedom ◽  
Physical Therapists ◽  
Plantar Flexion ◽  
Muscular Activity ◽  
Isokinetic Contraction ◽  
Peroneus Longus ◽  
Anterior Tibial ◽  
Gastrocnemius Muscles ◽  
And Control ◽  
And Inversion

While the number of people who need rehabilitation has been increasing because of the aging population, there are only a limited number of physical therapists engaged in rehabilitation, making it difficult to perform rehabilitation at a sufficient level. In this situation, various devices have been developed to replace physical therapists. However, no rehabilitation devices that can respond to the complicated degrees of freedom of an ankle joint complex (AJC) are commercially available. In the present study, we developed an AJC rehabilitation device using a Stewart platform parallel link mechanism. Using the device, we aim to measure and control the AJC with six degrees of freedom so that complicated composite motions of the AJC can be realized. To evaluate the device’s usefulness, we investigated how the composite motion generated by moving the AJC along the trajectory the device reproduced could influence a crural muscle. Muscular activities of the anterior tibial, soleus, and gastrocnemius muscles, generated by a composite motion of plantar flexion and inversion, had a similar feature to those generated by plantar flexion. However, the muscular activity of the peroneus longus muscle generated in the composite motion was significantly different from that generated only in plantar flexion. In the composite motion of plantar flexion and inversion, based on the knowledge that activity to develop only back muscles while suppressing muscular activities of the anterior tibial and peroneus longus muscles is possible. Based on the knowledge, the device was used to perform isokinetic contraction for evaluating the device’s usefulness for muscular training. We found a difference between the combination of active muscles during the composite motion and that during plantar flexion. A load can be applied to different muscles depending on the composite motion, which indicates that the device can be suitable for rehabilitation or training with high degrees of freedom.

Adult Acquired Flatfoot

2020 ◽  
Vol 62 (1) ◽  
pp. 55-59
Author(s):  
Krzysztof Mataczyński ◽  
Mateusz Pelc ◽  
Halina Romualda Zięba ◽  
Zuzana Hudakova
Keyword(s):  
Soft Tissues ◽  
Three Dimensional ◽  
Clinical Diagnostics ◽  
Clinical Image ◽  
Tibialis Posterior ◽  
Dynamic Force ◽  
Posterior Tibial ◽  
Flat Feet ◽  
Foot Arch ◽  
Motion Range

Acquired adult flatfoot is a three-dimensional deformation, which consists of hindfoot valgus, collapse of the longitudinal arch of the foot and adduction of the forefoot. The aim of the work is to present problems related to etiology, biomechanics, clinical diagnostics and treatment principles of acquired flatfoot. The most common cause in adults is the dysfunction of the tibialis posterior muscle, leading to the lack of blocking of the transverse tarsal joint during heel elevation. Loading the unblocked joints consequently leads to ligament failure. The clinical image is dominated by pain in the foot and tibiotarsal joint. The physical examination of the flat feet consists of: inspection, palpation, motion range assessment and dynamic force assessment. The comparable attention should be paid to the height of the foot arch, the occurrence of “too many toes” sign, evaluate the heel- rise test and correction of the flatfoot, exclude Achilles tendon contracture. The diagnosis also uses imaging tests. In elastic deformations with symptoms of posterior tibial tendonitis, non-steroidal anti-inflammatory drugs, short-term immobilization, orthotics stabilizing the medial arch of the foot are used. In rehabilitation, active exercises of the shin muscles and the feet, especially the eccentric exercises of the posterior tibial muscle, are intentional. The physiotherapy and balneotherapy treatments, in particular hydrotherapy, electrotherapy and laser therapy, are used as a support. In advanced lesions, surgical treatment may be necessary, including plastic surgery of soft tissues, tendons, as well as osteotomy procedures.

scholarly journals POSTERIOR TIBIAL TENDON INJURY - IS MISSED DIAGNOSIS, A POSSIBILITY? SHOULD IT BE SUSPECTED IN ALLANKLE EVERSION SPRAINS? - A CASE REPORT

2020 ◽  
pp. 1-2
Author(s):  
Chavda Sumant ◽  
Garg Chaitanya ◽  
George, Biji Thomas ◽  
Jad Allah, Bader
Keyword(s):  
Physical Examination ◽  
Ankle Sprain ◽  
Weight Bearing ◽  
Ankle Injuries ◽  
Radiographic Evaluation ◽  
Tibialis Posterior ◽  
Posterior Tibial Tendon ◽  
Persistent Symptoms ◽  
Posterior Tibial ◽  
Ankle Brace

