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At least 235 records · Page 13Linked to original sources
PubMed2001

Soft tissue injuries with the use of safe corridors for transfixion wire placement during external fixation of distal tibia fractures: an anatomic study.

OBJECTIVES: To determine which soft tissue structures are at risk and when joint violation can occur during small wire placement for hybrid external fixation of distal tibial fractures while adhering to published guidelines. DESIGN: Cadaver anatomic experiment. SETTING: University orthopaedic program. SUJBECTS: Five embalmed cadavers. INTERVENTION: Placement of small wire transfixion pins in the distal tibia. MAIN OUTCOME MEASUREMENTS: Dissection and measurements. METHODS: Four orthopaedic surgeons were shown diagrams that have been widely accepted as allowing for placement of transfixion pins in the distal tibia through safe corridors. Each of the orthopaedic surgeons was then asked to place two transfixion pins into each of five cadaver legs in a position that would provide stable external fixation of the metaphysis to the diaphysis with a circular fixator (forty pins total) for a distal tibial fracture within five centimeters of the plafond. The specimens were dissected, and pins impaling neurovascular structures, tendons, or the ankle capsule were recorded. The superior capsular synovial reflections were measured from the anterior joint line and the tip of the medial malleolus. These measurements were also performed on arthrograms of two extremities before their dissection. RESULTS: Fifty-five percent of the pins placed impaled at least one tendon that crosses the ankle joint. Neurovascular structures that were impaled included the saphenous vein (+/-10.5 percent) and the superficial peroneal nerve (+/-7.5 percent). One pin violated the superior capsular synovial reflection, which was an average of thirty-two millimeters (+/-1.58 millimeters) from the tip of the medial malleolus and twenty-one millimeters (+/-1.63 millimeters) from the anteromedial joint line. CONCLUSIONS: This study shows that tendons and neurovascular structures above the ankle are at risk during small transfixion pin placement, even when using safe corridors. Pins placed within two centimeters of the anterior joint line or three centimeters from the medial malleolus may be intracapsular.

Bone Nails↗
PubMed1996

Soft-tissue injuries of the cervical spine. 15-year follow-up.

Forty patients with a whiplash injury who had been reviewed previously 2 and 10 years after injury were assessed again after a mean of 15.5 years by physical examination, pain and psychometric testing. Twenty-eight (70%) continued to complain of symptoms referable to the original accident. Neck pain was the commonest, but low-back pain was present in half. Women and older patients had a worse outcome. Radiating pain was more common in those with severe symptoms. Evidence of psychological disturbance was seen in 52% of patients with symptoms. Between 10 and 15 years after the accident 18% of the patients had improved whereas 28% had deteriorated.

Adult↗
PubMed2000

Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes.

This review highlights three areas: plantar fasciitis, Achilles tendinitis, and carpal tunnel syndrome. The diagnosis and treatment of plantar fasciitis are reviewed; nonsurgical treatments remain the mainstay of management. Several recent articles support the use of night splints. Some novel treatments recently investigated, including low intensity laser irradiation and extracorporeal shock wave lithotripsy, are reviewed, as well as the effectiveness of steroid injection. Novel treatments for Achilles tendinitis are also reviewed, including the use of injection therapy and the treatment approach of one author for the management of Achilles tendon rupture. Nonsurgical techniques in the treatment of carpal tunnel syndrome, such as yoga, ultrasound, noninvasive laser neurolysis, manipulation, nerve and tendon gliding exercises, and medications, are reviewed. Prednisolone was shown to be effective in the treatment of mild to moderate disease and nonsteroidal anti-inflammatory drugs were found to be ineffective.

Athletic Injuries↗
PubMed1975

[Intramedullary fixation of fragments in soft-tissue injuries (author's transl)].

In cases of open fractures, careful reconstruction of the soft tissue and stable internal fixation are generally regarded as the best means of preventing infection. With this in mind, some of the author's own cases of open fractures of the upper and lower leg-stabilized either with conventional intramedullary nails or with interlocking nails-are demonstrated. The infection rate in the especially vulnerable open fracture of the tibia was 7.89 percent.

Adolescent↗
PubMed1987

[Primary management of large soft tissue injuries in the area of the face and skull].

The primary treatment even of extensive soft tissue lesions of the face and head after traffic or labour accidents should be immediate and definite reconstruction. The plastic surgeon called on the scene will evaluate the extent of tissue damage or loss and go ahead with his specific techniques to repair the injury in such a way that only minimal secondary interventions are necessary. Three characteristic cases document the thereby achievable primary and late results of the definite primary treatment.

Adult↗
PubMed2004

Soft-tissue injuries of the lower extremity.

A diverse set of conditions affect the lower extremities in athletes. Good history taking and knowledge of the anatomy of the affected areas can aid in accurate diagnosis. Most conditions can be treated conservatively with great success. Familiarity with rehabilitation strategies can assist physicians in working with physical therapists. New advances, especially in the therapy of plantar fasciitis, may aid physicians in more rapid treatment of conditions of overuse. Surgery can provide definitive relief from symptoms for athletes with whom conservative measures have failed.

Fasciitis, Plantar↗
PubMed1997

Sports-related and other soft-tissue injuries, tendinitis, bursitis, and occupation-related syndromes.

In this review, four areas are discussed: fluoroquinolone-induced tendinitis, volar flexor tenosynovitis (trigger finger), Achilles tendon lesions, and occupational medicine issues. The relationship of fluoroquinolone treatment to musculoskeletal lesions, especially Achilles tendinitis and tear, is most intriguing. The steady increase in reports of the association cannot be ignored. Although Achilles tendinitis and rupture have comprised the most frequently seen lesions, articles on additional sites of involvement, such as in lateral epicondylitis and De Quervain's tenosynovitis, are reviewed. Volar flexor tenosynovitis and trigger finger are among the most common musculoskeletal problems, and additional studies support the success of corticosteroid injections. Although the value of injections was reported well over 25 years ago, surgery is still unfortunately the first-choice treatment of some physicians. We review three studies on Achilles tendinopathy. In one of the reports, diagnostic ultrasonography is again demonstrated to be of value in assessing tendon lesions. The push to use the term tendinosis rather than tendinitis continues as a result of histologic studies of tendinitis that lack the usual findings of inflammation. However, the presence or absence of chemical inflammation is yet to be ascertained. We review an article that fails to show that work activities are the sole cause of such musculoskeletal syndromes as cumulative trauma or repetitive use. Further studies are needed in the area of work-related upper extremity disorders.

Athletic Injuries↗