scholarly journals Isometry of Potential Attachment Sites for the Iliotrochanteric Suture in Dogs: an ex vivo Study

2020 ◽  
Vol 48 ◽  
Author(s):  
Cristiane Alves Cintra ◽  
Luís Gustavo Gosuen Gonçalves Dias ◽  
Fernanda Gosuen Gonçalves Dias ◽  
Danyelle Rayssa Cintra Ferreira ◽  
Lucas De Freitas Pereira ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Surgical Techniques ◽  
Vertical Axis ◽  
Central Point ◽  
Neutral Position ◽  
Joint Movement ◽  
Caudal Portion ◽  
Attachment Sites ◽  
Suture Tension ◽  
Hip Extension

Background: Coxofemoral luxation is the most common traumatic luxation in dogs and the iliotrochanteric suture is one of the surgical treatment options. The orthopedic suture aimed at surgically restoring joint movement should be employed in an isometric manner in order to maintain adequate tension throughout the arc of motion. This study aimed to determine the isometric points for the iliotrochanteric suture in dogs during the joint extension and flexion movements. This evaluation was performed both in the intact hip joint and in the luxation model, establishing the best combination, among the determined points, for the reestablishment of normal joint movement.Materials, Methods & Results: Radiographic analyses of 12 canine cadaveric hips, both intact and in craniodorsal luxation model, were performed in a neutral position, flexion at 50°, and extension at 150°. In the trochanteric segment, two parallel lines were drawn, creating the central vertical axis and the secondary vertical axis. Three points were then determined on each axis, from proximal to distal, corresponding to 25, 50, and 75% of the height of the axis, and were labelled as T1, T2, and T3 and T4, T5, and T6, respectively. In the iliac segment, a line perpendicular to the longitudinal axis of the ilium was drawn, and 25, 50, and 75% of this height corresponded to points I1, I2, and I3, respectively. The lengths between the points were measured, with the objective of evaluating which combination of points presented less variation in the joint positions. The central location of the iliac and trochanteric segments, determined respectively by I2 and T2, provided smaller variations during the maximal movements of hip flexion and extension.Discussion: The surgical techniques of iliotrochanteric suture target to maintain the internal rotation of the femoral head inside the acetabulum and abduction of the femur until the soft tissues have healed. The described techniques for the iliotrochanteric suture present a great anatomical variety in the arrangement of the anchor points of the suture. It is known that if during motion, the attachment sites move closer to one another, the suture will become lax and, if the attachment sites move away from one another, the suture will tighten. Therefore, the implantation in isometric sites assists in reducing the variation of the distance between the points of origin and insertion of the suture during joint movement, keeping the suture tension constant and allowing the functional recovery of the joint. This study demonstrates that there are some locations for the origin and insertion of an iliotrochanteric suture that are associated with less length change than others. I2-T2 combination is the point closest to isometry for the iliotrochanteric suture during hip extension and flexion, so that, T2 is the most central point of the greater trochanter, corresponding to 50% of the height of its central vertical axis, as well as I2, which corresponds to the most central point of the ilium, representing 50% of the height of the most caudal portion of its body. The isometric point found by us details the exact location of perforation in all aspects (height and length), both in the ilium and the trochanter. In addition, it is a personalized point created for each patient from its radiographic examination and taking into consideration its anatomical variations, so that there is no damage to the suture during hip extension and flexion movements.

Envelopes of Passive Motion in the Intact Tibiofemoral Joint: An In Vitro Study

2013 ◽  
Author(s):  
Joshua D. Roth ◽  
S. M. Howell ◽  
M. L. Hull
Keyword(s):  
Computational Models ◽  
Soft Tissues ◽  
Surgical Techniques ◽  
Knee Kinematics ◽  
In Vitro Study ◽  
Neutral Position ◽  
Tibiofemoral Joint ◽  
Passive Motion ◽  
Posterior Translation

The kinematics (i.e. passive motions) of the knee are determined and constrained by the articular surfaces and soft tissues of the tibiofemoral joint [1]. Knee kinematics may be characterized by measuring the envelopes of passive motion which are described, for each DOF over a range of flexion, by the positive and negative limits of displacement about a neutral position, under a prescribed load. It is crucial to understand the kinematics of the intact tibiofemoral joint because the envelopes of passive motion could serve as a gold standard for validating computational models of the knee as well as evaluating the effectiveness of innovative and established surgical techniques. Therefore, the objective of this study was to define the envelopes of passive motion for internal-external (I-E) rotation, varus-valgus (V-V) rotation, anterior-posterior translation (A-P), and distraction (D) translation of the intact tibiofemoral joint.

scholarly journals Microvasculature of the Plantar Plate Using Nano–Computed Tomography

2018 ◽  
Vol 40 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Fred T. Finney ◽  
Aaron McPheters ◽  
Natalie V. Singer ◽  
Jaron C. Scott ◽  
Karl J. Jepsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Surgical Techniques ◽  
Phosphomolybdic Acid ◽  
Vascular Density ◽  
Plantar Plate ◽  
Tibial Arteries ◽  
Clinical Conditions ◽  
Mtp Joints

Background: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging. Methods: Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate. Conclusion: There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate. Clinical relevance: The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair.

