scholarly journals A New Radiographic Method for Estimating Tibial Malrotation

2020 ◽  
Vol 7 (3) ◽  
pp. 121-128
Author(s):  
Hamidreza Yazdi ◽  
◽  
Mohammad Taher Ghaderi ◽  
Alireza Yousof Gomrokchi ◽  
Parham Pezeshk ◽  
...  
Keyword(s):  
Lower Limb ◽  
Evaluation Method ◽  
Bone Fractures ◽  
Distal Tibia ◽  
Bone Diseases ◽  
The Body ◽  
University Hospital ◽  
Radiographic Evaluation ◽  
Minor Trauma ◽  
Lower Limb Injury

Background: Diaphyseal tibial fractures are the most frequent bone fractures in the body and are usually treated with intramedullary nailing method. However, this approach is responsible for 41% of the rotational deviation.  Objectives: This study aimed to provide a radiographic evaluation method to determine tibial malrotation in closed fixation of tibia bone fractures during or after the operation. Methods: This study was conducted in a university hospital from May 2015 to March 2016. All patients referring to the hospital with the complaints of minor trauma around the ankle and knee requiring radiographic evaluation of both joints were enrolled in the study. The inclusion criteria included being 20 and 50 years old; having normal axial, sagittal, and coronal lower limb alignment; lacking previous lower limb injury (such as fractures of the tibia or fibula), ankle or knee sprain; not having previous lower limb surgery, metabolic or congenital bone diseases, or malignancy. In all cases, a standard Anteroposterior (AP) radiograph of the knee was taken, and then, without changing the limb position or image setting, an AP radiograph of the ankle was obtained. The overlap between the distal tibia and fibula was measured in the PACS program environment.   Results: Fifty cases were included in this study. The Mean±SD ages of males and females were 29.08±2.49 years and 31.46±2.04 years, respectively. The range of distal tibia-fibula overlap one centimeter above the tibiotalar joint line was 7.81 to 9.09 mm (confidence interval of 95%), and its percentage to the fibula shaft width at the same level was 49.43% to 54.35%. Conclusion: According to the results, distal tibia-fibula overlap when the knee is in the true AP position, regardless of the side and gender, is 7.81 to 9.09 mm or 49.43% to 54.35%.

scholarly journals Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

2021 ◽  
Vol 18 (8) ◽  
pp. 4219
Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Heterotopic Ossification ◽  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
University Hospital ◽  
Pain Sensation ◽  
Vein Thrombosis ◽  
Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

scholarly journals TREATMENT OF TALAR BODY FRACTURES WITH CLOSED REDUCTION AND PERCUTANEOUS FIXATION AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Ramashish Yadav ◽  
Ramsagar Pandit ◽  
Nand Kumar ◽  
Debarshi Jana
Keyword(s):  
Closed Reduction ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Functional Results ◽  
The Body ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Medial Malleolus ◽  
Percutaneous Fixation ◽  
Medial Malleolus Fracture

Background: Fractures of the talus have a relatively low incidence accounting for 0.3% of all bone fracturesand 3–6% of all foot fractures. These injuries affect the neck of the talus, more than the head or the body. Talar body fractures of the talus are uncommon accounting for 7–38% of all talus fractures. Patients and Methods: Fifteen patients with fracture of the talus were operated on using closed reductionand percutaneous screws fixation. The patients (Table 1) were followed up for an average of 20 months (range 12-30 months). In 12 patients the talar fracture was an isolated fracture of the talus in the foot and ankle region. Patient no. 2 had ipsilateral fractures of the distal tibia, fibula, and calcaneus. Patient no. 7 suffered from ipsilateral fracture of the fifth metatarsal. Patient 4 had ipsilateral medial malleolus fracture. Results: Radiographic evaluation postoperative showed exact reduction in all cases but three which had astep of 2mm and 1.5 mm displacement. There were no re-displacements of the fractures, and all patients achieved union radiologically and clinically and could walk without external aid with full weight bearing by third to sixth month postoperative. Functional results according to Hawkins were excellent in five patients, good in seven, fair in three, and no poor results. Conclusion: Closed reduction and percutaneous fixation of talar body fractures is a good technique withaccepted clinical and radiological results, and less complications

scholarly journals Total Body Water (TBW) Percentage and 3rd Space Water Were Risk Factors for Recruit Injuries in Lower Limbs: A Case-Control Study

