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Shapla SP, Rahman MM, Paul P, Begum M, Debnath MR, Jahan F, Ferdousi A, Saha T, Sultana H, Biswas R. Usefulness of Diagnostic Ultrasound for Detection of Common Shoulder Abnormalities Prior to MRI. Mymensingh Med J 2024; 33:16-22. [PMID: 38163768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Shoulder pain is a common musculoskeletal pain in the general population and results in significant disability, quality of life impairment and financial burden to the health care system. This cross-sectional study was carried out among purposively selected 61 adult patients with shoulder pain and or limited range of motion in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2018 to August 2020 to determine the usefulness of USG in detection of common shoulder abnormalities, as an initial imaging modality using MRI as reference standard. The majority of the patients 25(40.98%) were in age group of 51-60 years with mean age of 52.98±10.85 years. In the dectection of rotator cuff pathology, the overall sensitivity, specificity and accuracy of USG for any complete tear were 100.0% each, for any partial tear were 79.71%, 96.57% and 91.80%, for any rotator cuff tear were 83.33%, 96.25% and 91.80%, and for any tendinosis were 90.48%, 99.37% and 96.31% respectively. The sensitivity, specificity and accuracy of USG were 88.23%, 92.59% & 90.16% for long head of biceps tendon sheath effusion, 100.0% each for long head of biceps tendon dislocation, 71.11%, 87.50% and 75.41% for glenohumeral joint effusion, and 58.06%, 96.67% and 77.05% for bursal effusion respectively. From this study, it is concluded that high resolution USG showed high sensitivity, specificity and accuracy compared to MRI in detecting common shoulder abnormalities, and could be considered as the first line imaging modality in the evaluation of shoulder pain.
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Affiliation(s)
- S P Shapla
- Dr Sanchita Paul Shapla, MD Resident, Department of Radiology and Imaging, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
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Tanzeem F. Rupture of Anterior Cruciate Ligaments and the Lever Test in Diagnosis: A Critical Review. Mymensingh Med J 2023; 32:1217-1224. [PMID: 37777925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Anterior Cruciate Ligament (ACL) rupture is known to be one of the most common musculoskeletal injuries in active individuals especially athletes. Approximately 200.000 ACL injuries occur every year of which 100,000 require surgery. Once ruptured, it becomes very difficult to regain its previous function and it does not have the capacity to heal on its own. It is thus very important to diagnose an ACL rupture as early as possible. Clinicians thus need to perform a test which has a high sensitivity to rule out a negative test and specificity in order to rule in a positive test in the diagnosis. In this review four different tests (Lever Sign Test, Lachman test, Anterior drawer test and Pivot Shift Test) are compared among each other to find out the better option among the selected tests.
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Affiliation(s)
- F Tanzeem
- Dr Fabiha Tanzeem, FY3, Trauma and Orthopaedics, Furness General Hospital, United Kingdom; E-mail:
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Evers JS, Kim SE, Johnson MD, Lazarus MA. Accuracy of needle arthroscopy for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture. Vet Surg 2023; 52:820-826. [PMID: 35560359 DOI: 10.1111/vsu.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/25/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the accuracy of needle arthroscopy (NA) for the diagnosis of medial meniscal tears in dogs with cranial cruciate ligament rupture (CCLR). STUDY DESIGN Prospective clinical trial. ANIMALS Twenty-six client-owned dogs. METHODS Dogs with CCLR and scheduled to undergo tibial plateau leveling osteotomy were recruited for the study. Needle arthroscopy was performed by an experienced surgeon; the same dog subsequently underwent standard arthroscopy (SA) by another experienced surgeon who was blinded to the NA findings. The SA arthroscopy findings were used as the gold standard. Arthroscopy time, visibility of the menisci, ability to probe the menisci, and the presence of meniscal tears were recorded for both arthroscopies. The degree of lameness before and after NA was subjectively quantified. RESULTS The sensitivity and specificity to diagnose medial meniscal tears with NA was 95% and 100%, respectively. Visibility of the menisci was lower (P < .01), probing of the lateral meniscus was harder (P = .0017), and procedure time was shorter (P = .073) with NA when compared to SA. The lameness scores did not differ before and after NA (P = .25). CONCLUSION Needle arthroscopy could be performed rapidly with low morbidity, and had high accuracy for detecting medial meniscal tears in dogs with CCLR. CLINICAL SIGNIFICANCE Needle arthroscopy is a promising minimally invasive technique for diagnosing medial meniscal tears in dogs with CCLR.
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Affiliation(s)
- Johanna S Evers
- University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Stanley E Kim
- University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Matthew D Johnson
- University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Matthew A Lazarus
- University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
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Agostini E, Vinci A, Bardhi D, Ingravalle F, Muselli M, Milanese G. Improving clinical diagnostic accuracy and management of False penile fractures characterizing typical clinical presentation: a systematic review and meta-analysis. World J Urol 2023; 41:1785-1791. [PMID: 37326652 PMCID: PMC10352434 DOI: 10.1007/s00345-023-04456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/20/2023] [Indexed: 06/17/2023] Open
Abstract
PURPOSE False penile fractures (FPF) represent a rare sexual emergency characterized by blunt trauma of penis in the absence of albuginea's injury, with or without lesion of dorsal penile vein. Their presentation is often indistinguishable from true penile fractures (TPF). This overlapping of clinical presentation, and lack of knowledge about FPF, can lead surgeons often to proceed directly to surgical exploration without further examinations. The aim of this study was to define a typical presentation of false penile fractures (FPF) emergency, identifying in absence of "snap" sound, slow detumescence, penile shaft ecchymosis, and penile deviation main clinical signs. METHODS We performed a systematic review and meta-analysis based on Medline, Scopus and Cochrane following a protocol designed a priori, to define sensitivity of "snap" sound absence, slow detumescence and penile deviation. RESULTS Based on the literature search of 93 articles, 15 were included (73 patients). All patients referred pain, most of them during coitus (n = 57; 78%). Detumescence occurred in 37/73 (51%), and all patients described detumescence occurrence as "slow". The results show that single anamnestic item have a high-moderate sensibility in the diagnosis of FPF, and the highest sensitive item was penile deviation (sensibility = 0.86). However, when more than one item is present, overall sensitivity increases greatly, closing to 100% (95% Confidence Interval 92-100). CONCLUSION Surgeons can consciously decide between additional exams, a conservative approach, and rapid intervention using these indicators to detect FPF. Our findings identified symptoms with excellent specificity for FPF diagnosis, giving clinicians more useful tools for making decisions.
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Affiliation(s)
- Edoardo Agostini
- Department of Urology, "IRCCS-INRCA" Hospital, 60127, Ancona, Italy
| | - Antonio Vinci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133, Rome, Italy
- Hospital Health Management Area, Local Health Authority "Roma 1", 00133, Rome, Italy
| | - Dorian Bardhi
- Post-Graduate School of Hygiene and Preventive Medicine, University of L'Aquila, 67100, L'Aquila, Italy
- Department of Life, Health and Environmental Science, University of L'Aquila, Piazzale Salvatore Tommasi, 1, 67100, L'Aquila, Italy
| | - Fabio Ingravalle
- Hospital Health Management Area, Local Health Authority "Roma 6", 00041, Albano Laziale, Italy
| | - Mario Muselli
- Department of Life, Health and Environmental Science, University of L'Aquila, Piazzale Salvatore Tommasi, 1, 67100, L'Aquila, Italy.
| | - Giulio Milanese
- Post-Graduate School of Urology, Polytechnic University of Marche, 60121, Ancona, Italy
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Camenzind RS, Martin Becerra J, Tondelli TO, Gossing L, Serane-Fresnel J, Lafosse T, Lafosse L. Correlation between preoperative clinical examination and intraoperatively found subscapularis tendon tear. Eur J Orthop Surg Traumatol 2023; 33:373-379. [PMID: 35006313 DOI: 10.1007/s00590-021-03197-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/29/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Analyze the diagnostic value for subscapularis (SSC) tendon tears, their correlation between pain and strength on clinical tests, and compare them with intraoperative arthroscopic findings to prove their diagnostic value. METHODS 110 consecutive patients undergoing arthroscopic rotator cuff repair were reviewed and allocated to isolated SSC (n = 39) and combined anterosuperior tendon tear (n = 71) groups and analyzed. Preoperative clinical testing included belly press (BPT), bear hug (BHT), lift-off (LOT), palm-up (PUT), and Jobe test (JT). All tests were performed in two categories: pain (in 4 categories: 0, 5, 10, and 15) and strength (from 0 to 5). The tendon tears were intraoperatively reviewed and classified. RESULTS Mean age was 59 years (SD 10). The sensitivity of the BHT was 88.2% and 74.5% for BPT, while specificity was only 41.9% for BHT and 45% for BPT. Sensitivity of JT was 90.5% and 87.5% for PUT, while specificity was only 41% for JT and 28.2% for PUT. A low positive correlation for an intraoperative SSC lesion and the strength of BPT (Spearman rank correlation - 0.425; p value < 0.0001) and the strength of BHT ( - 0.362; p value = 0.001) could be found. With linear regression analysis estimated by ordinary least squares, a correlation between BPT strength and surgical grade of SSC lesion (- 0.528; 95% CI, - 0.923 to - 0.133; pvalue < 0.01) was found. CONCLUSION The BHT showed a higher sensitivity for a SSC lesion, while the BPT had a higher correlation between preoperative testing, most notably internal rotation strength, and intraoperative surgical grade of the SSC tendon lesion. LEVEL OF EVIDENCE Level II, Prospective cohort study for Diagnostic tests.
