Search PubMed⌕ Search

Biomedical subjects

N Maffulli

Publications and source records attributed to N Maffulli.

At least 145 records · Page 8Linked to original sources
PubMed1996

Iliopsoas haematoma in an adolescent Taekwondo player.

A 16-year-old male Taekwondo player was admitted with a 1-day history of right groin pain and a palpable mass in the right lower abdominal quadrant following a Taekwondo training session. No history of direct trauma was given, but the pain followed a high inward-to-outward kick. The patient was not on any medication, and tumour and infection were excluded. A high-resolution real-time ultrasound scan identified a well-defined, hyperechoic, heterogeneous mass in the substance of the right iliopsoas muscle, compatible with a collection of partially clotted blood, confirming the clinical diagnosis of iliopsoas haematoma. After conservative treatment the patient resumed training and is now fully asymptomatic.

Adolescent↗
PubMed1996

Shoulder instability in athletes. The Asian perspective.

Recently, there has been an upsurge of interest among the orthopaedic sports medicine community in Asia on this subject of athletic shoulder instability. This is particularly prominent in countries such as Japan, Korea, Taiwan, and Hong Kong, where sports requiring throwing and overhead use of the upper limb are popular. In this review, the classification of the condition is analyzed with a specific account of the rotator interval injury. A systematic plan of clinical assessment is presented highlighting the specific regional considerations in clinical practice and cost-effectiveness of the health care systems in Asia. The management of athletic shoulder instability depends on patient attitude and cultural background. In Asia, the popular choice of Bankart repair with capsular shift procedure is presented with special reference to the unique experience of multidirectional and habitual posterior instability. Arthroscopic surgery is becoming popular in Asia, and the indications and limitations of the technique in the management of shoulder instability are discussed.

Arthroscopy↗
PubMed1996

Management of forme fruste fibular hemimelia.

Children with fibular hypoplasia and three-or four-ray feet have a forme fruste of congenital short tibia with absent or dysplastic fibula. We outline the criteria for management of this condition. Although fibular deficiency can be considered benign, two thirds of our patients underwent operation. Leg length inequality may require epiphysiodesis, leg lengthening, or simply a shoe raise. Only very occasionally, when the foot is nonfunctional, is amputation through the ankle undertaken.

Adolescent↗
PubMed1996

Eccentric and concentric isokinetic knee flexion and extension: a reliability study using the Cybex 6000 dynamometer.

OBJECTIVE: To determine the reliability of the Cybex 6000 isokinetic dynamometer in measuring the knee muscle performance concentrically and eccentrically. METHODS: 18 male and 12 female subjects with no previous knee injuries, who had not previously undergone any isokinetic testing, were studied. The flexor and extensor muscles groups of both knees were tested at 60 degrees s-1 and 120 degrees s-1 with the continuous concentric-eccentric cycle testing protocol. Variables studied included peak torque, total work, and average power. The interclass correlation coefficient (ICC 2,1) was used to determine the reliability with P < 0.05. RESULTS: Peak torque showed significantly greater ICC than the total work and average power, with test-retest reliability ranging from 0.82 to 0.91 for peak torque, from 0.76 to 0.89 for total work, and 0.71 to 0.88 for average power. Average variability for the three variables studied ranged from 9% to 14%. The ICCs for the three variables studied were significantly greater at 120 degrees s-1. The knee extensor muscle group showed greater test-retest reliability, and the results of isokinetic testing in the concentric contraction mode were more reproducible. CONCLUSIONS: The Cybex 6000 isokinetic dynamometer shows high reliability in measuring isokinetic concentric and eccentric variables. Some fluctuation should be allowed when evaluating variations of muscle performance between tests.

Adult↗
PubMed1996

Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes.

