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At least 253 records · Page 14Linked to original sources
PubMed2004

Combined rupture of the tibialis anterior and the extensor hallucis longus tendons--functional reconstruction.

BACKGROUND: Traumatic rupture of the tibialis anterior (TA) tendon represents a very rare foot injury. A combined injury of both the TA and the extensor hallucis longus (EHL) tendons has not yet been reported. Within the scope of this work we will prove that tendon transfers in cases of combined tendon injuries are a reasonable course of action in order to achieve the aim of a functional reconstruction. METHODS: A combined rupture of the tibialis anterior (TA) and the extensor hallucis longus (EHL) tendons was treated by suturing the EHL tendon to the distal TA tendon stump. The TA insertion was secured and the distal portion of the EHL tendon attached to an extensor digitorum slip. The TA muscle was proximally attached to the tendinous EHL segment. RESULTS: A 1 year follow-up verified very good results, showing the patient without complaints in regard to the trauma. Compared with the contralateral non-affected side, the repaired foot showed very satisfactory results in reference to range of motion, strength and gait. CONCLUSION: With this work we proved that tendon transfers in cases of combined tendon injuries make sense in order to achieve functional reconstruction. This approach preserves function and strength and avoids the problems and risks of alternate treatment techniques, including tendon grafting.

Adult↗
PubMed1992

Prevention of overuse injuries of the foot by improved shoe shock attenuation. A randomized prospective study.

In a randomized prospective study among 390 recruits, the hypothesis that improved shoe shock attenuation could lessen the incidence of overuse injuries was tested. During the 14 weeks of training, 90% of the recruits sustained overuse injuries. Recruits training in a modified basketball shoe had a statistically significant lower incidence of metatarsal stress fractures and foot overuse injuries, compared with standard infantry boots, but their overall incidence of overuse injuries was not reduced. The effect of improved shoe shock attenuation was limited to those overuse injuries resulting from vertical impact loads.

Elasticity↗
PubMed1980

Tendon injuries about the foot and ankle in children.

Sixty-four children with tendon injuries about the foot and ankle have been reviewed in order to present a plan of management when such injuries occur. One-third involved the tendo Achillis; the others were equally distributed between the dorsum and sole of the foot, and in only 12% was more than one tendon involved. Sensory nerves were frequently severed, but nearly all recovered completely after early repair. The results of immediate repair of tendons were good. When repair was delayed the results were less satisfactory, as severe deformities developed in the growing feet. Early exploration and surgical repair of selected tendons are recommended to avoid future disability.

Achilles Tendon↗
PubMed1999

MR imaging in sports injuries of the foot and ankle.

MR imaging has become the diagnostic modality of choice for the evaluation of traumatic ligamentous and tendinous injures of the foot and ankle, occult bony trauma, and osteochondral lesions of the talus. This article reviews the current applications of MR imaging for the evaluation of sports-related injuries of the foot and ankle, including fractures, sprains, tendon injuries, and heel pain.

Ankle Injuries↗
PubMed1998

Diabetic foot ulcers: prevention, diagnosis and classification.

Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Management of the diabetic foot requires a thorough knowledge of the major risk factors for amputation, frequent routine evaluation and meticulous preventive maintenance. The most common risk factors for ulcer formation include diabetic neuropathy, structural foot deformity and peripheral arterial occlusive disease. A careful physical examination, buttressed by monofilament testing for neuropathy and noninvasive testing for arterial insufficiency, can identify patients at risk for foot ulcers and appropriately classify patients who already have ulcers or other diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation. Adherence to a systematic regimen of diagnosis and classification can improve communication between family physicians and diabetes subspecialists and facilitate appropriate treatment of complications. This team approach may ultimately lead to a reduction in lower extremity amputations related to diabetes.

Amputation, Surgical↗
PubMed1998

Foot and ankle injuries and disorders.

This chapter analyses the mechanics of walking and running gait and delineates the terminology used to describe foot and ankle injuries. A helpful anatomic review precedes explanations of the mechanisms of sports injuries in this area. The author documents the correct diagnoses and treatments for foot and ankle sprains, fractures, and stress injuries.

Adolescent↗
PubMed2005

All-terrain vehicle-related nonfatal injuries among young riders: United States, 2001-2003.