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Affiliation(s)
- Roland Stefan Camenzind
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France.
- Department of Orthopedics, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Javier Martin Becerra
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France
- Ortomove, Centro Medico ABC, Av carlos graef Fernández 154 consultorio 0071, Santa Fe Cuajimalpa, 05300, Mexico City, Mexico
| | - Timo O Tondelli
- Department of Orthopedics, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Louis Gossing
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France
- Department of Orthopaedic Surgery, Braine-l'Alleud-Waterloo Hospital, Centre Hospitalier Interregional Edith Cavell (CHIREC), Braine-l'Alleud, Belgium
| | - Julien Serane-Fresnel
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France
- IECEM - Research Unit, Polyclinique Saint Côme, Compiègne, France
| | - Thibault Lafosse
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France
| | - Laurent Lafosse
- Alps Surgery Institute, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000, Annecy, France
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Tang Y, Kang JM, Peng J, Yuan YM, Zhang ZC, Han D, Meng YJ, Mei MJ. [Application value of color Doppler ultrasonography in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis]. Zhonghua Nan Ke Xue 2022; 28:891-895. [PMID: 37838955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To assess the accuracy and value of ultrasonography in the diagnosis of ruptured tunica albuginea (RTA) of the corpus cavernosum penis. Factors affecting prognosis were analyzed. METHODS This retrospective study included 57 cases of RTA of the corpus cavernosum penis ultrasonographically diagnosed and surgically treated in Peking University First Hospital from 2013 to 2021. We analyzed the location, size and number of ruptures and the presence or absence of urethral injury, and compared the intraoperative with the ultrasonographic findings. RESULTS Of the 57 cases of RTA of the corpus cavernosum penis diagnosed by ultrasonography, 54 (94.7%) were confirmed by surgery. Preoperative ultrasonography indicated 2 cases of bilateral RTA and 6 cases of urethral injury, while surgery revealed 7 cases of bilateral RTA and 13 cases of combined urethral injury. Those with urethral injury developed no urethral stricture or urinary fistula after one-stage urethral repair. And no severe or moderate ED was found in any of the patients during the 12-month follow-up. CONCLUSION Ultrasonography has a high accuracy in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis, and contributes to the determination of the site of surgical incision.
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Affiliation(s)
- Yuan Tang
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Jian-Min Kang
- Department of Urology, People's Hospital of Xiangtan County, Xiangtan, Hunan 411200, China
| | - Jing Peng
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Yi-Ming Yuan
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Zhi-Chao Zhang
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Di Han
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Yu-Jia Meng
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
| | - Man-Jin Mei
- Center of Andrology, Peking University First Hospital, Beijing 100034, China
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Amendola F, Barbasse L, Carbonaro R, Alessandri-Bonetti M, Cottone G, Riccio M, De Francesco F, Vaienti L, Serror K. The Acute Achilles Tendon Rupture: An Evidence-Based Approach from the Diagnosis to the Treatment. Medicina (B Aires) 2022; 58:medicina58091195. [PMID: 36143872 PMCID: PMC9500605 DOI: 10.3390/medicina58091195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: Acute Achilles tendon rupture (AATR) is a common injury with a significant impact on daily living. Although various systematic reviews and meta-analyses have been written on the topic, no actual consensus exists on the best treatment. We aimed to collect the highest quality of evidence on the subject and to produce a document to which to refer, from the diagnosis to the final treatment. Material and Methods: Inclusion criteria were systematic reviews discussing Achilles tendon rupture, concerning either diagnostic criteria, classification, or treatment; English language; clearly stated inclusion and exclusion criteria for patients’ selection. Results: Thirteen systematic reviews were included in the study. A strong consensus exists about the higher risk of re-rupture associated with non-operative treatment and a higher risk of complications associated with surgical repair. Conclusions: The combination of minimally invasive repair and accelerated functional rehabilitation seems to offer the best results in the treatment of Achilles tendon rupture.
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Affiliation(s)
- Francesco Amendola
- Plastic and Reconstructive Surgery Department, I.R.C.C.S. Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Léa Barbasse
- Plastic and Reconstructive Department, AP-HP, Hôpital Saint-Louis, 75010 Paris, France
| | - Riccardo Carbonaro
- Plastic and Reconstructive Surgery Department, I.R.C.C.S. Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Mario Alessandri-Bonetti
- Plastic and Reconstructive Surgery Department, I.R.C.C.S. Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Giuseppe Cottone
- Plastic and Reconstructive Surgery Department, I.R.C.C.S. Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Michele Riccio
- Hand Surgery Unit, Department of Plastic and Reconstructive Surgery, Azienda “Ospedali Riuniti”, Via Conca 21, 60126 Ancona, Italy
| | - Francesco De Francesco
- Hand Surgery Unit, Department of Plastic and Reconstructive Surgery, Azienda “Ospedali Riuniti”, Via Conca 21, 60126 Ancona, Italy
- Correspondence: ; Tel.: +39-0715963945
| | - Luca Vaienti
- Plastic and Reconstructive Surgery Department, I.R.C.C.S. Istituto Ortopedico Galeazzi, 20122 Milan, Italy
| | - Kevin Serror
- Plastic and Reconstructive Department, AP-HP, Hôpital Saint-Louis, 75010 Paris, France
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Koenders EE, Schoeber N, Koffeman EC, Jens S, Mauritz GJ. [Anaphylaxis due to traumatic rupture of an echinococcal cyst]. Ned Tijdschr Geneeskd 2022; 166:D6316. [PMID: 35899723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Echinococcus granulosis tapeworms' definitive hosts are dogs who live in endemic areas. Humans are infected by petting dogs or eating infected, not propely, heated food. In multiple organs, preferably in liver and lungs, these tapeworms can form cysts which in time might cause mechanical complications. CASE DESCRIPTION A 7 year old Syrian boy was brought to our emergency department unconsciously after a light abdominal trauma. On ultrasound and CT there was no sign of traumatic injury, but a ruptured echinococcal cyst was found in the liver. The patient developed a severe anaphylaxis, with hypotension and loss of consciousness on the spill of the echinococcal cyst. The cyst was removed surgically and the boy was treated with medication. CONCLUSION In patients with unexplained anaphylaxis, from an echinococcus endemic area, rupture of an echinococcal cyst should be part of the differential diagnosis.
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Salzman MJ. Silent Rupture of Silicone Gel Breast Implants: High-Resolution Ultrasound Scans and Surveys of 584 Women. Plast Reconstr Surg 2022; 149:7-14. [PMID: 34936597 PMCID: PMC8687613 DOI: 10.1097/prs.0000000000008632] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient compliance has been low for U.S. Food and Drug Administration-recommended magnetic resonance imaging scans to screen silicone gel breast implants for silent rupture. High-resolution ultrasound scans are a convenient, in-office alternative that may improve screening compliance; however, women's attitudes and feelings about silent rupture and their desire for rupture screening are unknown. METHODS Plastic surgeons and staff in nine private practices received 1-day training in high-resolution ultrasound scanning, then screened women with silicone gel implants implanted since 2000. Suspect scans were reviewed by a high-resolution ultrasound-experienced plastic surgeon to determine if they showed ruptures. Surgical and scan findings were correlated. To learn attitudes and feelings about silent rupture, women took surveys before and after the scan. RESULTS Of 584 women screened, 82 (14.0 percent) had scans showing ruptures; of 1153 implants, 92 (8.0 percent) showed ruptures. Forty women with scans showing ruptures underwent surgery, of which 30 (75 percent) had their ruptures confirmed. Surveys found 99.5 percent of women want to know if they have a rupture and 95.2 percent want the ruptured implant removed. If the scan showed no rupture, women felt relieved and 95.5 percent would get future high-resolution ultrasound screening for silent rupture. If a rupture was found, women expressed various concerns and 87.8 percent would remove the ruptured implant within 12 months. CONCLUSIONS Surveys show that women with silicone gel implants have concerns and feel anxious about possible silent rupture. Based on 14 percent of women showing a ruptured implant on high-resolution ultrasound scans and 75 percent of ruptures on high-resolution ultrasound scans surgically confirmed, 10.6 percent of women in this study have a silent rupture. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, IV.
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Wang C, Fan H, Li Y, Yun Z, Zhang Z, Zhu Q. Effectiveness of platelet-rich plasma injections for the treatment of acute Achilles tendon rupture: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27526. [PMID: 34731144 PMCID: PMC8519239 DOI: 10.1097/md.0000000000027526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The effect of platelet-rich plasma (PRP) on patients with acute Achilles tendon rupture is still controversial. The purpose of this systematic review is to assess the efficacy of PRP injections treating acute Achilles tendon rupture. METHODS A comprehensive electronic literature search was performed in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant studies that were published prior to April 29, 2021. Randomized controlled trials evaluating the efficacy of PRP injections in treating patients with acute Achilles tendon rupture were included. Statistical analyses were conducted using RevMan software. RESULTS Five randomized controlled trials were included in this systematic review. The results of the meta-analysis showed that PRP has positive effects on ankle dorsiflexion angle, dorsal extension strength of the ankle, and calf circumference compared with that in controls. However, the current evidence failed to show that PRP effectively improves ankle plantar flexion angle, plantar flexion strength of the ankle, and pain. CONCLUSIONS PRP injections for the treatment of acute Achilles tendon rupture significantly improved ankle dorsiflexion angle, dorsal extension strength of the ankle, and calf circumference compared with that in controls. Additional studies with larger sample sizes, more rigorous designs and standardized protocols are needed to draw more reliable and accurate conclusions.
