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PubMed1975

Angiography and hemodynamic measurements in extensive soft tissue trauma to the extremity.

The early circulatory changes following extensive soft tissue injury to the hind leg of the dog was examined by angiography and by measurement of blood flow by an electromagnetic flowmeter. The trauma caused a marked increase of blood flow and vasodilatation in the injured extremity with or without combination of a fracture. The later gradual increase of calculated vascular peripheral resistance was angiographically reflected by successively impaired flow in peripheral arteries. In spite of the decrease of flow, the dilatation of the larger arteries persisted for several hours.

Angiography↗
PubMed1991

Magnetic resonance imaging of the foot and ankle: correlation of normal anatomy with pathologic conditions.

Abnormalities of the foot and ankle can be difficult to diagnose by conventional examination and x-rays. Recently, magnetic resonance imaging (MRI) has emerged as a diagnostic tool for soft tissue and bony imaging. One hundred and ten normal feet and ankles were studied to define normal MRI anatomy. An additional 150 MRI scans were performed to diagnose and characterize various abnormal conditions. MRI demonstrated excellent definition of normal structures and pathologic entities. Surgical correlation with the MRI was done in 42 patients. MRI appears to be a useful examination for patients with certain soft tissue and bony abnormalities. A special oblique view also has been developed to assist in the diagnosis of injuries to the tibialis posterior, flexor hallucis longus, and flexor digitorum longus tendons.

Achilles Tendon↗
PubMed2003

Case reports of on-site investigations of auger-related farm injuries.

Previous reports have indicated that injuries involving augers (screw conveyors) are a serious problem in agriculture, but to date on-site engineering inspections linking injuries to mechanical and procedural aspects have not been available. This article details four events involving injuries as the result of being entangled in auger flighting. In each report, the circumstances surrounding the injury event are outlined, and the machinery involved is evaluated in terms of its compliance with current safety standards. In three of the four instances, the machinery did not conform to current guarding standards or to safety sign standards. In these three cases, injuries were preventable with improved guarding according to ASAE Standards. In the other case, the machine complied with ASAE Standards, but the injury could have been prevented with improved guarding of the auger flighting.

Accidents, Occupational↗
PubMed1993

Lower limb and back injury patterns of elite netball players.

The purpose of this study was to investigate the relationships between lower limb and back injuries with perceived landing patterns and podiatric variables for injured and uninjured elite netball players. 228 players of a possible 240 participants at the 1988 Australian netball championships completed injury questionnaires and were assessed for injury status. Approximately 92% of those who were part of the injury surveys were also given a podiatric assessment. Pearson chi 2 and unpaired t-tests were used to assess relationships between injury status in 2 groups (history of injury, and injuries sustained during the championships) and perceived landing patterns during play and podiatric variables. A significant association was found between history of lower limb and back injuries and level of competition. Open age netballers reported more injuries than the younger players. During each championship, a similar number of players (23%) were injured irrespective of playing level. 71% of these players sustained a grade 1 injury, 15.4% a grade 2 injury and 13.5% presented with severe grade 3 injuries. 2 players were diagnosed with an anterior cruciate ligament injury and a further 3 players sustained a fracture during the championships. Most of the injuries were ligamentous (40.5%) with some overuse tendinitis (11.5%) problems. The injury history profiles of the elite players surveyed showed that ankle and knee injuries were the most common lower limb injuries with incidences of 58 and 22%, respectively. More than a quarter of the players had overuse type injuries (24% retropatellar pain, 38% shin soreness) and 33% complained of back problems during their careers. 18 significant relationships were found between injuries sustained during a player's career and podiatric measures. Only 22.5% of a player's foot types were classified as normal while 42% presented with rearfoot varus and 20% were grouped into pronated foot postures.

Adolescent↗
PubMed2004

Youth football injuries.