BACKGROUND: All-terrain vehicles (ATVs) have gained in popularity in recent years, and this rise in use has been accompanied by increases in the number of ATV-related injuries. Because children often lack the physical strength, cognitive abilities, and fine motor skills to operate ATVs properly, their risk for injury is greater. Furthermore, most children ride adult-sized ATVs. OBJECTIVES: To estimate the numbers and rates of ATV-related nonfatal injuries to riders aged < or =15 years who were treated in hospital emergency departments (EDs) in the United States from 2001 through 2003. METHODS: Estimates of ATV-related injuries were obtained from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System-All Injury Program. The database is a nationally representative, stratified probability sample of 66 US hospitals with > or =6 beds and a 24-hour ED. ATV-related nonfatal injuries to riders aged < or =15 years who were treated in hospital EDs were examined by age group, gender, primary body part injured, diagnosis, and hospital admission status. RESULTS: From 2001 through 2003, an estimated 108724 children aged < or =15 years were treated in hospital EDs for nonfatal injuries sustained while riding ATVs. The number of ATV-related injuries increased by 25% over the 3-year period. Males aged 11 to 15 years accounted for 52% of all ATV-related ED visits and hospitalizations among young riders. Children aged 0 to 5 years were more likely than the older children to have facial injuries, whereas the older children were more likely to sustain lower trunk and leg or foot injuries. Fractures were the most common diagnosis, accounting for 27% of ED visits and 45% of hospitalizations. CONCLUSIONS: Current legal and regulatory standards have been ineffective in reducing injuries among young ATV riders. Renewed efforts by health care providers to counsel parents about the injury risk to children who ride ATVs and advocate for more stringent state-level minimum age requirements may help reduce the escalating rates of ATV-related injuries among young riders.

Adolescent↗
PubMed1999

The diabetic neuropathic ulcer: an overview.

The leading cause of amputation in patients with diabetes is the nonhealing foot wound and its complications. The effects of peripheral neuropathy, peripheral vascular disease, and infection often combine to facilitate ulcer development that can lead to gangrene and amputation. In many instances, foot ulcers and amputation can be prevented. The literature over the past 5 years has included information on the infrared thermometry in the diagnosis of infection and acute Charcot change. Pressure downloading has been facilitated by computerized foot scanning systems and the use of prefabricated pneumatic walkers as an alternative to the contact cast. Local wound care is enforced by repeated sharp debridement. Nonhealing ulcers can benefit from biologicals: platelet-derived growth factors and a human dermal replacement containing viable fibroblasts. The most successful outcomes are achieved when interdisciplinary teams are formed to provide coordinated care. The goal of this article is to provide healthcare professionals with an overview of the risks of neuropathic foot injury and to offer strategies for prevention, protection, and reduction of recurrences of the diabetic foot ulcer.

Algorithms↗
PubMed1994

Morbidity after crush injuries to the foot.

By retrospective review of hospital records and by follow-up clinical examinations, we evaluated 58 patients with crush injuries to the foot treated at our institution between 1986 and 1990. All patients had received initial treatment according to a standardized protocol determined by the type and magnitude of the injury. Patients were examined at a mean interval of 3.3 years (range 2-4) after injury, and the functional outcome was determined according to a foot trauma rating scale. Based on this scoring system, 46% of the patients had good functional outcome, 29% had fair results, and 25% had poor results. There was a significant correlation between a good functional outcome and careful adherence to the treatment protocol; however, some patients fared poorly regardless of treatment. Poor results occurred if treatment was not immediately initiated, if soft-tissue coverage was delayed (in those who experienced severe, mangling-type injuries necessitating partial foot amputation), if patients subsequently had neuritis or reflex sympathetic dystrophy, or if patients were involved in ongoing workers' compensation and litigation. We conclude that because crush injuries of the foot may be associated with prolonged morbidity, initial management should be directed toward recognition and treatment of compartment syndromes, early soft-tissue coverage, and rigid skeletal stabilization to enhance soft-tissue healing.

Activities of Daily Living↗
PubMed1995

Injuries of the foot related to the use of lawn mowers.