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Affiliation(s)
- Chenglong Wang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Hua Fan
- Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuhuan Li
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhihe Yun
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Zhuo Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Qingsan Zhu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
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Stringer S, Wendt WJ, Salavitabar A, Rogers A. Ruptured sinus of Valsalva aneurysm: An uncommon presentation of shock to the pediatric emergency department. Am J Emerg Med 2021; 49:80-82. [PMID: 34089967 DOI: 10.1016/j.ajem.2021.05.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022] Open
Abstract
This case report describes a rare etiology of cardiogenic shock, particularly in the pediatric population. A healthy 17 year old male presents from an outside hospital in undifferentiated shock requiring vasopressor support. Ruptured sinus of Valsalva aneurysm was diagnosed by echocardiogram and the patient went emergently to the operating room for surgical repair. We discuss the anatomy, incidence, and risk factors for sinus of Valsalva aneurysms, along with the range of clinical presentations and Emergency Department management of symptomatic rupture of sinus of Valsalva aneurysms.
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Affiliation(s)
- Samantha Stringer
- University of Michigan Hospital, Emergency Department, Ann Arbor, MI 48109, United States; C.S. Mott Children's Hospital, University of Michigan, Emergency Department, Ann Arbor, MI 48109, United States.
| | - Wendi-Jo Wendt
- C.S. Mott Children's Hospital, University of Michigan, Emergency Department, Ann Arbor, MI 48109, United States; Children's Wisconsin, Medical College of Wisconsin, Emergency Department, Milwaukee, WI 53226, United States
| | - Arash Salavitabar
- C.S. Mott Children's Hospital, University of Michigan, Pediatric Cardiology, Ann Arbor, MI 48109, United States
| | - Alexander Rogers
- C.S. Mott Children's Hospital, University of Michigan, Emergency Department, Ann Arbor, MI 48109, United States
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Bent S, O'Malley MJ. Diagnosis of Achilles' Tendon Rupture during a Virtual Examination. N Engl J Med 2021; 384:859. [PMID: 33657684 DOI: 10.1056/nejmicm2029689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Stephen Bent
- School of Medicine, University of California San Francisco, San Francisco, CA
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Yoon PW, Moon JK, Yoon JY, Lee S, Lee SJ, Kim HJ, Kim CH. A novel arthroscopic classification of labral tear in hip dysplasia. PLoS One 2020; 15:e0240993. [PMID: 33091048 PMCID: PMC7580891 DOI: 10.1371/journal.pone.0240993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Acetabular labral tears cause of pain in patients with symptomatic hip dysplasia. To date, no structured grading system has been developed to evaluate labral tears in these patients. The present study describes a new system of grading labral tears in patients with acetabular dysplasia. Methods The data of 66 patients who underwent hip arthroscopy for symptomatic hip dysplasia from March 2014 to February 2018 were reviewed. Labral tears were classified into four groups, based on the occurrence of chondrolabral junction (CLJ) disruption, capsulolabral recess (CLR) disruption, and labral displacement. Labral tears without instability were classified as grade 1 or 2. Partial delamination or blistering of the labrum with minimal fraying at the CLJ was classified as grade 1, whereas labral tears with CLJ disruption were classified as grade 2. Unstable labral tears with CLR disruption followed by CLJ disruption, but without labral displacement, were classified as grade 3, whereas unstable labral tears with CLR and CLJ disruption, but with labral displacement, were classified as grade 4. The radiological and clinical characteristics of patients in each grade were determined including by simple radiographs and MRI/MR arthrography, as were concomitant findings, including rupture of the ligamentum teres, articular cartilage damage, and presence of a paralabral cyst. The surgical options selected for each grade and clinical outcomes, including modified Harris hip scores (mHHS) and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores, were evaluated. Spearman’s correlation analyses were performed to assess whether labral tear grade correlated with baseline characteristics, the incidence of concomitant injuries, and the severity of osteoarthritis (OA). The Wilcoxon test for paired data was performed to compare treatment results with pain scores. Results The study cohort included six men and 53 women of mean ± SD age 39.9 ± 13.0 years (range, 15–66 years). Of the 66 hips, seven (10.6%), 10 (15.2%), 30 (45.5%), and 19 (28.8%) were classified as grades 1–4, respectively. Symptom duration (P = 0.017), preoperative Tönnis OA grade (P < 0.001), cartilage damage (P < 0.001), and the presence of a paralabral cyst (P = 0.001) correlated significantly with baseline tear grade. In all groups, mHHS and WOMAC scores improved after surgical treatment. Conclusions Arthroscopic findings of labral tears in patients with hip dysplasia differed from the conventional classification. The classification system proposed in this study will likely be useful for determining the degree of labral tear in patients with hip dysplasia and for predicting treatment outcomes.
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Affiliation(s)
- Pil Whan Yoon
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University, College of Medicine, Seoul, Republic of Korea
| | - Jun-Ki Moon
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Gyomoon-dong, Guri-si, Gyunggido, Republic of Korea
| | - Jae Youn Yoon
- Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, Republic of Korea
| | - Sunhyung Lee
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University, College of Medicine, Seoul, Republic of Korea
| | - Soong Joon Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Daehak-ro Jongno-gu, Seoul, Republic of Korea
| | - Hee Joong Kim
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Daehak-ro Jongno-gu, Seoul, Republic of Korea
| | - Chul-Ho Kim
- Department of Orthopedic Surgery, Gachon University Gil Medical Center, Namdong-daero beon-gil, Namdong-gu, Incheon, Republic of Korea
- * E-mail:
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Abstract
This sequential, cross-sectional study examines the prevalence of perforated appendicitis in children in the United States in relation to access to health care from 2001 to 2015.
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Affiliation(s)
- Darryl T. Gray
- Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Trina Mizrahi
- Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland
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Abstract
Recreational athletes are susceptible to experiencing pain in the Achilles tendon, affecting their ability to complete daily activities. Achilles tendinosis is a degenerative process of the tendon without histologic or clinical signs of intratendinous inflammation, which can be categorized by location into insertional and noninsertional tendinosis. This condition is one that can be treated conservatively with great success or surgically for refractory cases. Currently, there is a lack of consensus regarding the best treatment options. This review aims to explore both conservative and operative treatment options for Achilles tendinopathy and Achilles tendon rupture.
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Affiliation(s)
- Jeffrey Okewunmi
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Javier Guzman
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Ettore Vulcano
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA.
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16
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Malek I, Sayadi J, Zerei N, Mekni M, El Amri K, Zgolli H, Chebbi A, Nacef L. Epidemiology and prognostic factors of open globe injuries in a Tunisian pediatric population. J Fr Ophtalmol 2020; 43:604-610. [PMID: 32631693 DOI: 10.1016/j.jfo.2019.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/16/2019] [Accepted: 10/31/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. The purpose of our study was to determine demographic, etiologic, and clinical characteristics, visual outcome, and factors affecting visual prognosis in children with open globe injuries (OGI) and to analyze the predictive value of ocular trauma scoring systems for OGI in children. METHODS We conducted a retrospective study enrolling 120 pediatric patients hospitalized for OGI from January 2010 to March 2017. Age, gender, date of trauma, time between trauma and presentation, place and circumstances of injury, etiology, visual acuity (VA), wound location and type of injury based on the Birmingham Eye Trauma Terminology, and the clinical signs were recorded. We recorded the number of surgical procedures performed, complications and visual outcomes. RESULTS The mean age was 7.38 years. In all, 62.5% of the patients were male, and 37.5% were female. The gender ratio was observed to decrease with increasing age. The mean time interval between injury and consultation was 22.80±42.68hours. Injuries usually occurred at home (80%) followed by playgrounds and sports venues (8.3%), the street (6.7%) and school (5%). All of the OGI's were accidental, and the main context was play (70%). The most common traumas were penetrating injury (60.8%) and metal (30%) objects. Penetrating trauma accounted for 68.3% of cases, followed by rupture (27.5%) and intraocular foreign body (IOFB) (7.5%). Initial VA was<1/10 in 59.2% of cases, and the point of entry was the cornea in 65.8% of cases. Final VA was<1/10 in 39.69% of all cases. FVA was significantly correlated with BCVA prior to the surgery, mechanism of the trauma, wound location and size, and other associated lesions. The Ocular Trauma Score (OTS) and the Pediatric Ocular Trauma Score (POTS) were significantly correlated with final VA. CONCLUSION OGI's in children occurs most frequently in school-age boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.
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Affiliation(s)
- I Malek
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - J Sayadi
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - N Zerei
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - M Mekni
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - K El Amri
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - H Zgolli
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
| | - A Chebbi
- Service C d'ophtalmologie, Faculté de médecine de Tunis, Institut Hedi Rais d'ophtalmologie, Université Tunis El Manar, Tunis, Tunisia.
| | - L Nacef
- Service A, Faculté de médecine de Tunis, Institut Hedi Rais de Tunis, Université Tunis El Manar, Tunis, Tunisie.