Ankle sprains are one of the most common injuries that occur among people of all ages and accounts for 75% of ankle injuries and for 10 to 30 percent of sports-related injuries in young athletes. Inversion sprain is more common than eversion ankle sprain, to result in injury to the lateral ligament complex. Though injury to the posterior tibial tendon is not a very common injury associated with eversion ankle sprain, it often can be overlooked and missed in the initial physical examination. We present a case of a college student who sustained a twisting injury to his left ankle while playing football. After initial history, physical examination and plain radiographic evaluation, a diagnosis of eversion ankle sprain was made by a general practitioner and treated conservatively. Due to persistent symptoms and local signs, subsequent evaluation with an MRI study revealed tibialis posterior (TP) tendon strain with diffuse soft tissue swelling extending up to lower third of the leg and associated Grade I osteochondral injury to the posterolateral aspect of talus. The injury was successfully treated with medial arch support ankle brace, analgesics, guarded weight bearing and physiotherapy with full functional recovery in 12 weeks.

scholarly journals Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus

2019 ◽  
Vol 5 (1) ◽  
pp. 60-65
Author(s):  
Henry Ricardo Handoyo ◽  
Andryan Hanafi Bakri ◽  
Andri Primadhi Primadhi
Keyword(s):  
Platelet Rich Plasma ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Left Ankle ◽  
History Of

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

Role of Tendoscopy in Treating Stage II Posterior Tibial Tendon Dysfunction

2018 ◽  
Vol 39 (4) ◽  
pp. 433-442 ◽  
Author(s):  
Alessio Bernasconi ◽  
Francesco Sadile ◽  
Matthew Welck ◽  
Nazim Mehdi ◽  
Julien Laborde ◽  
...  
Keyword(s):  
Invasive Surgery ◽  
Stage Ii ◽  
Preoperative Imaging ◽  
Tibialis Posterior ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial ◽  
Spring Ligament ◽  
Sf 36

Background: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data. Methods: We reviewed prospectively collected data on 16 patients affected by stage II PTTD and treated by tendoscopy. We report the reoperation rate and functional outcomes evaluated by comparing pre- and postoperative visual analogic scale for pain (VAS-pain) and the Short-Form Health Survey (SF-36; with its physical [PCS] and mental [MCS] components). Postoperative satisfaction was assessed using a VAS-satisfaction scale. One patient was lost to follow-up. Spring ligament lesions were arthroscopically classified in 3 stages. Discrepancies between preoperative imaging and intraoperative findings were evaluated. Results: At a mean of 25.6 months’ follow-up, VAS-pain ( P < .001), SF-36 PCS ( P = .039), and SF-36 MCS ( P < .001) significantly improved. The mean VAS-satisfaction score was 75.3/100. Patients were relieved from symptoms in 80% of cases, while 3 patients required further surgery. MRI and US were in agreement with intraoperative data in 92% and 67%, respectively, for the tendon assessment and in 78% and 42%, respectively, for the spring ligament. Conclusions: Tendoscopy may be considered a valid therapeutic tool in the treatment of stage II PTTD resistant to conservative treatment. It provided objective and subjective encouraging results that could allow continued conservative therapy while avoiding more invasive surgery in most cases. MRI and US were proven more useful in detecting PT lesions than spring ligament tears. Further studies on PT could use this tendoscopic classification to standardize its description. Level of Evidence: Level IV, therapeutic study, case series.

scholarly journals Ankle Eversion and First Ray Plantar Flexion Muscle Strength After Peroneus Longus Tendon Harvest for Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0007
Author(s):  
Fidelis H. Wicaksono ◽  
Sholahuddin Rhatomy ◽  
Nicolaas C. Budipharama
Keyword(s):  
Cruciate Ligament ◽  
Plantar Flexion ◽  
Donor Site ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Ankle Eversion ◽  
Significant Difference ◽  
First Ray ◽  
Flexion Strength