A paucity of literature exists on the subject of youth football with the majority of research concentrating on athletes of high-school age or older. Youth football participants include those athletes who compete in organised football prior to high school. Injury rate and severity for youth players is surprisingly low when compared with those competitors who have passed through puberty. As children mature they become bigger, faster and stronger, which is accompanied by an increased injury risk. Quarterbacks and running backs are injured almost five times more often than offensive linemen and linebackers. The knee is the most common site of injury followed by the ankle, wrist and hand. Fortunately, traumatic brain and cervical spine injuries are exceedingly rare. In this article, we review the youth football literature, identify the most common injuries by anatomical location, discuss the differential diagnoses and outline treatment options.

Adolescent↗
PubMed2002

Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition.

OBJECTIVE: The purpose of this study was to examine relationships between MR imaging measurements of the extent of hamstring injury and the amount of time lost from competition in a group of athletes. SUBJECTS AND METHODS: Thirty-seven athletes with suspected hamstring injury underwent T1 and inversion recovery T2 turbo spin-echo MR imaging in axial and sagittal planes. The presence and dimensions of abnormal focal intra- and extramuscular T2 hyperintensity were independently recorded by two radiologists, and the muscles involved and intramuscular location of injury were noted. The percentage of abnormal cross-sectional muscle area, abnormal muscle volume, and length of extramuscular T2 hyperintensity were measured from T2-weighted images depicting the maximal extent of the injury. Time (days) lost from competition was noted during follow-up. RESULTS: MR imaging detected hamstring muscle and linear extramuscular T2 hyperintensity in 30 (81%) and 25 (68%) of 37 athletes, respectively. The long head of the biceps was the dominant site of injury in 21 cases. The musculotendinous junction was involved in 28 (76%) of 37 cases. A relationship was seen between days lost from competition and percentage of abnormal muscle area (r = 0.63, p = 0.001) and volume of muscle affected (r = 0.46, p = 0.01), but only a trend for linear extramuscular T2 hyperintensity (r = 0.33, p = 0.12) was shown. CONCLUSION: Rehabilitation time was related to MR measurements such as the percentage of abnormal muscle area and approximate volume of muscle injury. Hamstring injury most frequently involved the long head of the biceps femoris muscle, and involvement of the intramuscular tendon was common.

Adolescent↗
PubMedDate not supplied

[Effect of primary and secondary below-knee amputation of war injuries on the length of hospitalization and rehabilitation].

The results of below-knee amputations in 36 war wounded (mean age 35.42) were reviewed. The majority of the patients was wounded by land mines (94.4%). Most of them were between 25 and 35 years old. Bilateral amputation was done in 2.8% of cases. The amputation was performed on the day of wounding (primary below-knee amputation) in 30 (83.3%) amputees. Secondary amputation after the attempt to save the severely injured lower-limb was performed in 6 patients (16.7%) average 4.61 +/- 11.67 days after wounding. Reamputation was necessary in 6 cases (16.7%). Time period from the beginning of rehabilitation to the fitting of prosthesis, was 36.25 +/- 14.97 days for primary amputations, 32 +/- 17.8 days for secondary amputations and 68.66 +/- 33.52 days for reamputations. There was no significant correlation between the duration of rehabilitation to prosthetic management and the period between wounding and amputation (r = -0.102). The attempt to save the limb after severe below-knee injuries and the secondary amputation afterwards, did not significantly influence the ensuing rehabilitation and prosthetic works.

Adult↗
PubMed1994

Injury in ballet: a review of relevant topics for the physical therapist.