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Abstract
The purpose of this study is to analyze the risk factors of sporadic renal hamartoma and establish a risk scoring system, and to intervene in patients with high-risk sporadic renal hamartoma who are prone to rupture and bleeding as soon as possible.Retrospective univariate and multivariate logistic analyzes were conducted for clinical data of 332 sporadic renal hamartoma patients to screen out independent risk factors of tumor rupture. Score of each independent risk factor was calculated. (Calculation formula: the risk coefficient of each factor = the beta regression coefficient of each factor/the minimum value of the beta regression coefficient of all factors, the value of the smallest beta regression coefficient corresponding to all the factors was assigned 1 point. The score of each factor was equal to the risk coefficient of each variable was taken as an integer value by rounding.) The total score was equal to the sum of all factors. Then the area under the receiver operating characteristics (AUC) curve was compared between high risk factors and scoring system. Finally, the scoring system was evaluated by the area under the curve (AUC) and the Hosmer-Lemeshow method in an independent cohort of 130 patients.Factors such as symptoms at presentation, tumor size, tumor blood supply, and tumor growth pattern were significant predictors of sporadic renal angiomyolipoma rupture in both the univariate and multivariate analyses; these predictors were included in the scoring system to predict sporadic renal angiomyolipoma rupture. There were no significant differences in AUCs between high risk factors and scoring system (z = 0.6434, P = .583, AUC = 0.913, and 0.903 for high risk factors and scoring system, respectively). The sporadic renal angiomyolipoma patients who scored >6 points were prone to rupture. AUROC of the scoring system in the validation set was 0.854(95%CI:0.779, 0.928). Using the Hosmer-Lemeshow method, the value of X was 2.916, P = .893, suggesting the scoring system fitted well.A scoring system based on clinical features is simple and effective in predicting sporadic angiolipoma rupture and hemorrhage. When the score is higher than 6 points, the probability of hamartoma rupture and hemorrhage is significantly increased and early intervention is needed.
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Affiliation(s)
- Xiao-feng Xu
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Xian-hui Hu
- The Urinary Surgical Department of Chengdu First People's Hospital, Chengdu
| | - Qi-ming Zuo
- The Urinary Surgical Department of Liangping People's Hospital, Chongqing, China
| | - Jiao Zhang
- The Urinary Surgical Department of Liangping People's Hospital, Chongqing, China
| | - Hao-yu Xu
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Yao Zhang
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing
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Alaygut D, Soyaltin E, Camlar SA, Tekin A, Sayan A, Ozdemir T, Alparslan C, Mutlubas F, Yavascan O, Demir BK. Periumbilical swelling, erythema, and discharge in a girl: Answers. Pediatr Nephrol 2020; 35:411-413. [PMID: 31529155 DOI: 10.1007/s00467-019-04354-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/04/2019] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Demet Alaygut
- Tepecik Training and Research Hospital, Department of Pediatric Nephrology, Izmir, Turkey.
| | - Eren Soyaltin
- Tepecik Training and Research Hospital, Department of Pediatric Nephrology, Izmir, Turkey
| | | | - Ali Tekin
- Ege University, Faculty of Medicine, Department of Pediatric Surgery, Izmir, Turkey
| | - Ali Sayan
- Tepecik Training and Research Hospital, Department of Pediatric Surgery, Izmir, Turkey
| | - Tunç Ozdemir
- Tepecik Training and Research Hospital, Department of Pediatric Surgery, Izmir, Turkey
| | - Caner Alparslan
- Tepecik Training and Research Hospital, Department of Pediatric Nephrology, Izmir, Turkey
| | - Fatma Mutlubas
- Tepecik Training and Research Hospital, Department of Pediatric Nephrology, Izmir, Turkey
| | - Onder Yavascan
- Tepecik Training and Research Hospital, Department of Pediatric Nephrology, Izmir, Turkey
| | - Belde Kasap Demir
- Katip Celebi University, Faculty of Medicine, Department of Pediatric Nephrology, Izmir, Turkey
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Belyea CM, Krul KP, Lause G, Magee A, Anderson CD, Ryan PM. The Reliability of Kager's Triangle in Detecting Acute Achilles Tendon Ruptures. Orthopedics 2020; 43:e91-e94. [PMID: 31841605 DOI: 10.3928/01477447-20191212-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/14/2019] [Indexed: 02/03/2023]
Abstract
The Achilles tendon is a common site of anatomical injury among athletes and those participating in recreational sporting activities. Acute Achilles tendon ruptures are often misdiagnosed as a sprained ankle and are more common in the male population. Mechanism of injury is often a noncontact injury, resulting from sudden forced plantar flexion or violent dorsiflexion in a plantar flexed foot. Delays in diagnosis and treatment may complicate the clinical outcome. Because findings may be subtle on history and physical examination, the use of readily available adjunctive studies is important for practitioners. One method is the analysis of Kager's triangle on lateral ankle radiographs. Obscuration of Kager's triangle has been described as a radiographic indicator of Achilles tendon rupture, but the sensitivity and specificity of this finding have been poorly reported. [Orthopedics. 2020; 43(2): e91-e94.].
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20
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Abstract
Background: Pectoralis major ruptures are increasing in incidence primarily due to an increase in awareness, activity level among young males between 20 and 40 years of age, and use of anabolic steroids. Although the majority of pectoralis major ruptures are acute injuries, many chronic ruptures are unrecognized and it is imperative to understand the proper evaluation of these injuries, as well as the appropriate treatment for acute and chronic ruptures.Purpose: Pectoralis major ruptures can lead to deformity and physical disability if left untreated. This review paper discusses both acute and chronic ruptures as well as indications for nonoperative treatment and operative treatment to give the reader the best understanding of this diagnosis and proper management.Methods: A systematic review of the literature was performed using a search of electronic databases. Search terms such as pectoralis major rupture, pectoralis major repair, pectoralis major tendon transfer, and pectoralis major nonoperative treatment were used. Case reports, systematic reviews, prospective and retrospective studies were included to provide a comprehensive review. The only exclusion criteria consisted of studies not published in English. This review article includes the anatomy and biomechanics of the pectoralis major muscle, proper evaluation of the patient, operative and nonoperative treatment of acute and chronic pectoralis major ruptures, and outcomes of the recommended treatment.Conclusion: Nonoperative treatment is indicated for patients with medical comorbidities, older age, incomplete tears, or irreparable damage. Patients treated non-operatively have been shown to lose strength, but regain full range of motion. Patients with surgery before 6 weeks reported better outcomes than patients with surgery between 6 and 8 weeks. The chronicity of the rupture (>8 weeks) increases the likelihood of reconstruction, involving the use of autografts or allografts. Patients treated with delayed repair had significantly better strength, satisfaction, and outcomes than patients with nonoperative treatment. The pectoralis tendon can also be transferred in patients with rotators cuff tears, atrophy, or significant functional limitation. Tendon transfers have been shown to have unpredictable outcomes, but overall satisfactory results.
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Affiliation(s)
- Kamali Thompson
- Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY
| | - Young Kwon
- Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY
| | - Evan Flatow
- Department of Orthopaedic Surgery, The Mount Sinai Hospital, New York, NY, USA
| | - Laith Jazrawi
- Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY
| | - Eric Strauss
- Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY
| | - Michael Alaia
- Division of Sports Medicine, Department of Orthopaedic Surgery, NYU Langone Health, New York, NY
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Chun DI, Lee HS, Won SH, Moon SI, Jung KJ, Seo JH, Cho HK, Lee DW, Ryu A, Manggala Y, Kim WJ. Closed atraumatic complete rupture of the flexor halluces longus tendon during forward lunge exercise: A case report. Medicine (Baltimore) 2019; 98:e18409. [PMID: 31852162 PMCID: PMC6922354 DOI: 10.1097/md.0000000000018409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Acute rupture of the flexor halluces longus (FHL) tendon due to trauma or laceration is a well-known phenomenon. Partial rupture of the FHL tendon caused by tendinitis or stenosing tenosynovitis is common in ballet dancers and athletes. However, atraumatic complete rupture of the FHL is rare: as of 2018, only 7 cases of closed atraumatic complete rupture of the FHL tendon have been reported in the literature. Here, we report on a patient who presented with a closed atraumatic complete rupture of the FHL tendon during a forward lunge exercise. PATIENT CONCERNS A 35-year-old female visited the clinic with pain in the plantar medial aspect of the left foot, along with weakness and loss of great toe flexion. The patient had a normal foot structure and no history of trauma or systemic disease. She performed a forward lunge exercise more than 50 times on 1 leg per day, more than once a week to strengthen her leg muscles. She reported that she felt a slight pain in her left, great toe while exercising for 3 weeks prior to her visit. One week prior to presentation, severe pain occurred suddenly when her left hallux dorsiflexed strongly during an anterior lunge exercise motion. DIAGNOSIS Magnetic resonance imaging revealed complete rupture of the FHL tendon near the level of the metatarsal head and neck junction. The lesion was prolonged, with the proximal end displaced to the metatarsal shaft region. INTERVENTIONS Complete rupture of the FHL tendon was treated with a primary suture. OUTCOMES At the 1-year follow-up, active plantar flexion of the interphalangeal joint was possible but joint function had a range of 0° to 25°. Flexion strength was reduced slightly, measuring about 70% when compared to the contralateral side, but flexion strength of the metatarsophalangeal joint was normal. LESSONS We describe an extremely rare case of complete rupture of the FHL tendon at the level of metatarsal head and neck junction. It should be understood that this injury can occur not only in professional athletes but also in the general public, and we recommend educating personal trainers on how to prevent it.