The peroneus longus tendon has been used for a graft in orthopedic reconstruction surgery due to its comparable biomechanical strength to the native Anterior Cruciate Ligament (ACL) and hamstring tendon. However, one of the considerations in choosing autograft is donor site morbidity. This study aimed to compare ankle eversion and first ray plantar flexion strength between donor site and its contralateral. Hypothesis: The study hypothesis was that the eversion and first ray plantar flexion muscle strength were different between harvest site and contralateral healthy site. Methods: From March 2017 to December 2018, patients who underwent ACL reconstruction using peroneus longus tendon autograft were included in this study. From the first day after surgery, the patients followed rehabilitation protocol. Ankle eversion and first ray plantar flexion strength were measured using a modifieddynamometer 6-months after surgery. Donor site morbidities were assessed 6 months after surgery using the Foot and Ankle Disability Index and American Orthopedic Foot and Ankle Society scoring system for ankle and hindfoot. Results: Thirty-one patients fulfilled the inclusion criteria, with 22 males and 9 females, ranging from 18-45 years of age (mean: 27.58±8.69). There was no significant difference in ankle eversion strength at donor site compared to contralateral (p=0.54) with means 65.87±7.63 N and 66.96±8.38 N, respectively. Also, there was no significant difference in ankle first ray plantar flexion strength at donor site compared to contralateral (p=0.68) with means 150.64±11.67 N and 152.10±12.16 N, respectively. The FADI score of 99.71±0.57 and AOFAS score of 98.71±3.03 were considered excellent results. Conclusion: Our study shows that donor site ankle eversion and first ray plantar flexion strengths were similar with the contralateral healthy site with no donor site morbidity. This suggests that peroneus longus tendon is a promising graft in ACL reconstruction.

scholarly journals Ankle Bracing, Plantar-Flexion Angle, and Ankle Muscle Latencies During Inversion Stress in Healthy Participants

2008 ◽  
Vol 43 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Thomas Kernozek ◽  
Christopher J. Durall ◽  
Allison Friske ◽  
Matthew Mussallem
Keyword(s):  
Repeated Measures ◽  
Plantar Flexion ◽  
Ankle Injuries ◽  
Flexion Angle ◽  
Electromyographic Activity ◽  
Custom Made ◽  
Ankle Muscle ◽  
Main Effects ◽  
And Inversion ◽  
Healthy Females

Abstract Context: Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only. Objective: To examine the latency of the peroneus longus (PL), peroneus brevis (PB), and tibialis anterior (TA) muscles in response to various degrees of combined plantar-flexion and inversion stresses in braced and unbraced asymptomatic ankles. Design: Repeated measures. Setting: University biomechanics laboratory. Patients or Other Participants: Twenty-eight healthy females and 12 healthy males (n = 40: mean age = 23.63 years, range = 19 to 30 years; height = 172.75 ± 7.96 cm; mass = 65.53 ± 12.0 kg). Intervention(s): Participants were tested under 2 conditions: wearing and not wearing an Active Ankle T1 brace while dropping from a custom-made platform into 10°, 20°, and 30° of plantar flexion and 30° of inversion. Main Outcome Measure(s): The time between platform drop and the onset of PL, PB, and TA electromyographic activity was measured to determine latencies. We calculated a series of 2-way analyses of variance to determine if latencies were different between the conditions (braced and unbraced) and among the plantar-flexion angles (α = .05). Results: No interaction was found between condition and plantar-flexion angle. No significant main effects were found for condition or plantar-flexion angle. Overall means for braced and unbraced conditions were not significantly different for each muscle tested. Overall means for angle for the PL, PB, and TA were not significantly different. Conclusions: Reflexive activity of the PL, PB, or TA was unaffected by the amount of plantar flexion or by wearing an Active Ankle T1 brace during an unanticipated plantar-flexion inversion perturbation.

Effect Of Ankle Support And Inversion Perturbation On The Peroneus Longus Hoffmann Reflex

2005 ◽  
Vol 37 (Supplement) ◽  
pp. S397???S398
Author(s):  
JoEllen M. Sefton ◽  
Charlie Hicks-Little ◽  
David M. Koceja ◽  
Mitchell L. Cordova
Keyword(s):  
Hoffmann Reflex ◽  
Peroneus Longus ◽  
Ankle Support ◽  
And Inversion

scholarly journals Korelasi antara Gambaran Spektral Doppler Arteri Tibialis Posterior dan Arteri Dorsalis Pedis dengan Skor PEDIS pada Penderita Ulkus Kaki Diabetik

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Leise Limpeleh ◽  
Richard Sumangkut ◽  
Djoni E. Tjandra
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Posterior Tibial Artery ◽  
Foot Ulcers ◽  
Tibialis Posterior ◽  
Diabetic Foot Ulcers ◽  
Doppler Examination ◽  
Posterior Tibial ◽  
Dorsalis Pedis Artery