2020 ◽  
Author(s):  
Junjie Ouyang ◽  
Jing Yang ◽  
Wanling Jiang ◽  
Bing Li ◽  
Kexing Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Composition ◽  
Lower Limb ◽  
Multivariate Logistic Regression Analysis ◽  
The Body ◽  
Lower Limbs ◽  
Multivariate Logistic Regression ◽  
Lower Limb Injury ◽  
Limb Injury ◽  
Injury Group

Abstract Background: Recruit training injuries have caused serious problems for troop training and medical support. The lower limbs is the site where recruit injuries occur the most. Bio-impedance (BIA) measures body composition quickly and accurately. Our aim was to identify the risk factors for lower limbs training injuries to recruits due to body composition.Methods: A total of 282 recruits were included. Before training, use BodyStat QuadScan 4000 multifrequency BIA system to measure the body composition of recruits. After training, they were divided into two groups according to the occurrence of lower limb training injuries. The basic characteristics of the two recruits were compared by Wilcoxon rank sum test. Receiver operator characteristic (ROC) curves was performed on the indicators with statistical difference between the two groups to find the cutoff point. Finally, multivariate logistic regression analysis was used to find the risk factors of lower limb training injuries.Results: Compared with the lower limb uninjured group, the lean mass percentage (P = 0.003), TBW percentage (P = 0.010), extracellular water (ECW) percentage (P = 0.023), intracellular water(ICW) percentage (P = 0.027), 3rd space water (P = 0.021) and basal metabolic rate(BMR)/total weight (P = 0.014) of the lower limb injury group was higher. On the contrary, the body fat percentage (P = 0.003) and body fat mass index (BFMI) (P = 0.005) of the lower limb injury group was lower. The results of multivariate logistic regression analysis showed that TBW percentage > 65.350% (P = 0.050, OR=2.085) and 3rd space water >0.950 (P = 0.045, OR=2.342) were independent risk factors for lower limb injuries.Conclusions: TBW percentage> 65.35% and 3rd space water >0.950 were independent risk of lower limb training injuries. These recruits need to be paid more attention during training.

scholarly journals X-Linked Osteogenesis Imperfecta Possibly Caused by a Novel Variant in PLS3

Genes ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1851
Author(s):  
Petar Brlek ◽  
Darko Antičević ◽  
Vilim Molnar ◽  
Vid Matišić ◽  
Kristina Robinson ◽  
...  
Keyword(s):  
Osteogenesis Imperfecta ◽  
Bone Fractures ◽  
Bone Mineralization ◽  
Severe Disease ◽  
Compression Fracture ◽  
Lumbar Vertebra ◽  
Bone Diseases ◽  
Complex Spectrum ◽  
Minor Trauma ◽  
Sequencing Analysis

Osteogenesis imperfecta (OI) represents a complex spectrum of genetic bone diseases that occur primarily due to mutations and deletions of the COL1A1 and COL1A2 genes. Recent molecular studies of the network of signaling pathways have contributed to a better understanding of bone remodeling and the pathogenesis of OI caused by mutations in many other genes associated with normal bone mineralization. In this paper, a case of a rare X-linked variant of OI with a change in the gene encoding plastin 3—a protein important for the regulation of the actin cytoskeleton, is presented. A 16-year-old patient developed ten bone fractures caused by minor trauma or injury, including a compression fracture of the second lumbar vertebra during his lifetime. Next-generation sequencing analysis did not show pathologically relevant deviations in the COL1A1 and COL1A2 genes. Targeted gene analyses (Skeletal disorder panel) of the patient, his father, mother and sister were then performed, detecting variants of uncertain significance (VUS) for genes PLS3, FN1 and COL11A2. A variant in the PLS3 gene were identified in the patient, his mother and sister. Since the PLS3 gene is located on the X chromosome, the mother and sister showed no signs of the disease. Although the variant in the PLS3 gene (c.685G>A (p.Gly229Arg)) has not yet been described in the literature, nor is its pathogenicity known, clinical findings combined with genetic testing showed that this variant may explain the cause of X-linked OI in our patient. This rare case of the PLS3 variant of X-linked OI might point to a novel target for personalized therapy in patients with this severe disease.