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Affiliation(s)
- Dong Il Chun
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu
| | - Hong Seop Lee
- Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Hangeulbiseok-ro, Nowon-gu, Seoul
| | - Sung Hun Won
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu
| | - Sang Il Moon
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan
| | - Ki Jin Jung
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan
| | - Jong Hyun Seo
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu
| | - Hyung Ki Cho
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Yongsan-gu
| | - Dhong Won Lee
- Department of Orthopaedic Surgery, Konkuk University Medical Center, Neungdong-ro, Gwangjin-gu, Seoul
| | - Aeli Ryu
- Department of Obstetrics and Gynecology, Soonchunhyang University Hospital Cheonan, Suncheonhyang 6-gil, Dongam-gu, Cheonan, Korea
| | - Yudha Manggala
- Department of Orthopaedic and Traumatology Surgery, Medicine Faculty, Soegijapranata Catholic University, Semarang, Indonesia
| | - Woo Jong Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Dongam-gu, Cheonan
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Holt J, Preston G, Heindel K, Preston H, Hill G. Diagnosis and Management Strategies for Distal Biceps Rupture. Orthopedics 2019; 42:e492-e501. [PMID: 31355900 DOI: 10.3928/01477447-20190723-05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 12/12/2018] [Indexed: 02/03/2023]
Abstract
Rupture of the distal biceps tendon most commonly is secondary to mechanical overload during eccentric muscle contraction. Due to deficits of strength and endurance, surgical repair usually is recommended. Although both single- and double-incision approaches have been described, double-incision techniques have been shown to better re-create the native anatomic insertion. However, excellent and comparable clinical outcomes have been demonstrated with both techniques. Fixation with a cortical button and interference screw has been shown to be the strongest construct biomechanically; however, several modern constructs provide adequate strength. Surgical technique should focus on restoration of anatomy, early range of motion, and prevention of complications. [Orthopedics. 2019; 42(6):e492-e501.].
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23
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Mesropyan L, Urias D, Cho R, Stark O. Traumatic Blunt Rupture of Pulmonary Artery. Am Surg 2019; 85:e449-e451. [PMID: 31638534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Choi NY, Sim SH, Tan AC, Sirisena D. Partial Patella Tendon Tear in a Middle-Aged Man with No Previous Knee Injuries: A Non-Surgical Approach. Ann Acad Med Singap 2019; 48:268-273. [PMID: 31628746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Nicole Yy Choi
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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25
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Nawijn F, Emmink BL, Keizer J, Bosman WMPF. [Complete triceps tendon rupture; a rare tendon injury]. Ned Tijdschr Geneeskd 2018; 162:D2744. [PMID: 30556382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Only 1% of all tendon injuries affect the triceps tendon, making triceps ruptures very rare. An acute rupture can therefore easily be missed due to a low degree of suspicion. A palpable gap, inability to flex the elbow against resistance and a positive modified Thompson test are indicative for a complete triceps tendon rupture. The mechanism of injury is most commonly a sudden eccentric muscle contraction. We present the case of a 48-year-old man with an acute complete triceps tendon rupture, after a fall from an unstable chair while performing a one arm push-up. The rupture was surgically treated with Krackow sutures tunneled through drill holes in the olecranon. Postoperative treatment consisted of gradually increasing elbow flexion for six weeks with a brace. Three months following the operation, 150 degree flexion was possible with a 5 degree extension limitation. The Disabilities of the Arm, Shoulder and Hand score was 10.5. We demonstrate that early diagnosis and treatment facilitate excellent functional outcome.
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Affiliation(s)
- Femke Nawijn
- St. Antonius Ziekenhuis, afd. Heelkunde, Nieuwegein
- Contact: F. Nawijn
| | | | - Jort Keizer
- St. Antonius Ziekenhuis, afd. Heelkunde, Nieuwegein
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26
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Moniri NH, Momary KM, McMahon T, Nayee E. Statin-Associated Achilles Tendon Rupture and Reproducible Bilateral Tendinopathy on Repeated Exposure. Mayo Clin Proc 2018; 93:1531-1532. [PMID: 30286837 DOI: 10.1016/j.mayocp.2018.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/08/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Nader H Moniri
- Mercer University Health Sciences Center, Mercer University, Atlanta, GA
| | - Kathryn M Momary
- Mercer University Health Sciences Center, Mercer University, Atlanta, GA
| | - Timothy McMahon
- Mercer University Health Sciences Center, Mercer University, Atlanta, GA
| | - Ekta Nayee
- Mercer University Health Sciences Center, Mercer University, Atlanta, GA
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27
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Willinger L, Achtnich A, Imhoff AB, Lacheta L. [Rupture of the proximal hamstring tendon]. MMW Fortschr Med 2018; 160:39-41. [PMID: 29943012 DOI: 10.1007/s15006-018-0704-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Lukas Willinger
- Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Andrea Achtnich
- Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Andreas B Imhoff
- Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
- Klinikum rechts der Isar, Abtlg. für Sportorthopädie, Ismaninger Str. 22, D-81675, München, Deutschland.
| | - Lucca Lacheta
- Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
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28
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Gudas R, Šiupšinskas L, Gudaitė A, Vansevičius V, Stankevičius E, Smailys A, Vilkytė A, Simonaitytė R. The Patello-Femoral Joint Degeneration and the Shape of the Patella in the Population Needing an Arthroscopic Procedure. ACTA ACUST UNITED AC 2018; 54:medicina54020021. [PMID: 30344252 PMCID: PMC6037255 DOI: 10.3390/medicina54020021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/02/2018] [Accepted: 04/17/2018] [Indexed: 12/04/2022]
Abstract
Background: the main goal of the study was to investigate the prevalence of the articular cartilage defects (ACD) in the patellofemoral (PF) region of the knee joint based on the anatomical shapes of patella and its impact on the level of physical activity in the population needing arthroscopic procedures for all types of pathologies in the knee. Methods: The articular cartilage status of the PF region was obtained from 1098 arthroscopic procedures of the knee joint. The ACD were correlated to Wiberg’s shape of the patella and classified according to the degree, size and depth of the ACD in the PF region using the ICRS (International Cartilage Repair Society) system: group I consisting of patients with Wiberg type I shape (W1), group II—patients with Wiberg type II shape (W2) and group III—patients with Wiberg type III shape (W3). The Tegner physical activity scale was used to evaluate the physical activity of the patients. Results: The mean of ACD size (PF region) in the W3 group was 3.10 ± 0.99 cm2, which was a statistically significantly larger area in comparison with the W1 (1.90 ± 0.63 cm2; p < 0.0000) and W2 (1.95 ± 0.71 cm2; p < 0.0000). The patients from the W3 group (mean 3.10 ± 0.99) were less physically active (<4 Tegner) compared to the W2 group (mean of 4.48 ± 0.88; p = 0.004) and W1 group (mean of 4.55 ± 0.72; p = 0.002). Conclusions: The patients with the Wiberg type III patella shape had a higher incidence and larger size of ACD in the PF of the knee compared to the groups of Wiberg type I and II. Wiberg III patients with a lower level of physical activity had a larger size of ACD in the PF joint.
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Affiliation(s)
- Rimtautas Gudas
- Institute of Sports of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
- Sports Trauma and Arthroscopic Unit of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Laimonas Šiupšinskas
- Institute of Sports of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Agnė Gudaitė
- Institute of Sports of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Vladas Vansevičius
- Vilnius University Observatory, Ciurlionio 29, LT-03100 Vilnius, Lithuania.
- Center for Physical Sciences and Technology, Savanoriu 231, LT-02300 Vilnius, Lithuania.
| | - Edgaras Stankevičius
- Institute of Physiology and Pharmacology of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Alfredas Smailys
- Sports Trauma and Arthroscopic Unit of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Akvilė Vilkytė
- Institute of Sports of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Rasa Simonaitytė
- Institute of Sports of Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
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Mao YS, Hua B, Pan WX, Li WF, Gu YF, Yao HJ, Cai ZK, Wang Z, Lu C. [Surgical repair of the tunica albuginea for penis fracture: Selection of incision]. Zhonghua Nan Ke Xue 2018; 24:331-334. [PMID: 30168953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the diagnosis and management of penile fracture. METHODS From June 1993 to May 2017, 46 cases of penile fracture were treated in our hospital, averaging 33.5 (25-42) years of age and 3.45 (1-10) hours in duration, of which 41 occurred during sexual intercourse, 4 during masturbation and 1 during prone sleeping, 4 with hematuria, but none with dysuria or urethral bleeding. Hematoma was confined to the penis. Emergency surgical repair was performed for all the patients, 45 under spinal anesthesia and 1 under local anesthesia, 16 by coronal proximal circular incision and the other 30 by local longitudinal incision according to the rupture location on ultrasonogram. The tunica albuginea ruptures averaged 1.31 (0.5-2.5) cm in length, which were sutured in the "8" pattern for 6 cases and with the 3-0 absorbable thread for 18 cases. The skin graft or negative pressure drainage tube was routinely placed, catheters indwelt, and gauze used for early pressure dressing. In the recent few years, elastic bandages were employed for 3-5 days of pressure dressing and antibiotics administered to prevent infection. The stitches and catheter were removed at 7 days after surgery. RESULTS Short-term postoperative foreskin edema occurred in 14 of the 16 cases of circular degloving incision, but no postoperative complications were observed in any of the cases of local incision. Twenty-eight of the patients completed a long-term follow-up of 49.4 (10-125) months, which revealed good erectile function, painless erection, and satisfactory sexual intercourse. CONCLUSIONS For most penile fractures, local longitudinal incision is sufficient for successful repair of the tunica albuginea, with mild injury, no influence on the blood supply or lymph reflux, and a low rate complications. It therefore is obviously advantageous over circular degloving incision except when the cavernous body of urethra is to be explored, which necessitates circular degloving incision below the coronal groove.