We managed thirty-three patients who had open injuries of the foot related to the use of a lawn mower from 1985 through 1992. Twenty-eight of the patients were male and five were female. They ranged in age from four to seventy-three years old. The injuries were associated with the use of push lawn mowers (twenty-two patients), riding lawn mowers (nine patients), and self-propelled lawn mowers (two patients). The injuries included forty open fractures, twenty amputations, eighteen lacerations of the skin and nail beds, nine lacerations of tendons, two closed fractures, segmental loss of bone in two patients, and segmental loss of the Achilles tendon in one patient. The findings on culture of intraoperative specimens revealed a mean of 3.1 organisms (range, one to nine organisms) per patient. All of the patients were managed with at least one operative procedure (mean, 2.4 operations; range, one to five operations), and all were treated with parenteral antibiotic therapy (mean, 2.3 antibiotics; range, one to six antibiotics) except for one patient who had oral antibiotic therapy. The mechanism of injury was documented for twenty of the twenty-two patients who had been injured by a push lawn mower. Seventeen patients were injured while pulling the push lawn mower backward, and eight of those patients had been pulling the lawn mower up a slope.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Home↗
PubMedDate not supplied

Crush and avulsion injuries of the foot: their evaluation and management.

It is difficult to assess the damage resulting from crush or avulsion injuries so they may be treated adequately. The authors present a systematic approach to evaluating tissue involved in foot trauma. They also discuss antibiotic and tetanus prophylaxis and a technique of bacterial quantification that is helpful in determining the advisability of primary or delayed wound closure.

Adult↗
PubMedDate not supplied

Overuse ballet injury of the base of the second metatarsal. A diagnostic problem.

Performing classical ballet may cause major stress to the feet of the dancer. A variety of foot injuries have been described, with one such injury being an overuse syndrome involving the base of the second metatarsal and adjacent Lisfranc's joint. The diagnosis for this syndrome usually requires differentiating synovitis of Lisfranc's joint from a stress reaction of the base of the second metatarsal. Prompt diagnosis is important since the treatment for these two conditions differs significantly and, in the case of bone stress reaction, delay can cause progression of the lesion. We report good clinical results in a group of eight ballerinas for whom we obtained early diagnosis and treatment of their injuries. This is in contrast to poor results reported in the literature if the diagnosis and management of these types of injuries are delayed. We developed a simple diagnostic protocol to enable diagnosis at presentation. When a bone stress reaction had progressed to a fracture line, a characteristic appearance was found on magnetic resonance imaging, suggesting a specific mechanism of injury. A possible mechanism for this injury is discussed.

Adolescent↗
PubMedDate not supplied

Mechanisms of foot and ankle injuries in soccer.

BACKGROUND: Although player-to-player contact is a risk factor in the majority of soccer injuries, the mechanisms leading to these injuries have not been analyzed. PURPOSE: To assess the relationships between foot/ankle injuries and foul play and tackle type, and to identify the position of the foot and ankle at the time of injury. STUDY DESIGN: Prospective cohort study. METHODS: Team physicians prospectively recorded each injury in four world soccer competitions, and the videotaped incident leading to the injury was retrospectively analyzed. RESULTS: Of 76 foot and ankle injuries (52 contusions, 20 sprains, 4 fractures), direct contact occurred between players in 72. Significantly more injuries involved a tackle from the side and a lateral or medial tackle force. The injured limb was weightbearing in 41 and nonweightbearing in 35 of the incidents. Significantly more injuries resulted in time lost from soccer when the limb was weightbearing. The most common foot and ankle positions at the time of injury were pronated/neutral in the sagittal plane for weightbearing limbs, and plantar flexed/neutral in the coronal plane for nonweightbearing limbs. The most common foot and ankle rotations at the time of injury were external (23) and eversion (28). CONCLUSIONS: The majority of injuries were caused by tackles involving lateral or medial forces that created a corresponding eversion or inversion rotation of the foot or ankle. The weightbearing status of the injured limb was a significant risk factor.

Ankle Injuries↗
PubMed1999

Conventional radiography, CT, and MR imaging in patients with hyperflexion injuries of the foot: diagnostic accuracy in the detection of bony and ligamentous changes.