Effects of soft tissue artefacts on computed segmental and stifle kinematics in canine motion analysis

2019 ◽  
Vol 186 (2) ◽  
pp. 66-66 ◽  
Author(s):  
Ming Lu ◽  
Cheng-Chung Lin ◽  
Tung-Wu Lu ◽  
Shi-Nuan Wang ◽  
Ching-Ho Wu
Keyword(s):  
Soft Tissue ◽  
Motion Analysis ◽  
Soft Tissues ◽  
Functional Performance ◽  
Frontal Plane ◽  
Skin Marker ◽  
Attachment Sites ◽  
Mixed Breed ◽  
Dynamic Gait ◽  
Cluster Level

Skin marker-based motion analysis has been widely used to evaluate the functional performance of canine gait and posture. However, the interference of soft tissues between markers and the underlying bones (soft tissue artefacts, STAs) may lead to errors in kinematics measurements. Currently, no optimal marker attachment sites and cluster compositions are recommended for canine gait analysis. The current study aims to evaluate cluster-level STAs and the effects of cluster compositions on the computed stifle kinematics. Ten mixed-breed healthy dogs affixed with 19 retroreflective markers on the thigh and shank were enrolled. During isolated stifle passive extension, the marker trajectories were acquired with a motion capture system, and the skeletal poses were determined by integrating fluoroscopic and CT images of the bones. The cluster-level STAs were assessed, and clusters were paired to calculate the stifle kinematics. A selection of cluster compositions was useful for deriving accurate sagittal and frontal plane stifle kinematics with flexion angles below 50 per cent of the range of motion. The findings contribute to improved knowledge of canine STAs and their influence on motion measurements. The marker composition with the smallest error in describing joint kinematics is recommended for future applications and study in dogs during dynamic gait assessment.

Using MR Imaging and X-Ray Fluoroscopy to Quantify the Effects of Soft-Tissue Artifact on Measurement of Knee-Joint Kinematics

2009 ◽  
Author(s):  
Massoud Akbarshahi ◽  
Justin W. Fernandez ◽  
Anthony Schache ◽  
Richard Baker ◽  
Marcus G. Pandy
Keyword(s):  
Soft Tissue ◽  
Knee Joint ◽  
Soft Tissues ◽  
Surgical Techniques ◽  
Joint Kinematics ◽  
Segmental Motion ◽  
Coordinate Systems ◽  
Knee Joint Kinematics ◽  
Soft Tissue Artifact

The ability to accurately measure joint kinematics in vivo is of critical importance to researchers in the field of biomechanics [1]. Applications range from the quantitative evaluation of different surgical techniques, treatment methods and/or implant designs, to the development of computer-based models capable of simulating normal and pathological musculoskeletal conditions [1,2]. Currently, non-invasive marker-based three dimensional (3D) motion analysis is the most commonly used method for quantitative assessment of normal and pathological locomotion. The accuracy of this technique is influenced by movement of the soft tissues relative to the underlying bones, which causes inaccuracies in the determination of segmental anatomical coordinate systems and tracking of segmental motion. The purpose of this study was to quantify the errors in the measurement of knee-joint kinematics due solely to soft-tissue artifact (STA) in healthy subjects. To facilitate valid inter-subject comparisons of the kinematic data, relevant anatomical coordinate systems were defined using 3D bone models generated from magnetic resonance imaging (MRI).

scholarly journals Isolate and irreducible radial head dislocation in children: a rare case of capsular interposition

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Luigi Tarallo ◽  
Michele Novi ◽  
Giuseppe Porcellini ◽  
Fabio Catani
Keyword(s):  
Radial Head ◽  
Soft Tissues ◽  
Biceps Tendon ◽  
Annular Ligament ◽  
Neutral Position ◽  
Radial Head Dislocation ◽  
Anterior Capsule ◽  
Associated Lesions ◽  
Sport Activities ◽  
Tendon Interposition