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Affiliation(s)
- Yuan-Shen Mao
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Bao Hua
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Wei-Xin Pan
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Wen-Feng Li
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Yu-Fei Gu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Hai-Jun Yao
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Zhi-Kang Cai
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Zhong Wang
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
| | - Chao Lu
- Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, China
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Benameur H, Chaves C, Masquelet AC, Sautet A, Cambon-Binder A. Trans-tendinous flexor digitorum profundus ruptures: Diagnostic and surgical challenges. Hand Surg Rehabil 2018; 37:126-127. [PMID: 29449160 DOI: 10.1016/j.hansur.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/14/2017] [Accepted: 11/15/2017] [Indexed: 11/17/2022]
Affiliation(s)
- H Benameur
- Orthopedic department, Saint-Antoine Hospital, 184, rue du faubourg Saint-Antoine, BP 75012, 75571 Paris cedex 12, France.
| | - C Chaves
- Orthopedic department, Saint-Antoine Hospital, 184, rue du faubourg Saint-Antoine, BP 75012, 75571 Paris cedex 12, France; Paris Sud XI Medical University, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - A-C Masquelet
- Orthopedic department, Saint-Antoine Hospital, 184, rue du faubourg Saint-Antoine, BP 75012, 75571 Paris cedex 12, France
| | - A Sautet
- Orthopedic department, Saint-Antoine Hospital, 184, rue du faubourg Saint-Antoine, BP 75012, 75571 Paris cedex 12, France
| | - A Cambon-Binder
- Orthopedic department, Saint-Antoine Hospital, 184, rue du faubourg Saint-Antoine, BP 75012, 75571 Paris cedex 12, France
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Hogea GB, Pătraşcu JM, Săndesc MA, Bredicean AC, Nussbaum LA, Hogea LM, Laitin SMD, Erdelean D, Chiriac DV, Muntean FL, Chiriac SD. The utility of indirect imagistic signs in the diagnosis of anterior cruciate ligament ruptures. Rom J Morphol Embryol 2018; 59:741-745. [PMID: 30534812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We conducted a retrospective study, between 2013 and 2018. The study was conducted by analyzing the comparative imaging of two groups of patients. The two groups comprise 42 patients, 14 women and 28 men aged between 17 and 70 years old, to whom objective variables of statistical relevance were tracked. The results of this study show that there is a significant correlation between an angle value of less than 45° and the rupture of the anterior crossed ligament.
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Affiliation(s)
- Gheorghe Bogdan Hogea
- Discipline of Psychiatry, Department of Neurosciences, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania;
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Keeling J, Khodaee M. Weakness with left elbow flexion · left anterior shoulder pain · Dx? J Fam Pract 2018; 67:34-36. [PMID: 29309471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 41-year-old, right-hand dominant man sought care at our facility one day after trying to pull his boat out of the water. He'd tried to lift the boat with his hands while his forearms were fully supinated and his elbows were flexed to about 90 degrees. He then felt a sharp burning sensation in his left anterior shoulder and was unable to lift the boat. The patient denied feeling a popping sensation at the time of the injury. He had mild pain at night, but was able to sleep. He said that he had mild diminished strength with elbow flexion, but denied having any numbness, tingling, or discoloration of his skin.
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Affiliation(s)
- James Keeling
- Department of Family Medicine, University of Colorado Denver School of Medicine, Denver, CO, USA
| | - Morteza Khodaee
- Department of Family Medicine, University of Colorado Denver School of Medicine, Denver, CO, USA.
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Abstract
Although most astute clinicians can diagnose Achilles tendon ruptures by physical examination alone, more than 20% are not accurately diagnosed in a timely fashion. The definition of a "chronic" Achilles tendon rupture in foot and ankle literature varies widely: from 4 to 10 weeks status after injury. Neglected or chronic Achilles tendon ruptures can be significantly disabling to patients if the muscle-tendon unit is stretched beyond its normal passive limit. There are a variety of treatment options that all have valid uses but have not been proven to be superior to one another.
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Affiliation(s)
- Christopher E Gross
- Department of Orthopaedics, Medical University of South Carolina, 96 Jonathan Lucas Drive, CSB 708, MSC 622, Charleston, SC 29425, USA.
| | - James A Nunley
- Department of Orthopaedic Surgery, Duke University Medical Center, 4709 Creekstone Drive, Durham, NC 27703, USA
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Said Y, Mensi A, Khedher S, El Jeri K, Daldoul S, Menif N, Debbeche R. Hemoperitoneum secondary to injury of cystic artery: rare and serious complication of liver biopsy. Tunis Med 2017; 95:506-507. [PMID: 29878299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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35
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Jørgensen U, Krogsgaard MR. [Treatment of anterior cruciate ligament ruptures]. Ugeskr Laeger 2017; 179:V07170559. [PMID: 28918789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Anterior cruciate ligament (ACL) injuries are typically seen in cutting sports. Rehabilitation can be tried in athletes in non-cutting sports and in recreational athletes. If knee instability is experienced, the cessation of risk activities or reduction in activity level are recommended. With recurrent episodes of instability ACL-reconstruction is recommended. 65% return to sports at preinjury level after ACL-reconstruction, 18% after non-operated partial rupture and 7% after non-operated total rupture.
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Turmak M, Deniz MA, Özmen CA, Aslan A. Evaluation of the multi-slice computed tomography outcomes in diaphragmatic injuries related to penetrating and blunt trauma. Clin Imaging 2017; 47:65-73. [PMID: 28898729 DOI: 10.1016/j.clinimag.2017.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/13/2017] [Accepted: 08/29/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. MATERIAL AND METHODS 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study. RESULTS There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%). CONCLUSION Findings suggestive of diaphragmatic rupture must be carefully evaluated in patients with blunt or penetrating thoracoabdominal trauma.
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Affiliation(s)
- Mehmet Turmak
- Department of Radiology, Van Special Güven Hospital, Van, Turkey
| | - Muhammed Akif Deniz
- Department of Radiology, Health Scıence Unıversity Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.
| | - Cihan Akgül Özmen
- Department of Radiology, Dicle University School of Medical Science, Diyarbakir, Turkey
| | - Aydın Aslan
- Department of Radiology, Health Scıence Unıversity Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey
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Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current Management of Penile Fracture: An Up-to-Date Systematic Review. Sex Med Rev 2017; 6:253-260. [PMID: 28874325 DOI: 10.1016/j.sxmr.2017.07.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/22/2017] [Accepted: 07/23/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Because of the low incidence of penile fracture, many aspects of the diagnostic process and of the surgical and functional outcomes are rarely reported. AIM To systematically review the current literature on the surgical management of penile fracture, focusing on etiology, diagnosis, functional outcomes, and postoperative complications. METHODS The present review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration standards for systematic reviews. A systematic search for the terms penile fracture, fracture of penis, trauma of penis, rupture of corpora cavernosa, and immediate management of penile fracture was been carried out in the PubMed, EMBASE, Cochrane, SCOPUS, and Science Citation Index databases. MAIN OUTCOME MEASURES Etiology of penile fracture, clinical presentation, types of radiologic investigations and their accuracy, surgical approach, suture material used for tunica repair, timing of surgical exploration, intraoperative findings, surgical complications, and functional outcomes. RESULTS The total number of patients analyzed was 438, and the patients' an average age was 36 years. The most frequent reported cause of penile fracture was sexual intercourse (80% of cases). The most common finding at examination was a penile hematoma (97.5%). Although operator dependent, in experienced hands, ultrasonography was found to be a useful tool in confirming the location of the albuginea tear and identifying the presence of any concomitant urethral injury, helping the surgeon to choose the best surgical approach. Early surgical repair of a penile fracture was found to be a safe procedure, although long-term complications are not uncommon. Tertiary referral centers that managed a larger number of cases seemed to obtain more satisfactory long-term results with a significantly smaller number of complications. CONCLUSION A low incidence of postoperative complications and full satisfactory functional outcomes are reported when early repair is performed in high-volume centers. Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current Management of Penile Fracture: An Up-to-Date Systematic Review. Sex Med Rev 2018;6:253-260.