OBJECTIVE: The goal of this study was to compare the capabilities of conventional radiography, CT, and MR imaging in revealing ligamentous and bony changes in patients after hyperflexion injuries. SUBJECTS AND METHODS: Forty-nine patients with hyperflexion injuries of the foot were included in our study. Conventional radiography, weight-bearing radiography, CT, and MR imaging were performed. All images were reviewed with respect to ligamentous and bony abnormalities and alignment alterations. Eleven patients with joint malalignment underwent surgery, which is considered the gold standard in these patients. Five patients with joint malalignment refused surgery. RESULTS: For all 49 patients, conventional radiographs revealed 33 metatarsal and 20 tarsal fractures. Eight patients presented with tarsometatarsal joint (Lisfranc's joint) malalignment. Weight-bearing radiographs showed joint malalignment in the same eight patients only. CT showed 41 tarsal fractures and 53 metatarsal fractures. Joint malalignment was evident in 16 patients. MR imaging revealed 41 metatarsal fractures and 18 metatarsal bone bruises. Tarsal bones were fractured at 39 sites and there were nine tarsal bone bruises. Metatarsal fractures were mostly localized in the second metatarsal bone; tarsal fractures, in the cuboid. Joint malalignment was evident in 16 patients; in 11 of these 16 patients, Lisfranc's ligament was disrupted. Surgery confirmed bony and ligamentous changes and joint malalignment in 11 patients. CONCLUSION: Conventional radiographs including weight-bearing images are not sufficient for routine diagnostic workup of patients with acute hyperflexion injuries of the foot. CT should serve as the primary imaging technique for such patients.

Adolescent↗
PubMed2001

Comparing sports injuries in men and women.

OBJECTIVE: To compare the pattern of injury between men and women in seven collegiate sports to determine if gender-specific factors exist which could be modified to reduce the risk of injury to female athletes. DESIGN: Retrospective cohort study of injury reports compiled by certified athletic trainers between Fall 1980 and Spring 1995. SETTING: An NCAA division III College. PARTICIPANTS: Eighteen to 22 year-old male and female college athletes competing in seven like sports (basketball, cross-country running, soccer, swimming, tennis, track and water polo) at the intercollegiate level, playing similar number of contests and using the same facilities. MAIN OUTCOME MEASURES: Analyses of injury patterns, classified by sport and anatomic location, for men and women in seven like sports. RESULTS: A total of 3,767 participants were included in the study, with 1874 sports-related injuries reported among the men and women's teams. Of these injuries, 856 (45.7%) were sustained by female and 1018 (54.3%) by male athletes. Overall, no statistically significant gender difference was found for injuries per 100 participant-years (52.5 for female athlete versus 47.7 for males). A statistically significant gender difference in injury incidence (p < 0.001) was seen for two sports: swimming and water polo. Female swimmers reported more back/neck, shoulder, hip, knee and foot injuries: and female water polo players reported more shoulder injuries. When evaluating all sports concurrently, female athletes reported a higher rate of hip, lower-leg and shoulder injuries, while male athletes reported a higher rate of thigh injuries. CONCLUSION: Except for some minor gender differences in total injuries for two sports and several differences in total injuries by anatomic location, our data suggest very little difference in the pattern of injury between men and women competing in comparable sports. The increased rate of shoulder injury among female swimmers probably resulted from the more rigorous training philosophy of their coach. Thus, no gender-specific recommendations can be suggested for decreasing the incidence of injury to female athletes competing in these sports.

Adolescent↗
PubMed2003

Imaging sports injuries of the foot and ankle.

The complexity of foot and ankle anatomy and function is unique in the musculoskeletal system. Understanding the complex anatomy alone is a daunting task, not to mention transferring that understanding to the two-dimensional planes encountered on imaging studies. When evaluating sports injuries in the foot and ankle, the interpreting radiologist must take into account the type of activity, vector of stress, and inherent characteristics of the involved structures. A strong working relationship with the health care providers managing patient care, ideally orthopedists, is essential. But in this age of decreasing specialization and increasing availability of imaging resources, the interpreting radiologist must use all available tools for clinical investigation. When interpreting an ankle or foot MR imaging, one finding should trigger a search for the next finding along a logical pathway of injury evolution. Bone marrow edema patterns are guides to tendon and ligament failure. And a clinical syndrome without correlative imaging diagnosis should call attention to potential alternative diagnoses. As the number of MR imaging studies performed continues to increase and MR technology continues to improve, we expect further advancements in MR evaluation of foot and ankle injury. We hope to continue to work closely with our referring orthopedists in this arena to improve our diagnostic skills and our understanding of foot and ankle injury.

Ankle Injuries↗