Abstract Background Radial head dislocation with no associated lesions, is a relatively uncommon injury in children. In this case report, it is reported a case of anteromedial locked radial head dislocation in children, and we discuss its clinical presentation and pathogenetic mechanism of injury. Case presentation An 8-year-old girl fell off on her right forearm with her right elbow extended in hyperpronation. An isolated radio-capitellar dislocation was identified with no other fractures or neurovascular injuries associated. Elbow presented an extension-flexion arc limited (0°- 90°), and the prono-supination during general anesthesia shows “a sling effect” from maximal pronation (+ 55°) and supination (+ 90°) to neutral position of forearm. The radial head dislocation was impossible to reduce and an open reduction was performed using lateral Kocher approach. The radial head was found “button-holed” through the anterior capsule. The lateral soft tissues were severely disrupted and the annular ligament was not identifiable. Only by cutting the lateral bundle of the capsule was possible to reduce the joint. At 50 moths follow-up, patient presented a complete Range of motion (ROM), complete functionality and no discomfort or instability even during sport activities. Discussion and conclusion It is important to understand the pathogenic mechanisms of locked radial head dislocation in children. Some mechanism described are the distal biceps tendon or the brachialis tendon interposition. However even the anterior capsule can hinder reduction. A characteristic “sling-effect” of the forearm could be pathognomonic for capsular button-holing. Surgical release of the capsular bundle sometimes is the only way to reduce the dislocation and obtain a good outcome.

scholarly journals Relationship Between Lumbar Motor Control Ability and Spinal Curvature in Elderly Individuals

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 130
Author(s):  
Ryo Miyachi ◽  
Junya Miyazaki
Keyword(s):  
Motor Control ◽  
Comprehensive Evaluation ◽  
Movement Pattern ◽  
Standing Position ◽  
Spinal Curvature ◽  
Joint Movement ◽  
Hip Joints ◽  
Elderly Individuals ◽  
Spine Curvature ◽  
Hip Extension

This study aimed to clarify the relationship between spine curvature and the movement pattern/motor control ability of the lumbar and hip joints during prone hip extension in elderly individuals. The participants were 14 elderly people who attended a community health class. We measured the motion angle, motion ratio (movement pattern), and motor control ability of the lumbar and hip joints during prone hip extension. In addition, the lumbar lordosis angle and thoracic kyphosis angle were measured in the standing position. There was no correlation between the spinal curvature in the standing position and the lumbar/hip joint movement pattern and motor control ability during prone hip extension. When evaluating the lumbar spine, it is necessary to perform a comprehensive evaluation by interpreting static evaluations such as spinal alignment or dynamic evaluations such as movement patterns and motor control abilities.

Influence of suture tension to the tearing characteristics of the soft tissues: an in vitro experiment

2008 ◽  
Vol 19 (3) ◽  
pp. 314-319 ◽  
Author(s):  
Rino Burkhardt ◽  
Axel Preiss ◽  
Andreas Joss ◽  
Niklaus P. Lang
Keyword(s):  
Soft Tissues ◽  
Vitro Experiment ◽  
In Vitro Experiment ◽  
Suture Tension

scholarly journals Neglected Locked Patellar Dislocation in an Adult Female: Report of a Rare Case

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Sumedh D Chaudhary ◽  
Pratik R Gandhi ◽  
Maruti R Koichade ◽  
Suchit P Chavan ◽  
Shreyas H Ghuguskar
Keyword(s):  
Open Reduction ◽  
Patellar Dislocation ◽  
Soft Tissues ◽  
Vertical Axis ◽  
Successful Outcome ◽  
Trochlear Groove ◽  
Osteochondral Fracture ◽  
Chondral Injury ◽  
Wound Healing Problems

Introduction: Dislocation of patella is a very common injury which usually reduces spontaneously or can be reduced easily using gentle manipulation. Irreducible patellar dislocations are rare and usually result due to either rotation of patella along the horizontal or vertical axis or due to bony impaction. Neglected locked patellar dislocations are extremely rare injuries presenting additional challenges. Case Report: We are reporting a case of a 24-year female who presented to us 4 months after suffering a knee injury for which she received native treatment initially. On presentation, patient was able to walk with a limp and some discomfort but was unable to squat or sit cross-legged. Clinical examination revealed a patellar dislocation which was irreducible. On open reduction, the patella was found to be locked in the lateral gutter with rotation along its vertical axis and with an osteochondral fracture of its medial margin. There were a lot of fibrotic adhesions which required extensive release, following which the patella could be derotated and reduced into the trochlear groove. The medial retinaculum was repaired using transosseous sutures. Postoperatively, the patient developed wound edge necrosis which was managed with debridement and secondary suturing. At 1-year follow-up patient had almost full knee range of motion without any signs of patellar pain or instability and was able to squat and sit cross-legged. Conclusion: Unlike acute irreducible patellar dislocations which can be managed easily with open reduction, a neglected dislocation necessitates wider surgical exposure and a lot of soft tissue releases, which may jeopardize vascularity of the soft tissues leading to wound healing problems. Release of all adhesions while taking care to prevent further chondral injury, adequate lateral retinacular release, derotation of patella to relocate it into trochlear groove, and meticulous medial retinacular repair is essential for a successful outcome. Keywords

scholarly journals RADIO-FREQUENCY WAVE APPLICATION IN ESTHETIC SURGERY OF HEAD AND NECK