Currently, there is a need for a review of the literature on ballet injury as it pertains to the physical therapist. Relatively few articles have reviewed ballet injury prevalence and mechanisms of injury. The purpose of this paper was to provide a thorough literature review of the prevalence of ballet injury and mechanisms of injury. Environmental factors and footwear relating to ballet injury were also reviewed. The literature indicated that 65-80% of ballet injuries are in the lower extremity, 10-17% occur in the vertebral column, and most of the remaining percentage are upper limb injuries (5-15%). The etiology of common lower limb conditions included an incorrect turnout; soft tissue imbalances; reduced quadriceps performance; "rolling in of the foot;" inversion sprains; and frequent pliés, pointé, and demipointé work. Spinal conditions were reported to result from hyperextension and hyperlordosis of the lumbar spine as well as the psoas insufficiency syndrome. It was revealed that inappropriately fitting footwear lead to various foot conditions and abnormal lower kinetic chain biomechanics. Environmental factors, such as the dance surface, also have implications in ballet injury. The author concluded that ballet injuries have a multifactorial etiology that primarily involves the interplay of compensatory biomechanics in the spine and lower extremity, environmental factors, and footwear. In addition, some clinical recommendations have been made regarding the physical therapy management of ballet injuries.

Arm Injuries↗
PubMed1996

Extended free lateral arm flap with preservation of the posterior cutaneous nerve of the forearm.

The free lateral arm flap has become a well-defined and reliable flap for various reconstructive purposes. Little attention has been paid, however, to the possibility of preservation of the posterior cutaneous nerve of the forearm (nervus cutaneus antebrachii posterior) sacrifice of which results in numbness of the dorsal part of the forearm. In this study, an anatomical dissection showed that in many cases it would be possible to preserve the nerve. We did 23 free lateral arm flaps in 22 patients during the period 1989-1994. The maximum flap length was 40 cm. Standard maximum width in most cases was 6 cm, and by using a new expansion technique it reached 10 cm in one case. Furthermore, with meticulous dissection the posterior cutaneous nerve of the forearm was either preserved or cut and rejoined in 21 patients, so minimising sensory loss at the donor site.

Adult↗
PubMed2004

Lower limb landmine injuries.

The medical records of 186 patients seeking treatment for landmine injuries in the authors' region between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21 with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary wound coverage. In Group II, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in 1 case. In Group I, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group II, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial.

Adolescent↗
PubMed1993

Vascularized tendon graft using lateral arm flap. 5 microsurgery cases.

We treated 5 patients with soft tissue defects involving the skin and tendon with microsurgical transfer of vascularized tendon grafts from the upper lateral arm. All the flaps survived and recovery of motor function has been satisfactory. The advantages of a composite upper lateral arm flap are its versatility, constant anatomy, and skin sensibility.

Adult↗
PubMed1995

Lower limb soft tissue reconstruction using microsurgical techniques.

Trauma is the main cause of lower limb soft tissue defects followed by tumor resection, vascular disease and osteomyelitis. 17 patients were operated on using microsurgical techniques during the last 10 years. 9 of the patients had traumatic defects, 5 had various malignant tumors, 2 patients had arterial insufficiency and finally 1 patient had chronic osteomyelitis. The latissimus dorsi either as muscle flap with a split thickness skin graft or as a musculocutaneous flap was used the most frequently in our series. Other flaps, including the radial forearm neurovascular flap, the rectus abdominis flap, the scapular flap, the groin and the dorsalis pedis flaps were used less often. Delayed primary cover was used, except in 1 case with an opened knee joint trauma, where emergency repair was performed. Complications included: 2 partial skin graft necroses which required revision and 2 flap necroses caused by venous thrombosis. With follow-up more than 4 years in all but 2 patients, functional results were found satisfactory. Cosmetic results, however, were less satisfactory.

Adult↗
PubMed1999

Injuries in cross-country skiing. Trail markers for diagnosis and treatment.

Cross-country skiers can suffer acute injuries, such as sprains of the ulnar collateral ligament of the thumb, the medial collateral ligament of the knee, and the ankle. They are also subject to overuse injuries, including arthritic changes in the great toe, and are at risk for cold-related injuries. Most of these injuries can be treated conservatively, and some can be avoided with adequate preparation and training.

Arm Injuries↗