Foot core strengthening: relevance in injury prevention and rehabilitation for runners

2016 ◽  
Vol 64 (1) ◽  
Keyword(s):  
Injury Prevention ◽  
Lower Limb ◽  
Neuromuscular Electrical Stimulation ◽  
Plantar Fascia ◽  
Core Stability ◽  
Tibialis Posterior ◽  
Lower Limb Injury ◽  
Limb Injury ◽  
Plantar Fasciopathy ◽  
Intrinsic Foot Muscles

The human foot is a flexible structure characterized by a pronounced medial longitudinal arch (MLA) that compresses and recoils during running. That process is actively driven by the intrinsic foot muscles and requires a proper stability of the MLA. This introduces the concept of foot core stability. Because the intrinsic foot muscles are often neglected by clinicians and researchers, the purpose of this article is to provide some guidelines for incorporating foot core training in prevention or rehabilitation programmes for runners. The intrinsic foot muscles play a key role in postural control and maintain balance during single leg stance by controlling the height of the MLA and the foot pronation. During running, these muscles lengthen eccentrically during the absorption phase and subsequently shorten as the arch recoils during the propulsive phase, functioning in parallel to the plantar fascia. As a consequence, the dysfunction or weakness of the MLA active support may lead to injuries (e.g. plantar fasciopathy, Achilles or Tibialis posterior tendinopathy, metatarsalgia or medial tibial stress syndrome), due to numerous biomechanical cascades and mechanisms. In order to counteract or prevent these impairments, there are two ways for enhancing the foot core stability. Firstly in terms of volitional control of the intrinsic foot muscles, the “short foot exercise” must be practiced. Secondly strengthening sessions using neuromuscular electrical stimulation of these muscles seem to be a promising strategy in order to support the MLA and control the pronation during running. Practically, the foot core strengthening protocol may beneficiate not only the runners affected by excessive pronation related injuries but also those who sustained a long term lower limb injury and may be affected by a detraining process. In addition we warmly recommend integrating this protocol in any lower limb injury prevention programme or strength and conditioning plan for runners.

Study on Pramana Shareera in relation to Prakriti

2016 ◽  
Vol 2 (3) ◽  
Author(s):  
Rajendra Pai N. ◽  
U. Govindaraju
Keyword(s):  
Observational Study ◽  
Upper Limb ◽  
Lower Limb ◽  
Characteristic Property ◽  
The Body ◽  
Artificial Limbs ◽  
Body Parts ◽  
Unit Of Measurement ◽  
The Individual ◽  
Different Parts

Ayurveda in its principle has given importance to individualistic approach rather than generalize. Application of this examination can be clearly seem like even though two patients suffering from same disease, the treatment modality may change depending upon the results of Dashvidha Pariksha. Prakruti and Pramana both used in Dashvidha Pariksha. Both determine the health of the individual and Bala (strength) of Rogi (Patient). Ayurveda followed Swa-angula Pramana as the unit of measurement for measuring the different parts of the body which is prime step assessing patient before treatment. Sushruta and Charaka had stated different Angula Pramana of each Pratyanga (body parts). Specificity is the characteristic property of Swa-angula Pramana. This can be applicable in present era for example artificial limbs. A scientific research includes collection, compilation, analysis and lastly scrutiny of entire findings to arrive at a conclusion. Study of Pramana and its relation with Prakruti was conducted in 1000 volunteers using Prakruti Parkishan proforma with an objective of evaluation of Anguli Pramana in various Prakriti. It was observed co-relating Pramana in each Prakruti and Granthokta Pramana that there is no vast difference in measurement of head, upper limb and lower limb. The observational study shows closer relation of features with classical texts.

scholarly journals Kinect Azure–Based Accurate Measurement of Dynamic Valgus Position of the Knee—A Corrigible Predisposing Factor of Osteoarthritis

2021 ◽  
Vol 11 (12) ◽  
pp. 5536
Author(s):  
Ádám Uhlár ◽  
Mira Ambrus ◽  
Márton Kékesi ◽  
Eszter Fodor ◽  
László Grand ◽  
...  
Keyword(s):  
Motion Capture ◽  
Optical System ◽  
Lower Limb ◽  
Cruciate Ligament ◽  
Movement Pattern ◽  
Recognition Algorithm ◽  
Predisposing Factor ◽  
Lower Limb Injury ◽  
Q Angle ◽  
Dynamic Valgus