2008 ◽  
Vol 37 (2) ◽  
pp. 137-142
Author(s):  
Vukoje Novak
Keyword(s):  
Head And Neck ◽  
Surgical Procedures ◽  
Soft Tissues ◽  
New Technology ◽  
Surgical Techniques ◽  
Pathological Process ◽  
Wave Form ◽  
Esthetic Surgery ◽  
Frequency Wave ◽  
Radio Frequency Wave

Introduction: Four-megahertz radiowave surgery is a relatively new technology usage of which rapidly expands reaching superior results compared to other surgical techniques. Radiosurgery is an atraumatic metod of cutting and coagulation of soft tissues that uses optimal low heat 4.0 MHz source for numerous plastic,esthetic and cosmetic interventions which reguires surgical precision, penetration control and low temperature. This technology allows us to simultaneously cut and coagulate the tissue with minimal lateral tissue alteration, without burning damage and with better wounds healing.This mode is used by the author in high vascularity anatomical areas and for the deeper tissue of the head and neck. The pure cutting wave-form is ideal for skin excision with otoplasty and blepharoplasty when we expect ideal esthetic result. Coagulation is obviously paramount for any surgeon and can make the difference between a good and poor result. When he coagulates tissues in the head and neck, the surgen is frequently close to significant structures such as nerves and vessels which we must protect. Ellman Sugitron 4.0 offers great advantages. One of the stronges point of the Ellman system is the large array of specialized electrodes. By bending the malleable electrodes we can use them at any angle or even around corners. Material and Methods: The Author has done surgical procedures on over 600 patients using this technique on different esthetic problems with satisfying results. In operative material dominate various skin growths (hemangioma, fibroma, naevus, wart) blepharoplasy, otoplasty, rhinoplasty and other minor surgical procedures. Interventions were done in local anesthesy. The aim of this work is to present our observations about radioablation in heterogenous pathological process on head and neck based of our own experience. Results: Our results show that this technology have great advantage over other techniques (scalpel, electrocouter, laser) from which the most important are simultaneous cutting and coagulation,coagulation in liquid medium, minimal termal damage of latteral tissues, faster healing of wounds with excellent cosmetic results. If we want surgery without cut,cut without scar, Ellman Sugitron is the best choice.

scholarly journals Global sagittal spinal alignment at cervical flexion in patients with dropped head syndrome

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902094826 ◽  
Author(s):  
Takamitsu Konishi ◽  
Kenji Endo ◽  
Takato Aihara ◽  
Hidekazu Suzuki ◽  
Yuji Matsuoka ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Vertical Axis ◽  
Control Group ◽  
Sacral Slope ◽  
Neutral Position ◽  
Spinal Alignment ◽  
Sagittal Vertical Axis ◽  
Dropped Head Syndrome ◽  
Sagittal Spinal Alignment ◽  
Significant Difference

Purpose: Dropped head syndrome (DHS) is characterized by the passively correctable chin-on-chest deformity. The characteristic feature is emphasized in the cervical flexion position. The purpose of this study was to analyze the influence of cervical flexion on sagittal spinal alignment in patients with DHS. Methods: The study included 15 DHS subjects and 55 cervical spondylosis (CS) subjects as the control group. The following parameters were analyzed: cervical sagittal vertical axis (C-SVA), occipitoaxial angle (O–C2A), C2 slope (C2S), C2–C7 angle (C2–C7A), T1 slope (T1S), sagittal vertical axis, T1–T4 angle (T1–T4A), T5–T8 angle (T5–T8A), T9–T12 angle, lumbar lordosis, sacral slope, and pelvic tilt, in cervical flexion and neutral positions. Results: The values of C-SVA, O–C2A, C2S, and T1S were significantly different between CS and DHS at cervical neutral and flexion positions. C2–C7A showed significant difference in cervical neutral position, but the difference disappeared in flexion position. T1–T4A did not present a significant difference, but T5–T8A showed a difference in neutral and flexion positions. Conclusions: Malalignment of DHS extended not only to cervical spine but also to cranio-cervical junction and thoracic spine, except T1–T4. It is known that global sagittal spinal alignment is correlated with adjacent parameters, although in DHS the reciprocal change was lost from cranio-cervical junction to the middle part of thoracic spine at cervical flexion.

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