OBJECTIVE: To test the hypothesis that increasing the hamstrings and quadriceps (H:Q) isokinetic strength ratio will, in the short term, improve the functional ability of an anterior cruciate ligament (ACL) deficient knee. METHODS: The isokinetic muscular characteristics at a speed of 60 degrees s-1 and 180 degrees s-1 of 46 recreational athletes with an arthroscopically confirmed ACL tear were determined using the Cybex II+ isokinetic dynamometer. The variables tested included peak torque, endurance ratio, total work output, and explosive power. Functional ability was scored with the Cincinnati rating system, measuring the severity of pain and swelling, the degree of giving way, and the overall ability to walk, run, ascent and descent stairs, jump and twist. RESULTS: Among all muscular characteristics, the H:Q ratio at 180 degrees s-1 at 30 degrees of knee flexion was shown to have the highest correlation to the functional score (r = 0.6249, P < 0.001). All variables involving hamstring strength were shown to be significantly correlated to the functional ability score (P < 0.01), while none of the variables involving quadriceps strength showed significant correlation with the functional ability of the injured knee. CONCLUSIONS: The H:Q ratio is strongly correlated to the functional ability of ACL deficient knees in Chinese recreational athletes. It could be used as an additional measure to guide in the decision making process in the management of ACL deficient knees.

Adult↗
PubMed1996

Paediatric sports injuries in Hong Kong: a seven year survey.

OBJECTIVE: To ascertain the epidemiological characteristics of sports injuries in children in Hong Kong. METHODS: Retrospective review of all cases seen in the Sports Injury Clinic of the Prince of Wales Hospital, Shatin, Hong Kong, in the period May 1984 to December 1990. The variables studied were age at presentation, gender, side of the body injured, anatomical location of the injury, type and severity of injury, sport played, level (school, recreational, amateur and professional) and frequency of sports participation, length in years of sports practice, and initial management of the injury. RESULTS: Of the 2293 patients seen, 238 were youngsters (54% boys) 16 years old or younger. Ball games accounted for the greatest number of injuries, with 37 children taking part in basketball, 28 in soccer, 12 in volleyball, and 31 children taking part in a variety of other ball games. Of the remaining children, the single largest group was practising track and field, with sprinting and middle distance running accounting for 42 injuries, and 28 children were injured while cycling. Most of the injuries (85%) were classified as non-serious, but 15% of children presented with a total of 21 fractures, two joint dislocations, five concussions, and seven torn knee ligaments. CONCLUSIONS: Children sports participation in Hong Kong, although not at high level and not as widespread as in the West, accounts for significant morbidity. These injuries should be carefully monitored to ascertain whether they result in any detrimental long term effects.

Adolescent↗
PubMed1996

A review of 240 patients undergoing distraction osteogenesis for congenital post-traumatic or postinfective lower limb length discrepancy.

BACKGROUND: We reviewed 281 lower limb lengthenings in 240 patients treated at three centers for congenital, post-traumatic, or postinfective limb length discrepancy (LLD) in the period 1984 to 1992. STUDY DESIGN: A retrospective review was done of hospital charts and radiographs of patients who had completed lengthening at least 12 months prior to the beginning of the study. The variables studied included patients' age at operation, the bone segment lengthened, whether a corticotomy or an osteotomy had been done, the amount of lengthening planned and achieved, the level(s) of corticotomy or osteotomy, the external fixator used, and the difficulties encountered. RESULTS: Limb length discrepancy was reduced within 2 cm (1.6 percent or lower) of the normal contralateral leg in 249 (89 percent) lengthenings in 208 patients. The average time spent with the fixator in situ was 186.4 days (range, 94 to 617 days), with an average healing index of 35.3 days per cm (range, 26 to 43 days per cm). Femoral osteotomies or corticotomies healed faster than tibial osteotomies or corticotomies. The healing index in post-traumatic and postinfective LLD was significantly lower than in congenital conditions. The younger patients showed a significantly decreased time to bone healing and fewer complications. CONCLUSIONS: A significantly greater number of difficulties were found in patients whose lengthening exceeded 18 percent of the original length of bone. Bifocal lengthenings healed significantly faster than single level ones. The three external fixators used were equally effective for lengthenings of less than 20 percent. The Ilizarov and the Monticelli-Spinelli circular fixators were associated with a significantly decreased number of complications when lengthenings above 20 percent were performed.

Adolescent↗
PubMed1996

Athletic knee injuries. Similarities and differences between Asian and Western experience.