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Affiliation(s)
- Marco Falcone
- Urology Department, Città della Salute e della Scienza, Torino, Italy
| | - Giulio Garaffa
- The Institute of Urology, University College London Hospitals, London, UK
| | - Fabio Castiglione
- The Institute of Urology, University College London Hospitals, London, UK
| | - David J Ralph
- The Institute of Urology, University College London Hospitals, London, UK.
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Massey PA, Harris JD, Winston LA, Lintner DM, Delgado DA, McCulloch PC. Critical Analysis of the Lever Test for Diagnosis of Anterior Cruciate Ligament Insufficiency. Arthroscopy 2017; 33:1560-1566. [PMID: 28499922 DOI: 10.1016/j.arthro.2017.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/21/2017] [Accepted: 03/07/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To critically analyze the "lever test" in detecting anterior cruciate ligament (ACL) tears and to compare its accuracy with the Lachman, anterior drawer (AD), and pivot shift tests. METHODS From June 2014 to June 2015, 91 subjects were analyzed. Inclusion criteria were subjects aged 16 to 60 years, presenting after a knee injury with subjective swelling, or an objective effusion and an uninjured normal contralateral knee for comparison. Exclusion criteria included previous knee ligamentous reconstruction, fracture of the distal femur or proximal tibia, bilateral knee injuries, or known cruciate ligament tear. The Lachman, AD, pivot shift, and lever tests were performed in the office by 2 board-certified orthopaedic surgeons with patient awake. Examiners were blinded to the presence or absence of ACL injury. Magnetic resonance imaging was used to determine injury. Sensitivity, specificity, and accuracy were evaluated for all 4 tests. Accuracy was compared using χ-square and receiver operator curves. RESULTS Average subject age was 28 ± 11 years (61 males, 30 females). Seventy-one (79%) had ACL tears diagnosed by magnetic resonance imaging. The sensitivity, specificity, and accuracy of the lever test were 83%, 80%, and 82%, respectively. Accuracy was not statistically different from the Lachman, AD, and pivot shift tests (P = .78, .99, .07, respectively). Subanalyses were performed based on the presence of another ligament tear, timing of injury, and the presence of a meniscus tear. Although the groups were smaller and thus underpowered, the results were reported. Neither the presence of another ligament tear nor the timing of the injury affected accuracy (P = .62 and P = .47); however, the presence of a meniscus tear decreased its accuracy (P = .003). CONCLUSIONS The lever test showed high sensitivity, specificity, and overall accuracy in the detection of ACL tears. The accuracy of the lever test was not significantly different from the Lachman, AD, or pivot shift tests. LEVEL OF EVIDENCE Level II, prospective comparative study.
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Affiliation(s)
- Patrick A Massey
- Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, U.S.A
| | - Joshua D Harris
- Houston Methodist Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A
| | - Leland A Winston
- Houston Methodist Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A
| | - David M Lintner
- Houston Methodist Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A
| | - Domenica A Delgado
- Houston Methodist Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A
| | - Patrick C McCulloch
- Houston Methodist Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A..
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Abstract
To summarize the clinical features of eyeball rupture with or without orbital fracture and explore the differences between them.In all, 197 patients were observed, and the following data were recorded: sex, age, time of injury, place of injury, cause of trauma, zone of eye injury, intraocular content prolapse, surgical methods and the therapeutic process, visual acuity after injury, and the final best corrected visual acuity. The results were analyzed for statistically significant differences.There was no significant difference (P > .05) in the age, sex, or cause of injury. Patients with eyeball rupture with fracture had poorer vision than did those in the simple eyeball rupture group; eyeball rupture with fracture also had a higher probability of enucleation.In this study, the clinical results show that prognosis of eyeball rupture with orbital fracture is worse than that of eyeball rupture without orbital fracture.
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Affiliation(s)
| | - Yi Yao
- Department of Ophthalmology
| | | | | | - Xiao Zhao
- The First Department of Medical Oncology, The Chinese PLA General Hospital, Beijing, China
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Fridén T, Movin T, Andrén-Sandberg Å. [Missed diagnosis of Achilles tendon ruptures most common in elderly patients]. Lakartidningen 2017; 114:EHTD. [PMID: 28535025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We audited forty-six patients with a rupture of the Achilles tendon notified to the Swedish regulatory authority (the Health and Social Care Inspectorate) due to suspicion of malpractice. The patients' history and clinical presentation differed from those with a more classical acute rupture. The diagnostic errors were often found in patients older than 60 years, they were just as common in women as in men and the symptoms often had a subacute start. In most patients, the diagnostic errors were due to an incomplete clinical examination. More than one fourth of the patients were on medication with statins or quinolones.
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Affiliation(s)
- Thomas Fridén
- Inspektionen för vård och omsorg - Stockholm, Sweden Inspektionen för vård och omsorg - Stockholm, Sweden
| | - Tomas Movin
- Karolinska Institutet Department of Clinical Science and Education Sodersjukhuset - Stockholm, Sweden - Stockholm, Sweden
| | - Åke Andrén-Sandberg
- Karolinska Universitetssjukhuset - Gastrocentrum kirurgi Stockholm, Sweden Karolinska Universitetssjukhuset - Gastrocentrum Stockholm, Sweden
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Sallami S, Khouni H, Ichaoui H, Ben Atta M, Abou El Makarim S, Ben Rhouma S. Blunt scrotal trauma in adults: A multi-institution study evaluating the American Association for the Surgery of Trauma organ injury grading scale About 107 cases. Tunis Med 2017; 95:331-335. [PMID: 29509213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The authors evaluated the usefulness of the American Association for the Surgery of Trauma (AAST) testis injury scale based on preoperative scrotal ultrasonography (US) and physical examination compared to peroperative findings. METHODS A retrospective review was performed on 107 patients (mean age=29,2±5.8 years) with a testis blunt trauma treated between January 2005 and August 2015. All patients underwent surgical scrotal exploration. Preoperative US was performed in all cases. Testis trauma was classified according to the AAST organ injury scale, preoperatively based on physical examination and scrotal US and then compared to peroperative definitif grading scale. RESULTS Of the included patients, 14 were found to have abnormal testis contours on US, 25 had a rupture of the tunica albuginea, with a sensitivity of 70,8% and a specificity of 71,2%. Orchidectomy was performed in 12 cases, partial orchidectomy in 32 and tunica albuginea repair in 35 patients. CONCLUSIONS Through this series, US was not a specific and sensitive exam to really precise the severity grade of testis trauma. Pre- and preoperative findings were significantly different. Thus, we continue to support history and clinical findings and we encourage surgical exploration when testis lesion is suspected.
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Schelin L, Tengman E, Ryden P, Häger C. A statistically compiled test battery for feasible evaluation of knee function after rupture of the Anterior Cruciate Ligament - derived from long-term follow-up data. PLoS One 2017; 12:e0176247. [PMID: 28459885 PMCID: PMC5411110 DOI: 10.1371/journal.pone.0176247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 03/16/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose Clinical test batteries for evaluation of knee function after injury to the Anterior Cruciate Ligament (ACL) should be valid and feasible, while reliably capturing the outcome of rehabilitation. There is currently a lack of consensus as to which of the many available assessment tools for knee function that should be included. The present aim was to use a statistical approach to investigate the contribution of frequently used tests to avoid redundancy, and filter them down to a proposed comprehensive and yet feasible test battery for long-term evaluation after ACL injury. Methods In total 48 outcome variables related to knee function, all potentially relevant for a long-term follow-up, were included from a cross-sectional study where 70 ACL-injured (17–28 years post injury) individuals were compared to 33 controls. Cluster analysis and logistic regression were used to group variables and identify an optimal test battery, from which a summarized estimator of knee function representing various functional aspects was derived. Results As expected, several variables were strongly correlated, and the variables also fell into logical clusters with higher within-correlation (max ρ = 0.61) than between clusters (max ρ = 0.19). An extracted test battery with just four variables assessing one-leg balance, isokinetic knee extension strength and hop performance (one-leg hop, side hop) were mathematically combined to an estimator of knee function, which acceptably classified ACL-injured individuals and controls. This estimator, derived from objective measures, correlated significantly with self-reported function, e.g. Lysholm score (ρ = 0.66; p<0.001). Conclusions The proposed test battery, based on a solid statistical approach, includes assessments which are all clinically feasible, while also covering complementary aspects of knee function. Similar test batteries could be determined for earlier phases of ACL rehabilitation or to enable longitudinal monitoring. Such developments, established on a well-grounded consensus of measurements, would facilitate comparisons of studies and enable evidence-based rehabilitation.
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Affiliation(s)
- Lina Schelin
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Statistics, Umeå School of Business and Economics, Umeå University, Umeå, Sweden
- * E-mail:
| | - Eva Tengman
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Patrik Ryden
- Department of Mathematics and Mathematical Statistics, Umeå University, Umeå Sweden
| | - Charlotte Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Panagiotopoulos N, Patrini D, Barnard M, Koletsis E, Dougenis D, Lawrence D. Conservative versus Surgical Management of Iatrogenic Tracheal Rupture. Med Princ Pract 2017; 26:218-220. [PMID: 28208144 PMCID: PMC5588409 DOI: 10.1159/000455859] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022] Open
Abstract
Iatrogenic tracheal rupture (ITR) represents a life-threatening condition requiring prompt diagnosis, management, and treatment. The management of ITR is challenging, and treatment options depend on tear location, size, injury extent, and the patient's respiratory status. Although this complication has been extensively reported in published literature, the best evidence practice, for the management, requires clarification. In this review, the authors focused on the establishment of a differential diagnosis and the potential mechanism of the injury, the decision-making process, and the therapeutic approaches. It is suggested that for small lacerations or stable patients, conservative management could be considered sufficient, whereas invasive surgical therapy would be more appropriate in cases of large defects with significant air leak and patient instability.
