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PubMed2004

A pilot study of specialized nursing care for home health patients.

We conducted a pilot study to assess the feasibility of remote (Web-based) consultations for leg wounds. The wounds were photographed by a home care nurse using a digital camera and the images were transmitted to a server from the nurses' office, together with patient details. The home care nurse graded the wounds and suggested a treatment plan. Subsequently, a specialist wound-care nurse also graded them and suggested a treatment plan, using the data stored on the Web server. Thirty-four patients were studied. The Web system proved simple to use and staff responses were positive. The agreement between the home care nurses and the specialist nurse in assessing wounds was good (kappa coefficients 0.41 to 0.71). Agreement over the treatment of wounds was more variable (kappa coefficients -0.75 to 0.81). The results of the pilot study are encouraging and suggest that Web-based communication can improve the quality of care for patients with leg wounds and reduce costs.

Aged↗
PubMed1994

Opening-wedge osteotomy for angular deformities of long bones in children.

Mild angular deformities associated with a mild limb-length discrepancy of long bones in children can be treated effectively with opening-wedge osteotomy with insertion of a specially prepared autogenous tricortical iliac-crest bone graft and with minimum or no internal fixation. Thirty-one osteotomies in twenty-six children satisfactorily corrected the deformities so that the angulation and length of the bone were comparable with the values on the normal, contralateral side. Physeal arrest or ipsilateral excision of a physeal bar was performed either concomitantly or at a separate operation in twenty-one of the twenty-six patients, to aid in the treatment of the limb-length discrepancy. Opening-wedge osteotomy is applicable for correction when the angular deformity is 25 degrees or less and the limb-length discrepancy is, or will be, twenty-five millimeters or less at maturity.

Adolescent↗
PubMed1995

Overuse injuries in classical ballet.

Successful management of classical ballet dancers with overuse injuries requires an understanding of the art form, precise knowledge of anatomy and awareness of certain conditions. Turnout is the single most fundamental physical attribute in classical ballet and 'forcing turnout' frequently contributes to overuse injuries. Common presenting conditions arising from the foot and ankle include problems at the first metatarsophalangeal joint, second metatarsal stress fractures, flexor hallucis longus tendinitis and anterior and posterior ankle impingement syndromes. Persistent shin pain in dancers is often due to chronic compartment syndrome, stress fracture of the posteromedial or anterior tibia. Knee pain can arise from patellofemoral syndrome, patellar tendon insertional pathologies, or a combination of both. Hip and back problems are also prevalent in dancers. To speed injury recovery of dancers, it is important for the sports medicine team to cooperate fully. This permits the dancer to benefit from accurate diagnosis, technique correction where necessary, the full range of manual therapies to joint and soft tissue, appropriate strengthening programmes and maintenance of dance fitness during any time out of class with Pilates-based exercises and nutrition advice. Most overuse ballet conditions respond well to a combination of conservative therapies. Those dancers that do require surgical management still depend heavily on ballet-specific rehabilitation for a complete recovery.

Ankle Injuries↗
PubMed1998

Common sports injuries in young tennis players.

Tennis is a popular racquet sport played by boys, girls, men and women. Tennis players frequently begin playing in childhood and may continue playing into late adulthood. Preadolescent and adolescent players have open growth plates and a reduced muscle power, lower level of coordination and smaller stature compared with adult players. The physical characteristics of the young tennis player mean that unique demands are placed on the developing athlete which can, in turn, be associated with different types and patterns of injury. The most common types of injury in tennis players of all ages are muscle sprains and ligament sprains secondary to overuse. These are a particular problem in the adolescent age group because, in general, this group begin playing with a lower level of physical conditioning. Fortunately, injuries in younger players are usually not longstanding and the overuse (chronic) problems seen in older players, such as patellar tendinosis and tennis elbow, are less common in younger players. Anatomically, lower extremity injuries are twice as common as those to the upper extremity or spine, with ankle injury being the most common. Prevention of injury in young tennis players, or at least a reduction in the incidence, is possible. Some traumatic injuries, including contusions, abrasions, lacerations and fractures, may be unavoidable as a result of aggressive play, but others may be prevented by monitoring equipment and the court surface to ensure a safe field of play. The prime target of prevention in young tennis players should be overuse injuries. The principles of 'overload' and staged involvement are of particular importance in this age group. A gradual, progressive increase in the intensity of tennis practice, the slow introduction of new court surfaces and a staged progression in the teaching of tennis skills can help to reduce the incidence of injury in young tennis players.

Adult↗
PubMed2002

Ballet dancer's turnout and its relationship to self-reported injury.