(1) Dynamic knee valgus is a predisposing factor for anterior cruciate ligament rupture and osteoarthritis. The single-leg squat (SLS) test is a widely used movement pattern test in clinical practice that helps to assess the risk of lower-limb injury. We aimed to quantify the SLS test using a marker-less optical system. (2) Kinect validity and accuracy during SLS were established by marker-based OptiTrack and MVN Xsens motion capture systems. Then, 22 individuals with moderate knee symptoms during sports activities (Tegner > 4, Lysholm > 60) performed SLS, and this was recorded and analyzed with a Kinect Azure camera and the Dynaknee software. (3) An optical sensor coupled to an artificial-intelligence-based joint recognition algorithm gave a comparable result to traditional marker-based motion capture devices. The dynamic valgus sign quantified by the Q-angle at the lowest point of the squat is highly dependent on squat depth, which severely limits its comparability among subjects. In contrast, the medio-lateral shift of the knee midpoint at a fixed squat depth, expressed in the percentage of lower limb length, is more suitable to quantify dynamic valgus and compare values among individual patients. (4) The current study identified a new and reliable way of evaluating dynamic valgus of the knee joint by measuring the medial shift of the knee-over-foot at a standardized squat depth. Using a marker-less optical system widens the possibilities of evaluating lower limb functional instabilities for medical professionals.

scholarly journals High Cortico-Trabecular Transitional Zone Porosity and Reduced Trabecular Density in Men and Women with Stress Fractures

2021 ◽  
Vol 10 (5) ◽  
pp. 1123
Author(s):  
Afrodite Zendeli ◽  
Minh Bui ◽  
Lukas Fischer ◽  
Ali Ghasem-Zadeh ◽  
Wolfgang Schima ◽  
...  
Keyword(s):  
Lower Limb ◽  
Quantitative Computed Tomography ◽  
Distal Tibia ◽  
Transitional Zone ◽  
Peripheral Quantitative Computed Tomography ◽  
Stress Fractures ◽  
Cross Sectional ◽  
Men And Women ◽  
Trabecular Microstructure ◽  
Trabecular Density

To determine whether stress fractures are associated with bone microstructural deterioration we quantified distal radial and the unfractured distal tibia using high resolution peripheral quantitative computed tomography in 26 cases with lower limb stress fractures (15 males, 11 females; mean age 37.1 ± 3.1 years) and 62 age-matched healthy controls (24 males, 38 females; mean age 35.0 ± 1.6 years). Relative to controls, in men, at the distal radius, cases had smaller cortical cross sectional area (CSA) (p = 0.012), higher porosity of the outer transitional zone (OTZ) (p = 0.006), inner transitional zone (ITZ) (p = 0.043) and the compact-appearing cortex (CC) (p = 0.023) while trabecular vBMD was lower (p = 0.002). At the distal tibia, cases also had a smaller cortical CSA (p = 0.008). Cortical porosity was not higher, but trabecular vBMD was lower (p = 0.001). Relative to controls, in women, cases had higher distal radial porosity of the OTZ (p = 0.028), ITZ (p = 0.030) not CC (p = 0.054). Trabecular vBMD was lower (p = 0.041). Distal tibial porosity was higher in the OTZ (p = 0.035), ITZ (p = 0.009), not CC. Stress fractures are associated with compromised cortical and trabecular microstructure.

scholarly journals Validation method for body-mounted sensor attachments

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Katharina Schmidt ◽  
David Hochmann
Keyword(s):  
Evaluation Method ◽  
Tracking System ◽  
The Body ◽  
Exploratory Research ◽  
Body Segment ◽  
Validation Method ◽  
Sensor Position ◽  
Validation Parameters ◽  
Measurement Units ◽  
Soft Tissue Artifact

AbstractSmall sensor devices like inertial measurement units enable mobile movement and gait analysis, whereby existing systems differ in data acquisition, data processing, and gait parameter calculation. Concerning the validation, recent studies focus on the captured motion and the influence of sensor positioning with respect to the accuracy of the computed biomechanical parameters in comparison to a reference system. Although soft tissue artifact is a major source of error for skin-mounted sensors, there are no investigations regarding the relative movement between the body segment and sensor attachment itself. The aim of this study is to find an evaluation method and to determine parameters that allow the validation of various sensor attachment types and different sensor positionings. The analysis includes the comparison between an adhesive and strap attachment variant as well as the frontal and lateral sensor placement. To validate different attachments, an optical marker-based tracking system was used to measure the body segment and sensor position during movement. The distance between these two positions was calculated and analyzed to determine suitable validation parameters. Despite the exploratory research, the results suggest a feasible validation method to detect differences between the attachments, independent of the sensor type. To have representative and statistically validated results, further studies that involve more participants are necessary.

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