The pattern and prevalence of knee injuries among athletes are different in Asia, Europe, and North America because of factors such as the different sporting cultures of the regions and the type of favorite sports. Sampling and data bias and the variable levels of diffusion of sports in the different parts of the world also are responsible for the variation. In this review, the knee emerges as the most commonly injured part of the body; such injuries present significant problems of mechanical block or instability that may compromise athletic performance. Sports specific injuries are delineated, and specific groups, such as children and adolescents, female, and master athletes, are reviewed in light of the characteristic patterns of knee injuries. Differences in the patients' attitude, health care systems, and consultations of traditional medical practitioners produce major differences in management styles. However, it is encouraging to find a concerted effort on all continents in the search for a better understanding of knee injuries and a more satisfactory coordination between clinical and basic science research in this field.

Adolescent↗
PubMed1996

Percutaneous longitudinal tenotomy in chronic Achilles tendonitis.

In the period from August 1989 through December 1992, 42 track and field athletes with unilateral Achilles tendonitis and/or peritendinitis were operated using multiple percutaneous longitudinal tenotomy under local anesthesia following failure of conservative treatment. Patients were reviewed in a special clinic over three consecutive days at an average of 19.2 (9.4) months from the operation. Of the 42 patients operated, 36 (86%) attended. On this occasion, only subjective assessment was carried out. Of the other six patients, four were interviewed by telephone using the same questionnaire; two were lost to follow-up. The results in 25 patients (59.5) were rated as excellent, 11 (28.2%) as good, 4 (9.5%) as fair, and 2 (4.8%) as poor.

Achilles Tendon↗
PubMed1996

Callotasis lengthening: a review of some technical aspects.

Limb lengthening by gradual osteotomy distraction has been practiced since the beginning of the century. The results have not always been uniformly good because of the invasiveness and too sudden elongation applied. Using the callotasis technique, a low energy osteotomy is produced in a metaphyseal area. The periosteum is spared, and distraction, generally at a rate of 0.25 mm every six hours, is started 7 to 14 days after the osteotomy. Using the principle of tension-stress outlined by Ilizarov in the early 1950s, it is possible to produce consistent lengthening of a given bone segment. However, great attention to detail is necessary, as limb lengthening techniques show a steep learning curve, with a significant initial complication rate.

Bone Lengthening↗
PubMed1996

Minimal trauma knee hemarthrosis.

Four patients who suffered from minimal trauma knee hemarthrosis are presented. In all patients, the cause of the hemarthrosis was not the traumatic event in itself, but an underlying clotting or collagen disorder. The necessity of interaction between the orthopaedic surgeon and a coagulation unit is stressed.

Aged↗
PubMed1996

Tissue expanders in syndactyly: a brief review.

Tissue expansion has been advocated as a method of obtaining enough skin to correct syndactyly without using skin grafts. However, results have been disappointing, indications are unclear, and complication rates are still relatively high. We review the published cases of syndactyly treated with tissue expansion, acknowledging the lack of data and guidelines for its use in such condition. After more than 10 years since its introduction in the treatment of syndactyly, its use is still not as widespread as one would have been led to expect.

Humans↗
PubMed1996

Carcinomatous perforation of the sigmoid colon presenting as a thigh mass.

We report a patient presenting with a left psoas abscess causing necrotizing fasciitis of the upper thigh. The patient underwent exploration of the left thigh through a medial approach, confirming necrotizing fasciitis of the adductor compartment and the femoral triangle. The infective process also involved the left psoas. This was explored retroperitoneally through a left pararectal laparotomy incision. Further exploration revealed a carcinomatous ulcer of the sigmoid colon. Despite active resuscitation, antibiotic therapy, and further debridement, the patient died three days after admission.

Aged↗
PubMed1996

Brachial plexus injury in association with fracture-dislocation of the shoulder.

Anterior dislocation of the shoulder is generally not associated with neurological compromise. We report three patients in whom a brachial plexus injury was caused by an anterior dislocation of the shoulder. One patient was further complicated by vascular involvement. The forces producing the injury are usually small, and the neurological trauma is likely to be neuropraxia. Conservative management is usually successful, and, in our patients, recovery took place after an average of six months.

Adolescent↗