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the relationship between the degrees of turnout, passive hip external rotation range of motion, and self-reported history of low back and lower extremity injury in ballet dancers. BACKGROUND: Ballet dancers are encouraged to externally rotate their lower extremities (turnout) as far as possible. This may cause stress on the dancers' low back and lower extremities, putting them at risk for injury. METHODS AND MEASURES: Thirty college-level ballet dancers and instructors were evaluated. Each participant completed an injury questionnaire that placed the participant either in a group with a self-reported history of low back and lower extremity injury or in a group without a self-reported history of low back and lower extremity injury. Each dancer's first-position turnout and passive external rotation range of motion for both hips were measured. The comparison between each dancer's first-position turnout and the measured hip external rotation range of motion was called "compensated turnout." A 2-sample test was used to determine if the average compensated turnout was significantly different in the injured and noninjured groups. RESULTS: The mean (+/- SD) compensated turnout values for the injured and noninjured groups were 25.40 degrees (+/- 21.3 degrees) and 4.7 degrees (+/- 16.3 degrees), respectively. This difference was significant at P = 0.006. CONCLUSION: Based on a self-reported history of low back and lower extremity injuries, ballet dancers have a greater risk of injury if they reach a turnout position that is greater than their available bilateral passive hip external rotation range of motion.

Adolescent↗
PubMed1985

Venous function after fracture of the lower extremity. A 9-year follow-up of 150 cases.

One hundred and fifty patients were examined 8-10 years after a fracture of the lower limb to evaluate whether the frequency of deep venous insufficiency (DVI) was influenced by the type of fracture. The evaluation included clinical examination, subjective complaints, venous pressure, plethysmography and doppler sonography. Symptoms and signs of DVI were more common in the fractured than in the uninjured limbs, while objectively diagnosed DVI did not differ between the groups. Only minor differences were present in the development of DVI between limbs with various types of fracture (hip fractures were not included in the study). High age and incompetence of the popliteal valves were more important in the development of DVI than the earlier fracture. The frequency of objectively measured DVI in the fractured limbs was 35 per cent and in the uninjured limbs 30 per cent.

Adolescent↗
PubMed1989

Epidemiology of metabolic disorders in dairy cattle: association among host characteristics, disease, and production.

Logistic regression was used to investigate the effects of host characteristics, production, and 23 veterinary diagnoses on the odds of contracting seven metabolic disorders among 61,124 Finnish Ayrshire cows that calved during 1983. Cows in higher producing herds were at increased risk of parturient paresis, udder edema, and ketosis. Cows that had higher previous yields were at increased risk of parturient and nonparturient paresis and ketosis. All of the metabolic disorders except udder edema were directly interrelated. Dystocia, prolapsed uterus, other infertility, and abortion were not risk factors for any of the seven metabolic disorders; however, retained placenta, early metritis, traumatic reticuloperitonitis, acute and chronic mastitis, and foot or leg injury each were direct risk factors for at least two metabolic disorders.

Acidosis↗
PubMed2000

Evaluation and management of common running injuries.

Adults who run for sport or for pleasure often present to their primary care physician with musculoskeletal complaints. Rapid diagnosis and conservative management of common running injuries and referral of patients with injuries that have a propensity for morbidity, such as femoral neck stress fractures, are reviewed. Careful evaluation of the patient's running program and physical therapy are important components of management.

Adult↗
PubMed1975

Immature germ cells in the semen of thoroughbred stallions.

Small but significant numbers of primary and secondary spermatocytes and spermatids have been observed in the semen of some Thoroughbred stallions. Extensive histological examination of the testes of affected animals has not been undertaken but in one young stallion which died as the result of a leg injury, the premature dehiscence of these cells seemed to be related to segmental defects within the seminiferous tubules. The causes of lesions leading to premature shedding of germ cells are discussed.

Animals↗
PubMed1975

Tropical ulcers.

We review 230 cases of tropical ulcers, includied reports of 7 cases with squamous cell carcinoma. We think the etiology may be a combination of the hot, humid environment, trauma, local infection, and malnutrition. Agressive treatment of these ulcers is advocated, to heal the wounds and to prevent malignant transformation.

Adult↗
PubMed2000

Callotasis for post-traumatic shortening and deformity of leg.

We have been performed callotasis, including hemicallotasis, in cases of more than 30 mm limb lengthening and more than 15 degrees angular deformity. There were 21 cases in this series. The mean age was 29.8 years old. Ilizarov external fixator (EF) was used in 13 cases and Orthofix EF in 8. The operation site was femur in 12 cases and tibia in 9 cases. Pre-existed complications were noted to occur in 10 cases. Callotasis was indicated in 17 cases, and the average length gain was 28.4 mm. Hemicallotasis was indicated in 5 cases, and the mean degree of correction angle was 18 degrees. Among available types of EF, Orthofix EF was suitable for proximal femoral callotasis, while Ilizarov EF was suitable for corrective deformity using hemicallotasis and tibial callotasis. The bone healing process of callotsis was better in the absence than presence of pre-existed complication. Also, we performed bone transportation using Ilizarov EF in cases of pseudoarthrosis with leg shortening and in all cases where bone grafting was unnecessary.

Adolescent↗