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Affiliation(s)
- Nikolaos Panagiotopoulos
- Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospital, London, UK
| | - Davide Patrini
- Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospital, London, UK
| | - Matthew Barnard
- Department of Anaesthesiology and Intensive Care, St Bartholomew's Hospital, London, UK
| | - Efstratios Koletsis
- Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospital, London, UK
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
- *Efstratios Koletsis, MD, MSc, PhD, Department of Cardiothoracic Surgery, University of Patras, 31 Chlois Street, GR-166 73 Voula (Greece), E-Mail
| | - Dimitrios Dougenis
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
| | - David Lawrence
- Department of Cardiothoracic Surgery, The Heart Hospital, University College London Hospital, London, UK
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Pigolkin YI, Dolzhansky OV, Pal'tseva EM, Shilova MA, Fedorov DN, Boeva SE. [The forensic medical evaluation of traumatic and spontaneous ruptures of the organs affected by the tumours]. Sud Med Ekspert 2017; 60:49-56. [PMID: 28399088 DOI: 10.17116/sudmed201760249-56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present article was designed to report the results of the analysis of the cases of traumatic and spontaneous ruptures of the organs affected by the tumours based on the original observations and the literature data. It is shown that the probability of the tumour rupture depends on its histological type, localization, the size, and the distance from the capsule of the affected organ, the degree of involvement of the major blood vessels, the severity of the necrotic changes, the presence of cysts in the neoplasm, and the regimens of radio- and chemotherapy. Moreover, the rupture can be facilitated by anticoagulation therapy, intake or oral contraceptives, pregnancy, concomitant diseases, alcoholic intoxication, splenomegaly, and hypocoagulation resulting from dissemination of the neoplastic process or the metastatic lesions of the liver. Even a minimal injury to the skin can provoke the tumour rupture associated with the fatal hemorrhage. A delayed rupture within a few hours or days is possible.
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Affiliation(s)
- Yu I Pigolkin
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Russian Ministry of Health, Moscow, Russia, 119991
| | - O V Dolzhansky
- B.V. Petrovsky Russian Research Centre of Surgery, Russian Ministry of Health, Moscow, Russia, 119991
| | - E M Pal'tseva
- B.V. Petrovsky Russian Research Centre of Surgery, Russian Ministry of Health, Moscow, Russia, 119991
| | - M A Shilova
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Russian Ministry of Health, Moscow, Russia, 119991
| | - D N Fedorov
- B.V. Petrovsky Russian Research Centre of Surgery, Russian Ministry of Health, Moscow, Russia, 119991
| | - S E Boeva
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Russian Ministry of Health, Moscow, Russia, 119991
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Aujla R, Kumar A, Bhatia M. Non-surgical treatment of Achilles rupture: Does duration in functional weight bearing orthosis matter? Foot Ankle Surg 2016; 22:254-258. [PMID: 27810024 DOI: 10.1016/j.fas.2015.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/01/2015] [Accepted: 11/07/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND The treatment of acute Achilles tendon ruptures is continually being debated. The success of non-surgical regimes is now evident yet there remains a high rate of surgery in the United States of America and Scandinavia. Recent studies have investigated functional outcome rather than complication rates as primary outcome but the current data are still sparse. We aimed to investigate whether there is any difference in functional outcomes between two dynamic regimes of differing durations for acute Achilles tendon ruptures. METHODS The patients in the two groups were matched for age, gender, follow-up duration and mechanism of injury. Forty-four patients were managed in a regime of 11 weeks and another 44 patients for 8 weeks. Demographics, injury details, complications and functional outcome were recorded. The validated Achilles Tendon Rupture Score (ATRS) was used to assess functional outcomes. Minimum follow-up was 1 year. RESULTS The 11-week group had a mean age of 50.8 years (range: 27-80) with 36 (82%) males. The 8-week group had a mean age of 52.0 years (range: 32-77) with 36 (82%) males. The mean ATRS for the 11-week group was 76.0 (range: 8-100). The mean ATRS for the 8-week group was 76.1 (range: 30-100). There were no re-ruptures in the 11-week group and one in the 8-week group. There were three episodes of venous thromboembolism in the 11-week group and four in the 8-week group. CONCLUSION A reduction in duration of dynamic rehabilitation for non-operative treatment of Achilles tendon rupture from 11 weeks to 8 weeks does not lead to a significant detriment in functional outcomes or complication rates.
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Affiliation(s)
- Randeep Aujla
- Trauma & Orthopaedic Surgery, University Hospitals of Leicester, Leicester, United Kingdom.
| | - Amit Kumar
- Trauma & Orthopaedic Surgery, University Hospitals of Leicester, Leicester, United Kingdom
| | - Maneesh Bhatia
- Trauma & Orthopaedic Surgery, University Hospitals of Leicester, Leicester, United Kingdom
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Finsterer J, Stöllberger C, Haberler C. Dilated cardiomyopathy and recurrent myorrhexis suggest mitochondrial disorder. Acta Cardiol 2016; 71:491-2. [PMID: 27594366 DOI: 10.2143/ac.71.4.3159704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Rupture of the tendon of flexor pollicis longus is suspected when active flexion of the interphalangeal joint of the thumb is not possible. This can be a result of trauma but, when spontaneous, diagnostic confusion can exist as incomplete palsy of the anterior interosseous nerve can present in a similar way. We describe a simple clinical sign which can differentiate between these conditions.
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Affiliation(s)
- J T K Melton
- Department of Orthopaedics, The Great Western Hospital, Swindon, UK.
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Mahajan M, Tolman C, Würth B, Rhemrev SJ. Clinical evaluation vs magnetic resonance imaging of the skier's thumb: A prospective cohort of 30 patients. Eur J Radiol 2016; 85:1750-1756. [PMID: 27666612 DOI: 10.1016/j.ejrad.2016.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A skiers thumb, or a partial or complete rupture of the ulnar collateral ligament (UCL) is a clinical diagnosis. Swelling, pain, natural left-right difference and inexperience of a young physician can cause difficulty to correctly diagnose this injury. However, our theory is that any physician, given the correct instructions, should be able to diagnose this injury solely on clinical findings, without the necessity of additional imaging. MATERIAL AND METHODS In a large Dutch teaching hospital, physicians (residents with working experience of 6months-3years) working at the ER received instructions for physical examination. Patients >18 years, with an injury <1 week old, suspected of a true skier's thumb had an MRI reported by two independent radiologists to confirm the diagnosis. RESULTS Thirty patients were included. Seven patients had no fixed endpoint (23%), all had a complete ligamentous rupture of the UCL on MRI, of which three patients had a Stener lesion. Fifteen patients (50%) met with the criteria >35° laxity in extension of MCP/ >20° laxity in 30° flexion of the MCP. Of these, thirteen patients (81%) had a complete rupture (nine Stener lesions (56%)). One patient had a partial injury and one patient had no UCL-injury. Eight patients (27%) had inconclusive results during physical examination. Of these, two had a complete rupture (40%, 1 Stener). Three patients had a partial rupture and three patients had an intact UCL. CONCLUSION A skier's thumb can be diagnosed by any resident when correctly instructed. Additional imaging when diagnosing a skier's thumb should be reserved in cases when physical examination remains inconclusive.
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Affiliation(s)
- Mandhkani Mahajan
- Medical Center Haaglanden, Department of Surgery, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
| | - Christine Tolman
- Medical Center Haaglanden, Department of Radiology, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
| | - B Würth
- Medical Center Haaglanden, Department of Emergency Care, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
| | - Steven J Rhemrev
- Medical Center Haaglanden, Department of Surgery, Lijnbaan 32, 2512 VA The Hague, The Netherlands.
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Drenck TC, Akoto R, Meenen NM, Heitmann M, Preiss A, Frosch KH. [Operative treatment of anterior cruciate ligament ruptures with autologous hamstring tendons in children and adolescents]. Unfallchirurg 2016; 119:598-603. [PMID: 27369183 DOI: 10.1007/s00113-016-0201-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- T C Drenck
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland
| | - R Akoto
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland
| | - N M Meenen
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland
| | - M Heitmann
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland
| | - A Preiss
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland
| | - K-H Frosch
- Abteilung Unfall- und Wiederherstellungschirurgie mit Sektion Knie- und Schulterchirurgie, Sporttraumatologie, Chirurgisch-Traumatologisches Zentrum, ASKLEPIOS Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland.
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Jiménez Rodríguez I, Jiménez Rodríguez B, Sánchez García M. [Foreskin hematoma: rupture of a superficial vein in the penis]. Emergencias 2016; 28:205. [PMID: 29105455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Beatriz Jiménez Rodríguez
- Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, España. Servicio de Anestesiología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Manuel Sánchez García
- Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, España. 3Servicio de Anestesiología, Hospital Universitario Virgen de las Nieves, Granada, España
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