Abstract: Diabetic foot ulcer is still a major health problem worldwide due to its increasing prevalence. This study was aimed to prove the correlation between PEDIS score and vascular Doppler examination performed on dorsalis pedis and posterior tibial arteries of patients with diabetic foot ulcers. This was an observational study with a cross sectional design. The results showed that during the period of August 2017 until January 2018, there were 62 patients with diabetic foot ulcers at the wards of Surgery Department and Internal Medicine Department of Prof. Dr. R. D. Kandou Hospital Manado. Most patients were in the age group of 60-69 years, had leukocytosis (74.1%), poor blood sugar control (70.9%), and hypoalbuminemia (98.3%). Moreover, smoking history in 20.9% of patients; hypertension in 35.4% of patients; and dyslipidemia in 20.9% of patients. The Doppler examination resulted in biphasic waveform in posterior tibial artery (40.3%) as well as in dorsalis pedis artery (41.9%). Perfusion score showed 50% of subjects had PAD. Most subjects (90.3%) had ulcers of >3 cm2 and were infected superficially in the subcutaneous area (56.4%). Most subjects (58%) suffered from severe infection with high leucocyte counts, however, only 29% of subjects had lost of sensoric ability. The correlation Spearman test obtained r = -0.486 and P = 0.000 in the posterior tibial artery; and r = -0.281 and P = 0.0027 in the dorsalis pedis artery. Conclusion: There was a significant correlation between vascular Doppler result and PEDIS score. The higher the PEDIS score, the worse the vascular Doppler result.Keywords: diabetic foot ulcer, PEDIS score, vascular DopplerAbstrak: Ulkus kaki diabetik masih merupakan masalah kesehatan utama sedunia dengan prevalensi yang terus meningkat. Penelitian ini bertujuan untuk membuktikan apakah terdapat hubungan antara skor PEDIS dan pemeriksaan spektral Doppler vaskuler pada arteri poplitea, dorsalis pedis, dan tibialis posterior pada pasien dengan ulkus kaki diabetik. Jenis penelitian ialah observasional dengan desain potong lintang. Hasil penelitian mendapatkan 62 pasien dengan ulkus kaki diabetik di bangsal Bagian Bedah dan Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado selama periode Agustus 2017 sampai Januari 2018. Ukus diabetik tersering ditemukan pada kelompok usia 60-69 tahun dengan rerata usia 58,5 tahun. Sebagian besar pasien mengalami leukositosis (74,1%), kontrol gula darah buruk (70,9%), dan hipoalbuminemia (98,3%). Riwayat merokok didapatkan sebesar 20,9%; hipertensi 35,4%; dan dislipidemia 20,9%. Hasil pemeriksaan Doppler bifasik pada arteri tibialis posterior (40,3%) dan arteri dorsalis pedis (41,9%). Skor perfusi menunjukkan 50% subyek mengalami penyakit arteri perifer (PAD). Sebagian besar (90,3%) subjek memiliki ulkus >3 cm2 luas area. Infeksi sebagian besar superfisial di subkutan (56,4%), selebihnya menderita infeksi hingga fasia, otot, dan tendon. Sebagian besar subyek penelitian menderita infeksi berat (58%) dengan angka leukosit tinggi. Hanya 29% dari subjek penelitian mengalami kehilangan kemampuan sensorik. Hasil uji korelasi Spearman mendapatkan pada arteri tibialis posterior: r = -0,486 dengan P = 0,000 dan pada arteri dorsalis pedis: r = -0,281 dengan P = 0,0027. Simpulan: Terdapat hubungan bermakna antara hasil pemeriksaan spektral Doppler dan skor PEDIS. Semakin tinggi skor PEDIS semakin buruk hasil spektral Doppler.Kata kunci: ulkus kaki diabetik, skor PEDIS, Doppler spektral vaskular

scholarly journals Arthroscopically assisted resection of overlooked fracture of posterior talar procesus

2021 ◽  
pp. 50-50
Author(s):  
Branislav Krivokapic ◽  
Bojan Bukva ◽  
Danilo Jeremic ◽  
Nemanja Jovanovic ◽  
Filip Maljkovic
Keyword(s):  
Plantar Flexion ◽  
Quick Recovery ◽  
Posterior Process ◽  
Professional Soccer ◽  
Arthroscopic Excision ◽  
Arthroscopically Assisted ◽  
History Of ◽  
And Inversion ◽  
Professional Soccer Player

Introduction. The fractures of the posterior process of talus are relatively rare injuries of the ankle. They most frequently occur via the mechanism of the forced hyper plantar flexion and inversion. Sometimes they are not initially diagnosed, since over 40% of cases of the fractures of the posterior process of talus are not seen in the initial radiography. The objective of this work is the review of the case study of the arthroscopically treated unhealed fracture of the posterior process of talus. Case outline. In our case report we have presented the 30-year-old male, professional soccer player, with a three-month-long history of chronic pain in the region of the left ankle and heel and the fracture of the posterior process of talus. Conclusion. The work shows all the advantages of minimally invasive surgery - arthroscopic excision of the fragment, quick recovery and returning to physical activities.

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